Effective Rehabilitation Research Articles

Exercise Barriers in Older Individuals with Alzheimer's Disease: A Cross-Sectional Study.

Background and Objectives: Defining the exercise habits of individuals with Alzheimer's Disease (AD) may help to determine optimal rehabilitation programs. This study aimed to investigate the physical and psychological parameters associated with exercise barriers in older individuals with AD, with the goal of informing more effective rehabilitation programs. Materials and Methods: A cross-sectional prospective study was conducted with 50 individuals with AD. The individuals were evaluated with the Exercise Benefit/Barriers Scale (EBBS), the Mini-Mental State Examination (MMSE), the Five Times Sit to Stand Test (FTSTS), the Barthel Index (BI), the Tampa Scale for Kinesiophobia (TSK), and the Hospital Anxiety and Depression Scale (HADS). Results: There was a significant positive correlation between age with EBBS-Exercise Barriers (r = 0.308; p = 0.029) and EBBS-Total Score (r = 0.295; p = 0.038). There were significant negative correlations between the time of diagnosis with EBBS-Exercise Benefits (r = -0.569; p = 0.000), EBBS-Exercise Barriers (r = -0.324; p = 0.022), and EBBS-Total Score (r = -0.508; p = 0.000). There was a positive correlation between MMSE and EBBS-Exercise Benefits (r = 0.465; p = 0.001), EBBS-Exercise Barriers (r = 0.471; p = 0.001) and EBBS-Total Score (r = 0.519; p = 0.000). There were significant positive correlations between FTSTS and EBBS-Exercise Barriers (r = 0.340; p = 0.016), and EBBS-Total Score (r = 0.280; p = 0.049). There were positive correlations between BI and EBBS-Exercise Benefits (r = 0.362; p = 0.010), EBBS-Exercise Barriers (r = 0.377; p = 0.007), and EBBS-Total Score (r = 0.405; p = 0.004). Conclusions: Exercise barriers/benefits were associated with cognition and post-diagnosis duration in individuals with AD. Individuals with lower physical function had lower exercise perception. In addition, living with relatives or caregivers led to better exercise benefit scores.

Ultrasound and Doppler Study in Assessing the Efficiency of Complex Rehabilitation in Patients with Diabetic Neuropathy

The aim of the work: to evaluate the effectiveness of exercise therapy, ozone therapy, physiotherapy equipment in outpatient rehabilitation and treatment of patients with diabetic neuropathy of the lower extremities from the standpoint of the International Classification of Functioning, Disability, and Health. When evaluating the effectiveness of a monthly course of rehabilitation treatment, changes in the vessels of the lower extremities are of great importance. We were able to prove a positive change in the vessels of the lower extremities after treatment with the rehabilitation complex using ultrasound Dopplerography. In the main group, an increase in the blood flow velocity in the vessels of the lower extremities by 20.5% was noted, and in the comparison group, an increase in the blood flow velocity of the lower extremities by 12.7% was noted. The effectiveness of rehabilitation was assessed based on a comparison of the achieved rehabilitation results with the initial indicators.

Relationship of Suicidal Tendencies and Drug Dependence: Analysis of Causes and Approaches to Prevention

The relevance of the article is due to the high mortality rate among drug addicts and the severe mental and social consequences of drugs. Understanding the causes and factors that contribute to suicidal behavior among drug addicts is key to developing effective prevention and rehabilitation programs. The author focuses on the alarming aspect of drug addiction — the high risk of suicidal tendencies among drug addicts. Drug addiction is often accompanied by severe mental disorders such as depression, anxiety disorders and post-traumatic stress disorder (PTSD). These disorders, in turn, increase suicidal thoughts and behavior. In the article, the author provides a scientific review of existing research on the relationship between drug addiction and suicidal thoughts and behavior. Based on a study of international experience, the importance of family and community support in preventing suicide attempts is noted. Based on the results obtained, conclusions are formulated based on reviews of psychological, social and biological factors contributing to suicide risk among drug addicts, aimed at evaluating existing suicide prevention programs among drug addicts. The main provisions and conclusions can be used when studying the issue of preserving the institution of family, noting the importance of family and public support in preventing suicide attempts. Drug addiction poses one of the most serious threats to the health and well-being of society.

AVALIAÇÃO DA FUNÇÃO PULMONAR E CAPACIDADE FUNCIONAL DE PACIENTES RECUPERADOS DE COVID-19 APÓS PROGRAMA DE REABILITAÇÃO PULMONAR: REVISÃO SISTEMÁTICA CRÍTICA

The effects of pulmonary rehabilitation on lung function and functional capacity of individuals who recovered from COVID-19 were analyzed systematically. A randomized clinical trial and three case series that compared lung function and functional capacity of individuals who contracted COVID-19 before and after undergoing pulmonary rehabilitation programs were included in this review. The bias analysis of the randomized clinical trial was performed using the Rob tool from Cochrane, while the analysis of the case series was performed using the Checklist for case series – Critical Appraisal tools for use in JBI Systematic Reviews. Of the 6,868 abstracts selected, 45 full-text articles were reviewed and only four met the inclusion criteria. In conclusion, both lung function and functional capacity of individuals cured of COVID-19 after undergoing a pulmonary rehabilitation program showed significant improvement.

Classification of Patients Based on Dyspnea and Desaturation During Exercise in Interstitial Lung Disease.

Dyspnea and desaturation during exercise are essential assessment items for pulmonary rehabilitation. Characterizing patients using these 2 factors may be important for providing more effective pulmonary rehabilitation. This study aimed to categorize subjects with interstitial lung disease (ILD) using dyspnea and desaturation at the end of the 6-min walk test (6MWT). This was a retrospective study including 230 stable subjects with ILD who underwent 6MWT in our out-patient department at a general hospital in Japan. The modified Borg scale and oxygen saturation determined by SpO2 at the end of the 6MWT were used for cluster analysis using the k-means method with k = 4. Subjects were classified into 4 characteristic clusters. SpO2 at the end of the 6MWT was lower in cluster 4 (80.5 ± 3.0%) than in clusters 1 (94.3 ± 2.0%), 2 (94.3 ± 1.9%), and 3 (87.9 ± 1.8%) and was lower in cluster 3 than in clusters 1 and 2. The modified Borg scale score at the end of the 6MWT was higher in clusters 2 (4 [3-8]), 3 (3 [0-9]), and 4 (4 [0-7]) than in cluster 1 (0.5 [0-2.0]) and was higher in cluster 2 than in cluster 3. Subjects with ILD were classified into 4 characteristic clusters using dyspnea and SpO2 at the end of the 6MWT. The 4 clusters are characterized as follows: Cluster 1 had mild desaturation and mild dyspnea; cluster 2 had mild desaturation and severe dyspnea; cluster 3 had both moderate desaturation and dyspnea, and cluster 4 had both severe desaturation and dyspnea. These classification data offer insight for individualized pulmonary rehabilitation for patients with ILD.

Characteristics and outcomes of reversible platypnoea-orthodeoxia syndrome in COVID-19 pneumonia.

Platypnoea-orthodeoxia syndrome (POS) is an uncommon clinical entity characterised by dyspnoea and platypnoea (oxygen desaturation that follows the assumption of an upright position from recumbency). Since the coronavirus disease 2019 (COVID-19) outbreak, increasing reports of COVID-19-related POS and its associated morbidity have been reported around the world. We aimed to study the characteristics of COVID-19-related POS and orthodeoxia (including associations leading to a more prolonged orthodeoxia), and the postdischarge functional outcomes of patients with COVID-19-related POS. An observational cohort study was conducted in a tertiary hospital that managed post-COVID-19 patients. Twenty-four participants with severe-to-critical COVID-19 disease/pneumonia and POS, who received inpatient pulmonary rehabilitation, were enrolled. Descriptive analysis of the data was performed to describe POS/orthodeoxia characteristics and functional outcomes in these participants. Correlation analyses were carried out to identify significant factors associated with a prolonged orthodeoxia. The mean duration of POS and orthodeoxia was 12.9 ± 8.3 days and 28.5 ± 14.6 days, respectively. All participants demonstrated resolution of POS and orthodeoxia by hospital discharge. On multivariable analysis, intensive care unit admission and maximal level of respiratory support were significantly associated with a prolonged duration of orthodeoxia. One participant was lost to follow-up. The remaining 23 participants achieved independence in self-care. With the exception of one patient, who was recovering from a hip fracture, the rest achieved independence in ambulation and independent community access. Resolution of orthodeoxia was observed in all our participants with COVID-19-related POS. Good functional outcome can be attained with timely and effective rehabilitation interventions.

Investigating combined acupuncture and transcranial direct current stimulation in patients with poststroke shoulder pain from China: protocol for a randomised controlled trial

IntroductionPoststroke shoulder pain is a common complication that severely affects the recovery of upper limb motor function. Acupuncture has positive analgesic effects in treating poststroke shoulder pain, and studies have...

Community-Based Exercise Programs Post Spinal Cord Injury Hospitalization: A Pilot Study for a Randomized, Multicenter, Double-Blind Controlled Setting.

This study explores the effectiveness of community-based exercise programs for individuals with spinal cord injury (SCI) following hospital discharge. Given the rising incidence of SCI, particularly in South Korea, and the associated long-term disabilities, the necessity for comprehensive post-discharge rehabilitation is paramount. The study focuses on a pilot randomized multicenter double-blind controlled trial, targeting SCI patients who have completed inpatient rehabilitation and are living in the community. The primary aim is to evaluate the impact of structured exercise programs on physical fitness, functional capacity, and overall recovery. The research introduces the SpinalFit program, a community-based intervention designed to enhance muscle strength, cardiopulmonary endurance, and mobility through a combination of aerobic and resistance training. This program addresses the critical need for safe and effective rehabilitation options outside the hospital setting, utilizing circuit training with resistance bands and body-weight exercises tailored to each participant's capacity. The study also investigates barriers to physical activity in the community for SCI patients and the potential role of community exercise centers in bridging this gap. Preliminary findings from this pilot trial are expected to provide valuable insights into optimizing exercise regimens for SCI patients, informing future large-scale studies and contributing to improved post-discharge rehabilitation strategies.

Experimental and Analytical Evaluation to Strengthened R.C Beams Using Ferrocement Under Torsion

The safety of structures around the globe represents a significant and pressing concern, underscoring the urgent need for the development and implementation of effective rehabilitation methods to ensure their continued functionality. Ferrocement has emerged as a durable method for the restoration of reinforced concrete (RC) structures, demonstrating resilience and versatility in addressing structural damage. A substantial body of research has been conducted to examine the mechanical properties of ferrocement, with a particular focus on its efficacy in reinforcing beams against a range of forces. In light of the limited understanding of the factors affecting the torsional strength of ferrocement-wrapped beams, it is imperative to conduct experimental investigations. The objective of this study is to evaluate and compare the torsional strength, angle of twist and crack development of different wrapping types using both analytical analysis and experimental data. The findings indicate that three-sided wrapping is an effective method for enhancing torsional behaviour, as evidenced by both experimental and analytical results. Furthermore, the utilization of styrene-butadiene rubber (SBR) as a connecting material has been demonstrated to be an effective method for maintaining cohesion across reinforced beams.

A multifunctional polyacrylonitrile fibers/alginate-based hydrogel loaded with chamomile extract and silver sulfadiazine for full-thickness wound healing

Most conventional wound dressings do not meet the clinical requisites owing to their limited multifunctionality. Herein, a bilayer wound dressing containing both hydrogel and fibrous structures with multifunctional features was developed for effective skin rehabilitation. Sodium alginate (SA)/gelatin (Gel) hydrogel comprising Matricaria chamomilla L extract and silver sulfadiazine (AgSD) drug as antibacterial agents was cross-linked using genipin and CaCl2. Then, the surface of the hydrogel was covered by electrospun polyacrylonitrile (PAN) nanofibers to fabricate a bilayer dressing. FESEM images revealed formation of continuous, smooth, and bead-free PAN nanofibers with excellent compatibility between hydrogel and fibers. The bilayer wound dressing exhibited satisfactory mechanical virtues including elastic modulus (2.4 ± 0.2 MPa), tensile strength (6.2 ± 0.5 MPa) and elongation at break (21.8 ± 1 %) as well as suitable swelling ratio. Such bilayer dressing revealed biodegradability, cytocompatibility and effective antibacterial performance against gram positive and gram negative strains. Release kinetics of AgSD drug followed a Fickian diffusion mechanism, ensuring sustained drug release. In vivo studies demonstrated bilayer dressing could promote rate of wound closure, re-epithelialization and collagen deposition, facilitating the replacement of damaged skin with healthy tissue. Such engineered wound dressing has a high potency for inducing skin repair and could be used in skin tissue engineering.

Effectiveness of Home-Based Cardiac Rehabilitation with Optimized Exercise Prescriptions Using a Mobile Healthcare App in Patients with Acute Myocardial Infarction: A Randomized Controlled Trial.

Despite the effectiveness of cardiac rehabilitation (CR), the actual participation rate in CR is low. While home-based CR offers a viable alternative, it faces challenges in participation due to factors such as a lack of self-motivation and fear of exercising without supervision. Utilizing a mobile healthcare application (app) during counseling may be an effective strategy for patients. Therefore, the aim of this study was to assess whether 6 weeks of home-based CR with exercise readjustment using a mobile app is an effective therapy for patients with acute myocardial infarction (AMI). Post-AMI patients eligible for home-based CR were randomized into the intervention group (CR-Mobile) and the control group, which followed the usual home-based CR protocol (CR-Usual). Both groups participated in a 6-week home-based CR program, with exercise readjustment and encouragement carried out every 2 weeks. The CR-Mobile group was supervised using data recorded in the mobile app, while the CR-Usual group was supervised via phone consultations. The primary outcome measured was maximal oxygen consumption (VO2max). Within-group comparisons showed significant improvements in VO2max (PCR-Mobile = 0.011 vs. PCR-Usual = 0.020) and METs (PCR-Mobile = 0.011 vs. PCR-Usual = 0.011) for both groups. These findings suggest that a 6-week home-based CR program with exercise readjustment using a mobile app can potentially enhance exercise capacity as effectively as verbal supervision.

The influence of rehabilitation on the quality of life after radical treatment of endometrial cancer and atypical endometrial hyperplasia

Background. Gynecological cancers in women are a widespread type of oncology. Among them, endometrial cancer (EC) is often highlighted as one of the most common diseases in this group. The analysis of publications showed insufficient effectiveness of rehabilitation in patients with EC and recurrent atypical endometrial hyperplasia (rAEH).Objective: to compare the state of patients with rAEH or EC after hysterectomy with bilateral salpingo-oophorectomy, depending on the recovery tactics.Material and methods. The study included 119 patients diagnosed with rAEH (n=58) or stage IA EC (n=61) after hysterectomy with bilateral salpingo-oophorectomy. The group of women with rAEH was divided into two subgroups: 1A (“active” rehabilitation, n=27) and 1B (“passive” rehabilitation, n=31); two subgroups were also formed from the cohort of EC patients: 2A (“active” rehabilitation, n=29) and 2B (“passive” rehabilitation, n=32). “Active’ rehabilitation included a comprehensive, personalized program, “passive” one was based on standard rehabilitation protocols. Apart from standard clinical examination of patients, their quality of life (QoL), physical condition as well as the levels of cytokines and other biochemical blood parameters were assessed.Results. An analysis of the overall picture showed a high incidence of rAEH or EC in women aged 40–49 years. Comorbid pathologies, low QoL level and a number of significant changes in laboratory parameters were often observed. Regardless of the approach to rehabilitation, the patients' health improved over the course of 12 months. “Active” rehabilitation significantly improved psychological well-being, sexual function, overall QoL and a number of other objective health indicators of patients with rAEH or EC compared to standard rehabilitation course.Conclusion. The overall picture of rAEH or EC patients was presented, the main factors that reduce QoL in women with these diseases were identified. A system of integral QoL assessment in patients with rAEH or stage IA EC was developed including subjective and objective parameters obtained during general clinical examination, laboratory tests and analysis of questionnairing results, which should be used to adequately monitor the state of patients after surgery and the effectiveness of rehabilitation. The advantage of comprehensive rehabilitation over standard protocols in terms of efficiency and speed of recovery was shown.

Effect of Cardiac Rehabilitation on Cardiorespiratory Fitness in Patients With Acute Myocardial Infarction: Role of Diabetes Mellitus and Glycated Hemoglobin Level.

Following acute myocardial infarction (AMI), patients with diabetes mellitus (DM) have a poorer prognosis than those without DM. This study aimed to investigate the benefit of cardiac rehabilitation on cardiorespiratory fitness in patients with AMI, examining whether this effect varied depending on DM and glycated hemoglobin (HbA1c) levels. Data were collected from the medical records of 324 patients diagnosed with AMI who were subsequently referred to participate in a supervised exercise-based cardiac rehabilitation program. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing before and at 3 and 6 mo after the start of cardiac rehabilitation. Linear mixed models were used to evaluate changes in cardiorespiratory fitness between patients with and without DM during the follow-up period. In total, 106 patients (33%) had DM. Both patients with and without DM showed a significant improvement in cardiorespiratory fitness from baseline to the 6-mo follow-up. However, the improvement was significantly lower in patients with DM than in those without DM (1.9±1.5 vs. 3.7±3.2 mL/kg/min, P <.001). Among patients with DM, those with HbA1c levels<7% showed a greater improvement in cardiorespiratory fitness than those with HbA1c≥7% (2.7±1.5 vs. 1.1±1.8 mL/kg/min, P <.001) during the follow-up period. Improvements in cardiorespiratory fitness following cardiac rehabilitation were significantly lower in patients with AMI and DM. The response to cardiac rehabilitation in patients is influenced by HbA1c levels. These findings suggest potential implications for individualizing cardiac rehabilitation programming and ensuring optimal glycemic control in patients with AMI and DM.

EFFECTIVENESS OF THE ADHEAR BONE CONDUCTION DEVICE FITTED BILATERALLY IN A CHILD WITH CONDUCTIVE HEARING LOSS: CASE STUDY

IntroductionFrequently, bone conduction hearing aids on a softband are not tolerated by children due to pressure on the head or visual esthetics. By way of contrast, a non-surgical hearing system – Adhear (Med-El, Innsbruck, Austria) – allows the sound processor to be attached using a noninvasive adhesive adapter. The objective of this study was to evaluate the effectiveness of the Adhear system and assess its subjective benefits in a child who had bilateral conductive hearing loss.Case reportThe Adhear system was tested in a 13-year-old child with bilateral conductive hearing loss. Pure tone audiometry and speech audiometry in quiet were performed without and then with a pair of devices placed bilaterally. Word recognition scores (WRS) at 50 and 65 dB SPL in quiet were measured using the Pruszewicz monosyllabic Polish word test. After 4 weeks, subjective hearing benefit and experience with the Adhear system was done using the APHAB (&lt;i&gt;Abbreviated Profile of Hearing Aid Benefit&lt;/i&gt;) questionnaire.ResultsWith Adhear, WRS at 50 dB SPL increased significantly from an unaided score of 10% to 80%. The result of free-field audiometry with Adhear on both sides indicated a hearing level within the normal range.ConclusionsAdhear is an effective rehabilitation option for children with bilateral conductive hearing loss.

Effects of ankle joint degree of freedom of knee–ankle–foot orthoses on loading patterns and triceps surae muscle activity on the paretic side in individuals with subacute severe hemiplegia: a retrospective study

BackgroundIndividuals with subacute severe hemiplegia often undergo alternate gait training to overcome challenges in achieving walking independence. However, the ankle joint setting in a knee–ankle–foot orthosis (KAFO) depends on trunk function or paralysis stage for alternate gait training with a KAFO. The optimal degree of ankle joint freedom in a KAFO and the specific ankle joint conditions for effective rehabilitation remain unclear. Therefore, this study aimed to investigate the effects of different degrees of freedom of the ankle joint on center-of-pressure (CoP) parameters and muscle activity on the paretic side using a KAFO and to investigate the recommended setting of ankle joint angle in a KAFO depending on physical function.MethodsThis study included 14 participants with subacute stroke (67.4 ± 13.3 years). The CoP parameters and muscle activity of the gastrocnemius lateralis (GCL) and soleus muscles were compared using a linear mixed model (LMM) under two ankle joint conditions in the KAFO: fixed at 0° and free ankle dorsiflexion. We confirmed the relationship between changes in CoP parameters or muscle activity under different conditions and physical functional characteristics such as the Fugl–Meyer Assessment of Lower Extremity Synergy Score (FMAs) and Trunk Impairment Scale (TIS) using LMM.ResultsAnterior–posterior displacement of CoP (AP_CoP) (p = 0.011) and muscle activity of the GCL (p = 0.043) increased in the free condition of ankle dorsiflexion compared with that in the fixed condition. The FMAs (p = 0.004) and TIS (p = 0.008) demonstrated a positive relationship with AP_CoP. A positive relationship was also found between TIS and the percentage of medial forefoot loading time in the CoP (p < 0.001).ConclusionsFor individuals with severe subacute hemiplegia, the ankle dorsiflexion induction in the KAFO, which did not impede the forward tilt of the shank, promotes anterior movement in the CoP and muscle activity of the GCL. This study suggests that adjusting the dorsiflexion mobility of the ankle joint in the KAFO according to improvement in physical function promotes loading of the CoP to the medial forefoot.

The Impact of Exercise-Based Rehabilitation on ACL Patients: A Comprehensive Review in the Context of China’s Healthcare System

This journal review investigates the effectiveness of exercise-based rehabilitation in assisting ACL patients to return activity level. The main objective of this review is to analyze how exercise-based rehabilitation influences recovery for ACL clients within a Chinese healthcare system. The specific exercise-based rehabilitation that were investigated as part of the study included Nordic, hamstring exercises, aquatic workouts; suspension training and lastly eccentric isokinetic. The outcome factors for ACL healing were improved muscle strength and proprioception, remarkable functional stability levels, regain of full range of motion as well free of pain and reduced risk to re-injury. The retrieval of relevant scholarly sources were gathered from extensive use online databases and publications. The results of the research showed that exercise rehabilitation programs contributed to successful treatment of ACL injuries in Chinese patients. The literature has indicated that aquatic exercises and Nordic hamstring have proved to be successful in enhancing the muscle strength, proprioception among Chinese ACL patients. In addition, suspension training led to the improvement of functional stability and return-to play. Secondly, the study results indicated that rehabilitation training was appropriate for relieving pain and enhancing ROM in people with ACL injuries. Lastly, eccentric kinetic exercise was proven effective in decreasing the chances of re-injury and as a physical activity post injury. Recommendations in the study include targeted exercise-based rehabilitation therapies, and as required instituting combined exercise treatment among patients with ACL.

Examining Perceptions and Attitudes of Prison Visitation on Behavior Change and Recidivism in Nairobi County, Kenya

This study investigates the impact of prison visitation on perceptions, attitudes, behavior change, and recidivism rates among incarcerated individuals. Utilizing a mixed-methods approach, data was gathered through surveys, interviews, and official records from a sample of incarcerated individuals and their visitors. The analysis focused on understanding the role of visitation in shaping attitudes towards rehabilitation and family support and its influence on post-release behavior. Findings reveal a significant correlation between the frequency and quality of visitation and positive behavioral changes among inmates. Inmates who received regular visits reported higher levels of motivation for rehabilitation, improved mental health, and increased feelings of connection with their families and communities. Moreover, visitation played a pivotal role in strengthening family bonds and social support networks, which are crucial factors in successful reintegration post-release. Furthermore, the study explored the perceptions and experiences of both inmates and visitors regarding the visitation process, including logistical challenges, emotional dynamics, and barriers to maintaining contact. Understanding these perspectives is essential for enhancing visitation programs and addressing systemic issues that hinder family engagement in the correctional system. The study also examined recidivism rates among participants and found a notable decrease among those who received frequent and meaningful visitation compared to those who did not. These findings underscore the significance of visitation programs in reducing recidivism and promoting successful reentry into society. In conclusion, this research highlights the importance of fostering supportive relationships through visitation programs to facilitate positive behavior change and reduce recidivism rates among incarcerated individuals. Implementing policies that prioritize and improve access to visitation can contribute to more effective rehabilitation efforts and ultimately lead to safer communities.

Diagnostic value of miR-34a in Mycoplasma pneumoniae pneumonia in children and its correlation with rehabilitation effect

BackgroundMycoplasma pneumoniae pneumonia (MPP) is responsible for 20 to 40% of all cases of pneumonia acquired by children and shows an increasing incidence year by year. The aim of this study was to investigate the expression of miR-34a in children with MPP and its diagnostic value, and further explore the relationship between miR-34a and the rehabilitation effect of children with MPP.MethodsThe expression level of miR-34a was detected by RT-qPCR, and the clinical value of miR-34a was analyzed by ROC analysis. In addition, the levels of IL-6, IL-18 and TNF-α in serum of children with MPP were detected by ELISA kit, and the correlation with miR-34a was analyzed.ResultsElevated levels of miR-34a were observed in the serum of children with MPP, and significantly higher expression levels were observed in children with severe symptoms and poor rehabilitation. The study suggested that miR-34a has potential as a diagnostic marker for MPP in children, helping to distinguish between mild and severe cases and predicting rehabilitation from MPP in children. In addition, miR-34a expression was positively correlated with IL-6, IL-8, and TNF-α levels.ConclusionsmiR-34a is closely related to MPP in children and miR-34a may be used as a clinical biomarker for MPP in children.

Технологии виртуальной реальности в терапии постинсультных эмоциональных расстройств

AIM. To evaluate psychoemotional status and the influence of affective, motivational and asthenic disorders on the efficiency of rehabilitation using virtual reality technologies in patients in the acute period of ischemic stroke. MATERIAL AND METHODS. 160 patients diagnosed with ischemic stroke were examined. Depending on the volume of therapy, the patients were divided into two groups: the 1-st group – 80 patients who received therapy using virtual reality (VR) technologies in addition to basic therapy and standard methods of early rehabilitation; the 2-nd group – 80 patients who received only basic therapy and standard methods of early rehabilitation. Neuropsychological testing was performed on the 4-th day of hospitalisation using scales to assess cognitive function, apathy, aggression, asthenia, depression, and anxiety. From the 5-th day of hospitalisation, patients in the 1-st group underwent VR-therapy for 10 days with evaluation of the dynamics of the main psychoemotional parameters and their impact on the effectiveness of rehabilitation (Δ RE). RESULTS AND DICUSSION. All patients had subclinical depression, clinically expressed anxiety, moderate levels of physical, mental, general asthenia, apathy and physical aggression with prevalence of physical asthenia and the combination of depression/physical aggression in the 1-st group of patients. The greatest comorbidity was found with respect to depression, physical asthenia, anxiety and physical aggression scores. Significant improvement was demonstrated with respect to all indicators except the level of apathy and mental asthenia in both groups and general asthenia in the 2-nd group after therapy. A more significant regression was found with regard to anxiety, general aggression, mental and physical asthenia in the 1-st group of patients. The negative correlation of Δ RE with the level of apathy and the combination of apathy/depression indicated a negative impact of these disorders on the effectiveness of VR - rehabilitation. Positive correlations of Δ RE with the parameters of physical aggression and the combination of anxiety/physical aggression show the expediency of VR-therapy in the rehabilitation of patients with a high level of these emotional disorders. CONCLUSION. The positive effect of VR-intervention on the regression of anxiety, asthenic and aggressive post-stroke disorders determines the prospect of introducing this method into the program of early rehabilitation of patients with ischemic stroke. KEYWORDS: ischemic stroke, emotional disorders, virtual reality, rehabilitation

Effectiveness of Pulmonary Rehabilitation with Exercise Training in Improving Health Outcomes for Patients with Chronic Obstructive Pulmonary Disease

Effectiveness of Pulmonary Rehabilitation with Exercise Training in Improving Health Outcomes for Patients with Chronic Obstructive Pulmonary Disease