Functional Performance In Patients Research Articles

Virtual reality skateboarding training for balance and functional performance in degenerative lumbar spine disease

BackgroundDegenerative lumbar spine disease (DLD) is a prevalent condition in middle-aged and elderly individuals. DLD frequently results in pain, muscle weakness, and motor impairment, which affect postural stability and functional performance in daily activities. Simulated skateboarding training could enable patients with DLD to engage in exercise with less pain and focus on single-leg weight-bearing. The purpose of this study was to investigate the effects of virtual reality (VR) skateboarding training on balance and functional performance in patients with DLD.MethodsFourteen patients with DLD and 21 age-matched healthy individuals completed a 6-week program of VR skateboarding training. The motion capture and force platform systems were synchronized to collect data during a single-leg stance test (SLST). Musculoskeletal simulation was utilized to calculate muscle force based on the data. Four functional performance tests were conducted to evaluate the improvement after the training. A Visual Analogue Scale (VAS) was also employed for pain assessment.ResultsAfter the training, pain intensity significantly decreased in patients with DLD (p = 0.024). Before the training, patients with DLD took longer than healthy individuals on the five times sit-to-stand test (p = 0.024). After the training, no significant between-group differences were observed in any of the functional performance tests (p > 0.05). In balance, patients with DLD were similar to healthy individuals after the training, except that the mean frequency (p = 0.014) was higher. Patients with DLD initially had higher biceps femoris force demands (p = 0.028) but shifted to increased gluteus maximus demand after the training (p = 0.037). Gluteus medius strength significantly improved in patients with DLD (p = 0.039), while healthy individuals showed consistent muscle force (p > 0.05).ConclusionThis is the first study to apply the novel VR skateboarding training to patients with DLD. VR skateboarding training enabled patients with DLD to achieve the training effects in a posture that relieves lumbar spine pressure. The results also emphasized the significant benefits to patients with DLD, such as reduced pain, enhanced balance, and improved muscle performance.

Progressive Resistance Training or Neuromuscular Exercise for Hip Osteoarthritis : A Multicenter Cluster Randomized Controlled Trial.

Exercise is recommended as first-line treatment for patients with hip osteoarthritis (OA). However, randomized controlled trials providing evidence for the optimal exercise type are lacking. To investigate whether progressive resistance training (PRT) is superior to neuromuscular exercise (NEMEX) for improving functional performance in patients with hip OA. Multicenter, cluster-randomized, controlled, parallel-group, assessor-blinded, superiority trial. (ClinicalTrials.gov: NCT04714047). Hospitals and physiotherapy clinics. 160 participants with clinically diagnosed hip OA were enrolled from 18 January 2021 to 28 April 2023 and randomly assigned to PRT (n = 82) or NEMEX (n = 78). Twelve weeks of PRT or NEMEX with 2 supervised 60-minute group sessions each week. The PRT intervention consisted of 5 high-intensity resistance training exercises targeting muscles at the hip and knee joints. The NEMEX intervention included 10 exercises and emphasized sensorimotor control and functional stability. The primary outcome was change in the 30-second chair stand test (30s-CST). Key secondary outcomes were changes in scores on the pain and hip-related quality of life (QoL) subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS). The mean changes from baseline to 12-week follow-up in the 30s-CST were 1.5 (95% CI, 0.9 to 2.1) chair stands with PRT and 1.5 (CI, 0.9 to 2.1) chair stands with NEMEX (difference, 0.0 [CI, -0.8 to 0.8] chair stands). For the HOOS pain subscale, mean changes were 8.6 (CI, 5.3 to 11.8) points with PRT and 9.3 (CI, 5.9 to 12.6) points with NEMEX (difference, -0.7 [CI, -5.3 to 4.0] points). For the HOOS QoL subscale, mean changes were 8.0 (CI, 4.3 to 11.7) points with PRT and 5.7 (CI, 1.9 to 9.5) points with NEMEX (difference, 2.3 [CI, -3.0 to 7.6] points). Participants and physiotherapists were not blinded. In patients with hip OA, PRT is not superior to NEMEX for improving functional performance, hip pain, or hip-related QoL. Independent Research Fund Denmark.

Comparative Effects of Core Neuromuscular Training versus Conservative Physical Therapy to Reduce Pain and Improve Functional Performance in Patients with Patellofemoral Pain Syndrome

Running, stair climbing, jumping and squatting represent a few of the activities that can cause patellofemoral pain syndrome. Patellofemoral pain syndrome (PFPS) is one of the most typical causes of anterior knee discomfort in teenagers and persons below Sixty. Objective: To contrast the results of conservative physical treatment plus core neuromuscular training and conservative physical therapy alone. Methods: It was a quasi-experimental study in which patients suffering from patellofemoral pain syndrome were selected on the basis of convenience sampling from Government hospitals of Faisalabad after meeting the inclusion and exclusion criteria. Twenty patients with patellofemoral pain syndrome were divided into Group A and Group B at random. Participants of Group A performed neuromuscular core training plus conservative physical therapy exercise program for 4 weeks while participants of group B performed conservative physical therapy exercise alone for 4 weeks. Data were analyzed by SPSS version 27.0. Results: Following therapy, the pain level was substantially reduced in both of the groups (P < 0.05) with Intervention group showing better results. Similarly, there was improvement in scores of Kujala questionnaire in both groups after treatment (P< 0.05) but the results of Intervention group were comparatively better. Conclusions:  There is significant effect of core neuromuscular training plus conservative physical therapy as compared to conservative physical therapy alone.  

Pes Planuslu Hastalarda Kişiye Özel Tasarlamış 3D Baskılı Tabanlıkların Fiziksel Aktivite Düzeyi, Denge ve Fiziksel Performans Üzerine Etkisi: Randomize, Plasebo Kontrollü, Çift-Kör Bir Çalışma

Objective: The aim of this study was to investigate the effects of individually designed insoles on physical activity level, balance and functional performance in patients with pes planus.
 Methods: 38 participants were divided into 2 groups as 3D printed (n=20) and placebo(n=18). In the 3D printed group, medial longitudinal arch support, medial wedge of the foot, medial heel wedge and transverse arch support were given to the insoles according to the needs of the participants. The placebo group received placebo insoles. Range of motion, muscle strength, static and dynamic balance, physical and physical activity levels were measured at baseline, and eight weeks later (clinicaltrials.gov ID: NCT05306886).
 Results: Muscle strengths of the plantar flexion and eversion increased after the use of insoles in the 3D printed and placebo groups (p0.05), but there were significant improvements in dynamic balance in both groups (p

Efficacy of accommodating variable-resistance training on muscle architecture, peak torque, and functional performance in patients with juvenile idiopathic arthritis: A randomized controlled trial

PurposeThis study sought to find out if a 6-week accommodating variable-resistance (AcVR) training might enhance muscle architecture, peak torque, and functional performance in patients with juvenile idiopathic arthritis (Juv-IA). MethodsFifty-eight patients with polyarticular Juv-IA (aged 12–18 years) were involved in a randomized controlled trial. They were allocated into two groups: the AcVR group (n = 29; underwent AcVR training, and the control group (n = 29; received the usual exercise regimen). Interventions were applied three times a week over six consecutive weeks. Measurements were done at baseline and after the intervention. The primary outcome measures were muscle architecture and peak torque, with functional capacity being the secondary measure. ResultsCompared to the control group, the AcVR group showed favorable pre-to-post changes in muscle architecture [fascicle length (P = 0.0007, η2p = .18), pennation angle (P = 0.0004, η2p = .20), and muscle thickness (P = 0.001, η2p = .17)]. Further, the AcVR group revealed a greater increase in peak concentric torque of knee extensors at angular speeds of 120°/sec [right side (P = 0.0032, η2p = .08); left side (P = 0.039, η2p = .07)] and 180°/sec [right side (P = 0.01, η2p = .11); left side (P = 0.014, η2p = .10)]. Furthermore, The AcVR group achieved more conducive changes in functional performance [6-min walk test (P = 0.003, η2p = .15), timed up and down stair test (P = 0.009, η2p = .12), and 4 × 10 m shuttle run test (P = 0.036, η2p = .08)]. ConclusionA 6-week AcVR training is potentially effective for improving muscle architectural qualities, enhancing peak muscle torque, and boosting functional performance in patients with Juv-IA without experiencing any detrimental side effects.

A Pilot Feasibility Trial of an Upper Extremity Assistive System

ObjectiveTo develop and clinically evaluate a customizable active upper extremity (UE) assistive system with integrated functional electrical stimulation (FES) that improves function and independence of individuals during activities of daily living (ADLs). DesignSingle-arm, prospective, open-label cohort feasibility trial. SettingAn academic research institution. ParticipantsSubjects were 5 adults with a medical history of stroke resulting in distal UE impairment (N=5). The subjects volunteered from recruitment materials that detailed information about the study. InterventionsA novel, wearable, lightweight, low-profile, and patient-tailored UE assistive system. It comprises a splint component and FES unit that may each be controlled by electromyography (EMG) signals, inertial measurement units (IMUs), manual control source (joystick), and/or voice control. Main Outcome Measure(s)Several occupational therapy outcome measures were used, including the Canadian Occupational Performance Measure (COPM), Action Research Arm Test (ARAT), The Box and Blocks Test (BBT), the ABILHAND-Manual Ability Measure, and Patient Reported Outcomes Measurement Information System (PROMIS) UE Short Form. ResultsAll participants learned to use our UE assistive system to perform ADLs and were able to use it independently at home. Most participants experienced a clinically meaningful improvement in both performance and satisfaction for the majority of their COPM goals while using the system. All participants experienced improvement in hand grip and release as shown by their baseline and post assessment scores for hand function (BBT, ARAT) and patient-reported outcomes (ABILHAND, PROMIS). ConclusionsThe clinical outcomes suggest that our UE assistive system improves functional performance in patients with UE impairment, allowing them to engage more actively in ADLs. Further innovation including elbow and shoulder components will allow users to have more degrees of freedom during tasks.

To See Changes Following Physiotherapy in Pain, Range of Motion, Muscle Strength And Functional Performance in Patients with Osteoarthritis of Knee

Background: Osteoarthritis (OA) is a chronic, non-inflammatory, degenerative joint disease with Knee OA being the most prevalent one with main factor of disability among middle-aged and older people worldwide. Age and repetitive mechanical loads being the main causative factors, it shows pain Knee range to be painful. Techniques like IFT and wet packs, physiotherapy seeks to reduce signs and symptoms including pain and oedema. Non-weight-bearing muscle-strengthening exercises have been shown to be useful. Methodology: A Case series was carried out by the Interns on Patients having osteoarthritis of knee who visited Physiotherapy OPD, Dhiraj Hospital, with a minimal sample size of 5 cases, for the study duration of 3 Months. The Inclusion Criteria for the study were: Both Male and Female patients with Age 40-70 years, Patients diagnosed with Unilateral/bilateral OA knee, willing to perform physical therapy exercise, having Kellgren-Lawrence Grade 1 & 2 graded by radiologist. Outcome Measures used were: Numeric Pain Rating Scale, Western Ontario and McMaster universities arthritis index (WOMAC), Repetition Maximum (RM), Goniometery. Result: The results showed decrease in pain, Increase ROM of knee ranges, improve strength of the muscles and better functional performance Conclusion: It was observed that Physiotherapy improved knee range of motion, muscle strength, pain and physical function in patient with osteoarthritis of knee.

Effects of Combined Endurance and Resistance Eccentric Training on Muscle Function and Functional Performance in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

ObjectiveTo evaluate the adherence to treatment and efficacy of an eccentric-based training (ECC) program on peripheral muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). DesignProspective, assessor-blinded, randomized controlled trial. SettingThe cardiopulmonary rehabilitation unit of a tertiary subacute referral center. ParticipantsThirty (N=30) stable inpatients (mean age 68±8 years; FEV1 44±18% of predicted) with COPD were included in the study. InterventionsInpatients were randomly assigned to 4 weeks of a combined endurance and resistance ECC (n=15) or conventional training (CON; n=15). Main Outcome MeasuresQuadriceps peak torque (PT) was the primary outcome measure for muscle function. Rate of force development (RFD), muscle activation and quality (quadriceps PT/leg lean mass), 6-min walk distance (6MWD), 4-meter gait speed (4mGS), 10-meter gait speed, 5-repetition sit-to-stand (5STS), dyspnea rate, and mortality risk were the secondary outcomes. Evaluations were performed at baseline and repeated after 4 weeks and 3 months of follow-up. ResultsQuadriceps PT, RFD, and muscle quality improved by 17±23% (P<.001), 19±24%, and 16±20% (both P<.05) within the ECC group. Besides, a significant between-group difference for RFD (56±94 Nm/s, P=.038) was found after training. Both groups showed clinically relevant improvements in 6MWD, 4mGS, dyspnea rate, and mortality risk, with no significant differences between groups. ConclusionCombined endurance and resistance ECC improved lower limbs muscle function compared with CON in inpatients with COPD. In contrast, ECC did not further improve functional performance, dyspnea, and mortality risk. ECC may be of particular benefit to effect on skeletal muscle function in patients with COPD.

Lurasidone for the Treatment of Schizophrenia: Design, Development, and Place in Therapy.

Thisreviewaims to provide a comprehensive overview of the current literature on the drug design, development, and therapy of lurasidone for the treatment of schizophrenia. Lurasidone has antagonistic effects on the dopamine D2, 5-hydroxytryptamine (5-HT)2A, and 5-HT7 receptors and a partial agonistic effect on the 5-HT1A receptor with low affinities for muscarinic M1, histamine H1, and a1 adrenergic receptors. The receptor-binding profile of lurasidone is thought to be associated with fewer side effects such as anticholinergic effects, lipid abnormalities, hyperglycemia, and weight gain. Behavioral pharmacological studies have demonstrated that lurasidone exerts anxiolytic and antidepressive effects and improves cognitive function, which are associated with the modulation of 5-HT7 and 5-HT1A receptors. Literature search using PubMed was performed to find published studies of randomized controlled trials and recent meta-analyses regarding efficacy and safety, particularly metabolic side effects of lurasidone in schizophrenia. In short-term studies, the results of randomized placebo-controlled trials and meta-analyses have suggested that lurasidone was superior to placebo in improving total psychopathology, positive symptoms, negative symptoms, and general psychopathology in patients with acute schizophrenia. Regarding safety, lurasidone had minimal metabolic side effects, and was identified as one of the drugs with the most benign profiles for metabolic side effects. Long-term trials revealed that lurasidone had the preventive effects on relapse, with minimal effects on weight gain and other metabolic side effects. Furthermore, lurasidone improves cognitive and functional performance of patients with schizophrenia, especially in long-term treatment. Patients with schizophrenia require long-term treatment with antipsychotics for relapse prevention; thus, minimizing weight gain and other side effects is crucial. Lurasidone is suitable as one of the first-line antipsychotic drugs in the acute phase, and a switching strategy should be considered during the maintenance phase, to balance efficacy and adverse effects and achieve favorable outcomes in the long-term course of schizophrenia.

OA-38 Physical activity interventions to improve functional performance in patients with multiple myeloma

OA-38 Physical activity interventions to improve functional performance in patients with multiple myeloma

Investigation of the Relationship Between Isokinetic Muscle Strength and Functional Performance in Patients with Knee Osteoarthritis

Investigation of the Relationship Between Isokinetic Muscle Strength and Functional Performance in Patients with Knee Osteoarthritis

Transcutaneous Spinal Cord Stimulation Facilitates Respiratory Functional Performance in Patients with Post-Acute COVID-19.

A growing number of studies have reported Coronavirus disease (COVID-19) related to both respiratory and central nervous system dysfunctions. This study evaluates the neuromodulatory effects of spinal cord transcutaneous stimulation (scTS) on the respiratory functional state in healthy controls and patients with post-COVID-19 respiratory deficits as a step toward the development of a rehabilitation strategy for these patients. In this before-after, interventional, case-controlled clinical study, ten individuals with post-acute COVID-19 respiratory deficits and eight healthy controls received a single twenty-minute-long session of modulated monophasic scTS delivered over the T5 and T10 spinal cord segments. Forced vital capacity (FVC), peak forced inspiratory flow (PIF), peak expiratory flow (PEF), time-to-peak of inspiratory flow (tPIF), and time-to-peak of expiratory flow (tPEF), as indirect measures of spinal motor network activity, were assessed before and after the intervention. In the COVID-19 group, the scTS intervention led to significantly increased PIF (p = 0.040) and PEF (p = 0.049) in association with significantly decreased tPIF (p = 0.035) and tPEF (p = 0.013). In the control group, the exposure to scTS also resulted in significantly increased PIF (p = 0.010) and significantly decreased tPIF (p = 0.031). Unlike the results in the COVID-19 group, the control group had significantly decreased PEF (p = 0.028) associated with significantly increased tPEF (p = 0.036). There were no changes for FVC after scTS in both groups (p = 0.67 and p = 0.503). In post-COVID-19 patients, scTS facilitates excitation of both inspiratory and expiratory spinal neural networks leading to an immediate improvement of respiratory functional performance. This neuromodulation approach could be utilized in rehabilitation programs for patients with COVID-19 respiratory deficits.

A retrospective study of Cerebrolysin in patients with moderate to severe traumatic brain injury: Cognitive and functional outcomes.

In this retrospective study, we aimed to evaluate the effects of the neurotrophic compound Cerebrolysin on executive, cognitive, and functional performance in patients with traumatic brain injury (TBI) with a highly severe disability level. A total of 44 patients were included in the study, with 33 patients in the control group and 11 patients in the interventional group who received intravenous infusions of 30 mL Cerebrolysin. Both groups received standard rehabilitation therapy following the rehabilitation protocol for patients with TBI at Hospital Clínico Mutual de Seguridad. Functional and cognitive scales were evaluated at baseline, at four months, and at the endpoint of the intervention therapy at seven months (on average). The results revealed a significant improvement in the Cerebrolysin-treated group compared to the control group. Specifically, patients who received Cerebrolysin showed a moderate residual disability and a significant reduction in the need for care. Concerning the promising results and considering the limitations of the retrospective study design, we suggest that randomized controlled studies be initiated to corroborate the positive findings for Cerebrolysin in patients with moderate to severe brain trauma.

Role of the Inspiratory Muscles on Functional Performance From Critical Care to Hospital Discharge and Beyond in Patients With COVID-19.

The role of inspiratory muscle performance in functional performance in patients with coronavirus disease 2019 (COVID-19) is poorly understood. The purpose of this study was to perform a longitudinal examination of inspiratory and functional performance from intensive care unit (ICU) discharge (ICUD) to hospital discharge (HD) and symptoms at HD and 1month after HD in patients with COVID-19. Thirty patients (19 men, 11 women) with COVID-19 were included. Examination of inspiratory muscle performance at ICUD and HD was performed with an electronic manometer, which provided the maximal inspiratory pressure (MIP) and several other inspiratory measures. Examination of dyspnea and functional performance was performed at ICUD and HD with the Modified Borg Dyspnea Scale and the 1-minute sit-to-stand test (1MSST), respectively. The mean age was 71 (SD = 11) years, the mean length of ICU stay was 9 (SD = 6) days, and the mean length of hospital stay was 26 (SD = 16) days. Most of the patients were diagnosed with severe COVID-19 (76.7%) and had a mean Charlson Comorbidity Index of 4.4 (SD = 1.9), reflecting high comorbidity. The mean MIP of the entire cohort increased minimally from ICUD to HD (from 36 [SD = 21] to 40 [SD = 20] cm H2O), reflecting predicted values for men and women at ICUD and HD of 46 (25%) to 51 (23%) and 37 (24%) to 37 (20%), respectively. The 1MSTS score increased significantly from ICUD to HD (9.9 [SD = 7.1] vs 17.7 [SD = 11.1]) for the entire cohort but remained far below population-based reference values (2.5th percentile) for the majority of patients at ICUD and HD. At ICUD, MIP was found to be a significant predictor of a favorable change in 1MSTS performance (β = 0.308; odds ratio = 1.36) at HD. A significant reduction in inspiratory and functional performance exists in patients with COVID-19 at both ICUD and HD, with a greater MIP at ICUD being a significant predictor of a greater 1MSTS score at HD. This study shows that inspiratory muscle training may be an important adjunct after COVID-19.

Daily steps and stepping cadence increase one-year following prosthesis osseointegration in people with lower-limb amputation

Purpose People with lower-limb loss participate in less physical activity than able-bodied individuals, which increases the mortality risk and incidence of metabolic syndromes. This study evaluated the effect of lower-limb prosthesis osseointegration on physical activity, including daily steps and stepping cadence. Methods Free-living walking activity was assessed from 14 patients scheduled to undergo prosthesis osseointegration at two time points (within 2 weeks prior to osseointegration surgery and 12-months following). Daily step count, stepping time, number of walking bouts, average step cadence per bout, maximum step cadence per bout, and time spent in bands of step cadence were compared before and after osseointegration. Results Twelve months after prosthesis osseointegration, participants increased daily steps, daily stepping time, average step cadence, and maximum cadence per walking bout compared to pre-osseointegration. Conclusions Participants engaged in more daily steps, higher stepping cadence, and longer bouts at higher cadence one year following osseointegration compared to when using a socket prosthesis. As a novel intervention that is becoming more common, it is important to understand walking activity outcomes as these are critical for long-term health.

The Sonoelastography and Functional Outcome of Upper Extremity after Kinesiotaping on the Spastic Forearm in Patients with Subacute Stroke.

This study is aimed at exploring the feasibility of sonoelastography on muscle stiffness of spastic forearm and evaluating the improvement of functional performance in patients with poststroke spasticity (PSS) after receiving kinesiotaping (KT) and rehabilitation. According to the spastic levels (using modified Ashworth scale (MAS)) of the affected upper extremity, 59 patients with stroke were allocated into two groups, group A (MAS 0-1): 31 patients (14 men and 17 women; mean age: 60 years) and group B (MAS 1+-2): 28 patients (22 men and 6 women; mean age: 51 years). The Brunnstrom motor recovery stage at the wrist/distal parts in groups A and B was stage 3/3.5 and stage 2.75/3. We evaluated the Brunnstrom stage, spastic levels by MAS and modified Tardieu scale (MTS), and Fugl-Meyer Assessment for upper extremity (FMA-UE). We also evaluated the muscle spasticity of flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), and flexor digitorum superficialis (FDS) muscles using sonoelastography with shear wave velocity (SWV). We applied KT for 20 patients in group B, comparing the changes in sonoelastography and functional outcomes between KT and without KT interventions. Both the MAS and MTS scales were moderately correlated with the SWV in forearm muscles on hemiplegic side (r = 0.336-0.554) After KT intervention, the SWV in FCR decreased (p = 0.028). Muscle spasticity was reduced (p < 0.01), and distal part of the Brunnstrom stage and FMA-UE were increased (p = 0.045 and p = 0.001). In patients without KT intervention, only the MTS degree reduced (p = 0.026). The SWV of sonoelastography could objectively assess the reduction of muscle stiffness of the affected forearms in patients with PSS after KT intervention. Advances in Knowledge. Sonoelastography could be a quantitative method to follow up for therapeutic effect of the spastic forearm.

High-Frequency versus Low-Frequency Spinal Cord Stimulation in Treatment of Chronic Limb-Threatening Ischemia: Short-Term Results of a Randomized Trial

Introduction: The objective of the study is to determine if high-frequency (1 kHz) spinal cord stimulation (SCS) is better than low-frequency SCS for pain relief in chronic limb-threatening ischemia (CLTI). Methods: HEAL-SCS trial was designed as an open-label, parallel-group, single-center randomized study with a 1:1 allocation ratio. The trial was conducted in Meshalkin National Medical Research Center between August 2018 and February 2020. Total 56 patients underwent screening, 50 were enrolled, 6 were rejected. The participants were randomized into 2 cohorts of 25 patients each by an external coordinator using an online tool. A neurosurgeon and a vascular surgeon both examined all patients and estimated the pain intensity using visual analog scale (VAS), quality of life with short-form-36 health survey (SF-36), and functional status by walking impairment questionnaire (WIQ) at 3 and 12 months. Tissue perfusion was evaluated for 34 patients using transcutaneous oxygen tension measurement (TcPO₂) at baseline and in 12 months. Results: All 50 patients (84% men, median age 66.5 y.o) were available for primary outcome assessment 3 and 12 months after implantation. Intention-to-treat analysis demonstrated comparative advantage of HF-SCS over LF-SCS at 3 months with mean VAS score 2.8 (95% CI, 2.4; 3.2) and 3.3 (95% CI, 3.0; 3.6), respectively (p = 0.031). Clinical superiority of HF-SCS persisted at 12-month follow-up (p < 0.001). HF-SCS produced significantly greater pain relief by WIQ at 3 (p < 0.001) and 12 months (p = 0.009). Despite stair-climbing ability was better in HF-SCS group (p = 0.02), no significant difference between groups was found at 1-year post-op in terms of speed (p = 0.92) and distance scores (p = 0.68). Accordingly, the general and mental health domains of SF-36 were significantly better in HF-SCS at 12 months. Despite a tendency toward better resting oxygen pressure in HF-SCS group, there was no intergroup difference by TcPO₂ (p = 0.076). Only 1 patient (2%) required above-the-knee amputation at 10 months after LF-SCS implantation. Conclusion: High-frequency SCS provides better pain relief, life quality, and functional performance in patients with CLTI during short-term follow-up. The lack of perfusion difference between high-frequency and conventional SCS requires further examination to the possible long-term advantages of the method.

The Relationship between Transversus Abdominis and Internal Oblique Thickness and Disease-Related Characteristics in Parkinson's Disease

Background and Aim: The core muscles are essential for spinal stability during functional activities. Trunk muscle function is affected by specific neurodegenerative processes of Parkinson's disease (PD). This study aimed to investigate whether changes in transversus abdominis (TrA) and internal oblique (IO) thickness during the abdominal drawing-in maneuver (ADIM) were associated with clinical manifestations, core endurance, and functional mobility in patients with PD. Materials and Methods: We included patients with a modified Hoehn and Yahr staging of 3 or lower. TrA and IO muscle thickness were measured using ultrasound both at rest and during ADIM, and the percent change (%) was calculated to assess TrA and IO activation. Patients performed core endurance (prone bridge and sit-ups) and functional mobility tests (timed “up and go” [TUG] and five times sit-to-stand [FTSTS]). All assessments were conducted during the “on” phase. Results: Five female and 17 male patients were included in this study. We found a statistically significant correlation between ultrasound parameters of IO and the clinical manifestations of PD (P &lt; 0.05). Correlations were observed between TrA percent change and prone bridge, sit-ups, TUG, and FTSTS (P &lt; 0.05). Conclusion: To the best of our knowledge, this is the first ultrasound imaging-based study to demonstrate the relationship between TrA and IO muscle thickness and clinical outcomes, and functional performance in patients with PD. Percentage changes in IO were associated with the clinical manifestations of PD. Increased activation of TrA during ADIM was associated with improved core endurance and mobility. The results suggest that a trunk-specific exercise program may be the cornerstone in the treatment of PD-related changes.

ОПТИМИЗАЦИЯ ОКАЗАНИЯ МЕДИЦИНСКОЙ ПОМОЩИ ПАЦИЕНТАМ С ОСТРЫМ НАРУШЕНИЕМ МОЗГОВОГО КРОВООБРАЩЕНИЯ В МНОГОПРОФИЛЬНОМ СТАЦИОНАРЕ

Significance. Acute cerebrovascular accident also known as stroke is one of the most common causes of morbidity, mortality and disability in Russia and abroad. In this regard, constant efforts are being undertaken to improve and optimize the diagnosis and provision of emergency specialized medical care to patients with this condition. The purpose of the study is to demonstrate experience of a multidisciplinary team at the regional vascular center, set up at a multidisciplinary medical institution that also operates in an ambulance mode, City Clinical Hospital named after M.P. Konchalovsky of the Moscow Healthcare Department. Material and methods. The material of the study was performance evaluation of a multidisciplinary team at the City Clinical Hospital named after M.P. Konchalovsky for the period from 2019 to 2022 to optimize the diagnosis and choice of treatment for patients with stroke. Results. Optimizing routing of patients with suspected stroke upon admission made it possible to save time and reduce the timespan before the thrombolytic therapy or thromboextraction is initiated. The introduction of a multidisciplinary team made it possible to reduce time for making the right decisions related to the treatment of patients with stroke. The change in the concept of diagnosing and treating patients with stroke from “sequence” to “parallelism” has significantly reduced the time spent on making a diagnosis, initiating thrombolytic therapy, thromboextraction if necessary, and reducing disability and mortality in patients with stroke. Conclusion. Specialized vascular centers and departments have proven to be effective in improving the diagnosis, treatment and functional performance of patients with stroke. However, the lack of regulatory documents requires further development of algorithms of the work of multidisciplinary teams. The introduction of multidisciplinary teams at the Regional Vascular Center of the "stroke network" made it possible to: achieve medical efficiency by reducing the "door-to-needle" time, mortality and severity of disability indicators; attain cost effectiveness by reducing length of hospital stay and cost of inpatient treatment of patients with stroke. Scope of application. Public health and health organization

Cognitive Outcomes and Functional Performance for Patients After Open Heart Surgery

Context: Open heart surgery is a lifesaving procedure for patients who need coronary artery bypass graft (CABG) and heart valve replacement or repair (HVR). However, it also carries a risk of cognitive and functional performance injuries. Between 30% to 60% of patients undergoing open heart surgery worldwide are at high risk of cognitive and functional performance injuries.&#x0D; Aim: The study aimed to assess cognitive outcomes and functional performance of patients after open heart surgery.&#x0D; Methods: A descriptive exploratory design was applied to achieve the aim of this study on a purposive sample of 103 adults who were scheduled for elective open-heart surgery (CABG and valve replacement or repair). Montreal Cognitive Assessment (MOCA); Physical Self-Maintenance Scale (Activities of Daily Living) (PSMS) tests were used to determine the effect of cardiac surgery on cognitive outcomes and functional performance abilities of patients undergoing cardiac surgery. Both scales were used twice for each patient (preoperative and postoperative).&#x0D; Results: The current study shows a statistically significant deterioration in all cognitive functions (visuospatial &amp;executive function, naming, short-term memory recall task, attention, language, abstraction, orientation) (p=0.000). A total cognitive score reveals that 68% of the patients had normal cognitive function before open heart surgery, significantly decreasing to 55.3% after surgery. The functional outcomes measured by the assessment of activity of daily living shows that 100% of patient were independent before open heart surgery and significantly decreased to 74.8% postoperatively.&#x0D; Conclusion: It can be concluded that open heart surgery impacts cognitive functions, particularly in domains of visuospatial and executive function, memory, and attention. Besides, the everyday functional performance includes toileting, feeding, dressing, grooming, physical ambulation, and bathing). Instrumental activities of daily living (IADL), which include the ability to use the telephone, shopping, food preparation, housekeeping, laundry, away for transportation, responsibility for following their medication regimens, and ability to handle finances, were also affected. Nurses caring for patients undergoing open heart surgery should consider cognitive limitations when giving them health education and discharge instruction, their readiness to learn should be considered before any educational event. Further studies should be carried out to identify the factors that may contribute to the impairment of cognitive function and functional performance for patients undergoing cardiac surgery.