Efficiency Of Rehabilitation Research Articles

Rehabilitation for Patients with COVID-19: A Japanese Single-center Experience.

ABSTRACTObjectives:The aim of the study was to describe the characteristics and efficiency of rehabilitation for patients diagnosed with moderate-to-severe coronavirus disease (COVID-19).Methods:We retrospectively assessed the medical records of patients with COVID-19 who underwent rehabilitation for early mobilization and to maintain activities of daily living at our hospital between April 21 and August 20, 2020. The following patient data were evaluated: age, sex, diseases, and the total number of sessions completed by patients with severe COVID-19 in the intensive care unit (ICU) and by patients with moderate disease in the general COVID-19 wards. The number of daily sessions performed by physiotherapists was also evaluated.Results:Of 161 patients with COVID-19 admitted during the study period, 95 underwent rehabilitation (78 in the general COVID-19 wards and 17 in the ICU). These 95 COVID-19 patients completed 1035 rehabilitation sessions in total (882 in the general ward and 153 in the ICU). Polymerase chain reaction test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were positive for 79 patients on the initiation of rehabilitation. Moreover, 86 sessions were supervised remotely, thereby reducing the duration of the medical staff’s stay in the SARS-CoV-2 isolation area. Patients with COVID-19 in the ICU received significantly more daily physiotherapy sessions than general ward patients (P<0.001). Each physiotherapist performed, on average, 4.6 sessions daily, with 4.3 daily sessions being performed wearing personal protective equipment (PPE).Conclusions:COVID-19 rehabilitation required more efforts as wearing PPE was necessary for most cases although tried with remote rehabilitation in some cases. Overall, a longer rehabilitation period was needed for ICU patients.

Impact of short-term physical prehabilitation on psychophysiological parameters in patients undergoing coronary artery bypass grafting

Aim.To study psychophysiological parameters in the patients undergoing coronary artery bypass grafting (CABG) who optionally underwent a short course of physical prehabilitation (PPR).Materials and Methods.We carried out a prospective randomised study which included 97 male patients (45 to 70 years) with coronary artery disease who underwent elected CABG; 47 of them additionally underwent a 5-7-day course of aerobic physical training before the surgery. Both patient groups were comparable with respect to the baseline clinicopathological features. Neuropsychological examination and electroencephalography was performed before the surgery and at 7th-10th day after CABG. Development of postoperative cognitive dysfunction (POCD) was considered as the study endpoint.Results.POCD developed in 58% patients with PPR and in 78.7% patients without PPR (p = 0.037); therefore, the risk of developing POCD in those who underwent PPR was lower (OR=0,39, р=0,045). Further, patients with PPR showed an increase in integral attention value relative to the preoperative state (p = 0.04) while those without PPR demonstrated a decrease in this cognitive parameter (p = 0.03). Integral attention value and general cognitive status remained higher in patients with PPR than in those without (p = 0.048 and p = 0.048, respectively) at 7th-10th day after CABG. The theta1 rhythm power increase was higher in patients without PPR at 7th-10th day after CABG (p = 0.01).Conclusion.The patients with a short preoperative course of PPR had better indicators of electrical cortical activity and higher integral cognitive value in the early postoperative period after CABG than those without training. Short course of PPR before CABG can increase the resistance of the brain to the intraoperative injury and may reduce the severity of the cognitive impairment after cardiac surgery. Indicators of brain electrical activity can be informative to evaluate the efficiency of cardiac rehabilitation

Economic evaluation in oral health: rehabilitation of a single prosthetic space

Objective: To evaluate the allocative efficiency, financial impact, and cost-effectiveness of rehabilitation of a single tooth by means of a 3-unit fixed dental prosthesis and of a dental implant from the perspective of the Commercial Social Service - SESC (“Serviço Social do Comércio”). Methods: An economic analysis of the cost-effectiveness type was designed. A Markov model was developed to capture long-term clinical and economic outcomes considering the temporal horizon of 25 years. Results: Within this temporal horizon it would be possible to perform 308 more procedures with a saving of R$ 351,737.49, if rehabilitation by means of the one-unit implant were chosen. Conclusion: The implant technique with an implant and an implant-supported prosthesis was dominant; that is, it had lower cost and higher effectiveness and its allocative efficiency allowed a much higher number of persons to have access to treatment.

Benefits of robotic devices in medical rehabilitation of a case with neurofibromatosis type1

The term neurofibromatosis (NF) describes a group of genetic disorders that primarily affect the cell growth of neural tissues. Three clinically and genetically distinct forms of neurofibromatosis have been described: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis. The inheritance pattern is autosomal dominant for all three types. We present the case of a 57 years old man, admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, who was diagnosed with spastic tetraparesis, neurofibromatosis type 1, chronic viral hepatitis B and D, hypercholesterolemia, sarcopenia and osteoporosis. The objectives of the rehabilitation treatment were combating pain; preventing and correcting vicious postures at rest and during activity; maintaining or increasing joint mobility; increasing the mobility of the cervical and lumbar spine; decreasing spasticity; increasing strength of paralyzed muscles; improving motor control of paralyzed limbs; transfers re-education, gait re-education; improving breathing; improving ADLs; maintaining autonomy; gaining daily independence; prevention of recurrent complications and increasing the quality of life. The rehabilitation treatment was complex, performed over a period of 2 weeks and included various physiotherapy approaches, hydrokinetotherapy, massage, occupational therapy, robotic devices and virtual reality. It improved the patient's functional independence and quality of life. Innovations in information technology will refine and increase the efficiency, expertise and competence of medical rehabilitation, in order to ensure comfort for the patient and an appropriate and safe therapeutic approach. Keywords: neurofibromatosis, robotic devices, medical rehabilitation,

PhyMDAN: Physics-informed knowledge transfer between buildings for seismic damage diagnosis through adversarial learning

Automated structural damage diagnosis after earthquakes is important for improving efficiency of disaster response and city rehabilitation. In conventional data-driven frameworks which use machine learning or statistical models, structural damage diagnosis models are often constructed using supervised learning. Supervised learning requires historical structural response data and corresponding damage states (i.e., labels) for each building to learn the building-specific damage diagnosis model. However, in post-earthquake scenarios, historical data with labels are often not available for many buildings in the affected area. This makes it difficult to construct a damage diagnosis model. Further, directly using the historical data from other buildings to construct a damage diagnosis model for the target building would lead to inaccurate results. This is because each building has unique physical properties and thus unique data distribution.To this end, we introduce a new framework, Physics-Informed Multi-source Domain Adversarial Networks (PhyMDAN), to transfer the model learned from other buildings to diagnose structural damage states in the target building without any labels. This framework is based on an adversarial domain adaptation approach that extracts domain-invariant feature representations of data from different buildings. The feature extraction function is trained in an adversarial way, which ensures that extracted feature distributions are robust to variations of structural properties. The feature extraction function is simultaneously jointly trained with damage prediction function to ensure extracted features being predictive for structural damage states. With extracted domain-invariant feature representations, data distributions become consistent across different buildings. We evaluate our framework on both numerical simulation and field data collected from multiple building structures. The results show up to 90.13% damage detection accuracy and 84.47% damage quantification accuracy on simulation data, and up to 100% damage detection accuracy and 69.93% 5-class damage quantification accuracy when transferring from numerical simulation data to real-world experimental data, which outperforms the state-of-the-art benchmark methods.

Aerobic physical training improves skeletal muscle metabolism in heart failure patients

Abstract Purpose To evaluate the efficiency of aerobic physical rehabilitation (PR), selected on the basis of lactate threshold achievement during cardiopulmonary exercising test (CPET), in heart failure patients with normal body mass index (BMI); to study metabolism changes in skeletal muscle fibers (MF) after PR. Methods 100 patients; heart failure with reduced ejection fraction (HFrEF), NYHA III, mean age 52±5.2 years, ejection fraction (EF) 27.3±4.2%, BMI 23.5±2.8 kg/m2. The original estimated CPET, exercise tolerance (ET), quality of life (QOL) and echocardiography (EchoCG). Effects of physical rehabilitation were estimated on the basis of peak oxygen uptake (VO2peak), EF, QOL and ET dynamics after 6 months of training. Shin muscle biopsy was performed at baseline and after 3–6 months of training programm. In muscle samples activity of lactate dehydrogenase (LDH), succinate dehydrogenase (SDG) and alkaline phosphatase (AP) was evaluated with plag-method. Data were statistically processed using software package Statistika, 9.0. Results After 6 months of physical training ET increased by 9.7±0.5 points and QOL improved by 24.8±3.5 points (p1,2 &amp;lt;0.05), EF increased by 10.5±2.3% and VO2 peak increased by 5.2±0.5 ml/min/kg (p3,4 &amp;lt;0.05). After 3–6 months of training AP activity increased by 24.2% (p&amp;lt;0.05). LDH activity in glycolytic MF decreased by 24.4%, in oxidative MF it decreased by only 6.0% (p1 &amp;lt;0.05, p2&amp;gt;0.05). SDG activity in glycolytic MF increased by 30% and in oxidative – by 20% (p1,2 &amp;lt;0.05). There was a positive relation between SDG activity and VO2 peak dynamics (r=0.6, p=0.04), increase in CPET parameters was associated with AP activity (r=0.5, p=0.05). Conclusion Aerobic physical training in stable HFrEF patients with normal BMI was effective in improving values of EF, VO2 peak, QOL and ET; Participating in the rehabilitation program decreased LDH activity in both oxidative and glycolytic muscle fibers; it also significantly increased AP activity and SDG activity in both oxidative and glycolytic MF. This may indicate a decrease in glycolytic metabolism activity and aerobic metabolism activation; The relation between the increase in exercise tolerance and endothelium condition marker (AP activity in muscle tissue), SDG activity and VO2 peak dynamics has been revealed. Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): Project was partially funded by the Russian Science Foundation grant 16-15-1017

Multidisciplinary principle of management in stroke patients. Criterions of efficiency and factors of successful rehabilitation

The article is devoted to the principles and features of the multidisciplinary team’s activity which are providing the adequate maintaining in stroke patients. The principles of carrying out, advantages and risks of early rehabilitation and early verticalization are considered. The main principles of physical rehabilitation are analyzed also.

Modern Opportunities of Medical Rehabilitation of Children with Chronic Constipation

This article reviews the methods of medical rehabilitation used in the complex treatment of children with chronic constipation. Medical rehabilitation of children with chronic constipation is a complex system of measures that include rational nutrition, medication therapy, physiotherapy, kinesotherapy, massage, etc. The main objectives of the medical rehabilitation of children with chronic constipation are normalization of the passage through the intestines, improvement of tone of the pelvic floor muscles, restoration of the defecation reflex. The article describes the methods of physiotherapy used in the treatment of chronic constipation in children in combination with diet, daily regimen, drug treatment, physiotherapy exercises and massage: amplipulse therapy, interference therapy, ultrasound therapy, percutaneous electroneurostimulation, fluctotuorization, high-intensity magnetic therapy, transient transduction. The methods of balneotherapy are widely used: the internal and external use of mineral waters, as well as heat therapy and peloidotherapy. Natural and artificial physical factors are assigned differentially, taking into account the type of intestinal motility disorder. One of the promising directions of modern physiotherapy is to study the combined and combined use of two physical factors that increase the effectiveness of the medical rehabilitation program for children with chronic constipation. Methods of medical and psychological correction are of great importance in the medical rehabilitation of children with chronic constipation. The medical rehabilitation of children with chronic constipation is carried out taking into account the individual program of medical rehabilitation of the child, which makes it possible to increase the efficiency of medical rehabilitation and the patient’s quality of life.

Comorbidity Development in Patients with Severe Brain Injury Resulting in Chronic Critical Condition (Review)

Advances in intensive care have enabled patients to survive an acute critical condition, producing a growing population of patients in a chronic critical condition with long-term dependence on intensive care. These patients make up 5–10% of all patients with acute respiratory failure and require a disproportionate share of resources in the intensive care units, with an overall yearly survival rate of 40–50%. The aim of review is to identify the impact of comorbid complications on the course and outcome of patients with severe brain injury. Ninety-six sources were selected according to the data characterizing the clinical (syndromic) model of the patient with consciousness disorders after coma of different etiologies. This model takes into account the stages and phases of the syndrome as well as a number of comorbid conditions that determine the course and outcome of the disease. The list of sources includes papers addressing the issues of comorbidity in patients with brain injury and conditions such as strokes, consequences of severe brain injury and brain surgery. The sources reflecting the most significant mechanisms of consistent development of comorbidities were examined. These include metabolic disorders with subsequent protein and energy deficiency and comorbidities of the gastrointestinal tract. The role of microbiome in the development of comorbidity in patients in chronic critical condition was also identified. C onclusion. The comorbidity development starts from the moment of brain injury and extends until sustained stabilization or multi-organ failure and death. Timely detection and correction of comorbidities allows optimizing treatment and increasing efficiency of rehabilitation in patients with severe brain injury.

Telemedicine as a perspective instrument for developing mobile rehabilitation technology (on the example of FNKC RR)

Among the innovative technologies of medical care for citizens with impaired consciousness, a special place is occupied by the technology of mobile rehabilitation service (MRS), with the help of which a wide range of patients are served at home, and their relatives and friends receive extensive counseling. The practice of the Federal State Budgetary Institution Federal Scientific and Clinical Center for Resuscitation and Rehabilitation indicates the high efficiency of mobile rehabilitation in this category of patients. Positive experience can be developed, incl. due to the use of telemedicine after completion of the main rehabilitation course. The methodology, in which online sessions and consultations are conducted using video conferencing technology, can significantly increase the territorial coverage of MRS patients, and ensure the continuity of rehabilitation. A special place is given to the interaction of a speech therapist with patients and their relatives, in the framework of which the course of medical and social rehabilitation is continuing. It is stated that the use of telemedicine contributes to the development of remote rehabilitation of handicapped patients with impaired consciousness at home. The accumulated experience allows us to recommend the extensive use of a combination of technologies of MPC and telemedicine, thereby greatly expanding the rehabilitation potential of a significant number of patients at home. It seems expedient to scale up and replicate the experience of MRS FNKC RR within the framework of medical rehabilitation institutions in the country, as well as to raise discussion about the possibilities of expanding the practice of distance counseling and receptions to other stages of mobile rehabilitation.

Study of the Clinical Efficiency of an Interdisciplinary Approach to the Treatment of Orofacial Pain and Temporomandibular Joint Disorders in Patients with Complete or Partial Edentulism.

Objective The aim of this study is to improve the safety and efficiency of prosthodontic treatment of patients with dental defects. It is necessary to perform a comprehensive assessment of the dentofacial system disorders, including the analysis of the features of pain manifestations. This study also supports to improve the efficiency of prosthodontic rehabilitation of patients with complete dental reconstruction on the basis of an assessment of the severity of orofacial pain manifestations. Materials and Methods The study was a single-site prospective open nonrandomized study with the examination and treatment of 452 patients (age = 44.3 ± 15.2 years, including 282 men and 170 women) with partial or total edentulism. The patients were divided into two groups: group 1 (control) of 218 patients treated with a standard prosthodontic approach and group 2 (study) of 234 patients treated which the proposed interdisciplinary approach to prosthodontic rehabilitation. Results The study establishes higher safety and clinical efficiency of the proposed interdisciplinary approach. The patients undergoing full-mouth reconstruction with the use of the interdisciplinary approach demonstrated statistically significant decrease in the rate of pain in muscles of the maxillofacial area on palpation, pain, and spasms in the neck area, statistically significantly less frequent pains in the temporomandibular joint (TMJ) during chewing, pain during opening and closing the mouth. Conclusion The application of the developed comprehensive approach to prosthodontic rehabilitation planning makes it possible to improve essentially the results of treatment at the expense of reduction of pain manifestations in the area of maxillofacial muscles and pain sensations associated with functioning of the TMJ.

General learning ability in perceptual learning

Developing expertise in any field usually requires acquisition of a wide range of skills. Most current studies on perceptual learning have focused on a single task and concluded that learning is quite specific to the trained task, and the ubiquitous individual differences reflect random fluctuations across subjects. Whether there exists a general learning ability that determines individual learning performance across multiple tasks remains largely unknown. In a large-scale perceptual learning study with a wide range of training tasks, we found that initial performance, task, and individual differences all contributed significantly to the learning rates across the tasks. Most importantly, we were able to extract both a task-specific but subject-invariant component of learning, that accounted for 38.6% of the variance, and a subject-specific but task-invariant perceptual learning ability, that accounted for 36.8% of the variance. The existence of a general perceptual learning ability across multiple tasks suggests that individual differences in perceptual learning are not "noise"; rather, they reflect the variability of learning ability across individuals. These results could have important implications for selecting potential trainees in occupations that require perceptual expertise and designing better training protocols to improve the efficiency of clinical rehabilitation.

Co-Located or Freestanding Multi-Trauma Orthopedic Rehabilitation.

Multi-trauma rehabilitation is delivered in a variety of hospital settings. However, it is unclear whether the proximity of rehabilitation to acute services has an effect on rehabilitation outcomes. To evaluate whether the primary outcomes of an inpatient multi-trauma rehabilitation program (functional outcome and length of rehabilitation stay) are impacted when rehabilitation is delivered in a unit co-located in an acute hospital compared with a unit located in a freestanding hospital. To also compare these outcomes at a national level using data provided by the Australasian Rehabilitation Outcomes Centre (AROC). Observational, retrospective audit study. An inpatient, orthopedic, multi-trauma rehabilitation unit that re-located from an acute co-located facility to a freestanding facility. Patients following multi-trauma injury admitted to the co-located rehabilitation unit (n = 216) or after its relocation to the freestanding rehabilitation unit (n = 186). Data were audited from the patients' hospital medical records including demographics, injury characteristics, and rehabilitation outcome measures (Functional Independence Measure [FIM] and length of rehabilitation stay). The primary outcome variables were motor FIM change (change in function between admission and discharge), FIM efficiency (functional gain per inpatient day), and length of rehabilitation stay. There were no statistically significant differences between the two settings in terms of motor FIM change (adjusted for admission motor FIM score) and motor FIM efficiency. In general, there was no statistically significant difference in length of rehabilitation stay between settings (median: 26 vs 27 days). At a national level, the majority of facilities offering inpatient multi-trauma rehabilitation are co-located. Nationally, freestanding units resulted in a slightly greater motor FIM change (difference between median changes adjusted for baseline = -.5, 95% confidence interval [CI] = -2.5, -0.6, P = .0012). There were no differences observed in outcomes between multidisciplinary rehabilitation programs in either setting. Optimizing the individual components of a rehabilitation program and improving staff skill sets should be a focus going forward.

Адаптивная физическая культура и спорт в системе комплексной реабилитации и абилитации инвалидов Костромской области

The article is devoted to the problem of active introduction of adaptive physical culture and sports as the means of comprehensive rehabilitation of people with disabilities. The paper highlights the experience of development and implementation of the model of habilitation and social rehabilitation of disabled people and disabled children by means of adaptive physical culture in Romanovsky Rehabilitation Center of the Kostroma Region. The proposed model is based on the principles of interdepartmental interaction and inter-sector social partnership in the implementation of adaptive physical culture and sports. The implementation of the habilitation and social rehabilitation model is built in stages, and the sequence of tasks solved by different specialists is determined. The paper defines the algorithm of actions of the Center’s clients, areas of responsibility of major specialists, and important criteria of an assessment of efficiency of complex rehabilitation by means of adaptive physical culture and sports.

КИНЕЗИОТЕЙПИРОВАНИЕ И ВОЗМОЖНОСТЬ ЕГО ПРИМЕНЕНИЯ ПРИ ТРАВМАТИЧЕСКИХ ПОВРЕЖДЕНИЯХ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ

Subject. A literature review is devoted to the urgent problem of maxillofacial surgery and surgical dentistry ― improving the efficiency of rehabilitation of patients with fractures of the lower jaw using kinesiotape.&#x0D; The goal is to study the materials of publications devoted to kinesiotape during traumatic injuries of the maxillofacial region.&#x0D; Methodology. The mechanisms of action of a kinesiological teip applied in the form of applications on the skin are described in detail, which lead to the creation of favorable conditions for sanogenetic processes that are realized in normalizing microcirculation, reducing edema and the severity of pain. An increase in the number of publications on the use of this method in the prevention and treatment of injuries of the musculoskeletal system in athletes was noted. Moreover, at present, kinesioteiping is also used in clinical medicine, for example, in the practice of neurology and orthopedics. According to modern scientific research, the use of kinesiotape in patients with chronic back pain, subacromial impingement syndrome, acute whiplash injury of the cervical spine can significantly reduce the severity of pain.&#x0D; Results. Despite the rather widespread use of the method of kinesiotapeing in sports and clinical medicine, in the available literature there is a small number of works devoted to its use in maxillofacial surgery, in particular for fractures of the lower jaw. The use of the method of kinesiotherapy after surgery for osteosynthesis of fragments of the lower jaw has significantly reduced the level of inflammatory edema and the intensity of the pain syndrome.&#x0D; Conclusions. The presented literature review results indicate that kinesiotherapy is a promising, simple, non-traumatic method of rehabilitation after surgical treatment of lower jaw fractures, which does not have side effects and complications and significantly improves the quality of life of patients.&#x0D; However, scientific studies devoted to the analysis of the use of kinesiotherapy for traumatic injuries of the maxillofacial region are not enough for this period.

Estimation of efficiency of comprehensive dental rehabilitation of patients with separate oral cavity precautions

Estimation of efficiency of comprehensive dental rehabilitation of patients with separate oral cavity precautions

Assessment of the Implementation of Critical Pathway in Stroke Patients: A 10-Year Follow-Up Study.

Background The complications after stroke inhibit functional recovery and worsen the prognosis of patients. The implementation of a critical pathway (CP) can facilitate functional recovery after stroke by enabling comprehensive and systematic structured rehabilitation. Objective To evaluate the effects of the implementation of CP in stroke patients for 10 years. Methods The data were collected from 960 patients who were diagnosed with a stroke at the university hospital emergency room, who were transferred to the rehabilitation center after the acute phase, and who were discharged after undergoing comprehensive rehabilitation. Based on data collected over a period of 10 years, changes in demographic and stroke characteristics, preexisting medical conditions, poststroke complications, and functional states, as well as length of stay (LOS), were evaluated before and after CP implementation. The modified Rankin Scale (mRS) and the Korean version of the Modified Barthel Index (K-MBI) were used to evaluate functional states. Results There were no significant differences in demographic and stroke characteristics before and after CP implementation. For those with preexisting medical conditions, there was no significant difference between before and after CP implementation. The majority of the complications were significantly decreased after the implementation of CP. Except for hemorrhagic stroke patients, the Brunnstrom stage in the ischemic and total stroke patients after CP implementation was significantly increased in the upper and lower extremities. The total hospitalization LOS and rehabilitation center hospitalization times were significantly reduced in ischemic and total stroke patients. There was no statistically significant difference in the functional gain of K-MBI and the efficiency of rehabilitation between before and after CP implementation. Conclusion The implementation of CP allows for better application of evidence- and guideline-based key interventions and helps to provide early, comprehensive, organized, and more specialized care to stroke patients. Despite limited evidence, CP is still recommended as a means of promoting best practices in hospital care for stroke patients.

Orbital Floor Blow-Out Fractures: Ultrasonography, Postoperative Complications and Rehabilitation

The aim of this retrospective study was to analyze indications and the efficiency of post-operative rehabilitation in patients with orbital floor blow-out fractures. The selected patients were with orbital floor blow-out fractures and post-operative rehabilitation; eight case records were traced. The symptoms of the eyes (eye position and movements, coordimetry, ultrasonography) were noted before and after surgical correction and rehabilitation treatment. The data were statistically analyzed using a computer software package, SPSS version 16.0. A value of p &lt; 0.05 was considered as statistically significant. All eight (100%) patients were men. The average age was 19.88 ± 8.25 years (14–34 years). The most common complaint was diplopia, it was in eight (100%) patients’ numb of affected face side was in two (28.6%), vertigo in one (12.5%), nausea in one (12.5%) patient. Post–operative complications were: diplopia – eight (100%) patients, postoperative scar – three (37.5%), eyelid swelling – four (50%), haematoma – one (12.5%) patient. After rehabilitation post-operative symptoms (postoperative scar, eyelid swelling, haematoma) decreased significantly (p &lt; 0.05). Insignificant diplopia was left in seven (87.5%) (p &gt; 0.05) patients, but it did not disturb their general activities. Patients were not treated surgically, neither they got correction with prismatic spectacles after rehabilitation. One (12.5%) patient was under supervision. Before rehabilitation ultrasonography was done for five (62.5%) patients. Ultrasonography was repeated only for one (12.5%) patient after rehabilitation. Coordimetry was done for all patients while they were being treated in order to find out the efficiency of rehabilitation. Rehabilitation can be recommended to patients with post-operative complications such as diplopia, swelling, post-operative scar. Treatment effect should be objectified by ultrasonography.Keywords: rehabilitation, orbital floor fracture, postoperative complications, ultrasonography.

Big Data Analytics and Sensor-Enhanced Activity Management to Improve Effectiveness and Efficiency of Outpatient Medical Rehabilitation.

Numerous societal trends are compelling a transition from inpatient to outpatient venues of care for medical rehabilitation. While there are advantages to outpatient rehabilitation (e.g., lower cost, more relevant to home and community function), there are also challenges including lack of information about how patient progress observed in the outpatient clinic translates into improved functional performance at home. At present, outpatient providers must rely on patient-reported information about functional progress (or lack thereof) at home and in the community. Information and communication technologies (ICT) offer another option—data collected about the patient’s adherence, performance and progress made on home exercises could be used to help guide course corrections between clinic visits, enhancing effectiveness and efficiency of outpatient care. In this article, we describe our efforts to explore use of sensor-enhanced home exercise and big data analytics in medical rehabilitation. The goal of this work is to demonstrate how sensor-enhanced exercise can improve rehabilitation outcomes for patients with significant neurological impairment (e.g., from stroke, traumatic brain injury, and spinal cord injury). We provide an overview of big data analysis and explain how it may be used to optimize outpatient rehabilitation, creating a more efficient model of care. We describe our planned development efforts to build advanced analytic tools to guide home-based rehabilitation and our proposed randomized trial to evaluate effectiveness and implementation of this approach.

Interdisciplinary data bank in oncoendocrinology. Medullary thyroid cancer and type 2 multiple endocrine neoplasia syndromes

Medullary thyroid cancer (MTC) is about 5% of all thyroid carcinomas and is hereditary in 2030% of cases. Multiple endocrine neoplasia syndrome type 2 (MEN2), in addition to medullary thyroid cancer, may include pheochromocytoma, hyperparathyroidism, and some other manifestations.&#x0D; The multidisciplinary data bank (MDB) developed by us is a specialized resource for storing, accumulating and subsequent analysis of data on patients with MTC and MEN2 syndromes. The MDB allows you to collect data from any sources (primary care, medical institutions at various levels, federal centers) and provides internal automated control of the quality and quantity of input data. It is necessary to keep a record of such data to improve the efficiency of diagnostics, treatment and rehabilitation of patients.&#x0D; MDB is an integrated digital platform containing reference materials for doctors, which allows combining evidence-based clinical experience in patients, and provides the opportunity for expert support of medical decisions. In the long run, it will help us organize digitally stored data for machine learning and lays the groundwork for the development of artificial neural networks.