Early Stages Of Rehabilitation Research Articles

Early increases in artisanal shore-based fisheries in a Nature-based Solutions mangrove rehabilitation project on the north coast of Java

We studied nearshore diurnal fish catches and fisheries development in the early stages of mangrove rehabilitation around the village of Timbulsloko on the central north coast of Java, Indonesia. Mangrove rehabilitation was part of a Nature-based Solutions project to re-establish ecological and economic resilience by combining coastal engineering measures with ecological recovery in conjunction with sustainable land and resource use. Creel surveys were conducted during the onset of the monsoon season October–December 2017 to document yields of the three main fishing gears targeting mangrove finfish in a 419 ha mangrove backwater basin. These were accompanied by structured interviews to obtain fisher views on developments in these fisheries. Analysis of satellite images and GIS-mapping were used to follow developments in mangrove coverage and effort in the estuarine lift-net fishery. Mangrove recovery between 2005 and 2018 achieved 8.5% of its maximum possible (historic) cover potential in the basin and followed an exponential growth curve. The increase in lift-net installations targeting finfish lagged in comparison to mangrove increase, remaining virtually zero till 2014, after which it rapidly increased. A baseline study in 2015 found no mangrove-associated finfish fisheries occurring in our study area. The 51 fishers surveyed in 2017, indicated that fishing activity in the area had strongly increased since 2015, with 45% of fishers stating to having started fishing this area a year earlier or even more recently. A significant majority of 87% of respondents with more than one year of experience at this location, stated that their catches had changed in terms of either fish size, quantity or composition since they started fishing, while 86% indicated improvement in terms of either size or quantity. Fishing generated about 1.05 ± 1.11 (SD) USD/hr worth of catch to professional fishers using either of the two net-types studied. As per 2017, fishing had become profitable in our study area, whereas this kind of fishery practically did not exist prior to 2014. We suggest that higher profitability may partially explain the rapid growth seen in fishing activity in the mangrove rehabilitation area. However, for 12 of the 18 larger species caught, the mean size in the catch was lower than mean size of maturation, indicating that these fisheries were principally targeted towards immature nursery fish. The results highlight the need to manage this currently developing fishery, otherwise any benefits to the local community might be nullified by overfishing.

Does Blood Flow Restriction Resistance Training Improve Knee-Extensor Strength, Function, and Reduce Patient-Reported Pain? A Critically Appraised Topic.

Clinical Scenario: Knee pathologies often require rehabilitation to address the loss of knee-extensor (KE) strength, function, and heightened pain. However, in the early stages of rehabilitation, higher loads may be contraindicated. Blood flow restriction (BFR) resistance training does not require high loads and has been used clinically to promote strength improvements in a variety of injured populations. BFR resistance training may be an effective alternative to high-intensity resistance training during early rehabilitation of knee pathologies. Clinical Question: Following a knee injury, does BFR resistance training improve KE strength and function, and reduce patient-reported pain? Summary of Key Findings: Four randomized controlled trial studies met the inclusion criteria. Each included study evaluated the use of BFR resistance training on knee pathologies and the effects on KE strength, functional outcomes, and pain compared with high- or low-load resistance training. All 4 studies reported significant improvements in KE strength, function, and pain through a variety of outcome measures, following BFR resistance training use as the treatment. Clinical Bottom Line: There is consistent evidence to support the use of BFR resistance training as a treatment intervention following knee injury and as a means to improve KE strength and function and to reduce pain. Strength of Recommendation: Grade A evidence supporting the use of BFR resistance training for improvement in KE strength and function, and the reduction of patient-reported pain following an acute or chronic knee pathology.

Effect of acupuncture on neck muscle training and sports rehabilitation of freestyle skiing aerial skiers

To explore the effect of acupuncture therapy on strengthening the muscle groups around the cervical spine of freestyle skiing aerial skiers and preventing cervical spine injury of freestyle skiing aerial skiers, so as to ensure the reduction of injury. After neck injury, whether it can accelerate the rehabilitation of neck injury and reduce the time of sports rehabilitation. In this paper, through comparative analysis and literature analysis, we will carry out general resistance training and acupuncture therapy for freestyle skiing aerial skiers respectively, and then test and evaluate the muscle strength of the muscle group around the cervical spine through hand-held dynamometer and adjustable tension belt, so as to draw a conclusion that acupuncture therapy can promote the growth of muscle strength, The effect of acupuncture therapy in the early stage of athletes' sports injury rehabilitation is better than that of ordinary resistance training.

Application effect for a care bundle in optimizing nursing of patients with severe craniocerebral injury.

BACKGROUNDSevere craniocerebral injury (STBI) is a critical physical trauma caused by a sudden external force acting on the head. The condition is complex and changeable, and disability and mortality rates are high. Although the life of STBI patients can be saved through treatment, the sequelae of consciousness, speech, cognitive impairment, stiffness, spasm, pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family. In the past, routine nursing was often used to treat/manage STBI; however, problems, such as improper cooperation and untimely communication, reduced therapeutic effectiveness.AIMTo investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI.METHODSFrom January 2019 to December 2020, 126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center. These patients were retrospectively selected as the research participants in the current study. The study participants were then divided into a control group (61 cases) and a study group (65 cases). The control group was treated with routine nursing. The study group adopted the proposed care bundle. The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale (GCS) were used to evaluate neurological function before and after emergency treatment. After 3 mo of rehabilitation, experimental outcomes were assessed. These included the GCS, Barthel Index, complication rate, muscle strength grade and satisfaction.RESULTSThere was no significant difference in gender, age, cause of injury and GCS between the two groups. After emergency, the National Institutes of Health Stroke Scale/Score of the study group (10.23 ± 3.26) was lower than that of the control group (14.79 ± 3.14). The GCS score of the study group (12.48 ± 2.38) was higher than that of the control group (9.32 ± 2.01). The arrival time of consultation in the study group was 20.56 ± 19.12, and the retention time in the emergency room was 45.12 ± 10.21, which were significantly shorter than those in the control group. After 3 mo of rehabilitation management, the GCS and Barthel Index of the study group were 14.56 ± 3.75 and 58.14 ± 12.14, respectively, which were significantly higher than those of the control group. The incidence of complications in the study group (15.38%) was significantly lower than that in the control group (32.79%). The proportion of muscle strength ≥ grade III in the study group (89.23%) was significantly higher than that in the control group (50.82%). The satisfaction of patients in the study group was significantly higher than that in the control group.CONCLUSIONCare bundles are used to optimize the nursing process. During first-aid, care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time. In early rehabilitation, they can effectively improve the consciousness of STBI patients, improve the activities of daily living, reduce the risk of complications, accelerate the recovery of muscle strength and improve their satisfaction.

Effect of initial switch-on within 24\xa0hours of cochlear implantation using slim modiolar electrodes

Reducing electrode impedance is an important factor in improving the functional benefits of cochlear implants (CIs). The immediate effect of early switch-on within 24 h of surgery on impedance among CI recipients with various types of electrodes has been reported previously; however, the immediate change and the evolution of electrode impedances of slim modiolar electrodes after early switch-on within 24 h of implantation has not. Therefore, the focus of this retrospective cohort study of CI patients was to compare the effect of early switch-on (n = 36) and conventional switch-on (n = 72) 2–4 weeks post-operation on impedance. Compared with impedance measured intraoperatively, our results demonstrate a significant decrease in impedance from 11.5 to 8.9 kΩ (p < 0.001) at 2–4 weeks after implantation in the early switch-on group, which sharply contrasted with elevated impedance values for conventional switch-on 2–4 weeks after implantation (from 10.7 to 14.2 kΩ, p = 0.001). Notably, a comparatively lower impedance than the conventional switch-on protocol was observed for up to 2 months post-operation. Most importantly, a much earlier stabilization of impedance can be achieved with the early switch-on protocol coupled with the slim modiolar electrode array compared to the conventional switch-on protocol, offering the advantage of reducing the number of required mapping sessions in the early stages of rehabilitation.

Distribution of a Newly Recorded Gastropod Species, Mainwaringia leithii (Gastropoda, Littorinidae), in Young, Rehabilitated Mangroves in China

The species within the genusMainwaringiain Littorininae have been recognized as being strongly associated with mangroves; however, their abundance and distribution patterns in mangroves have rarely been reported. In this study, we reportedMainwaringia leithiispecimens collected from young, rehabilitated mangroves in Xiamen city as a newly recordedMainwaringiaspecies in China, based on their DNA barcoding and morphological taxonomy characteristics. The recruitment pattern of this species and its relationships with mangrove species in the early stage of mangrove rehabilitation were also investigated. The snails were mainly collected from the backsides of leaves and from some leaf nodes. Continuous sampling showed the rapid recruitment ofM. leithiifollowing mangrove rehabilitation, with a density up to 278 ind m–2in a 2.5-year-old mangrove site; however, declining densities were observed and snails were only occasionally collected at mangrove sites 4 years after rehabilitation.Aegiceras corniculatummangroves in shrub form could support a snail abundance higher than that supported byKandelia obovatamangroves of the same age. The present study suggests thatM. leithiicould be common in mangrove forests and that intensive changes in its assemblage occurs in the early stage of mangrove rehabilitation. Moreover, the recruitment ofM. leithiifollowing mangrove rehabilitation is related to the planting of different mangrove species. The spatio-temporal patterns ofM. leithiidistribution are likely owing to the variability in habitat characteristics related to mangrove species and stand age. Future studies should give more attention to the ecology of this species in mangrove forests.

Toward Personalized Web-Based Cognitive Rehabilitation for Patients With Ischemic Stroke: Elo Rating Approach.

BackgroundStroke is a worldwide cause of disability; 40% of stroke survivors sustain cognitive impairments, most of them following inpatient rehabilitation at specialized clinical centers. Web-based cognitive rehabilitation tasks are extensively used in clinical settings. The impact of task execution depends on the ratio between the skills of the treated patient and the challenges imposed by the task itself. Thus, treatment personalization requires a trade-off between patients’ skills and task difficulties, which is still an open issue. In this study, we propose Elo ratings to support clinicians in tasks assignations and representing patients’ skills to optimize rehabilitation outcomes.ObjectiveThis study aims to stratify patients with ischemic stroke at an early stage of rehabilitation into three levels according to their Elo rating; to show the relationships between the Elo rating levels, task difficulty levels, and rehabilitation outcomes; and to determine if the Elo rating obtained at early stages of rehabilitation is a significant predictor of rehabilitation outcomes.MethodsThe PlayerRatings R library was used to obtain the Elo rating for each patient. Working memory was assessed using the DIGITS subtest of the Barcelona test, and the Rey Auditory Verbal Memory Test (RAVLT) was used to assess verbal memory. Three subtests of RAVLT were used: RAVLT learning (RAVLT075), free-recall memory (RAVLT015), and recognition (RAVLT015R). Memory predictors were identified using forward stepwise selection to add covariates to the models, which were evaluated by assessing discrimination using the area under the receiver operating characteristic curve (AUC) for logistic regressions and adjusted R2 for linear regressions.ResultsThree Elo levels (low, middle, and high) with the same number of patients (n=96) in each Elo group were obtained using the 50 initial task executions (from a total of 38,177) for N=288 adult patients consecutively admitted for inpatient rehabilitation in a clinical setting. The mid-Elo level showed the highest proportions of patients that improved in all four memory items: 56% (54/96) of them improved in DIGITS, 67% (64/96) in RAVLT075, 58% (56/96) in RAVLT015, and 53% (51/96) in RAVLT015R (P<.001). The proportions of patients from the mid-Elo level that performed tasks at difficulty levels 1, 2, and 3 were 32.1% (3997/12,449), 31.% (3997/12,449), and 36.9% (4595/12,449), respectively (P<.001), showing the highest match between skills (represented by Elo level) and task difficulties, considering the set of 38,177 task executions. Elo ratings were significant predictors in three of the four models and quasi-significant in the fourth. When predicting RAVLT075 and DIGITS at discharge, we obtained R2=0.54 and 0.43, respectively; meanwhile, we obtained AUC=0.73 (95% CI 0.64-0.82) and AUC=0.81 (95% CI 0.72-0.89) in RAVLT075 and DIGITS improvement predictions, respectively.ConclusionsElo ratings can support clinicians in early rehabilitation stages in identifying cognitive profiles to be used for assigning task difficulty levels.

Backward Running on a Negative Slope as a Treatment for Achilles Tendinopathy in Runners: A Feasibility Pilot Study.

Achilles tendinopathy (AT) is a common musculoskeletal injury among runners. Eccentric exercises are considered first-line treatment. However, during the early stages of rehabilitation, patients are usually instructed to stop running. Backward running (BR) on a negative slope provides a similar eccentric load while enabling ongoing physical activity; thus, it may be suggested as an alternative treatment. To determine the feasibility of a BR program as a treatment option for AT in runners. Prospective, single-arm feasibility study. Outpatient clinic. Recreational runners diagnosed with AT and referred to the Meuhedet Health Services Physical Therapy Clinic in Jerusalem, Israel, from September 2019 to February 2020. The patients completed a 5-week (9 sessions) rehabilitation program of supervised BR on a negatively inclined treadmill. Compliance with the program was evaluated by calculating the percentage of patients who completed the full protocol with no adverse events. Personal running-related goals were set before the program and were assessed following rehabilitation using the goal attainment scaling method. Forward-running time until the onset of relevant Achilles tendon pain, and the Victorian Institute of Sports Assessment Scale-Achilles were measured at baseline (T0), before treatment session 6 (T1), and after the last session (T2). Among the 15 patients recruited, 14 (93%), average age 48.8 (10.4) years (86% males), completed the full protocol with no adverse events. Almost all participants (85.7%) achieved their running-related functional goals. Postintervention, the median forward-running time increased from 52.5 (92.5) to 900 (522.5)seconds (P = .008, effect size = .858), and the median Victorian Institute of Sports Assessment Scale-Achilles score improved by 28 points (P = .003, effect size = .881). BR on a negative slope may be a feasible treatment method for runners suffering from AT. Future randomized control trials are required to further validate the efficacy of this method.

The Theoretical Framework of the Clinical Pilates Exercise Method in Managing Non-Specific Chronic Low Back Pain: A Narrative Review.

Simple SummaryExercise is important in helping people with chronic low back pain to regain wellness. General exercises such as cycling and strength training helps with the condition but require a longer time to achieve meaningful improvements in pain and function. Movement preference is potentially useful in exercise and can help an individual to achieve improvements faster. The Clinical Pilates exercise method uses movement preference and thus is a hybrid of two of the best exercise techniques in managing chronic low back pain. However, current studies in Clinical Pilates are lacking and thus challenge the translation of the technique into clinical practice. Hence, a narrative review of the theory of the Clinical Pilates exercise method is examined, and current literature is reviewed to provide a guide towards successful exercise prescription. A structured approach to physical assessment of human movement is proposed to guide clinicians or researchers involved in exercise prescription to design effective exercises. The structured assessment approach also helps with managing clinical cases with multiple episodes of injuries. Despite limited evidence, the Clinical Pilates exercise method is safe and provides faster and earlier recovery and the same longer term outcomes as general exercises.Exercise plays an important role in rehabilitating people with chronic low back pain. Aerobic exercise and resistance training are general exercise strategies to manage chronic low back pain, but these strategies require longer intervention period to achieve clinical outcomes in pain reduction and functional improvements. Directional preference is recognised as an important exercise strategy in managing low back pain. The Clinical Pilates exercise method leverages on the directional preference of an individual to achieve clinical outcomes faster. Clinical Pilates is a hybrid of two of the best exercise interventions for low back pain, which are general Pilates and the McKenzie method. Due to the scarcity of Clinical Pilates literature, a review of its theory and studies was undertaken to provide a structured guide to the technique in managing people with chronic low back pain. Hypothetical algorithms are developed to support translation into clinical practice and future research studies. These algorithms are useful in the management of complex cases involving multiple directional trauma. Although limited, current evidence suggests that the Clinical Pilates exercise method is safe and provides faster functional recovery in the early stage of rehabilitation and similar longer term outcomes as general exercises.

Cognitive and psychoemotional impairment dynamics in patients with hemorrhagic hemispheric stroke at the early rehabilitation stage

The aim of the study was to establish the dynamics of cognitive and psychoemotional disorders under comprehensive rehabilitation in patients with hemorrhagic hemispheric stroke (HHS) during the recovery period of the disease. 46 patients with HHS during the recovery period (31 males and 15 females) were examined on the 30th, 90th, and 180th day. For this purpose, the following modern clinical scales and tests were used: National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Barthel Index (BI), Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), “10 words remembering” test (by Luriya A.), memory self-evaluation scale, State-Trait Anxiety Inventory scale (STAI) and Beck's Depression Inventor (BDI). It was found that 89,13 % of patients with HHS had cognitive impairment. It was also determined signifi‑cant cognitive improvement during the recovery period of the disease. Additionally, the correlation analysis of values on the 30th day of the condition showed the credible impact of the neurological deficit severity by NIHSS on the MMSE, MoCA, and memory self-evaluation scale rates (p &lt; 0.05). As well correlation between neurological impairment and Beck's somatic sings subscale was established (p &lt; 0.05). It was additionally evaluated the impact of neurology deficit level on the BDI overall score (both subscales) on the 180th day of the disease (p &lt; 0.05). It was estimated the age influenced on both the situational anxiety and patient gender on the personal anxiety level (p &lt; 0.05). In addition, it was revealed the impact of lesion location on the presence and severity of depressive disorders (p &lt; 0.05).

Hematocrit changes during early post-stroke rehabilitation with oral hydration and without

General blood test is the simplest and most accessible method of research, which provides sufficient information about the body. We aimed to find out if water consumption during the early rehabilitation stage can impact the blood hematocrit (HTC) level in patients with stroke.

Soil Metaproteomics as a Tool for Environmental Monitoring of Minelands

Opencast mining drastically alters the landscape due to complete vegetation suppression and removal of topsoil layers. Precise indicators able to address incremental changes in soil quality are necessary to monitor and evaluate mineland rehabilitation projects. For this purpose, metaproteomics may be a useful tool due to its capacity to shed light on both taxonomic and functional overviews of soil biodiversity, allowing the linkage between proteins found in soil and ecosystem functioning. We investigated bacterial proteins and peptide abundance of three different mineland rehabilitation stages and compared it with a non-rehabilitated site and a native area (evergreen dense forest) in the eastern Amazon. The total amount of identified soil proteins was significantly higher in the rehabilitating and native soils than in the non-rehabilitated site. Regarding soil bacterial composition, the intermediate and advanced sites were shown to be most similar to native soil. Cyanobacteria and Firmicutes phyla are abundant in the early stages of environmental rehabilitation, while Proteobacteria population dominates the later stages. Enzyme abundances and function in the three rehabilitation stages were more similar to those found in the native soil, and the higher accumulation of many hydrolases and oxidoreductases reflects the improvement of soil biological activity in the rehabilitating sites when compared to the non-rehabilitated areas. Moreover, critical ecological processes, such as carbon and nitrogen cycling, seem to return to the soil in short periods after the start of rehabilitation activities (i.e., 4 years). Metaproteomics revealed that the biochemical processes that occur belowground can be followed throughout rehabilitation stages, and the enzymes shown here can be used as targets for environmental monitoring of mineland rehabilitation projects.

Nano-ligament combined with sports rehabilitation training on the therapeutic effect after ligament reconstruction

As for the postoperative treatment effect of joint reconstruction, researchers have recognized the following point of view: surgical treatment alone not only has many complications, but also the recovery of knee joint function in some patients is not ideal. The effect of ligament reconstruction depends not only on the level of operation, but also on the postoperative rehabilitation. In order to study the effect of the new nano ligament combined with sports rehabilitation training on the treatment effect of ligament reconstruction, strict method analysis and control experiment were carried out in this paper.This paper first studies the importance, significance and related research status of link reconstruction at home and abroad, and then studies the proprioception training rehabilitation methods, rood multi sensory stimulation promotion, Mrs lower limb training methods and so on. Based on the theoretical support of these methods, this paper carried out the experimental study on the influence of rehabilitation training on the therapeutic effect of ligament reconstruction and the experimental results. This paper innovated on the traditional rehabilitation training: using more technical experimental results and comparing the experimental results of this paper, setting more control groups than the traditional reference experiments. In order to achieve more in-depth research results.The results showed that at the early stage of recovery, the passive flexion of bilateral knee joints was also slightly limited. After 24 weeks of rehabilitation training, the passive flexibility angle of the injured side of the three patients increased from 84 degrees to 92 degrees, from 148 degrees to 154 degrees, and the maximum increase was 64 degrees. At the early stage of rehabilitation, it gradually decreases with the rehabilitation process, and finally tends to be stable, which shows that the effect of early rehabilitation is very obvious, and it proves that early rehabilitation is more important in the whole rehabilitation training.

대학 여자축구선수의 재활과정에 따른 심리적 변화와 극복전략: 근거이론적 접근

Purpose: This study aimed to discover psychological changes of female soccer athletes in college during the rehabilitation process for their successful recovery and seek solutions that can help them overcome their difficulties. Methods: The current research selected seven female soccer athletes registered in the College Women’s Soccer League who have had experiences of receiving rehabilitation from injury. The approach of Constructing Grounded Theory analyzed the obtained data through individual and focus group interviews. Result: Women soccer athletes had negative thoughts in the early stages of rehabilitation and at the same time experienced a cyclical psychological process in which they repeatedly put effort to think positive. In addition, they felt ambivalent feelings about their career. Their psychological changes in the middle of the rehabilitation process showed that the rehabilitation situation made them feel nervous, anxious, and pressured. However, they gradually gained confidence while recovering from injury and focused on their efforts to return. While they felt excited to return at the end of the rehabilitation process, the current study found ambivalent feelings derived from burden and pressure due to the anxiety about the recurrence. There were four dimensions to overcome difficulties as follows: 1) self-confidence improvement strategies and psychological overcoming such as positive thinking conversion; 2) physical overcoming such as training for return; 3) environmental support for professional programs to female athletes; and 4) social support from critical others. Conclusion: Female college soccer players went through various psychological changes in the rehabilitation process. We can see the conflict of ambivalent emotions that made them seriously consider their athletic careers. In the rehabilitation process, the psychological process of reducing or resolving the scope of these ambivalent emotions can serve as a vehicle to redefine one’s identity as an athlete. Therefore, professional sports psychological counseling and systematic support that contains the content based on this will be in need for athletes in the rehabilitation process.

Design, development, and evaluation of upper and lower limb orthoses with intelligent control for rehabilitation

World's ageing population, prevalence of chronic diseases, and shortage of healthcare resources have increased interest in home-based physical therapy and rehabilitation. However, the standard equipment is often too bulky and unsuited for home use. This paper presents the design, development, and evaluation of a set of wearable orthoses for home-based physical therapy. Originatively utilising miniature electromagnetic brakes, the system can deliver a low to moderate range of resistive torques suitable for isotonic, isometric, and open-chain resistance exercises. In human tests with the orthoses, low-level muscle activation and low- to moderate-level energy expenditure were achieved. This suggests the system's potential for use in a wide range of applications, including postoperative treatments for muscle injury and the early stages of rehabilitation, and tele-rehabilitation. The orthoses were integrated with a video game console to form a new research platform that can be used to study the effects of force haptics on muscle activation and energy expenditure in exergames. The data obtained aid the future development of exergame prescription standards.

Early Stage Rehabilitation for Strain Hamstring : A case report

The purpose of the study. This study's purpose is to report on the early stage physiotherapists' intervention on patients with hamstring strains as recommended in the early stage management of sports injuries.&#x0D; Materials and methods. This study is a case report from of a patient who has a hamstring strain with complaints of pain and decreased range of motion of the knee joint. Physiotherapists provide ultrasonic therapy with isometric contraction exercises on the hamstring muscles for 4 sessions for 2 weeks.&#x0D; Results. Ultrasound therapy and isometric contraction exercises increased the range of motion of the knee joint by 60% (active) and 50% (passive). Pain reduction also occurred by 83% for active motion pain and 80% for passive motion pain.&#x0D; Conclusions. The physiotherapy interventions with ultrasonic therapy and isometric contraction exercise therapy is in accordance with the early stage rehabilitation for the case of hamstring strains. With the interventions, the patient experienced a decrease in pain and an increase in Range of Motion from the knee joint

The Effect of Crank Length Changes from Cycling Rehabilitation on Muscle Behaviors.

Background Many sports and physical activities can result in lower limb injures. Pedaling is an effective exercise for lower extremity rehabilitation, but incorrect technique may cause further damage. To some extent, previous experiments have been susceptible to bias in the sample recruited for the study. Alternatively, methods used to simulation activities can enable parametric studies without the influence of noise. In addition, models can facilitate the study of all muscles in the absence of the effects of fatigue. This study investigated the effects of crank length on muscle behavior during pedaling. Methods Six muscles (soleus, tibialis anterior, vastus medialis, vastus lateralis, gastrocnemius, and rectus femoris), divided into three groups (ankle muscle group, knee muscle group, and biarticular muscle group), were examined under three cycling crank lengths (100 mm, 125 mm, and 150 mm) in the present study. In addition, the relationship between crank length and muscle biological force was analyzed with the AnyBody Modeling System™, a human simulation modeling software based on the Hill-type model. Findings. Based on inverse kinematic analysis, the results indicate that muscle activity and muscle force decrease in varying degrees with increases in crank length. The maximum and minimum muscular forces were attained in the tibialis anterior and vastus lateralis, respectively. Interpretation. Studying the relationship between muscle and joint behavior with crank length can help rehabilitation and treating joint disorders. This study provides the pedal length distribution areas for patients in the early stages of rehabilitation.

Depression after acute traumatic injuries in children

Introduction Acute traumatic injuries in children are diverse: skeletal trauma, traumatic brain injury (TBI), spinal injury (SCI), amputations, combined trauma and others. Severe injuries lead to severe disability and desadaptation of the child. It is known that children tolerate hard the awareness and acceptance of their new state.ObjectivesTo study emotional disorders after traumatic injuries in children at early stages of rehabilitation.Methods159 children up to 18 y.o.: 80 (TBI), 60 (SCI), 19 (amputation, skeletal injury, electro-trauma). Methods: psychopathological, psychological; scales, questionnaires.Results In children after severe and moderately severe TBI, depression was detected in 43% as a consequence of injury and recovery of mental activity. In children with SCI, depression was detected in 48% as a reaction to stressful situation. In children with amputation, severe skeletal injury, electro-trauma depression was in 60%, both as a consequence of organic recovery of mental activity and as a reaction to psycho-traumatic situation. In the acute period, children had comprehensive interdisciplinary rehabilitation. Neuropsychiatrist recommended neuropharmacotherapy with antidepressants from the group of serotonin reuptake inhibitors (sertraline), GABA preparations. For psychological support, gestalt correction techniques were used.ConclusionsAfter acute trauma, depression in children occupies a significant place in clinical picture. Genesis of depressive disorders can be caused both by organic damage to brain structures and by reaction to psychotraumatic situation. In order to improve rehabilitation effectiveness, to make patient’s returning to usual living environment easier as well as to improve the quality of life, interdisciplinary approach is needed since early stages of rehabilitation and after.

Options for the recovery of mental activity in children after acute brain damage

IntroductionChildren with acute brain damage make up a large group of patients who require multi-stage rehabilitation. Rehabilitation requires the creation of special conditions for psychiatric care and psychological and pedagogical correction of the consequences of severe damage to the nervous system.ObjectivesTo identify the options for mental activity during the restoration of the level of consciousness in children after acute severe brain damage.Methods210 children under the age of 18 with severe brain damage (traumatic brain injury, hypoxia, hydrocephalus). Clinical-psychopathological, pedagogical methods were used; additionally diagnostic scales, questionnaires.Results4 groups were formed: 1st 37 (18%) patients had manifestations of mental activity with physical, cognitive and social capabilities in the minimal consciousness “+” (a- / hyperkinetic mutism with emotional reactions, understanding of addressed speech); 2nd 67 (32%) - manifestations of physical and cognitive abilities with minimal consciousness “-” (a- / hyperkinetic mutism without reactions); 3rd 95 (40%) - only the manifestation of physical capabilities at the exit from the vegetative status. 4th 11 (10%) - a low manifestation of mental activity in the form of physical capabilities with a vegetative status.Conclusions4 variants of mental activity in children after acute severe brain damage have been identified: from minimal involuntary reactions or their absence in vegetative status to voluntary actions according to the instructions of an adult in minimal consciousness “+”. Taking into account the variability of mental activity helps to differentiate the methods of psychiatric and psychological-pedagogical assistance in the recovery of children already in the early stages of rehabilitation.

Diagnostic automated algorithms in neurodevelopmental disorders: Focus on automatic motor assessment

Difficulties in motor development are frequent and impairing. However, the assessment of these motor learning skills is difficult and limits early stage rehabilitation. Electronic sensors and algorithms can help to measure motor difficulties more easily and objectively. We will present a systematic review detailing these methods and challenges in Autism Spectrum Disorders (ASD). Electronic tablets, give access to handwriting features that are not usually evaluated in classical assessments. We describe how such digital features (in static, dynamic, pressure, and tilt domains) allow diagnosing dysgraphia and how they evolve during children development. From a finer analysis, three different clusters of dysgraphia emerge, longitudinal studies will allow to underline different patterns of development that seemingly require tailored remediation strategies. However, those digital features are not used in the context of conventional pen and paper therapies. It is possible to engage children with typical development in handwriting exercises by asking them to teach a robot to write. We implemented a long-term case study (20 sessions, 500 minutes in total) observing a child with severe Developmental Co-ordination Disorder who did not progress anymore with a classic pen and paper approach by enriching this setup with various training activities using real-time feedback loops (on tilt, pressure, dynamic, pauses). We show how this new method tackles previous child’s behaviour avoidances, boosting his motivation, and improving his motor and writing skills. This talk demonstrates how new motor digital features allow the implementation of innovative motor remediation interventions, which rely on fostering children’s personal characteristics and adaptation skills.DisclosureThe work presented in this talk was conducted during a PhD in computer science (funded by APHP and Paris 8 University, France). A company was funded by a PhD collaborator, dynamico.ch. The presenter does not have consultancy or financial connection with d