Comprehensive Rehabilitation Program Research Articles

Modern approaches of rehabilitation in COPD patients

Chronic Obstructive Pulmonary Disease (COPD) presents a significant challenge to public health, impairing the quality of life for affected individuals. Traditionally, the management of COPD primarily involved pharmacological interventions and symptom management, but a shift towards comprehensive rehabilitation programs has been observed in recent times. This study focuses on exploring these modern approaches to COPD rehabilitation, including exercise training, education, psychosocial support, and self-management strategies. By emphasizing patient-centered and multidisciplinary methodologies, modern rehabilitation approaches aim to address the individual needs of COPD patients. Previous studies affirm the positive impacts of these comprehensive programs, including improved exercise capacity, reduced symptoms, and enhanced overall well-being. This current investigation aims to further analyze the effects of various pulmonary rehabilitation methods on COPD management within a modern medical context. By critically evaluating literature and research databases like SCOPUS, PubMed, SciELO, Google Scholar, and Cochrane Library, this study seeks to provide unique insights into the efficacy and benefits of pulmonary rehabilitation for COPD patients. The implications of this research could contribute significantly to evidence-based practices, assisting healthcare professionals in optimizing the selection and implementation of pulmonary rehabilitation interventions for improved patient outcomes.

SCARRED FOR LIFE: THE ENDURING BATTLES OF ACID ATTACK SURVIVORS IN PAKISTAN

The aim of this study was to examine the challenges that acid attack survivors faced in their daily lives long after the incident. A qualitative approach was used, and in-depth interviews were conducted with a purposive sample of 25 acid attack survivors using an interview guide. The collected data was analyzed using thematic analysis. The study findings revealed that acid attack survivors in Pakistan faced multiple challenges in their daily lives long after the incident. The majority of the survivors were from poor families and had little or no education. Due to their poor economic condition, they could not afford the necessary medication and treatment. They often experienced mental health issues and faced little social acceptance. To address these challenges, acid attack survivors required rehabilitation programs that empowered and educated them, helping them reintegrate into society and return to normalcy. The challenges faced by acid attack survivors in Pakistan were significant and required immediate attention from government and non-governmental organizations. To enable acid attack survivors to recover from their trauma, comprehensive rehabilitation programs that addressed their mental, physical, and social needs needed to be implemented. By empowering and educating acid attack survivors, we could help them overcome the multiple challenges they faced and enable them to lead fulfilling lives. Keywords: Acid violence, human rights violation, women victims, lifelong challenges,

Changing the approach to rehabilitation exercise during the COVID-19 pandemic: A brief review

Background: It is necessary to design a comprehensive rehabilitation program after high-grade systemic inflammation caused by the coronavirus, followed by a long rest and quarantine. In addition, pandemic quarantine has led to a lack of access to rehabilitation clinics and sports clubs. However, integrated information on how to implement a rehabilitation program in pandemic conditions is not yet available. Objectives: We aimed to investigate clinical trials regarding exercise rehabilitation related to Covid-19 in PubMed. Methods: The keywords (Covid-19 and exercise rehabilitation) were examined in PubMed electronic database until 11 August 2021, and 707 articles were found. Results: Twenty-nine clinical trial articles were found, and one unrelated article was deleted. Particular attention should be paid to maintaining the physiological and psychological health of health care workers. Most of the programs implemented include home-based rehabilitation (HBR) through web-based rehabilitation [WBR]. The multiplicity and variety of existing programs are not enough to cover all groups in society, including the healthy and sick ones. No problems have been reported for healthy people during strenuous exercise when wearing a surgical or cloth mask Conclusions: In addition to conventional therapies and modern rehabilitation techniques, virtual rehabilitation learning through WBR is expanding [due to the quarantine conditions of patients and the closure of sports and clinical centers] with positive physiological and psychological effects.

Functional improvements of patients admitted to an inpatient rehabilitation facility after bilateral lung transplant due to severe COVID-19 pulmonary disease.

Coronavirus disease (COVID-19) has introduced a new subset of patients with acute end-stage lung damage for which lung transplantation has been successfully performed. To describe the inpatient rehabilitation course of patients who underwent bilateral lung transplant due to severe COVID-19 pulmonary disease. Retrospective chart review. Free-standing, academic, urban inpatient rehabilitation hospital. Seventeen patients aged 28-67 years old (mean 53.9 ± 10.7) who developed COVID-19 respiratory failure and underwent bilateral lung transplant. Patients participated in a comprehensive inpatient rehabilitation program including physical, occupational, and speech therapy tailored to the unique functional needs of each individual. Primary outcome measures of functional improvements, include mobility and self-care scores on section GG of the Functional Abilities and Goals of the Improving Post-Acute Care Transformation Act, as defined as quality measures by the Centers for Medicare and Medicaid Services. Other functional measures included 6 minute walk test, Berg balance scale, Mann Assessment of Swallowing Ability (MASA), and Cognition and Memory Functional Independence Measure (FIM) scores. Wilcoxon signed rank sum test was used to evaluate statistical significance of change between admission and discharge scores. Fourteen patients completed inpatient rehabilitation. Self-care (GG0130) mean score improved from 20.9 to 36.1. Mobility (GG0170) mean score improved from 30.7 to 70.7. Mean 6-minute walk distance improved from 174.1 to 467.6 feet. Mean Berg balance scores improved from 18.6/56 to 36.3/56. MASA scores improved from 171.3 to 182.3. All functional measures demonstrated statistically significant improvements with p value ≤ .008, except for cognition and memory FIM scores, which did not show a statistically significant difference. A majority (76%) of patients discharged home. This new and unique patient population can successfully participate in a comprehensive inpatient rehabilitation program and achieve functional improvements despite medical complications.

Case Report: Rehabilitation of bilateral below-knee and partial-hand amputations in a developing country

Limb ischemia is a complication of peripheral artery disease (PAD)which can lead to amputation. Amputation occurs in approximately 3-4% of PAD patients. In Indonesia, post-amputation patients are only hospitalized for the acute phase and the post-amputation rehabilitation programs must be done as an outpatient. This could be a barrier to the continuity of rehabilitation programs. A solution is the application of home-based rehabilitation programs. A 57-year-old female was referred from the Cardiothoracic Surgery Outpatient Clinic post-amputation with bilateral below-knees and partial-hands amputation after being diagnosed with PAD. On initial examination, all her elbows, wrists, thumbs, hips, and knees showed weakness. The patient received neuromuscular electrical stimulations (NMES) as well as a home-based rehabilitation programs. On the second examination, after considering the data from the clinical finding and supporting examination, the patient received bilateral below-knee prostheses and bilateral functional partial-hand prostheses, created using 3D printing technology with polylactic acid material. After a few months, she was able to do most of her activities of daily living (ADLs) independently, work as a shopkeeper in her store, and feel more confident interacting with others. A comprehensive rehabilitation programs, patient adherence to exercise, and caregiver support are critical to improving functional capacity and the quality of life in a patient with bilateral below-knee and bilateral partial-hand amputation caused by PAD.

Rehabilitation interventions for glioma patients: a mini-review.

Glioma is a group of tumors that originate from glial cells within the central nervous system and comprise 27% of all tumors and 80% of malignant tumors. With remarkable progress in surgical practices, chemotherapy, and radiation therapy, patients with glioma are experiencing greater survival times, which means they need more rehabilitative care. In fact, people with this condition may experience a variety of symptoms that can affect their functions and drastically reduce their quality of life. In fact, patients suffering from glioma has a distinctive symptom complex highlighting the requirement for customized care. Growing evidence shows that rehabilitation therapy can improve the functional prognosis and quality of life of glioma patients. However, there is limited evidence of the success of rehabilitation protocols designed specifically for individuals with glioma. It is essential to determine the most comprehensive rehabilitation programs as well as the sufficient resources, dosage, and duration. The goal of this mini-review was to classify and map rehabilitation interventions used to treat multiple disabling sequalae in individuals affected by glioma. We aim to provide a comprehensive overview of the rehabilitation protocols used for this population, so that clinicians have a guide to support treatment and an inspiration for further research. This document is intended to be a reference point for professionals involved in the management of adult patients with gliomas. Further exploration is needed to form improved care models for recognizing and addressing functional restrictions in this population.

Effects of Inpatient Rehabilitation in Leg Lymphedema: A Naturalistic Prospective Cohort Study With Intra-individual Control of Effects

ObjectiveTo quantify therapy-attributable effects of a comprehensive inpatient rehabilitation program for lower limb lymphedema (LLL) and to compare the levels of health-related quality of life (HRQL) to population-based norms. DesignNaturalistic prospective cohort study with intra-individual control of effects. SettingRehabilitation hospital. ParticipantsPatients with LLL (N=67; 46 women). InterventionsComprehensive, multidisciplinary inpatient rehabilitation with 45-60 hours of therapy. Main Outcome MeasuresShort Form 36 (SF-36) for HRQL, lymphedema-specific Freiburg Quality of Life Assessment for lymphatic disorders, Short Version (FLQA-lk), knee-specific Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), and Symptom Checklist-90Standard (SCL-90S). Observed pre/post rehabilitation effects were individually corrected by subtracting the home waiting-time effects and expressed as standardized effect sizes (ESs) and standardized response means (SRMs). Score differences to norms were quantified by standardized mean differences (SMDs). ResultsParticipants were on average aged 60.5 years, not yet obese, and had 3 comorbidities (n=67). The greatest improvement was in HRQL on the FLQA-lk with ES=0.767/SRM=0.718, followed by improvements in pain and function with ES/SRM=0.430-0.495 on the SF-36, FLQA-lk, and KOS-ADL (all P<.001). Vitality, mental health, emotional well-being, and interpersonal sensitivity improved most by ES/SRM=0.341-0.456 on all 4 measures (all P≤.003). Post rehabilitation scores were significantly higher than population norms on SF-36 bodily pain (SMD=1.140), vitality (SMD=0.886), mental health (SMD=0.815), and general health (SMD=0.444) (all P<.001), and comparable on the other scales. ConclusionsThose affected by LLL stages II and III benefited substantially from the intervention, attaining equal or higher levels of HRQL than expected compared with the general population norms. Multidisciplinary, inpatient rehabilitation should be recommended for LLL management.

Clinical management of finger joint capsulitis/synovitis in a rock climber.

This case study presents a 23-year-old male recreational rock climber, who climbed an average of 3-4 times per week and presented with finger joint capsulitis/synovitis after increasing his climbing intensity and training from moderate to high over 6 months, which led up to injury. During the exam, the diagnosis was ruled in with clinical orthopedic testing. Additional movement analyses revealed improper gripping mechanics contributing to asymmetric finger loading. A comprehensive rehabilitation program was developed based on the concept of a progressive framework that included unloading of the affected tissues, increasing mobility, improving muscle performance, and correcting suboptimal climbing movements. After 6 weeks, the climber's pain 24 h after climbing, which was rated on a visual analog pain scale (VAS), decreased from 5.5/10 to 1.5/10 and 0/10 at the 12-month follow-up. His patient-specific functional scale improved from 0% at the initial evaluation to 43% after 6 weeks and to 98% after 12 months. His sports-specific disabilities of the arm, shoulder, and hand improved from 69% to 34% to 6% during the initial evaluation, 6-week follow-up, and 12-month discharge. He made a full recovery to his previous grade of V8 bouldering. This is the first case study of its kind to provide a rehabilitation framework for the management of finger joint capsulitis/synovitis in a rock climber.

Effectiveness of a Sedentary Behaviour Intervention as a Personalised Secondary Prevention Strategy (SIT LESS) for patients with coronary artery disease: primary outcomes of the SIT LESS trial

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation. Background High levels of time spent sedentary are associated with increased risk of cardiovascular disease morbidity and mortality, even after accounting for traditional risk factors. A sedentary lifestyle is highly prevalent among patients with coronary artery disease (CAD). Purpose This clinical trial aimed to determine whether a multicomponent, hybrid (center- and home-based), sedentary behaviour change intervention as a personalized secondary prevention strategy (SIT LESS) reduces daily sedentary time among patients with CAD participating in cardiac rehabilitation. Methods Patients were randomised to usual care (n=104) or SIT LESS (n=108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with an activity tracker connected to a smartphone application. Primary outcome was the change in objectively measured sedentary time between pre- to post-rehabilitation. Results Patients (77% male) were 63±10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (−1.6 [−2.1 to −1.1] hours/day) and controls (−1.2 [ ─1.7 to −0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day, Central Figure). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥9.5 hours/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2-0.8)). No differences were observed in the other predefined secondary outcomes. Conclusions Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥9.5 hours/day was observed.

Effect of Balance and Strength Training in Proprioception and Functioning of Posterior Cruciate Ligament After Injury: A Case Study

Background/Purpose: This case study aims to evaluate the impact of a comprehensive rehabilitation program, including a combination of balance and strength training exercises, on knee function, pain, and quality of life. Case Description: This case study explores the effects of balance and strength training in the rehabilitation of a 23-year-old male patient, Vishal Vaishnavi, who sustained a posterior cruciate ligament (PCL) injury while playing football. Patient’s objective in physical therapy was to resume functional activities and return to sports as soon as possible. Outcome: The results of the study revealed significant improvements in all five subscales of the KOOS, including pain, symptoms, activities of daily living (ADL), sports and recreation (sport/rec), and knee-related quality of life (QoL). Additionally, the IKDC score showed a notable improvement in knee function, pain, and subjective knee stability Discussion: The case study highlights the importance of a personalized and progressive rehabilitation approach for PCL injury patients. By targeting specific needs and goals through a combination of balance and strength training exercises, healthcare professionals can facilitate significant improvements in knee function, pain reduction, and enhanced quality of life. This study contributes to the body of evidence supporting the effectiveness of balance and strength training in the rehabilitation of PCL injury patients, emphasizing the importance of a multidimensional approach to optimize outcomes and promote successful return to activity.

565 Rehabilitation Time to Evaluation Report: A Quality Improvement Study

Abstract Introduction Successful rehabilitation of patients with burn injuries requires an in-depth occupational therapy (OT) and physical therapy (PT) evaluation early in the acute phase of a patient’s injury to develop a detailed therapy plan of care. In addition, it is a standard of the American Burn Association for verified burn centers to have a comprehensive rehabilitation program designed for burn patients within 24 hours of admission. However, there is no standardized report for tracking timeliness of issuing PT/OT orders or completion of therapy evaluations by PT/OT after a patient is admitted to a burn unit. This quality improvement study details the creation of a “Time to PT/OT Order Placement and Evaluation Completion Report” and results of a quality improvement process used to improve these metrics. Methods A multi-disciplinary workgroup was created and included a burn surgeon, PT and program nurse coordinator and an electronic report was created in collaboration with the hospital’s business intelligence team. The report included the following metrics: average time from admission to PT/OT order placement, average time from PT/OT order placement to therapist acknowledgement, and average time from PT/OT order placement to therapist completion of initial evaluation. A baseline report was run (3-months) and results were analyzed. A quality improvement process was then put into place including education of burn attending physicians, fellows, and rotating residents on timeliness of therapy order placement, therapy staff education on findings and a new process for morning coordination of burn therapist caseloads to prioritize new evaluations, and initiation of monthly reporting at the burn joint practice committee meetings. The report was then run for an additional 3-months and results were analyzed. Results Baseline and post-quality improvement process results (3-month averages) were as follows: Average time from admission to PT/OT order placement increased from 3.4 to 8.3 hrs, average time from PT/OT order placement to therapist acknowledgement decreased from 43.2 to 31.5 hrs, and average time from PT/OT order placement to therapist completion of evaluation decreased from 43.6 to 35.1 hrs. Conclusions After development of this report findings showed that the quality improvement process used to improve timeliness of inpatient PT/OT initial evaluation completion was effective. In addition, this report has been useful for metric reporting during burn joint practice committee meetings, the ABA verification process and burn therapy staffing/daily caseload management. Applicability of Research to Practice This report could be used by other burn centers to help track and improve timeliness of initial PT/OT evaluations for acute burns. In addition, metrics created from this report could be used for the ABA verification process and help justify burn unit therapy staffing needs.

The effectiveness of a comprehensive rehabilitation program including interactive balance therapy with biofeedback and kinesihydrotherapy in reducing body weight and changing the body composition in patients with obesity

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

The effectiveness of a comprehensive rehabilitation program on the balance function in patients with obesity

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Residual Deficits in Reactive Strength After Anterior Cruciate Ligament Reconstruction in Soccer Players.

Deficits in plyometric abilities are common after anterior cruciate ligament reconstruction (ACLR). Vertical rebound tasks may provide a targeted evaluation of knee function. To examine the utility of a vertical hop test for assessing function after ACLR and establishing factors associated with performance. Cross-sectional study. Rehabilitation program. Soccer players with a history of ACLR (n = 73) and matched control individuals (n = 195). The 10-second vertical hop test provided measures of jump height, the Reactive Strength Index (RSI), and asymmetry. We also examined possible predictors of hop performance, including single-legged vertical drop jump, isokinetic knee-extension strength, and the International Knee Documentation Committee questionnaire score. Between-limbs differences were identified only for the ACLR group, and asymmetry scores increased in those with a history of ACLR (P < .001) compared with the control group. The single-legged vertical drop jump, RSI, and knee-extension torque were significant predictors of 10-second hop height (R2 = 20.1%) and RSI (R2 = 47.1%). Vertical hop deficits were present after ACLR, even after participants completed a comprehensive rehabilitation program. This may have been due to reduced knee-extension and reactive strength. Vertical hop tests warrant inclusion as part of the return-to-sport test battery.

Advocating for a patient- and family centered care approach to management of short bowel syndrome.

Patient- and family centered care (PFCC) is a model of providing healthcare that incorporates the preferences, needs, and values of the patient and their family and is built on a solid partnership between the healthcare team and patient/family. This partnership is critical in short bowel syndrome (SBS) management since the condition is rare, chronic, involves a heterogenous population, and calls for a personalized approach to care. Institutions can facilitate the practice of PFCC by supporting a teamwork approach to care, which, in the case of SBS, ideally involves a comprehensive intestinal rehabilitation program consisting of qualified healthcare practitioners who are supported with the necessary resources and budget. Clinicians can engage in a range of processes to center patients and families in the management of SBS, including fostering whole-person care, building partnerships with patients and families, cultivating communication, and providing information effectively. Empowering patients to self-manage important aspects of their condition is an important component of PFCC and can enhance coping to chronic disease. Therapy nonadherence represents a breakdown in the PFCC approach to care, especially when nonadherence is sustained, and the healthcare provider is intentionally misled. An individualized approach to care that incorporates patient/family priorities should ultimately enhance therapy adherence. Lastly, patients/families should play a central role in determining meaningful outcomes as it relates to PFCC and shaping the research that affects them. This review highlights needs and priorities of patients with SBS and their families and suggests ways to address gaps in existing care to improve outcomes.

Dynamics of indicators characterizing the health of children in the territory of military conflict. The impact of rehabilitation measures: cohort study

Background. There are still understudied issues concerning the health indicators of children who are in conditions of conducting warfare in primary school age. Objective. The aim of the study is to evaluate comprehensive rehabilitation measures to optimize health indicators (physical, functional and mental capacity parameters) of primary school children in conditions of military conflict.Methods. An examination of 419 elementary school children was conducted in the period from March 2022 to September 2022 including. The main group: 128 children, who lived in the territory of military operations. Control group: 291 children who lived peaceful territories. The indicators (body mass index, Robinson index, vital index, strength index, V.A. Shapovalova power index and mental capacity of children according to the results of V.Ya. Anfimov correction task) were compared before the start of the developed comprehensive rehabilitation program and 6 months after the start of its implementation.Results. It was found that all elementary school children who lived in locations of military conflict had a decrease in physical and functional parameters of varying degrees of severity, as well as indicators of mental capacity. The comprehensive rehabilitation program promoted to the normalization of the studied indicators in evacuated (57/86, 56%) children in comparison with children who remained in the locations of military operations (43/70, 49%). The studied indicators had the highest recovery rates at the age of 7-8 years. The most vulnerable was a subgroup of 9-10 years old boys who permanently living in conditions of conducting warfare. The development and implementation of the comprehensive integration program using individual rehabilitation routes had an optimizing effect on the studied indicators of physical and functional conditions, as well as cognitive performance in 101 children of the main subgroups, which amounted to 78.9%.Conclusion. Under the influence of the comprehensive integration rehabilitation program, optimization of health indicators was observed in children living in locations of conducting warfare. The most pronounced effect was observed in children who left the territories of shelling as a result of evacuation to Rostov-on-Don.

Efficacy of Bilateral Cochlear Implantation in Pediatric and Adult Patients with Profound Sensorineural Hearing Loss: A Retrospective Analysis in a Developing European Country.

This retrospective study aimed to evaluate the outcomes of bilateral cochlear implantation in patients with severe-to-profound sensorineural hearing loss at the Timisoara Municipal Emergency Clinical Hospital ENT Clinic. The study involved 77 participants, divided into four groups based on their hearing loss characteristics and implantation history. Assessments were conducted pre- and post-implantation, focusing on speech perception, speech production, and reading achievement. Standard surgical procedures were performed, and participants were provided with a comprehensive rehabilitation program involving auditory training and communication therapy. The variables considered for analysis included demographic factors, implantation period, and quality of life assessment, with no statistically significant differences pre-implantation between the four study groups. Results revealed significant improvements in speech perception, speech production, and reading achievement after cochlear implantation. In adult patients, speech perception scores increased from 21.3% to 73.4% for WIPI and from 22.7% to 68.4% for HINT after 12 months of rehabilitation. Speech production scores improved from 33.5% to 76.8% and reading achievement scores increased from 76.2 to 106.3. Moreover, there was a significant improvement in patients' quality of life following cochlear implantation, with mean scores increasing from 2.0 to 4.2. Although it is known that bilateral cochlear implantation significantly improves speech perception, speech production, reading achievement, and quality of life in patients with severe-to-profound sensorineural hearing loss, this is the first study of its kind from Romania. Further research is warranted to optimize patient selection and rehabilitation strategies to maximize outcomes and determine better policies towards funding and access of cochlear implants for a wider range of patients in need.

A modern approach to the rehabilitation of patients with fractures of the bones of the lower extremities

BACKGROUND: General injury rates tend to increase in most federal districts of Russia. The patients with fractures of the bones of the lower extremities reaches for 8.525% of the total number of patients with fractures. Fractures of the bones of the lower extremities are characterized by long period of reparation, persistent contractures, a violation of the congruence of the articular surfaces, and changes in the biomechanics of walking. Only full course of rehabilitation can eliminate the these complications and restore the previous motor activity.&#x0D; АIMS: The study aimed to analyze the structure of injuries in patients of the traumatology department and to present and the results of the recovery of patients with fractures of the bones of the lower extremities using and algorithm of organization of medical rehabilitation in the case study.&#x0D; MATERIALS AND METHODS: A retrospective analysis of statistical data on 995 patients of the traumatology department № 1 of the Kazan City Clinical Hospital, who underwent 981 operations, was carried out. Randomly selected two groups of patients ― I main (n=45) and II control (n=45). Patients of group II after the treatment at the trauma center underwent outpatient medical rehabilitation, group I received inpatient medical rehabilitation in the rehabilitation department of the Kazan City Clinical Hospital № 7. In a hospital setting, a comprehensive rehabilitation program included physiotherapy exercises, CPM-veloergometry, exercises on rehabilitation simulators, the PNF kinesiotherapy technique, etc.&#x0D; RESULTS: A more pronounced statistically significant positive dynamics at the end of the course of medical rehabilitation was noted in patients of group I (reduction of pain syndrome, increased joint mobility, degree of dependence on others, increased mobility index, the ability to dress independently, maintain body position in space, reduced dysfunction in lifting and carrying objects, walking disorders, and caring for body parts). The dynamics of motor function and psycho-emotional sphere also improved to a greater extent in patients of group I.&#x0D; CONCLUSIONS: The effectiveness of the presented algorithm of organization of medical rehabilitation of patients with fractures of the bones of the lower extremities is confirmed by the results of present study. It is revealed that patients in the I (main) group showed more significant improvement in functions, activity and participation, a decrease of disability, reduce of pain, anxiety and depression, as well as an increase of the level of quality of life compared to patients of group II (control), who did not receive comprehensive medical rehabilitation in the hospital (p 0.1).

Factors Affecting Recidivism of Persons Deprived of Liberty at Tabaco City District Jail

Recidivism is a term used to describe the tendency of a person who has been released from prison or other Detention facilities to re-offend and return to incarceration. The study aimed to identify the factors that affect the recidivism of persons deprived of liberty at Tabaco City District Jail using a descriptive-quantitative research design. The data were collected through a survey questionnaire administered to 100 selected PDL who were detained or had been released and returned to the jail. The study found several factors contributing to recidivism, including lack of employment opportunities, substance abuse problems, lack of education and skills, and poor social support. The findings suggest the need for more comprehensive rehabilitation and reintegration programs that address these underlying factors to reduce the likelihood of repeated offenses and promote successful re-entry into society. These programs should focus on providing educational and vocational training, substance abuse treatment, and social support to help PDL successfully reintegrate into their communities. This is useful for policymakers and practitioners in the criminal justice system to develop and implement more effective interventions to reduce recidivism rates among persons deprived of liberty at Tabaco City District Jail.

Sexual Rehabilitation and Relational Satisfaction in People with Multiple Sclerosis and their Partners.

Sexuality is an integral part of our existence. Multiple Sclerosis (MS) can complicate the lifelong course of sexual development and the ways in which one defines and expresses sexuality. Unfortunately, these issues are not adequately addressed by the health professionals involved in the rehabilitation process. Present research attempts to study the effect that can arise on the sexual and relational satisfaction of couples having a partner with MS after the implementation of a sexual rehabilitation program. 60 couples where one partner has MS and the other does not, were divided into three groups and accepted the PLISSIT (PLISSIT stands for Permission, Limited Information, Specific Suggestions, Intensive Therapy) sexual rehabilitation program as follows: Group a (n = 40, control group) completed self-referencing questionnaires at three times (initial measurement, after 10 weeks and 6 months later), group b (n = 40) did 10 weeks of sexual counselling and completed the same questionnaires at the same times and group c (n = 40) followed the PLISSIT programme and was evaluated in the same way at the same times. The implementation of PLISSIT improved Sexual Dysfunction (SD) levels, increased sexual satisfaction between partners along with general relational satisfaction. PLISSIT can be used by professionals involved in the management of the disease as a comprehensive psychosexual rehabilitation program for MS patients and their partners.