Long-term Rehabilitation Program Research Articles

Impact of a Long-Term Home-Based Rehabilitation Program on Quality of Life, Balance, and Autonomy in Adults with Disabilities.

Rehabilitation is a critical process for enhancing functionality, independence, and quality of life in individuals with disabilities. Grounded in the biopsychosocial model, it addresses physical, emotional, and social dimensions through personalized, evidence-based interventions. By integrating standardized assessments and continuous evaluation, rehabilitation has the potential to promote recovery and support active participation in society. This study evaluated the impact of a long-term, multidisciplinary, home-based rehabilitation program on quality of life, balance, and functional autonomy in adults with neuromusculoskeletal disabilities. A total of 559 participants received individualized interventions from a team of physical therapists, occupational therapists, psychologists, and other health professionals. Functional independence, balance, depressive symptoms, and quality of life were assessed using the Barthel Index, Berg Balance Scale, Beck Depression Inventory, and SF-36 questionnaire, respectively. A longitudinal analysis comparing pre- and post-intervention outcomes revealed statistically significant improvements (p < 0.001) across all metrics. The Barthel Index median increased from 85 to 90 points, indicating greater functional independence, while the Berg Balance Scale improved from 39 to 47 points, reflecting reduced fall risk. Depressive symptoms decreased, with Beck Depression Inventory scores dropping from 12 to 9, and both physical and mental health components of the SF-36 showed marked enhancements. These findings demonstrate the program's effectiveness in addressing both physical and emotional needs, emphasizing the value of extended, personalized, home-based care in improving health, autonomy, and overall quality of life for individuals with disabilities. This study underscores the potential of multidisciplinary approaches to support long-term rehabilitation in diverse populations.

Social Justice and Economic Sustainability: The Mitigation Role of Islamic Economics Against Natural Disasters

This article discusses the role of Islamic economic mitigation in achieving social justice and economic sustainability in the context of natural disasters. The main focus of this research is how the principles and instruments of Islamic economics, such as zakat, infaq, alms, waqf, andIslamic microfinance institutionscan be used to reduce the social and economic impact of natural disasters. Islamic economics, based on the principles of social justice and redistribution of wealth, offers a holistic and sustainable approach to dealing with disasters. These instruments are capable of providing immediate and effective assistance, as well as supporting long-term rehabilitation and development programs. This research uses a descriptive analysis method with a library research approach. The research results show that Islamic economics not only functions as an economic system, but also as a mechanism for achieving social justice and economic sustainability, which can significantly increase society's resilience to future disasters. This paper emphasizes that the application of Islamic economic principles can be an effective and sustainable solution in dealing with the macroeconomic impacts of natural disasters.

Self-Stigma in Patients with Endogenous Mental Disorders: A Cross-Sectional Comparative Study.

Self-stigma remains one of the most vexing issues in psychiatry. It complicates the treatment and social functioning of patients with endogenous psychiatric disorders. Identifying the specific features of self-stigma depending on the type and duration of the endogenous mental illness can help solve this problem. The aim of this study was to establish the level and specific features of self-stigma in patients with various types of chronic endogenous psychiatric disorders at different disease stages and to establish the correlation between the level of self-stigma and the attitude of the patient to his/her disease and treatment. Clinical psychopathology assessment, psychometric scales and questionnaires: "Positive and Negative Syndrome Scale" (PANSS), "Questionnaire for Self-Stigma Assessment in Mentally Ill Patients", and Russian versions of the "Insight Scale for Psychosis" (ISP), and "Drug Attitude Inventory" (DAI-10). The cross-sectional study included 86 patients with endogenous mental illnesses (bipolar affective disorder and schizophrenia spectrum disorders. The analysis of the results of the "Questionnaire for Self-Stigma Assessment in Mentally Ill Patients" showed that at the initial disease stages the highest level of self-stigma is observed in patients with bipolar affective disorder (M±σ=1.22±0.73; Me [Q1; Q3]=1.10 [0.83; 1.60]), while the lowest level was observed in patients with schizophrenia spectrum disorders (M±σ=0.86±0.53; Me [Q1; Q3]=0.77 [0.31; 1.25]). Patients with schizophrenia and schizoaffective disorder and a disease duration more than five years participating in a long-term comprehensive psychosocial rehabilitation program also demonstrated high rates of self-stigma (M±σ=1.20±0.57, Me [Q1; Q3]=1.26 [0.89; 1.47]). The study groups showed differences in terms of the structure of components of self-stigma and their severity; significant correlations were uncovered between the self-stigma parameters and the attitude of patients to their disease and therapy. The results of this study contribute to a better understanding of the specific features of self-stigma in patients with various endogenous disorders at different stages of the disease. These data can be used as part of a comprehensive psychosocial treatment program for this patient cohort, as well as for future research.

폐이식 수혜자에 대해 적용한 장기간 호흡재활프로그램의 효과

Purpose: The purpose of this study was to provide long-term pulmonary rehabilitation program (PR) to lung transplant recipients for more than a year and verify their effectiveness.&#x0D; Methods: A 52-year-old female patient who had bilateral lung transplantation received an outpatient PR 3 times a week for a total of 97 weeks. The PR applied was composed of aerobic exercise, strength exercise, breathing exercise, flexibility exercise, and home exercise education. Evaluation was performed on the participant at 3, 6, 9, 12, and 24 months after surgery. For each period, the following parameters were determined: 6-minute walk distance (6MWD), grip strength, respiratory muscle strength, lung function, peak cough flow rate, skeletal muscle mass (SMM), and skeletal muscle index (SMI).&#x0D; Results: The 6MWD increased up to 12 months following surgery, and exercise-induced hypoxemia occurred only 3 months following surgery. The grip strength increased up to 12 months after surgery and decreased at 24 months after surgery. The MIP increased up to 12 months after surgery, and the MEP increased until 24 months after surgery. The FVC increased up to 12 months following surgery and FEV1 increased up to 24 months following surgery. PCF increased up to 12 months after surgery. Body weight also increased steadily until 24 months postoperatively. SMM and SMI increased up to 12 months after surgery, and SMI decreased at 24 months following surgery.&#x0D; Conclusion: It is essential that the PR for lung transplant recipients be applied intensively in less than 12 months after surgery, and the goal of the PR should be configured for the purpose of management in more than 12 months following surgery.

Clinical Applications of Virtual Reality in Musculoskeletal Rehabilitation: A Scoping Review.

(1) Background: VR is based on a virtual world that creates sounds effects and videos that replace the real environment. Arising literature shows VR efficacy in the field of neurological rehabilitation (NR) and that its use is also taking a place in musculoskeletal rehabilitation (MSR), as a treatment of various disorders that cause disability and chronic pain. (2) Aim: We discuss the role of VR in MSR, presenting its use and development on acute and chronic musculoskeletal disorders, based on the most recent literature. (3) Design and Methods: Literature searches were conducted in the databases Pubmed and Medline up to 30 September 2023. The PRISMA-Scr Checklist was followed. (4) Results: A total of 51 records were included. The analysed studies were conducted within a variety of populations, musculoskeletal disorders, settings, and VR technologies. Only a few studies could statistically affirm the efficacy of VR in MSR, as mentioned for the rehabilitation of the upper limb. Nevertheless, the observed trend is an improvement of the global perceived effect compared to traditional rehabilitation. (5) Conclusion: VR allows for the personalisation of treatment with an adaptable treatment platform, which may improve the participation of the patient and increase acceptability and adherence to long-term rehabilitation programs. We provide recommendations and suggestions for future research and use of VR in musculoskeletal rehabilitation.

Limb Salvage Strategy Amendment for a Better Future in the Era of Bone Cancer Therapy: A Cross-Sectional Study in North India.

Bone tumors remain a formidable challenge for orthopedic surgeons. In developing countries, the challenge is exacerbated by limited diagnostic, therapeutic, and management facilitiesand ignorance. Patients with upper and lower-extremity muscle and skeletal tumors are candidates for amputation or surgical rescue of the limbs. Traditionally, limb rescue surgery by neo-adjuvant chemotherapy is the preferred surgery method for localized carcinoma. Amputations are usually reserved for patients with increased tumor size. The purpose of this study is to investigate health-related quality of life (HRQOL) and physical disability, focusing on surgical care, gender, and age, in adolescent and young adult survivors of malignant bone tumors treated surgically. This cross-sectional study consists of 38 long-term survivors who underwent amputation or limb-salvage surgery at King George's Medical University, Lucknow, from 2019 to 2022. After obtaining ethical clearance and informed consent, 38 patients which included 26 patients treated with limb salvage in Group A and 12 patients treated with amputation in Group B were included in the study. The SF-36 and HUI3 scores were used to assess the functional outcome and health-related QoL of these patients. After minimal six months of interventions, we have found a significant improvement in all the following factors: physical functioning (P=0.000), role limitations due to physical health (P=0.000) and emotional problems (P=0.001), energy/fatigue (P=0.000), emotional well-being (P=0.000), social functioning (P=0.000), pain (P=0.000), and general health (P=0.000). Group A showed a higher degree of significance than Group B through SF-36 (Short Form-36, patient-reported outcome), whereasHUI-3 did not show any significant outcomes (P=0.347). The overall quality of life of patients with salvaged limbs appears to be higher than that of the quality of life of amputee patients in tumor survivor patients. Further analyses must be carried out to verify the results and focus on areas that have a major impact on the overall quality of life using other assessmenttools. The impact of therapy on the quality of life depends on maintaining the necessary structures for functional functions, adjusting patient expectations to cancer treatments, and designing long-term rehabilitation programs to support functional functions.

Patient motivation, satisfaction and attitudes towards involvement in inter-professional collaborative practice: A cross-sectional study

During hospital-based long-term rehabilitation programmes, particularly for patients with spinal cord injuries, healthcare providers must make sure those patients are motivated, satisfied, and have positive views towards inter-professional collaboration among the team members. If they do this, patients will have a higher chance of sticking to their treatment plan, completing prescribed drugs, and getting better health results will have a higher chance of adhering to their treatment plan, taking the therapy recommended, and getting better health results if they comply with this. In a developing nation like Bangladesh, there is still much to learn about how patients feel about their care, what motivates them, and how they see the team that works with them. The purpose of the study was to investigate the level of motivation, attitudes, and satisfaction of people with spinal cord injury towards interprofessional collaborative practice. Quantitative research was applied to achieve the objectives. The overall motivation and satisfaction level of the patient with SCI towards interdisciplinary teamwork was high, 83.35% and 84.2%. Similarly, the patient attitude toward the team was just above average. The study findings could improve the rehabilitation sector's collaboration level by addressing strengths and weaknesses.

Meditation as a stress management strategy in cardiac rehabilitation for coronary artery disease patients: a randomized controlled trial

Abstract Funding Acknowledgements Type of funding sources: None. Background There is a growing body of empirical research that shows that psychological risk factors such as stress, type D personality, anger and hostility can lead to depression, anxiety, social isolation, and low socio-economics status. Psychological risk factors increase the risk of coronary artery disease (CAD) and contribute to a poorer quality of life (QoL) and worst cardiovascular prognosis. Stress, anxiety, and depression deteriorate the cardiovascular (CV) system through psycho-neuro-immunoendocrinology system and behavioural pathways. Meditation, as a form of body–mind interaction for primary and secondary prevention in CV disease has been discussed critically in the past and has been growing as a therapeutic practice. However, in CV rehabilitation programmes, more studies are needed to demonstrate meditation as a complementary therapy for CV patients. Purpose To evaluate the benefits of meditation as a stress management strategy, in a traditional CV rehabilitation programme, in terms of stress, anxiety, depression and QoL for people with CAD. Methods Eighty CAD patients were invited to join the meditation programme, 48 (60%) accepted and attended the initial assessment and 32 (40%) declined participation. The patients who accepted were attending for at least 6 months a 3x week exercise-based CV rehabilitation programme (usual care) and were randomized (1:1) into two distinct groups: the intervention group (IG) with meditation practice for 4 months and the control group (CG), usual care. In the IG, for one month, participants had a weekly session of 90 minutes consisting of Conscient breathing and Compassion Meditation (Karuna). During the next 3 months, all participants at the IG were asked to practice daily for 20 minutes alone or with the support material (video), with a weekly follow-up call. At the end of the 4th month, it was offered to the CG the same meditation programme. Outcome measures were assessed at the beginning (M0) and 4 months after (M1) including stress (Perceived Stress Scale), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory) and QoL (HeartQoL questionnaire). Results Forty patients (65 ± 8 years, 80% male) completed all study requirements and were included in analyses. The IG reduced 44% of the depression levels when compared to the CG (-44.0 ± 32.0% vs -2.9 ± 5.0%; p&amp;lt;0.001). There were 30% (p=0.04) and 31% (p=0.05) reductions in anxiety and stress levels in the IG, respectively. The emotional dimension of QoL increased 60% in the IG, p&amp;lt;0.001. In contrast, physical QoL did not change between groups. Conclusion Meditation has proved to be an additional practice with effective reduction on stress, anxiety, and depression levels, as well as increasing QoL for patients with CAD who are attending a long-term CV rehabilitation programme.

Review of Factors Affecting Remission in Narcological Patients

INTRODUCTION: Achievement of a sustained remission in patients with substance dependence syndrome is the main criterion of the quality of narcological treatment and a priority treatment task. The article presents a review of factors that influence remission in patients with mental and behavioral disorders resulting from use of psychoactive substances. Studies performed in the recent 15 years, consider the main five groups of factors for development and failure of remission: biological (gender, age, genetic parameters, organic lesions of the brain, etc.), narcological (course of the disease, age at the first use of a drug), personality and pathopsychological (cognitive disorders, comorbid mental disorders, mental trauma, etc.), social (employment, family and social situation, social support, etc.) and therapeutic factors (duration and methods of treatment, therapeutic alliance, etc.)..&#x0D; CONCLUSION: There are basic factors of favorable prognosis of the course of narcological diseases that are confirmed from study to study: late onset of the disease, absence of a comorbid dependence syndrome and of a severe mental disorder, involvement in long-term treatment and rehabilitation programs that continue after remission.

Lung Support Service: Implementation of a Nationwide Text Message Support Program for People with Chronic Respiratory Disease during the COVID-19 Pandemic

COVID-19 pandemic lockdowns led to the closure of most in-person pulmonary rehabilitation programs in Australia. Text message programs are effective for delivering health support to aid the self-management of people with chronic diseases. This study aimed to evaluate the implementation of a six-month pre-post text message support program (Texting for Wellness: Lung Support Service), and the enablers and barriers to its adoption and implementation. This mixed-methods pre-post study used the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate the Texting for Wellness: Lung Support Service, which is an automated six-month text message support program that included evidence-based lifestyle, disease-self management and COVID-19-related information. Reach was measured by the proportion of participant enrolments and demographic characteristics. Adoption enablers and barriers were measured using text message response data and a user feedback survey (five-point Likert scale questions and free-text responses). Implementation was evaluated to determine fidelity including text message delivery data, opt-outs, and intervention costs to promote and deliver the program. In total, 707/1940 (36.4%) participants enrolled and provided e-consent, with a mean age (±standard deviation) of 67.9 (±9.2) years old (range: 23-87 years). Of participants who provided feedback, (326/707) most 'agreed' or 'strongly agreed' that the text messages were easy to understand (98.5%), helpful them to feel supported (92.3%) and helped them to manage their health (88.0%). Factors influencing engagement included a feeling of support and reducing loneliness, and its usefulness for health self-management. Messages were delivered as planned (93.7% successfully delivered) with minimal participant dropouts (92.2% retention rate) and low cost ($AUD24.48/participant for six months). A total of 2263 text message replies were received from 496 unique participants. There were no reported adverse events. Texting for Wellness: Lung Support Service was implemented quickly, had a broad reach, with high retention and acceptability among participants. The program was low cost and required minimal staff oversight, which may facilitate future implementation. Further research is needed to evaluate the efficacy of text messaging for the improvement of lung health outcomes and strategies for long-term pulmonary rehabilitation program maintenance.

The effectiveness of rehabilitation programs for the mobilization of compensatory-adaptive neuroplasticity processes in patients with Parkinson’s disease according to indicators of neurotrophic factors

The purpose of the study: is to objec- tively evaluate the effectiveness of non- drug rehabilitation programs for patients with Parkinson’s disease (PD) based on in- dicators of specific neurotrophic factors. Sixty-one patients with PD: study group — 33 patients, comparison group — 28 people. There were 33 patients in the ex- perimental group and 28 in the compari- son group. The patients of the experi- mental group did daily physical exercises for two months, unlike the representatives of the comparison group. Patients of both groups were examined for the serum level of the neurotrophic fac- tors: glial cell line-derived neurotrophic factor (GDNF) and cerebral dopamine neurotrophic factor (CDNF) In patients with PD of the comparison group, the synchronous dynamics of CDNF and GDNF indicators occurred and char- acterized the individual course of the dis- ease. On the other hand, in the experimental group, asynchrony of changes of these neuro- trophic factors in blood serum was observed under conditions of physical exertion. Summarizing the data obtained, it is nec- essary to consider many factors that can af- fect the level of neurotrophic factors. There is probably a genetically determined hetero- geneity of the Parkinson’s disease pheno- type, which is also expressed by the features of the synchronous dynamics of CDNF and GDNF parameters. It follows that the initial assessment of these parameters in patients with PD is optimal to identify those for whom motor rehabilitation will cause a long and stable positive effect and ensure the course of the disease according to a favourable type. The multidirectional and asynchrony of changes in neurotrophic factors in blood serum under conditions of physical exer- tion indicates the "sensitivity" of the sys- tem of neurotrophic factors to rehabilitation measures, even if they are used for a short time. Since long-term rehabilitation programs provide positive dynamics in the design of neurotrophic factors, a sufficient dura- tion and regularity of non-drug rehabilitation programs are advisable.

Personalised socially assistive robot for cardiac rehabilitation: Critical reflections on long-term interactions in the real world.

Lack of motivation and low adherence rates are critical concerns of long-term rehabilitation programmes, such as cardiac rehabilitation. Socially assistive robots are known to be effective in improving motivation in therapy. However, over longer durations, generic and repetitive behaviours by the robot often result in a decrease in motivation and engagement, which can be overcome by personalising the interaction, such as recognising users, addressing them with their name, and providing feedback on their progress and adherence. We carried out a real-world clinical study, lasting 2.5 years with 43 patients to evaluate the effects of using a robot and personalisation in cardiac rehabilitation. Due to dropouts and other factors, 26 patients completed the programme. The results derived from these patients suggest that robots facilitate motivation and adherence, enable prompt detection of critical conditions by clinicians, and improve the cardiovascular functioning of the patients. Personalisation is further beneficial when providing high-intensity training, eliciting and maintaining engagement (as measured through gaze and social interactions) and motivation throughout the programme. However, relying on full autonomy for personalisation in a real-world environment resulted in sensor and user recognition failures, which caused negative user perceptions and lowered the perceived utility of the robot. Nonetheless, personalisation was positively perceived, suggesting that potential drawbacks need to be weighed against various benefits of the personalised interaction.

Design of a Smart Elbow Brace as a Home-Based Rehabilitation Device.

Poststroke and traumatic elbow injuries are the most common cause of elbow stiffness, which results in loss of functional range of motion (ROM). Various studies support early mobilization of the elbow joint after injury or after surgery to reduce risks of elbow stiffness development. After hospitalization, patients are required to follow a long-term rehabilitation program during home recovery. Still, most patients do not adhere to their clinical therapy schedule due to either rehabilitation cost, social obligations, negligence, or lack of inspiration. Moreover, the numbers of therapists and assessment equipment are insufficient. This study introduces a smart elbow brace (SEB) as a home-based rehabilitation device that reduces regular in-patient rehabilitation costs and therapist workload and motivates patients to comply with the rehabilitation program that enhances the achievement of rehabilitation goals. Our device has two active degrees of freedom (2-DoF) that allow extension, flexion, pronation, and supination elbow motions. An extra sliding joint between forearm and wrist is added, which helps dump forces concentration at the elbow joint during extension-flexion movement. Mechanical design requirements, motion-tracking systems, and serious game development are described. The feasibility of a proposed SEB device is tested with five healthy subjects playing developed serious games with the device. The results show that subjects can attain maximum and minimum angles of flexion-extension and pronation-supination motion designed for elbow stiffness rehabilitation. The SEB device will be beneficial and be used at home as a complementary tool to support elbow stiffness rehabilitation during long-term home recovery.

Self-Regulation Processes in Patients with Alcohol Dependence (Pilot Study)

IntroductionThe first stage of the psychological intervention is related to diagnosticsObjectivesPurpose of the study was to explore features of mental self-regulation processes in patients with diagnosis “Mental and behavioral disorders due to use of alcohol”.MethodsThe study involved 39 male patients with alcohol dependence, the average age of 43.6 ± 6 years. The experimental group (20 patients) was taking part in in-patient rehabilitation program, the duration of rehabilitation ranged 4-6 months. The control group included 19 patients of the in-patient addiction treatment department, with average duration of treatment 21 days. To assess self-regulation processes, questionnaires “Style of behavior self-regulation” (Morosanova V.) and questionnaire of volitional self-control (Zverkov A., Eydman E.) were used. To compare differences between two independent groups Mann-Whitney U-test was usedResults There was a significant difference for the subscale “Persistence and perseverance” in “Volitional self-control” test (p≤0.05) for the control and experimental groups. Patients, involved in clinical rehabilitation program, have higher ranks comparing to patients got clinical treatment (22.2 and 17.7). The comparison of the results of the questionnaire “Style of behavior self-regulation” showed that there is a significant difference for subscales “Modeling of significant conditions” and “Independence” (p≤0.05); participants from the experimental group had higher mean rank in both cases.Conclusions Patients who took part in the long-term in-patient rehabilitation program had more stable motivation to achieve their goals, better self-regulation and activity planning skills, higher independence and self-confidence, they were less dependent on opinion of others. The identified features can be used in psychological programs aimed at improving planning skills, reducing behavioral rigidity, stabilizing self-esteem and improving adaptive capacity.DisclosureNo significant relationships.

Болезнь Альцгеймера и ядерная медицина: циркадианный стресс и нейровоспаление, нейрокоммуникации и нейрореабилитация

Modern neurotechnologies of nuclear medicine, a new 5P of Medicine and 5G technology have made a discovery in solving the problem of Alzheimer's disease. Ten-year author's experience in implementing research results (algorithms/tools/inventions) allowed for successful medical rehabilitation of cognitive impairment and increased (healthy/qualitative/cultural/religious) life expectancy. Romanchuk N.P. research on mitigating the effects of circadian stress on healthy longevity of Homo sapiens has opened multidisciplinary targeted opportunities for psychiatrists, neurologists, cardiologists, endocrinologists, and geriatricians. Genetic and epigenetic therapy of age-dependent endothelial dysfunction in vascular aging is strategic, in the activities of active longevity. Modern neurotechnologies of nuclear medicine, a new 5P of Medicine and 5G technology have made a discovery in solving the problem of Alzheimer's disease. In the studies of Romanchuk N.P., it is shown that for new neurogenesis and neuroplasticity, to manage human neuroplasticity and biological age, for modern neurophysiology and neurorehabilitation of cognitive disorders and cognitive disorders, sufficient functional and energy nutrition of the brain is needed using modern neurotechnologies of nuclear medicine: radioprotective pharmaceuticals and nutricology, radio modulators and radiomythiters. An increase in the combined total risk on the brain of Homo sapiens is being investigated: pathological accelerated brain aging, cerebral COVID-19 exposure, nuclear medicine technologies. Modern principles of rational design of nanomaterials optimize therapeutic effectiveness, therefore, systematic generalization of achievements in this field allows developing new highly effective nanoradioprotectors with maximization of drug effectiveness. Combined drug platform and enriched bioelementology and nutritionology (brain/microbiota and genome/epigenome), hybrid neuroimaging and nuclear medicine neurotechnologies work both proactively and in long-term medical rehabilitation programs. The Homo sapiens brain health cultural paradigm in the ten-year study Active Longevity: Genome Biophysics, Nutrigenomics, Nutrigenetics, Revitalization Activates the Penetration of Evolutionary and Socio-Cognitive Human Brain Neurocommunications into Modern Nuclear Medicine Neurotechnologies, a new 5P of Medicine and 5G technology.

Nutrition guidelines compliance in cardiovascular disease patients attending a long-term exercise-based cardiac rehabilitation program during COVID-19 era

Funding AcknowledgementsType of funding sources: None.IntroductionDietary habits influence cardiovascular disease (CVD) risk, mainly through risk factors such as lipids, blood pressure, body weight and diabetes. Therefore, a healthy diet is recommended as a cornerstone of CVD prevention in all individuals and in reducing risk of recurrent disease, yet few studies have examined diet quality in cardiac-rehabilitation patients on a long-term basis.PurposeTo evaluate the compliance with dietary guidelines in patients who attend a long-term cardiac rehabilitation program (phase III) during COVID-19 era.MethodsThe study was developed between October 2020 and October 2021 in a phase III centre-based cardiac rehabilitation program. To evaluate dietary intake a 24hour recall questionnaire was used. Diet composition was analysed using ESHA’s Food Processor® software. Cunningham equation was used to evaluate resting energy expenditure and physical activity expenditure measured by accelerometery was added to calculate daily energetic requirements. The nutrients and cut-offs considered for the analysis were saturated fat (<10%), sodium (<2g), potassium (≥3.5g), fibre (≥30g), and alcohol (<100g/week), considering the 2021 ESC Guidelines on CVD Prevention in Clinical Practice or the World Health Organization guidelines for a healthy diet. To evaluate weight and height a digital scale SECA 799 and a stadiometer SECA 220 were used, respectively.ResultsA total of 57 patients (78.9% men) with a mean age of 63.8±8.5 were evaluated. Mean body mass index (BMI) was 28.4±3.8kg/m2, being most patients overweight or obese (61.7%). A higher caloric consumption, compared to the individual energy requirements, was found in 26.3% of patients. No statistical differences were found between mean saturated fat intake (10.1±3.6%) and the recommended intake (p=0.85). Mean sodium consumption was 3.42±1.46 grams and mean potassium intake was 3.0±1.0 grams. Sodium intake was significantly higher (p<0.001), and potassium intake significantly lower (p<0.001) than the recommendation. Fibre intake was also significantly lower than the recommendation (median intake was 21.1±12.2 grams, p<0.001). Among patients who drank alcoholic beverages (n=28), the median alcohol intake per day was 17.4±26.3 grams which was significantly higher than the limit recommended (p=0.043).ConclusionOur findings showed that these patients deviated from the recommendations in some key nutrients. The intake of sodium and alcohol was higher than the recommendations, and the intake of potassium and fibre were lower than the recommendations. Moreover, most patients were overweight or obese. This study highlights the need for individual nutritional counselling sessions as a reinforcement of a standard educational program, to effectively promote an adequate diet, which may reduce the risk of recurrent disease. Further research about nutritional intervention in patients undergoing on a long-term basis cardiac rehabilitation is warranted.

Rehabilitation of post-COVID patients with chronic fatigue and cognitive disorders syndromes

Almost all patients, who have experienced acute manifestations of COVID-19, regardless of the severity of the acute phase of the disease, are only at the beginning of a long way to recovery. According to experts, SARS-CoV-2 infection should affect almost 80% of the world's population, so all these patients to a greater or lesser extent will need a rehabilitation of certain manifesta-tions of postcovid syndrome. Purpose: to study the effectiveness of rehabilitation program and the dynamics of cognitive im-pairment and manifestations of chronic fatigue syndrome in patients after coronavirus disease. Methods: The study design included 60 patients after SARS-Cov-2 infection. Among the exam-ined patients there were 26 (43,3%) women and 34 (56,7%) men. An average age of the patients was 43,9±1,08 years. Patients were referred to the Department of Physical Rehabilitation after coronavirus disease with chronic fatigue and cognitive disorders syndromes. Accordingly, all patients, who participated in the study, were divided into two groups: group I - 28 patients with a general condition of moderate severity at the hospital stage and 32 patients - group II, with se-vere course of the disease and oxygen demand at the hospital stage. Depending on the duration of rehabilitation, two observation periods were used - on the 7th and 14th day of rehabilitation program. Results: It has been proven, that patients, who didn’t need oxygen, were complaining about an-osmia, cephalgia, cognitive impairment, increased anxiety and fatigue. Dysgeusia, dyssomnia, and depression were more common in patients, requiring oxygen therapy at the hospital stage. Rehabilitation program eliminated cognitive dysfunction, depression, cephalgia, drowsiness and dyssomnia on the 7th day in patients, who did not require oxygen therapy (p&gt;0,05), and in patients, who needed oxygen therapy - on the 14th day of the rehabilitation program (p&gt;0,05). However, 2 (6,3%) and 3 (9,4%) patients, who needed oxygen therapy, even after 14 days of reha-bilitation had manifestations of minor recurrent headache and drowsiness. Conclusion: Thus, patients after coronavirus disease, who needed oxygen therapy at the hospital stage, need long-term rehabilitation program. Keywords: postcovid syndrome, anxiety, depression, drowsiness, rehabilitation

Video and social rehabilitation of persons with mental illness helps to structure everyday life: a qualitative study.

Living with a mental disorder has a significant impact on everyday life. In 2018, one out of every six adults, equivalent to 17.3% of the adult population of the European Union, had symptoms of mental disorders. This paper focus on social rehabilitation of patients with mental illness who have been discharged from hospital and who use video communication technologies in their rehabilitation in collaboration with their social worker. The aim of this study has been to explore the experiences of persons with mental illnesses who participated in a long-term video-based tele-social rehabilitation program, the Video Assist. The overall research strategy is the case study method. Data collection techniques are based on triangulation. Document analysis has been performed. Participant observation in homes of persons with mental using video with social workers (168 hours). Semi structured qualitative interviews with persons with mental illness (n=13) has been conducted lasting between 30 and 60 minutes. Data were analyzed using NVivo 10.0. Experiences of persons with mental illness participating in the tele-social rehabilitation program are in themes: user friendly video technology, video created a new means of communication between citizen and social worker, feeling of surveillance by having the technology in the home, development of new coping strategies in everyday life and need for psychosocial support and training via the video technology. Persons with mental illness who are in a recovery process find that participating in a tele-social-rehabilitation program gives them a sense of mobility, security, surveillance but the ability to develop new coping strategies in their everyday lives. Future research is needed on long-term effects of tele-social rehabilitation for persons with mental illness.

Основные модели медико-психологической работы по профилактике повторного управления транспортным средством в состоянии опьянения (международный опыт)

The article analyses foreign scientific data and looks into the medical and psychological aspect of modern system of prevention of recurring crimes arising from drunk driving. Eco-nomically developed countries are shown to have obligatory medical and psychological in-terventions as part of their process of re-authorization to drive, and the scale and duration of such interventions depend on the legal framework of a particular state. Generalization of the material studied by the authors of the article led to formulation of a few organizational work models for medical practitioners and psychologists to help them prevent recurring drunk driving. The first model suggests that preventive measures are only aimed to raise of-fending drivers’ awareness of alcohol and drug addiction. The second model demands that the authorities assess the mental health and psychological preparedness for safe driving in offending drivers. The compulsory therapeutic and rehabilitation measures for persons ad-dicted to psychoactive substances in these countries are not included in drunk driving pre-vention system. The third model involves extended and long-term therapeutic and rehabili-tation programs for persons who indulged in drunk driving. Such programs include reveal-ing one’s unconscious motivations along with subsequent transformation of one’s former convictions and customary behavioral patterns. The authors believe that the "extended out-come" of these programs can be seen as an advantage of this model, since overcoming one’s addiction has a positive impact on all social aspects of one’s life activity. The authors point out the social and economical effectiveness of the models under discussion and sub-stantiate their applicability in the domestic system of recurrent drunk driving prevention.

Features of remote rehabilitation using the developed mobile app in patients after cardiac bypass surgery

Abstract Aim of the study The aim of the study is to evaluate the features and availability of the developed remote rehabilitation program with the use of a mobile application in patients who have undergone coronary artery bypass surgery (CABG) and surgical correction of valvular heart disease (VHD). Material and methods of research In the current epidemiological situation, to increase the availability of cardiorehabilitation for patients after open heart surgery, a mobile application with the program “Remote rehabilitation of patients who have undergone heart surgery” was developed. The remote rehabilitation program included 46 patients (median age 60.0 [53.0; 64.0]) who underwent cardiac surgery. Of these, 22 patients after CABG (median age 61.0 [53.0; 63.5]) and 24 patients after surgical correction of VHD (median age 59.5 [54.0; 63.75]). On the 5th day after the surgery, the developed application for remote rehabilitation was installed on the smartphone. It consisted of 5 sections: Dosed Walking, Therapeutic gymnastics, Diet, Psychology and Chat. After application installing and until the moment of discharge from the hospital, 3 classes with a total duration of 6 academic hours were conducted with each patient. After being discharged from the hospital the patients were recommended to use the mobile app for rehabilitation at home for 4 months. 4 months after the surgery the app usage statistics were evaluated and a telephone survey of the reasons for non-complience was conducted. Results A total of 34 (74%) patients used the mobile app for remote rehabilitation. Of these, 24 (52.0%) used the app section “Dosed Walking” and “Therapeutic Gymnastics” at least 5 times a week for 4 months, 10 (22%) used the app no more than 10 times during the entire follow-up period, and 12 (26%) did not engage in remote rehabilitation using the app. 22% of patients received consultations with a cardiologist via chat in mobile app. The telephone survey revealed the main reasons for the irregular participation of patients in the remote rehabilitation program using the mobile app: lack of interest/desire to engage in physical rehabilitation – 16 (35%), problems with the Internet – 6 (13%), lack of time – 4 (8.5%), incorrect function of the app – 4 (8.5%). Conclusions Insufficient adherence of patients after cardiac surgery to a remote rehabilitation program using a mobile application, associated with a lack of motivation in patients, was demonstrated. This implies the importance of developing and implementing further measures to increase the motivation and adherence of patients to participate in long-term remote cardiac rehabilitation programs. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Russian Federation President grant