Physical Challenges Research Articles

Associations between religion and suicidality for LGBTQ individuals: A systematic review

Studies have consistently shown that LGBTQ individuals are at increased risk for several mental and physical health challenges including suicidality. The relationship between religion and LGBTQ well-being in general and LGBTQ suicidality specifically has increasingly been the subject of scholarly investigation. This systematic review examines all peer-reviewed articles included in the EBSCO PsycInfo database since 2000 that examined the relationship between religiosity and LGBTQ suicide (50 studies in all). These studies reveal a complex relationship that is nuanced and, at times, contradictory. Overall, 65% identified at least one religiosity-related predictor as a risk factor for LGBTQ suicidality, 41% identified at least one religiosity-related predictor as a protective factor against suicidality, while 53% found no associations between religiosity-related predictors and suicide risk. However, when specifically examining religious affiliation/denomination, salience, or beliefs and behaviors, typically, religiosity was either protective or unassociated with LGBTQ suicidality. This held particularly true for studies that had population-based samples, employed control variables and included comparison groups, thus enhancing their generalizability. The one religiosity-related predictor that was almost universally identified as a risk factor was when an individual felt conflicted between their religious and sexual-gender identities.

DNA Logic Gates Integrated on DNA Substrates in Molecular Computing.

Due to nucleic acid's programmability, it is possible to realize DNA structures with computing functions, and thus a new generation of molecular computers is evolving to solve biological and medical problems. Pioneered by Milan Stojanovic, Boolean DNA logic gates created the foundation for the development of DNA computers. Similar to electronic computers, the field is evolving towards integrating DNA logic gates and circuits by positioning them on substrates to increase circuit density and minimize gate distance and undesired crosstalk. In this minireview, we summarize recent developments in the integration of DNA logic gates into circuits localized on DNA substrates. This approach of all-DNA integrated circuits (DNA ICs) offers the advantages of biocompatibility, increased circuit response, increased circuit density, reduced unit concentration, facilitated circuit isolation, and facilitated cell uptake. DNA ICs can face similar challenges as their equivalent circuits operating in bulk solution (bulk circuits), and new physical challenges inherent in spatial localization. We discuss possible avenues to overcome these obstacles.

PSYCHO-SOCIAL IMPACT AND QUALITY OF LIFE AMONG PATIENTS WITH PSORIASIS ATTENDING A TERTIARY CARE INSTITUTE IN NORTH CHENNAI

Objective: To assess the psycho-social impact of psoriasis and the quality of life (QoL) among psoriasis patients. Methods: This is a cross-sectional study with a sample size of 140 done in a dermatology outpatient clinic in a tertiary care institution in North Chennai. The dermatology life quality index (DLQI) was the primary tool for assessing QoL. Results: The study participants’ mean±SD DLQI score was 8.84±4.59. Out of 140 patients, 32.9% had severely affected QoL with a DLQI score >10. About 81.4% of study participants felt embarrassed due to their skin lesions, and marital life was affected by 36.4%. Suicidal thoughts and alcohol addiction (for coping up) were found to be prevalent among 12.9% of the subjects, both of which were maladaptive coping strategies. It was found that patients with DLQI scores of 10 or more tend to cling to alcohol as a coping mechanism, and this association is statistically significant. Further, a significant association was also noted between the site of the lesion and marital life getting affected by psoriasis. (x2=9.893, p=0.042). Conclusion: Patients with psoriasis are subjected to an intricate web of physical and psycho-emotional challenges. Hence, the physician offering chronic follow-up care to those patients needs to adopt a holistic strategy to address their continuing medical and psychosocial needs.

Mitigating Microaggressions in Medical Education Through the TRAUMA Framework.

Microaggressions are defined as brief communications directed at members of a stigmatized group that are received as derogatory but are unrecognized by the offender. Studies show that microaggressions are detrimental to those of all identities who endure them. Given that microaggressions can result in specific emotional, psychological, and physical challenges for underrepresented medical students from minoritized backgrounds, it is imperative that the medical education community focus efforts on reducing them and their impact through appropriate responses. The TRAUMA framework was developed by the authors and can be used to organize a thorough response to the threat that microaggressions create for all students. The framework includes improved student support, guidelines for faculty and institutional responses to microaggressions, improved faculty development for addressing microaggressions, recommendations to improve classroom environments, and interventions both to create and measure culture change in medical education.

An examination of the psychological well-being of patients undergoing oncological treatments

Cancer remains one of the critical diseases severely impacting the quality of life globally. Patients typically endure both physical and psychological challenges upon diagnosis. They are often faced with the decision of whether to accept the oncological treatment plans proposed by their physicians. The potential psychological changes in patients post-treatment pose a new challenge. This study aims to analyze the impact of various cancer treatment modalities on patients mental health, providing a comprehensive analysis. Utilizing comparative and summary methods, this paper evaluates the impact of different treatment approaches on the psychological state of patients. Patients with cancer commonly experience negative emotions prior to receiving treatment, leading to persistent states of anxiety and depression post-treatment. Proactive psychological interventions are recommended for implementation both before and after cancer treatment. These interventions can effectively alleviate the psychological distress and anxiety experienced by patients.

Mental and Physical Symptoms and Perceived Health Risks of Pregnant and Postpartum Women following the Significant Shift in COVID-19 Management in China: A Cross-Sectional Survey

Background. There was a remarkable downgrade in China’s COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members’ SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members’ SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized.

The role of a community health worker-delivered preconception and pregnancy intervention in achieving a more positive pregnancy experience: the Bukhali trial in Soweto, South Africa

BackgroundA patient-centered, human-rights based approach to maternal care moves past merely reducing maternal mortality and morbidity, towards achieving a positive pregnancy experience. When evaluating an intervention, particularly in the context of the complex challenges facing maternal care in South Africa, it is therefore important to understand how intervention components are experienced by women. We aimed to qualitatively explore (i) factors influencing the pregnancy and postpartum experience amongst young women in Soweto, South Africa, and (ii) the influence of Bukhali, a preconception, pregnancy, and early childhood intervention delivered by community health workers (CHWs), on these experiences.MethodsSemi-structured, in-depth interviews were conducted with 15 purposively sampled participants. Participants were 18–28-year-old women who (i) were enrolled in the intervention arm of the Bukhali randomized controlled trial; (ii) were pregnant and delivered a child while being enrolled in the trial; and (iii) had at least one previous pregnancy prior to participation in the trial. Thematic analysis, informed by the positive pregnancy experiences framework and drawing on a codebook analysis approach, was used.ResultsThe themes influencing participants’ pregnancy experiences (aim 1) were participants’ feelings about being pregnant, the responsibilities of motherhood, physical and mental health challenges, unstable social support and traumatic experiences, and the pressures of socioeconomic circumstances. In terms of how support, information, and care practices influenced these factors (aim 2), four themes were generated: acceptance and mother/child bonding, growing and adapting in their role as mothers, receiving tools for their health, and having ways to cope in difficult circumstances. These processes were found to be complementary and closely linked to participant context and needs.ConclusionOur findings suggest that, among women aged 18–28, a CHW-delivered intervention combining support, information, and care practices has the potential to positively influence women’s pregnancy experience in South Africa. In particular, emotional support and relevant information were key to better meeting participant needs. These findings can help define critical elements of CHW roles in maternal care and highlight the importance of patient-centred solutions to challenges within antenatal care.Trial registrationPan African Clinical Trials Registry PACTR201903750173871, 27/03/2019.

Expression of bond-related behaviors affects titi monkey responsiveness to oxytocin and vasopressin treatments.

Social bonds influence physiology and behavior, which can shape how individuals respond to physical and affective challenges. Coppery titi monkey (Plecturocebus cupreus) offspring form selective bonds with their fathers, making them ideal for investigating how father-daughter bonds influence juveniles' responses to oxytocin (OT) and arginine-vasopressin (AVP) manipulations. We quantified the expression of father-daughter bond-related behaviors in females (n = 10) and gave acute intranasal treatments of saline, low/medium/high OT, low/high AVP, or an OT receptor antagonist (OTA) to subjects prior to a parent preference test. While females spent more time in proximity to their parents than strangers, we found a large degree of individual variation. Females with greater expression of bonding behaviors responded to OT treatments in a dose-dependent manner. Subjects also spent less time in proximity to strangers when treated with High OT (p = 0.003) and Low OT (p = 0.007), but more time when treated with High AVP (p = 0.007), Low AVP (p = 0.009), and OTA (p = 0.001). Findings from the present study suggest that variation in the expression of bond-related behaviors may alter responsiveness to OT and AVP, increasing engagement with unfamiliar social others. This enhanced sociality with strangers may promote the formation of pair bonds with partners.

Learning Markovian dynamics with spectral maps.

The long-time behavior of many complex molecular systems can often be described by Markovian dynamics in a slow subspace spanned by a few reaction coordinates referred to as collective variables (CVs). However, determining CVs poses a fundamental challenge in chemical physics. Depending on intuition or trial and error to construct CVs can lead to non-Markovian dynamics with long memory effects, hindering analysis. To address this problem, we continue to develop a recently introduced deep-learning technique called spectral map [J. Rydzewski, J. Phys. Chem. Lett. 14, 5216-5220 (2023)]. Spectral map learns slow CVs by maximizing a spectral gap of a Markov transition matrix describing anisotropic diffusion. Here, to represent heterogeneous and multiscale free-energy landscapes with spectral map, we implement an adaptive algorithm to estimate transition probabilities. Through a Markov state model analysis, we validate that spectral map learns slow CVs related to the dominant relaxation timescales and discerns between long-lived metastable states.

"I Feel Like I Have Lost Part Of My Identity" - A Qualitative Study Exploring The Impact Of Chronic Ankle Instability.

Lateral ankle sprain is the most common ankle injury and up to 40% of those who sustain a lateral ankle sprain will develop chronic ankle instability (CAI). The aim of this study was to explore the thoughts and expectations of CAI-patients concerning their condition and expectations of care in an orthopedic setting. . Qualitative study. Nine semi-structured one-to-one interviews were conducted with CAI-patients who were referred to an orthopedic setting. Interviews were recorded, transcribed, and analyzed using systematic text condensation with an inductive goal free approach. . Seven themes emerged. The themes were Injury history and symptoms (Lateral ankle sprain during sport, pain and instability), Information from health professional (conflicting information about management and prognosis), Management (mental and physical challenges), Expectation and hope (explanation of symptoms, prognosis and imaging to provide clarification of condition), Activity and participation (restriction in sport and daily life and feelings of uncertainty), Support (support from family/friends) and Identity (low ability to participate in sport and social life result in loss of identity). . The impact of CAI exceeds an experience of pain and instability. Patients experienced loss of identity, having to manage uncertainty regarding their diagnosis and prognosis and had hopes of being able to explain their condition. . Not applicable.

Challenges in urban data center design

The data center market is experiencing significant growth, with each new facility requiring increased power density and cooling needs. This growth brings new challenges, including noise pollution and its impact on nearby communities, which becomes excessively difficult in urban environments. This presentation will explore the issues faced by data centers in urban environments and discuss potential solutions to create quieter facilities. Key points include:—Physical challenges: Every site design faces numerous physical constraints, including limited rooftop and equipment room space, tight and complex adjacencies of neighboring sites, and design and performance standards for equipment.—Political issues: Every site and community have a different set of laws and regulations that a site needs to meet, and often go beyond to ensure that the community will accept the site.—People issues: Data centers must navigate contentious relationships with neighbors and address noise concerns to maintain a positive reputation. By addressing these challenges, data centers can minimize noise pollution and maintain positive relationships with surrounding communities, ensuring a sustainable future for the industry in urban environments.

Handheld Sonographic Cardiovascular Imaging Under Hypergravity Conditions.

INTRODUCTION: Real-time cardiovascular imaging during hypergravity exposure has been historically limited by technological and physical challenges. Previous efforts at sonographic hypergravity imaging have used fixed ultrasound probes; the use of hand-held ultrasound, particularly performed by minimally trained laypersons, has been less explored. Here we will discuss handheld sonography to self-visualize carotid vascular and cardiac changes during hypergravity.METHODS: Three subjects with variable ultrasound experience ranging from no familiarity to extensive clinical experience used handheld ultrasound at rest and under stepwise +Gz hypergravity exposures (maximum +3.5 Gz) to visualize carotid vascular changes. Subxiphoid cardiac ultrasound was obtained by the most experienced subject. Subjects had variable prior hypergravity experience; all were trained in anti-G straining techniques. Sonographically inexperienced subjects underwent a brief (< 5 min) familiarization with the ultrasound probe, user interface, and desirable viewing window immediately prior to centrifugation; real-time coaching was provided. Ultrasound images were correlated to self-reported symptoms and hemodynamic data.RESULTS: Handheld ultrasound performed as desired; all subjects were successful at obtaining ultrasound images with adequate capture of windows of interest. Subxiphoid imaging efforts were limited by probe overheating and associated with variable quality of imaging due to probe displacement from straining techniques; the subject noted transient, mild discomfort and ecchymosis after imaging in the subxiphoid region.DISCUSSION: Even individuals with minimal or no ultrasound experience successfully obtained usable images under centrifuge conditions. While there were some limitations, this technical demonstration provides initial validation of handheld sonography as an available tool for real-time cardiovascular imaging in a hypergravity environment.Blue RS, Ong KM. Handheld sonographic cardiovascular imaging under hypergravity conditions. Aerosp Med Hum Perform. 2024; 95(3):158-164.

Challenges in pre-service physics teachers’ practical training after pandemic restrictions

The paper presents challenges caused by COVID-19 pandemic situation and lockdowns of pre-service teachers’ practical training between March 2020 and May 2021. The standard structure of practical training is introduced and the impact of pandemic restrictions on practical training from pre-service teachers’ and supervising teachers’ views are described. Suggestions for changes in future design of practical training are formulated.

Palliative Care for Adult Patients Undergoing Hemodialysis in Asia: Challenges and Opportunities.

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

Adverse childhood experiences and subsequent physical and mental health among young adults: Results from six universities in China

Research has shown that individuals with adverse childhood experiences (ACEs) are more likely to encounter heightened risks of physical and psychological challenges later in life. However, limited research has explored the comprehensive impact on the physical and mental health of young adults. Thus, we conducted a study to investigate the associations of ACEs with the physical and mental health of 18,723 college students in China. Their physical and mental health status was assessed using self-perceived health assessments, self-reported disease diagnoses, and the Generalized Anxiety Disorder-7-item scale. Results showed that 82.6 % of participants had experienced at least one ACE, with 10.7 % reporting exposure to four or more ACEs. Compared to participants with low ACEs exposure (≤ 1), participants with high ACEs exposure (≥ 4) had a nearly twofold increase in the odds of cardiometabolic diseases (OR [95 % CI] = 2.06 [1.55-2.74]) and fractures (2.32 [1.88-2.87]). Additionally, individuals with high ACE exposure exhibited a threefold increased odds of severe anxiety symptoms (3.78 [2.59-5.51]) and bipolar disorder/schizophrenia (3.38 [2.18-5.23]). These findings highlight ACEs as a significant risk factor for poor physical and mental health among young adults. Targeted support and interventions for individuals with multiple ACEs may help mitigate their long-term disease burden.

Beyond the Burden: A Qualitative Inquiry into the Experiences of Chinese Informal Caregivers for People Living with HIV or AIDS.

Informal caregivers are defined as families or close friends of patients, which take considerable responsibilities for providing care to people living with HIV/AIDS (PLWHA). Although there have been a number of studies in caregiver of PLWHA, research studies that sought to quantify the effects of informal caregiving for the caregivers failed to successfully provide empirical understanding of the nature of caregiving experience. Therefore, this study adopted a qualitative approach to explore the experiences and feelings of caregivers of PLWHA during the long-term care process. The qualitative study was conducted in August 2023 in Beijing, China. Data were collected through individual in-depth semi-structured interviews with informal caregivers of PLWHA. Theme analysis was used to identify themes from the interview transcripts. A total of 21 participants were recruited into our study, 16 were family members of PLWAHA, and 5 were homosexual lover or close friend of PLWHA. Three major themes and ten sub themes were identified by thematic analysis: (1) care burden experience (including 5 sub-themes: negative emotional experience, psychological burden, economic burden, physical health loss and limitation of social interaction); (2) benefit findings from care (including 3 sub-theme: positive emotional experience, perceived social support, health promotion); (3) Demands for caregiving capacity (including 2 sub-theme: inadequate caregiving capacity and inadequate psychological comfort capacity). This qualitative study provides a comprehensive exploration of the experiences faced by informal caregivers of PLWHA in China, uncovering the complex spectrum of psychological, physical, social, and economic challenges inherent in their caregiving roles, while predominantly challenging, caregivers also reported personal growth, increased social support, and emotional fulfillment. The research results could help in developing effective interventions to reduce the caregiver burden and improve their mental health.

Evaluating the effects of mobile application-based rehabilitation on improving disability and pain in patients with disputed thoracic outlet syndrome: A randomized controlled trial

BackgroundDisputed thoracic outlet syndrome (D.TOS) stands as one of the primary global contributors to physical disability, presenting diagnostic and treatment challenges for patients and frequently resulting in prolonged periods of pain and functional impairment. Mobile applications emerge as a promising avenue in aiding patient self-management and rehabilitation for D.TOS. This study aimed to investigate the impact of a certain mobile application-based rehabilitation on pain relief and the improvement of disability in patients experiencing D.TOS. MethodsEighty-eight patients diagnosed with D.TOS randomized 1:1 to either the control group (n = 44) or the intervention group (n = 44). Participants in the control group were provided with a brochure containing standard rehabilitation exercise instructions, a written drug prescription from the physician, and guidance on recommended physical activity levels, including home exercises. In contrast, all participants in the intervention group used the mobile application. Disability and pain levels in patients were assessed after six weeks in both groups. ResultBoth groups improved pain and disability based on the scaled measurements. According to the questionnaire scale, the intervention group showed a considerable decline in disability; however, there was a significant difference in just one question (P < 0.05). Furthermore, the intervention group showed significant improvement in neck pain NRS (p = 0.024) compared to the control. Based on the shoulder and head pain numeric rate scale (NRSs), both groups showed improvement in disability conditions; but there were no significant differences between the groups (p > 0.05). ConclusionMobile applications are promising tools for alleviating disabilities and pain in patients with musculoskeletal conditions. This study confirmed the potential of mobile technology to enhance active and corrective physical activity, thereby reducing pain in patients with D.TOS. Trial RegistrationIranian Registry of Clinical Trials (IRCT) with the identifier IRCT20141221020380N3 (http://www.irct.ir/)

Peculiarities of Providing Palliative Care to Tuberculosis Patients

The data from literary sources (the electronic database of medical publications PubMed) have been summarized to highlight contemporary concepts of providing palliative care and recent statistics regarding the provision of palliative care to tuberculosis patients in Ukraine were analyzed. Objective of this analysis was to highlight problematic issues and aspects that require improvement in the field of providing palliative care to tuberculosis patients in Ukraine.The problem of tuberculosis remains relevant today. Despite significant achievements in the fight against tuberculosis, the effectiveness of treating this disease in Ukraine does not reach the target set by the WHO. The issue of drug-resistant tuberculosis remains acute. Individuals with tuberculosis and their families face a range of physical, socio-economic, and psychological challenges associated with the illness, which dimi­nish their quality of life and require a comprehensive approach to address them. Therefore, according to modern concepts, an important component of managing patients with tuberculosis, especially drug-resistant forms, is palliative care. The modern concept of palliative medicine envisions the earliest possible initiation of palliative care for patients with indications as early as possible, simultaneously with curative therapy, gradually increasing the scope of palliative care interventions until completely replacing curative treatment as the disease progresses. Early integration of palliative care for tuberculosis patients enhances the quality of life for patients and their families, promoting better adherence to etiotropic treatment.For the further development and improvement of the palliative care system for tuberculosis at the state level, the resolution of the following issues is necessary: ensuring the integration of palliative care services at all levels of medical care; strengthening and expansion of personnel potential in matters of palliative care; improvement and implementation of guidelines for integrated palliative care for tuberculosis at all levels of care; integration of palliative care into the program management system of drug-resistant tuberculosis from the first day of diagnosis; ensuring sustainable and comprehensive access of people suffering from tuberculosis to essential medicines for providing palliative care; improving the quality of providing psychological assistance to patients and their families.

Explaining the challenges of Iranian caregivers in provision of home health care to spinal cord injury patients: a qualitative study

BackgroundThe incidence of spinal cord injury (SCI) is increasing across the globe. The caregivers of patients with spinal cord injuries experience many problems during providing care to these patients. Identifying the problems experienced by caregivers can facilitate the process of care provision to these patients. So, the aim of this study was to explore the challenges of caregivers in provision of home health care to SCI patients.MethodsThis study was conducted by qualitative description approach in Iran from Apr 2021 to Dec 2022. The participants included the caregivers of SCI patients recruited by purposive sampling. The data were collected by face-to-face interviews and analyzed using the method proposed by Lundman and Graneheim.ResultsTwo themes emerged from the data analysis, including burnout (with the categories of physical challenge and psychological challenges) and coping strategies (with the categories of social support and professional support).ConclusionResolving the obstacles and problems faced by home caregivers can improve the circumstances of care provision so that they can be relieved of their own physical and psychological conundrums and deliver suitable home care to SCI patients.Trial registration numberNot applicable.

The Effects of Combined Virtual Reality Exercises and Robot Assisted Gait Training on Cognitive Functions, Daily Living Activities, and Quality of Life in High Functioning Individuals With Subacute Stroke.

Stroke is a global health concern causing significant mortality. Survivors face physical, cognitive, and emotional challenges, affecting their life satisfaction and social participation. Robot-assisted gait training with virtual reality, like Lokomat, is a promising rehabilitation tool. We investigated its impact on cognitive status, activities of daily living, and quality of life in individuals with stroke. Between September 2022 and August 2023, we exposed 34 first stroke patients (8 women, 26 men; M age = 59.15, SD = 11.09; M height = 170.47, SD = 8.13cm; M weight = 75.97; SD = 10.87kg; M days since stroke = 70.44, SD = 33.65) in the subacute stage (3-6 months post-stroke) to Lokomat exercise. Participant exclusion criteria were Lokamat exercise inability, disabilities incompatible with intended measurements, and any cognitive limitations. The Control Group (CG) received conventional physiotherapy, while the Lokomat Group (LG) received both conventional physiotherapy and robot-assisted gait training with virtual reality, administered by an occupational therapist. Evaluations were conducted by a physiotherapist who was unaware of the participants' group assignments and included assessments with the Montreal Cognitive Assessment, Lawton Brody Instrumental Activities of Daily Living Scale, and Stroke Specific Quality of Life Scale (SS-QoL). Both groups demonstrated an improved quality of life, but the LG outperformed the CG with regard to SS-QoL (p = .01) on measures of Energy (p = .002) and Mobility (p = .005). Both groups showed improvements in cognitive functioning (p < .001) with no between-group difference, and in activities of daily living (p < .05) for which the LG was superior to the CG (p = .023). Thus, adding robot-assisted gait training with Lokomat and virtual reality improved self-reported quality of life and daily activities at levels beyond conventional physiotherapy for patients in the subacute stroke phase. An incremental impact on cognitive functions was not evident, possibly due to rapid cognitive recovery or this was undetected by limited cognitive testing.