Individualized Rehabilitation Program Research Articles

Persistência de Sintomas um ano após Infeção por SARS-COV-2 em trabalhadores e seu desempenho em atividades e participação em situações de vida

Introduction Although most individuals recover after acute infection by SARS-CoV-2, others may suffer from persistent symptoms with potential medium and long-term consequences on the performance of activities and participation, with possible implications for their fitness for work. Objective To analyze the persistence of symptoms twelve months after SARS-CoV-2 infection, and the perception of the performance level in activities and participation in life situations, of workers in a company of the industrial sector in the Aveiro Region. Methodology An observational study, developed in an Occupational Health Service of an industrial company in the region of Aveiro, including workers with positive SARS-COV-2 RT-PCR/TRAg test, between October/2020-January/2022. After signaling the infection, the Occupational Health Team applied a questionnaire collecting sociodemographic variables, a list of common symptoms during the acute phase of infection by SARS-COV-2, and the perceived functionality assessed by the Portuguese version of WHODAS 2.0-PT12 (where ’12 points’ means the most functionality). At twelve months, they filled out another list of persistent symptoms after SARS-CoV-2 infection and again WHODAS 2.0-PT12. Data analysis included descriptive statistics and univariate and multivariate linear regression. The analysis was conducted with the software JASP 0.16.3. Results Eighty-five workers were infected with SARS-CoV-2, with a mean age of 36.1±9.8years, 77.7% were male, 36.7% had higher education and 17.7% reported at least one chronic condition. At twelve months, thirty workers (35.3%) reported persistent symptoms, with fatigue (27.7%) and arthralgia (14.4%) being the most mentioned. The mean WHODAS 2.0 in the two evaluation moments was 19.2±8.0 vs 15.7±5.0. Significant associations between WHODAS 2.0 items and persistent symptoms of fatigue, headache, cough, myalgia, arthralgia, and previous chronic disease were found. Conclusions Persistent symptoms twelve months after acute SARS-CoV-2 infection have repercussions on workers’ self-perception of performance in some activities and participation in life situations. The occupational health team can implement continuous surveillance of the infected worker’s health, assess the presence of persistent symptoms of this infection, and implement an individualized rehabilitation program, which minimizes the impact of the persistence of symptoms on their work performance, and in activities and participation in life situations. KEYWORDS: Occupational Health, Occupational Medicine; Occupational Health Nursing, SARS-CoV-2, Symptoms, WHODAS 2.0.

Stages of motor development in children with cyanotic congenital heart defects after surgical treatment

Background. The article deals with the actual problem of pediatric neurology, pediatric cardiology, and pediatric cardiac surgery, in particular, the peculiarities of neurodevelopment in children with congenital heart defects (CHD). The purpose is to conduct a study of stages of stato-motor development (SMD) in patients with cyanotic congenital heart defects after surgical treatment and to determine the influence of pathogenic factors on neurodevelopmental delay. Materials and methods. Thirty-five patients with cyanotic CHD underwent examination and surgical treatment at the Center for Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine: 20 children — with transposition of the great vessels (TGV) and 15 children — with tetralogy of Fallot (TOF). The control group consisted of 35 healthy patients whose motor development corresponded to their age. Gestational age, body weight at birth, Apgar score, saturation, and duration of artificial blood circulation during surgical treatment for CHD were considered. Assessment of motor development was carried out with the help of the following scales: Munich Functional Developmental Diagnosis (G.J. Köhler, H.D. Egelkraut) and section 2 of the Hammersmith Infant Neurological Examination. Data were processed using the software Microsoft Excel version 16.0.12527.21236. Results. The gestational age of the studied group of patients with cyanotic CHD was 38 weeks, body weight — 3,500 g, which corresponded to the control group. Patients of the first subgroup with TGV were diagnosed with lower saturation indicators (р = 0.0001), a lower 1-minute Apgar score (p = 0.028) and a longer duration of artificial blood circulation — 146.00 ± 29.03 (р = 0.043) compared to the second subgroup with TOF. SMD delay was diagnosed in 29 % of cases, namely 12 % with TGV and 17 % with TOF. The average period of sitting with delayed SMD was 8.4 ± 2.2 months (p = 0.002), walking — 18.4 ± 6.3 months (p = 0.0001). Subsequently, children with TGV continue to develop without a significant delay compared to the TOF subgroup. Conclusions. 1. Patients with cyanotic CHD are born at 38 weeks of gestation, with sufficient body weight without a significant difference depending on the type of CHD and compared to the control group of healthy children. The predominance of the male gender is typical in cyanotic CHD. However, children with transposition of the great vessels are characterized by a lower 1-minute Apgar score and lower indicators of saturation at birth compared to those with tetralogy of Fallot. 2. Based on the conducted study, a delay of SMD was found in 29 % of patients with cyanotic CHD, namely 17 % with TOF and 12 % with TGV. The average duration of sitting with delay was 8.4 ± 2.2 months and walking was 18.4 ± 6.3 months. 3. Surgical treatment was carried out according to the detected indications, for transposition of the great vessels on the first day and for tetralogy of Fallot at 8 months of life. No pathogenic influence of the duration of artificial blood circulation and aortic clamping during cardiosurgical treatment on SMD in children was found. An increase in the duration of artificial blood circulation was noted during arterial switch operation in children with TGV, but no significant difference was found in children with SMD delay. 4. Timely early surgical treatment of critical CHD — TGV on the first day after birth, a developed route for pregnant women, techniques of performing operations — ensure a better SMD of this subgroup in the future. In patients with TOF, taking into account the long period of hypoxia before the start of surgical correction, neuropsychiatric disorders of varying degrees are more often noted. The development of an individual rehabilitation program is provided for this category of children.

Effectiveness of video-based psychiatric rehabilitation for patients with early-phase schizophrenia spectrum: A randomized controlled trial.

This study aimed to establish a comprehensive set of recovery-oriented rehabilitation programs for individuals with schizophrenia, comparing the efficacy of video-based rehabilitation to traditional face-to-face interventions. The primary objective was to assess whether video-based rehabilitation could serve as a viable alternative for individuals with schizophrenia residing in remote areas. A randomized controlled study was used to recruit 80 patients with schizophrenia in a stable post-hospitalization stage following discharge. Participants were categorized into three groups: 24 in the control group, 21 in the face-to-face group, and 35 in the remote group. Assessment parameters included psychiatric symptoms, social skills, family function and self-stigma. A total of 68 participants completed the program. The findings indicated significant differences (p < .05) between the control group and intervention group, particularly in the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance Scale (PSP). The rehabilitation program, tailored for patients in the early phase of the schizophrenia spectrum, demonstrates both effectiveness and feasibility in enhancing clinical symptoms and social functions. Notably, interventions conducted via video proved to be equally effective as those administered face-to-face.

Postural balance in the comprehensive rehabilitation of adolescents with cleft lip and palate and maxillofacial anomalies: A literature review

BACKGROUND: Patients with cleft lip and palate experience significant jaw relationship disorders and pathological bite formation, leading to changes in the motor activity of chewing muscles and postural balance disturbances. Most studies on postural control are conducted on patients with skeletal dentofacial anomalies and deformities without cleft lip and palate. The state of postural balance in children with cleft lip and palate requiring long-term complex medical rehabilitation, including bone-reconstructive operations on the jaw bones, remains poorly understood.&#x0D; AIM: To analyze publications dedicated to the evaluation of postural balance in adolescents with cleft lip and palate combined with jaw relationship disorders and pathological bite formation.&#x0D; MATERIALS AND METHODS: The article includes an analysis and review of several studies that investigated the state of postural balance in adolescents with cleft lip and palate, particularly at the final stages of growth and formation of the musculoskeletal system. Scientific articles published in various medical journals, monographs, dissertations, and materials from scientific symposiums related to this topic were used in the literature review. PubMed, Medline, Scopus, Web of Science, and RSCI were searched without language restrictions. The search depth was 23 years, and 64 studies were selected.&#x0D; RESULTS: The article analyzes literature data related to theories of the mechanism of mutual influence between postural balance and the dentofacial apparatus (disorders and pathological bite formation). The state of postural balance is influenced by various factors, including the craniosacral system and anomalies of the cervical spine. Patients with cleft lip and palate, hemifacial microsomia, and other craniofacial dysostoses with growth disorders of jaw bones experience an imbalance in the entire “descending” chain, causing postural disturbances, increased plantar pressure, increased foot rigidity, and changes in photogrammetry indicators, which should be considered when developing an individual rehabilitation program for these patients. The treatment of these patients without considering postural balance disorders can lead to temporomandibular joint pathologies, unstable results of the conservative orthodontic treatment of bite pathologies, and bone-reconstructive operations on jaws.&#x0D; CONCLUSIONS: The study highlights the ways of adaptation of the musculoskeletal system in the presence of occlusal relationship disorders and emphasizes the need to evaluate this influence comprehensively for the treatment of these patients. The limitations of the presented studies should be emphasized: insufficient sample size, lack of control groups and prospective studies, limited types of examination, and lack of studies dedicated to more severe anomalies of craniofacial development.

Modern approaches to ensuring health protection of persons with disabilities based on interdepartmental interaction

The article provides an overview of the basic principles, approaches and activities in the field of ensuring the health of people with disabilities. An analysis of the global experience of the United Nations on this topic, modern legal regulation in the Russian Federation devoted to the issues of ensuring the rights of people with disabilities in the field of health care, including the formation and implementation of individual rehabilitation or habilitation programs for people with disabilities (disabled children), including medical rehabilitation, based on broad intersectoral and interdepartmental interaction, was carried out. The main aspects and scope of disability as a human rights and public health problem are analyzed, as well as the approaches, principles, objectives and action plans supported by the Russian Federation aimed at ensuring inclusive healthcare systems for people with disabilities and improving the level of health and well-being of people with disabilities at all ages and in all contexts

Trunk kinematic analysis of ascent and descent stairs in college students with idiopathic scoliosis: a case-control study

BACKGROUND CONTEXTTraditional 3D motion analysis typically considers the spine as a rigid entity. Nevertheless, previous single-joint models have proven inadequate in evaluating the movement across different spinal segments in patients with idiopathic scoliosis (IS). Scoliosis significantly impairs movement functions, especially during activities such as ascending and descending stairs. There is a lack of research on the patterns of stair movement specifically for patients with IS. PURPOSEThis study aims to investigate trunk kinematics in college students with IS during stair ascent and descent tasks. A total of 56 participants, 28 with IS and 28 with healthy controls, were recruited for this case-control study. The trunk movements were analyzed using a motion analysis system that incorporated a multisegment spine model. Understanding the multi-segment spine kinematics during stair tasks can contribute to the development of effective rehabilitation programs for individuals with IS. STUDY DESIGNCase-control study. SAMPLE SIZE28 IS and 28 controls. OUTCOME MEASURESCobb angle, spinal curvature, spinal active range of motion (ROM), Kinematics METHODSThe Qualisys system (Gothenburg, Sweden) was utilized in this study with a sampling frequency of 150 Hz. It recorded the kinematics in the thoracic, lumbar, thoracic cage, and pelvis while ascending and descending stairs for both the 28 IS individuals and the 28 control participants. Additionally, clinical parameters such as the Cobb angle, curvature of the spine, spinal range of motion (ROM), and other relevant factors were concurrently assessed among the subjects. Project supported by the National Natural Science Foundation of China (Grant No. 82205306). The authors declare no conflict of interest in preparing this article. RESULTSThe findings of this study revealed that IS individuals exhibited reduced kyphotic curvature in the sagittal plane (p<.05) when compared to the control group. In contrast, these IS patients displayed greater coronal curvature (Cobb angle) in the frontal plane and a more substantial difference in thoracic side bending range of motion in comparison to the control group (p.05). Moreover, during the ascending stair activity, IS patients showed reduced thoracic cage flexion-extension range of motion (p<.05), while displaying increased lumbar rotation range of motion and anterior-posterior pelvic tilt range of motion (p<.05) in contrast to the control group. Notably, the kinematic analysis during the descent of stairs indicated that IS patients exhibited a larger range of motion in thoracic flexion-extension, thoracic side bending, thoracic cage side bending, thoracic rotation, and thoracic cage rotation when compared to the control group (p<.05). CONCLUSIONSThe results showed significant differences in trunk kinematics between the two groups during both stair ascent and descent tasks. The utilization of the "multisegment spine model" facilitates the acquisition of motion information across multiple segments of the spine in patients diagnosed with IS, effectively enhancing the assessment outcomes derived from imaging information. The three-dimensional structural deformity in the trunk affects both static and dynamic activity patterns. In different activity states, IS patients demonstrate stiff movements in certain segments while experiencing compensatory instability in others. In the future, clinical rehabilitation programs for IS should prioritize stair-related activity training.

The Relevance of Differential Assessment Between Campimetry Deficit and Neglect in Hospitalized Neurologic Patients

Background: This study investigates the clinical impact of visual system diseases and neuropsychological deficits on individualized rehabilitation programs for hospitalized neurologic patients. This study aimed to evaluate the clinical impact of visual system diseases and neuropsychological deficits on individualized rehabilitation programs for hospitalized neurologic patients. Methods: An observational study was conducted on adult inpatients with neurologic disorders who were admitted to the neurology ward between February 2022 and January 2023. These patients underwent comprehensive multidisciplinary assessments as well as clinical orthoptic evaluations. We collected data pertaining to demographics, medical history, diagnoses, and rehabilitation reports. All participants met specific eligibility criteria, including age, cognitive status, and clinical stability. Results: Initially, 120 patients, 68 ±13 years old, were included in the full cohort. Subsequently, after excluding patients with low interview reliability, those lacking campimetry defects, or those solely presenting neglect, a final cohort of 7 patients remained for qualitative analysis. This final group exhibited a broad age range, predominantly had vascular diagnoses, and experienced prolonged hospital stays. These patients were notable for the presence of campimetry disorders and frequently faced challenges associated with spatial neglect. Conclusions: Visual system diseases and neuropsychological deficits significantly impact the planning and execution of rehabilitation programs for hospitalized neurologic patients. A multidisciplinary approach, with the orthoptist's expertise, is essential to address visual impairments, improving the quality of life and functional outcomes of stroke survivors.

β-crosslaps in knee osteoarthritis – assessment and rehabilitation

Abstract: The bone turnover is important for the progression of osteoarthritis. The C-terminal telopeptide of type I collagen, β-CrossLaps (β-CTx) is considered as the first-choice bone resorption markers. Today, the biochemical markers have been associated with pain and disease severity in knee osteoarthritis (KOA) patients. We studied the association between β-CTx and functional status in KOA patients, pre- and postrehabilitation program. The primary goals of our study are both to establish the correlation between the serum level of β-CTx and other parameters of clinical and functional status in KOA patients and to compare the CTX-I values before and after rehabilitation program. We respected the actual international management recommendations for KOA. A total of 130 patients were randomly allocated into two distinct groups: Study Group (SG = 90 patients) performed 10 sessions of complete rehabilitation program (magnetodiaflux, transcutaneous nerve stimulation, ultrasound and low intensity laser treatment, kinetic measures), and Control Group (CG = 40 patients) performed 10 sessions of kinetic program. Both programs were performed daily, 5 days/week, 2 weeks. Evaluation of patients was carried out in two stages - initial (T1) and after 3 months (T2). Comparing the initial values with the final ones for β-CTx, we noticed a high significant difference between initial and final values only in SG patients. For the both T1 and T2 moments, there was no a statistically significant difference between β-CTx values from the two groups. Analyzing the differences between the values of clinical parameters (Six Minutes Walking Test, Timed Up-and-Go test, walk cadence and Symmetry index in walk) obtained between the patients from the two groups, we noticed that, for the T2 moment, there was a statistically significant difference between studied parameters, except walk cadence. In the assessment of global KOA patient status (clinical and functional status in accordance with bone-cartilage interface dynamics), β-CTx has significant value and could be used for monitoring the individualized rehabilitation program.

Methods of examination in physical therapy, and occupational therapy of people after stroke (clinical case)

the prognosis of recovery of patients after acute cerebrovascular accident depends on the type, severity, and area of brain damage. This article highlights standardized tests and scales for physical therapy and occupational therapy for patients after stroke. An example is given of a clinical case of a patient with stroke consequences, with right-sided spastic hemiplegia. Medical rehabilitation was provided in April 2023 at the Municipal Non-Profit Enterprise "Consultative and Diagnostic Center", branch №6, Sviatoshynskyi district, Kyiv, Department of Physical and Rehabilitation Medicine. After the patient visited the outpatient department of physical and rehabilitation medicine, the examination was conducted by the attending physician. A multidisciplinary team of a physical therapist and an occupational therapist was involved. An important step is the use of standardized tests and scales in physical therapy and occupational therapy. Based on the results of the examinations, the patient's goals are determined, and an individual rehabilitation program is built using evidence-based physical therapy and occupational therapy methods to provide a high-quality and effective rehabilitation cycle. Description of the objective. The standardized tests and scales in physical therapy, and occupational therapy are analyzed on the example of a clinical case of a patient after a stroke with right-sided spastic hemiplegia. Materials and methods. The clinician's handbook for 2020 on stroke rehabilitation was analyzed, with the justification of standardized tests and scales for physical therapy, and occupational therapy. A systematic review of the PubMed database was conducted, which included 44 scientific randomized trials and meta-analyses with accurate diagnoses of tests and scales for physical therapy and occupational therapy. The National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) were used to assess stroke. Modified Ashworth Scale for the assessment of spastic muscles in patients with neurological disorders. To determine cognitive outcomes and complications after stroke: Montreal Outcome Cognitive Assessment (MOCA); Modified Barthel Index (BI); Line Drawing Test. For motor function: Fugl-Meyer Assessment (FMA); Chedoke Arm and Hand Activity Instrument (CAHAI). Berg Balance Assessment; Morse Fall Risk Test; Stand and Walk Test. Results. The results of the initial examination in physical therapy and occupational therapy determined the patient's functional and cognitive state, consequences, and limitations arising after a stroke. The intermediate examination summarizes the effectiveness of the selected rehabilitation measures. If the patient's results remain unchanged, the physical and occupational therapist changes the approach and methods to achieve the goals. The final examination analyzes the dynamics of restoration of impaired functions, and achievement of goals by the end of the rehabilitation cycle. Therefore, we used the patient's clinical case to compare the initial, intermediate, and final examinations. This allowed us to analyze the results and determine the effectiveness of the selected individual rehabilitation program. Conclusions. The main principle of providing quality rehabilitation measures is the examination in the clinical practice of a physical therapist, and occupational therapist, which is used to measure the goals and compare the results achieved.

Enhancing Postural Stability in Patients with Diabetic Peripheral Neuropathy: Assessing the Impact of Vestibulo-Postural Training Using a Bipodalic Stabilometric Platform

Aims &amp; Objective: The aim of this study is to evaluate the effectiveness of Vestibulo-Postural Training Using a Bipodalic Stabilometric Platform in patients with diabetic peripheral neuropathy. Methodology: Thirty-two participants were randomly allocated into either Level Bipodalic Stabilometric Training Group (LBSTG) or Tilted Bipodalic Stabilometric Training Group (TBSTG), using a computer-generated randomization sequence. The study's approach to evaluating postural control in individuals with Diabetic Peripheral Neuropathy (DPN) involved a precise methodology using a state-of-the-art ProKin 252 balancing platform (ProKin 252, TecnoBody, Italy). Results: The study revealed that while the LBSTG training did not produce a significant change in postural control for individuals with DPN, the TBSTG training led to a significant improvement. These results highlight the potential benefits of incorporating challenging balance tasks into rehabilitation programs for individuals with DPN to enhance postural control and stability. Conclusions: this study advocates for the importance of innovative balance training interventions in enhancing the stability and mobility of patients with DPN, potentially leading to improved clinical outcomes in the management of this condition.

Implementation of an Interdepartmental Model of Complex Rehabilitation in the Perm Region in a Specialized Centre

BACKGROUND: Contemporary Russian system of complex rehabilitation and habilitation of disabled people is in the process of transformation. Application of the biopsychosocial approach through the use of the International Classification of Functioning, Disability and Health as a planning methodology Implementation and evaluation of rehabilitation measures make it possible to implement the key principles of rehabilitation: earlier, comprehensiveness, continuity, individual approach.&#x0D; AIM: To substantiate the possibility of implementing a modern regional interdepartmental model of integrated rehabilitation in a specialized centre, taking into account the structure of disability and the formation of new target rehabilitation groups.&#x0D; MATERIALS AND METHODS: Analysis of the dynamics of primary disability of the adult population, description of the structural and functional model of the creation and operation of a multidisciplinary rehabilitation center in conditions of interdepartmental cooperation.&#x0D; RESULTS: The structure of primary and secondary disability in the Perm Region is characterized by the predominance of persons with disabilities of groups 1 and 2 (60%) of working age, whose disability is caused in 30% of cases by malignant neoplasms. This determines the content of individual rehabilitation and habilitation programs to be developed for persons with disabilities and should be reflected in the development of appropriate infrastructure in the region. Modernization of the whole system, involving the use of targeted rehabilitation groups, ensuring continuity of medical and social activities in the relevant organizations and creating conditions for their continuation in the place of residence, should contribute to the effectiveness of rehabilitation activities in general.&#x0D; CONCLUSION: Recommendations on improvement of the system of complex rehabilitation in the conditions of a specialized center on the basis of interdepartmental cooperation have been proposed as a result of the research.

СТРУКТУРА РАННИХ ПОСТИНСУЛЬТНЫХ КОГНИТИВНЫХ НАРУШЕНИЙ У ПАЦИЕНТОВ. С ПОРАЖЕНИЕМ ПРАВОГО И ЛЕВОГО ПОЛУШАРИЙ ГОЛОВНОГО МОЗГА: КОГОРТНОЕ ИССЛЕДОВАНИЕ

AIM. To identify the most informative indicators of functional-cognitive status, allowing for a differentiated approach to the diagnosis of cognitive impairment in patients with damage to the right and left hemispheres in the acute period of ischemic stroke. MATERIAL AND METHODS. 240 patients diagnosed with ischemic stroke in the carotid region were examined. Depending on the location, the patients were divided into two groups: Group 1 — 122 patients with damage to the left hemisphere of the brain;Group 2 — 118 patients with damage to the right hemisphere. The following scales were used to assess parameters of cognitivefunctional status: Montreal Cognitive Assessment Scale (MoCA), National Institutes of Health Scale (NIHSS), Barthel Index (BI), Questionnaire for Cognitive Decline in the Elderly (IQCODE), additional scales for assessing praxis, semantic aphasia, perceptual and executive function, Hospital Anxiety and Depression Scale (HADS), MFI-20 and Apathy Scale (AES). The latency and amplitude of acoustic endogenous evoked potential, P300, was used as neurophysiological markers. Statistical analysis was performed using the SPSS 23 software package. RESULTS AND DISSCUSION. The main relevant indicators of cognitive dysfunction in both groups were declines in the areas of memory, perception and executive function, which prevailed in patients of the 1st group. The disorder of visual perception, understanding of complex grammatical structures, a predominance of decreased motivation and mental fatigue were identified in patients of the 1st group; impaired recognition of emotions and understanding of idioms, the presence of general fatigue and depression — in patients of the 2nd group. Statistically significant neurophysiological indicators were an increase in P300 latency in the frontal and central leads in patients of the 2nd group. CONCLUSION. The study identified relevant indicators of cognitive and psychoemotional status depending on the lateralization of the lesion in patients in the acute period of ischemic stroke. The P300 evoked potential method can be used to objectify cognitive dysfunction and evaluate the effectiveness of therapy for cognitive disorders. The results prove the feasibility of a comprehensive examination of cognitive deficits with the inclusion of additional scales and tests to assess perception, executive and mnestic functions, fatigue, affective and personality disorders. This will allow us to develop more effective individual rehabilitation programs aimed at restoring the cognitive and emotional resources of patients. KEYWORDS: ischemic stroke, cognitive function, affective disorders, fatigue, evoked potentials, Р300

Neuropsychological syndromes of disorders of mnestic activity in patients with strokes in the right (subdominant) hemisphere

The work carried out a neuropsychological assessment of different types of memory and determined the profiles of mnestic disorders depending on the type of hemispheric asymmetry and localization of the lesion. The analysis of the features of the course of stroke in the right (subdominant) hemisphere was carried out. The main symptoms of impaired types of memory, for which the subdominant hemisphere is responsible, were studied. The presented data correlate with the data found in the world literature: stroke in the subdominant hemisphere has a less pronounced effect on memory impairment, is associated with a better prognosis, while visual memory, spatial, logical, and mechanical suffer more often. A detailed topographic analysis of the syndromatics is presented, comparing instrumental data on visualization of the lesion and psychological tests that reveal a deficiency of a particular type of memory. The data obtained make it possible to identify targets and opportunities for early neuropsychological correction of disorders by attracting compensatory brain capabilities, which is important when planning an individual rehabilitation program. The analysis of mnestic activity in patients with strokes in the right (subdominant) hemisphere was carried out. The applied set of patho- and neuropsychological methods: The Wexler memory scale, Indirect memorization according to A.N. Leontiev, the "Pictograms" technique, Benton's Visual retention, the "Memorizing 10 words" Technique, the "Memorizing faces" technique, the "Memorizing shapes" method., the MOSS test. For the first time, a comprehensive clinical, psychological and experimental psychological study was conducted, which made it possible to characterize the quality and hierarchy of impaired and preserved types of mental activity in the defeat of the right (subdominant) hemisphere. For the first time, a comparative analysis of disorders of the mnestic activity of the dominant and subdominant hemispheres of the brain was carried out, which allowed us to identify the specifics of memory disorders depending on the lateralization of lesions. The novelty is also represented by the systematization of mnestic disorders carried out by the author, accompanied by the isolation of neuropsychological syndromes of disorders of mnestic activity in the defeat of various parts of the right (subdominant) hemisphere in the acute period of syndromes of occipital, temporal, parietal lobe lesions and their combinations. Based on the data obtained, the necessity of studying the features of mnestic activity in order to restore and further rehabilitate higher mental functions in patients with cerebral infarction in the right hemisphere is justified.

An Individual Rehabilitation and/or Habilitation Program for Children with Disabilities (IPRH)

Introduction: The individual program of rehabilitation and (or) habilitation of children with disabilities (IPRH) is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational-legal forms and forms of ownership. Objective: To conduct a pilot analysis of the implementation of the IPRH contingent of patients of children with disabilities in an urban children’s clinic. Patients and methods: There were 366 reports on the implementation of measures provided for by an IPRH for a disabled person (disabled child) of 222 disabled. The organization of the study was in the nature of a continuous sample. The criterion for the inclusion of patients in it was the passage of an IPRH in a disabled child within a specified time frame. The following techniques were used: grouping, absolute and relative values, average values, detailing, and generalization. The threshold error probability for statistically significant differences was set at a level of 0.05. Results: The structure of the results of the control of the performance of IPRH in 222 disabled children according to the classes of diseases that caused the onset of disability (ICD) was as follows 1) G00-G99 - 35.47 ± 3.13%; 2) Q00-Q99 - 23.50 ± 2.77%; 3) 11.11 ± 2.05%; 4) C00-D48 - 10.25 ± 1.98%; 5) H60-H95 - 7.26 ± 1.67%; 6) M00-M99 - 2.99 ± 1.11%; 7-8) H00-H59 and P00-P96 - 2.14 ± 0.95%; 9-10) K00-K93 and S00-T98 - 1.29 ± 0.74% each; 11-12) I00-I99 and N00-N99 - 0.85 ± 0.60% each; 13-14) J00-J99 and L00-L99 - 0.43 ± 0.42% each. Conclusion: 1. In the structure of IPRH in 222 disabled children, according to the classes of diseases that caused disability (ICD), the following prevailed: 1) VI Diseases of the nervous system G00-G99 – 35.47%; 2) XVII Congenital anomalies, chromosomal disorders Q00-Q99 - 23.50%; 3) IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders E00-E90 – 11.11%; 4) II Neoplasms C00-D48 - 10.25%; 5) VIII Diseases of the ear and mastoid process H60-H95 - 7.26%; 6) XIII Diseases of the musculoskeletal system and connective tissue M00-M99 - 2.99%; 7-8) VIII Diseases of the ear and mastoid process H60-H95 and VII Diseases of the eye and its adnexa H00-H59 - 2.14% each. 2. The effectiveness of medical rehabilitation of disabled children was as follows: 1) Improvement - 23.26%; 2) Stabilization - 74.88%; 3) Deterioration - 1.86%. Dynamic observation was carried out on 94.26% of disabled children, drug therapy - 77.32%, non-drug therapy - 66.93%, and other types of medical rehabilitation were received by 14.48% of patients. Reconstructive operations were performed on 11.26% of disabled children. 3. Prosthetics and orthotics were performed on 38.74% of disabled children. 32.43% of disabled children in need received sanatorium treatment, and 30.18% are currently in line to receive a voucher. For various reasons, 24.32% refused this type of rehabilitation; 3.60% of patients had contraindications at the time the voucher was provided. 4. The obtained research results become the initial everyday statistical tool for objectifying the process of rehabilitation of patients and determining the strength and means of a medical institution to monitor and successfully implement an individual rehabilitation/habilitation program for a disabled person

Tuning in to recovery: influence of music on emotional well-being during mealtime in inpatient facilities for eating disorders

BackgroundIn rehabilitating eating disorders (ED), mealtimes are critical but often induce stress, both for restrictive and binge-purge disorders. Although preliminary data indicate a positive effect of music during mealtime, few studies employ an experimental approach. This study examines the influence of background music during mealtime in an inpatient ward setting, offering a real-world perspective.MethodsFifty-one women diagnosed with ED participated in this within-subjects study. Over two weeks, during lunch and dinner, they were exposed to three randomized music conditions: no music, focus piano music, and pop music. The self-report questionnaires captured affective states, noise levels, and hunger, while trained dietitians recorded food consumption and eating rituals.ResultsThe absence of music led to an increase in uneaten food (p = 0.001) and the presence of eating rituals (p = 0.012) during mealtimes. Significantly, only silence during mealtime reduced positive emotional states, while background music maintained positive emotions (p < 0.001). No specific differences emerged between the two types of music (focus piano and pop).ConclusionsThese findings affirm the positive impact of background music during mealtime in real-world settings, enhancing the potential of inpatient eating rehabilitation programs for individuals with ED. More studies are needed to validate and extend these results, particularly in outpatient settings.

Psycho-Emotional Aspect in Early Rehabilitation of Patients Who Have Suffered Ischemic Stroke in a Specialized Hospital in Bishkek

The psycho-emotional aspect during early rehabilitation of patients who have suffered an ischemic stroke is an important factor in determining an individual rehabilitation program. For successful rehabilitation treatment, it is necessary to adequately determine the state of impaired functions in each person, taking into account the likelihood of its independent recovery, duration, nature and degree of the existing defect. The period of recovery of neurological functions after a stroke can last differently, from several months to several years.

Clinical properties and rehabilitation needs of earthquake survivors in a subacute rehabilitation setting.

This descriptive analysis examines the victims of the February 6, 2023, earthquakes in Kahramanmaraş and Elbistan, Türkiye. It aims to detail the injury profiles related to neuro-musculoskeletal trauma, assess the rehabilitation needs of patients, and propose a comprehensive rehabilitation approach. The study included patients injured in the Kahramanmaraş-centered earthquake on February 6, 2023, who were transported to our hospital based on their rehabilitation needs. Data from patients treated at our hospital were recorded retrospectively. This included demographic information, accompanying pathologies, laboratory findings, rehabilitation programs, and treatments received during their hospital stay. Statistical analyses were conducted to examine the data. A total of 141 patients with musculoskeletal injuries were admitted due to injuries sustained from the earthquake. The mean age of the participants was 39.76 years, with a slight female predominance (56.7%). The majority of patients sustained injuries while trapped under debris (90.1%), with an average duration of 10 hours under rubble. Fractures were the most common form of injury (53.2%), predominantly affecting the lower extremities. Peripheral nerve injuries were present in 41.1% of patients, and amputations were observed in 30.5%. Complications included compartment syndrome (46.1%), crush syndrome (36.2%), and various infections. Pain was prevalent among patients, with somatic pain being the most reported type. Individualized rehabilitation programs were implemented, incorporating physical therapy, wound care, pain management, and psychosocial support. This study highlights the critical rehabilitation needs of earthquake survivors and emphasizes the importance of early and comprehensive rehabilitation interventions. Multidisciplinary rehabilitation programs were crucial in addressing medical issues, functional limitations, and psychological challenges faced by the survivors. The findings contribute to a deeper understanding of earthquake-related injuries and underscore the significance of well-coordinated rehabilitation strategies in disaster responses.

Functional status of patients after myocardial revascularization combined with chronic low back pain at the sanatorium-resort stage of medical rehabilitation

To develop an algorithm for assessing the functional status of patients after myocardial revascularization with chronic low back pain. The single-center cross-sectional cohort study (September 2021 - May 2022 yrs) included 50 patients after a myocardial revascularization with chronic low back pain (36 women, 14 men; median age 63.5 [55.5; 67.5] years), who were the study group and 10 patients with CIHD (5 women, 5 men; median age 65.0 [62.0; 68.0] years) who joined the control group. All patients underwent clinical (neurological and therapeutic examination), functional (clinical tests, echocardiography) and laboratory (general and biochemical blood analysis, blood cytokine levels) investigations, the functional class of impairment was defined. There are 4 groups with combined pain syndrome (cardiogenic and vertebrogenic) in different ratios due to different functional and laboratory status among patients after the myocardial revascularization with chronic back pain. The presence of cardiogenic pain syndrome was associated with an increase in leukocyte and peripheral blood glucose levels, interleukin-6, myocardial mass enlargement, while vertebrogenic pain syndrome correlated with personal anxiety. The evaluation of the functional status of patients according to the degree of severity of cardiogenic and vertebrogenic pain syndrome has revealed a simple method of pathogenetically based differentiation selection for individual rehabilitation program of patient development.

A clinical case of post-concussion syndrome in an elite professional football player

Objective: to demonstrate our own clinical case of an athlete with an unusual post-concussion syndrome after repeated concussion of the brain.Materials and methods: presentation of own clinical observation in dynamics of a professional football player with repeated concussion of the brain complicated by post-concussion syndrome with laboratory-instrumental diagnostic methods.Results: a professional football player, as a result of a re-diagnosed concussion of the brain, had headaches, mainly in the temporal and occipital regions, weather dependence, subfebrility, while there was no effect from taking nonsteroidal anti-inflammatory drugs. As a result of instrumental examinations, changes in MCT and MRI were revealed. The conducted examinations, methods of treatment, the plan of an individual rehabilitation program are described.Conclusion: this clinical case is of great interest to practicing sports doctors, due to frequently recurring head injuries, especially in contact sports and the lack of an algorithm for treatment and rehabilitation of highly qualified athletes.

Effectiveness of Virtual Reality Rehabilitation versus Conventional Physical Therapy on Quality-of-Life function and Balance in Parkinson's Disease Patients: A Randomized Controlled Trial

Background: Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, affecting the quality of life, functional independence, and balance of individuals. While conventional physical therapy (PT) has been a standard approach, emerging technologies like Virtual Reality (VR) have shown promise in neurorehabilitation. Objective: This study aimed to compare the effectiveness of Virtual Reality (VR) Rehabilitation with Conventional Physical Therapy (PT) in enhancing the quality of life, functional status, and balance among individuals diagnosed with Parkinson's disease (PD). Methods: A randomized controlled trial was conducted, involving 46 PD patients the participants were randomly assigned to either the VR group (n=23) or the PT group (n=23). Data was collected from johar poly clinic Lahore Pre-intervention and post-intervention assessments included the Short Form 36 (SF-36) for quality of life, Barthel Index for functional status, and Berg Balance Scale for balance. Descriptive statistics and paired t-tests were employed for data analysis. Results: Pre-intervention demographics indicated comparable age distributions (VR group: 65.0 ± 5.2; PT group: 67.1 ± 4.8) and a predominance of males in both groups. Baseline scores demonstrated no significant differences between VR and PT groups for SF-36 (41.40 ± 4.87 vs. 38.20 ± 4.21), Barthel Index (90.00 ± 7.14 vs. 86.00 ± 6.93), and Berg Balance Scale (44.00 ± 6.52 vs. 40.00 ± 7.11). Conclusion: The study results indicated that rehabilitation programs for individuals with Parkinson's disease were efficacious in enhancing their functional outcome. An evaluation of the two programs, both centered around physical exercises, demonstrated that virtual reality (VR) rehabilitation surpasses traditional therapy in assessing overall improvements (such as upper limb function, gait, balance, and the psychological aspect of quality of life) in a secure and stimulating setting.