Medical Rehabilitation Research Articles

Riemannian Locality Preserving Method for Transfer Learning With Applications on Brain-Computer Interface.

Brain-computer interfaces (BCIs) have been widely focused and extensively studied in recent years for their huge prospect of medical rehabilitation and commercial applications. Transfer learning exploits the information in the source domain and applies in another different but related domain (target domain), and is therefore introduced into the BCIs to figure out the inter-subject variances of electroencephalography (EEG) signals. In this article, a novel transfer learning method is proposed to preserve the Riemannian locality of data structure in both the source and target domains and simultaneously realize the joint distribution adaptation of both domains to enhance the effectiveness of transfer learning. Specifically, a Riemannian graph is first defined and constructed based on the Riemannian distance to represent the Riemannian geometry information. To simultaneously align the marginal and conditional distribution of source and target domains and preserve the Riemannian locality of data structure in both domains, the Riemannian graph is embedded in the joint distribution adaptation (JDA) framework and forms the proposed Riemannian locality preserving-based transfer learning (RLPTL). To validate the effect of the proposed method, it is compared with several existing methods on two open motor imagery datasets, and both multi-source domains (MSD) and single-source domains (SSD) experiments are considered. Experimental results show that the proposed method achieves the highest accuracies in MSD and SSD experiments on three datasets and outperforms eight baseline methods, which demonstrates that the proposed method creates a feasible and efficient way to realize transfer learning.

'Aisyiyah's Posbakum Strategy in Optimising Legal Aid for Women and Children

This paper focused on the ‘ Aisyiyah Legal Aid Post (Posbakum) under the Regional Leadership of ‘ Aisiyah Central Java, which has been accredited by the Ministry of Law and Human Rights and has provided legal aid services to the poor, including women, children and people with disabilities. The establishment of the ’Aisyiyah Legal Aid Post was a decision of the 46th Congress in Yogyakarta , born out of ’Aisyiyah’s concern for law enforcement and justice in society and as a means of fighting for the rights of people who were violated or faced legal problems, especially women and children. This paper explains the strategies and efforts made by the Legal Aid Post ’Aisyiyah Regional Leader of ’Aisyiyah Central Java, in providing services and legal assistance for victims during and after receiving assistance. In addition, it also explains the strategy for institutional strengthening. Data were obtained through documentation studies and open interviews with informants of Posbakum Regional Leader of ’Aisyiyah Central Java Management. Data analysis was carried out using a qualitative descriptive method with a normative approach. The results showed that the Legal Aid Post ’Aisyiyah Central Java provides services to law seekers in the form of both litigation and non- litigation cases. Litigation cases included victim assistance in case settlement, court proceedings and post-litigation assistance. Meanwhile, non-litigation cases included several activities, like legal consultation, research, and community empowerment. The implementation of advocacy and assistance for women, children and disabled victims of violence aim ed to heal trauma, protect women from violence and neglect, protect the rights of women and their children and provide legal defence and protection. The victim assistance strategy used a collaborative approach involving curative and preventive. The collaborative approach is psychological and religious. After providing assistance in court, Legal Aid Posts (PosBakum) assisted victims through psychological and medical rehabilitation of victims, raising awareness of victims so that their rights can be protected, providing training on life skills for victims so that they have technical skills and expertise both in the community and family environment to earn an income that can be used to support themselves and their families. In an effort to strengthen institutions and implement the programmes carried out, the Legal Aid Post (Posbakum) built synergy between all parties to gain a good perspective from law enforcement officials in order to help women with disabilities who are victims of sexual violence get justice. This synergy was achieved through the Fogus Group Discussions with law enforcement officials, facilitators and the community. Additionally, an audience with the Central Java Regional Office of the Ministry of Law and Human Rights was offered. A workshop was conducted for accredited legal aid organisations throughout Central Java in providing legal aid with the Regional Office of the Ministry of Law and Human Rights. They campaigned for the fulfilment of disabled rights in accessing justice, such as having special legal officers trained to handle disabled issues because they need special knowledge and handling. Moreover, they submitted aspirations to provincial parliaments during recess and provided input for draft regulations and bills. Also, conducting education and training. Lastly, make Memorandum of Understanding with networks for case assistance. Keywords: ’Aisyiyah, Legal Aid Post, Victim Assistance, Women and Children, strategy

The standards and tools of the European Union of Medical Specialists Physical and Rehabilitation Medicine Section and Board for rehabilitation management and care: an evidence brief for rehabilitation practitioners.

In line with the World Health Organization's Rehabilitation 2030 initiative that led to its landmark resolution on rehabilitation, the Physical and Rehabilitation Medicine (PRM) Section and Board of the European Union of Medical Specialists have been developing functioning-based standards and tools using the International Classification of Functioning, Disability and Health (ICF) as a reference framework the past few years. This evidence brief aims to enable rehabilitation practitioners to implement these functioning-based standards and tools in rehabilitation care, management, and programming by clarifying functioning as the foundational concept for rehabilitation, introducing the functioning-based standards and tools and presenting concrete applications. This evidence brief also calls for the continuous development of these standards and tools and discusses the implementation challenges and opportunities in the context of the interaction between practice, science and governance.

Sociological Analysis of Restorative Justice in Rehabilitative Law Enforcement for Drug Abuse Cases

The escalating trend in drug abuse, particularly among the youth, necessitates a unified approach from all law enforcement entities to address this shift in paradigm. It is essential to view drug addicts and victims of drug abuse not only as perpetrators but also as victims, warranting the incorporation of rehabilitation as an alternative form of punishment. The severity of narcotics crime in Indonesia poses a profound threat not only to individual health both physical and mental but also to societal well-being and national development, potentially compromising state security and sovereignty. This paper explores the enforcement of narcotics law in Indonesia as dictated by Law Number 35 of 2009 and examines the application of restorative justice, a concept often referred to in criminal law enforcement, which emphasizes recovery and atonement for the perpetrator or their family towards the victim, facilitating out-of-court reconciliatory efforts. By examining the legal sociological perspective, this research advocates for resolving narcotics-related criminal cases through means that prioritize restoration over retribution. It argues for a restorative justice approach, where the focus shifts from imprisonment to alternatives like medical and social rehabilitation, aiming for a resolution that restores harmony and agreement between involved parties, thereby aligning legal outcomes with societal values and needs.

Design of a Real-Time Monitoring System for Electroencephalogram and Electromyography Signals in Cerebral Palsy Rehabilitation via Wearable Devices

Cerebral palsy is a disorder of central motor and postural development, resulting in limited mobility. Cerebral palsy is often accompanied by cognitive impairment and abnormal behavior, significantly impacting individuals and society. Time, energy, and economic investment in the rehabilitation process is substantial, yet the rehabilitation outcomes often remain unsatisfactory. Additionally, some patients have limited sensory perception during rehabilitation training, making it challenging to effectively regulate exercise intensity. Traditional evaluation methods are mostly based on recovery performance, lack guidance at the neurophysiological level, and have an unequal distribution of medical rehabilitation resources, which pose great challenges to the rehabilitation of patients. Based on the issues mentioned above, this paper proposes a real-time cerebral signal monitoring system based on wearable devices. This system can monitor and store blood oxygen, heart rate, myoelectric, and EEG signals during cerebral palsy rehabilitation, and it can track and monitor signals during the rehabilitation treatment process. The system includes two parts: hardware design and software design. The hardware design includes a data signal acquisition module, a main control chip (ESP32), a muscle electrical sensor module, a brain electrical sensor module, a blood/heart rate acquisition module, etc. It is primarily for real-time signal data acquisition, processing, and uploading to the cloud server. The software design includes functions such as data receiving, data processing, data storage, network configuration, and remote communication and enables the visual monitoring of data signals. The system can achieve real-time monitoring of electromyography, electroencephalography, and blood oxygen levels, as well as the heart rate of patients with cerebral palsy, and adjust rehabilitation training in real-time during the rehabilitation process. At the same time, based on the real-time storage of the original electromyography and electroencephalography data, it can provide auxiliary guidance for later rehabilitation evaluation and effective data support for the entire rehabilitation treatment process.

Use of orthoses in complex rehabilitation of children that have underwent oncological arthroplasty

Background: The urgency of medical rehabilitation for children with bone sarcoma is extremely high due to the significant impact on a socially important population and the increasing life expectancy of patients with bone sarcomas, leading to long-term orthopedic complications. This necessitates the development of highly effective, comprehensive programs not only for treatment but also for rehabilitation. AIM: Maximizing the recovery of residual quality of life abilities in children with bone sarcomas through the use of orthoses during various perioperative periods. MATERIALS AND METHODS: The study included 61 patients with bone tumors who underwent anti-tumor treatment and surgical intervention involving tumor removal with endoprosthesis implantation. Medical rehabilitation began from the moment of diagnosis and was conducted throughout all periods of anti-tumor therapy to help patients adapt to the treatment, restore functions in the postoperative period, and during remission, as well as to minimize the effects of aggressive specialized treatment. RESULTS: The functional outcome was assessed using the international MSTS scale. Limb function according to the MSTS scale was evaluated 12 and 24 months after surgery. No unsatisfactory results were observed. Functional outcomes improved over the course of 24 months. CONCLUSION: A dynamically evolving individualized rehabilitation program for children with bone sarcomas is necessary, tailored to the patient's condition and needs at the time of observation, along with personalized selection of orthoses and timely surgical correction of orthopedic consequences, which should be performed in orthopedic specialized hospitals.

The social class of orthopedic rehabilitation patients: Are there differences in subjective health, return to work motivation, and participation in aftercare interventions?

This longitudinal quasi-experimental study examines the relationship between social class, subjective health, motivation to return to work (RTW) following medical rehabilitation, and participation in aftercare interventions, utilizing the Social Cognitive Theory of Social Class. To do so, a prospective multicentric study was conducted. The analysis was based on data from N = 1044 orthopedic rehabilitation patients in three clinics in Germany. Latent growth curve models, fixed-effect linear regression models, and multilevel binomial logistic regression were employed for data analysis. As hypothesized, the findings demonstrate that lower social class is associated with poorer subjective health, while higher social class is linked to increased solipsistic motives, characterized by pursuing personal goals in the context of RTW. Conversely, individuals from lower social classes exhibit contextualist motives, which indicate a focus on social and environmental threats influencing their motivation to RTW. Surprisingly, social class does not significantly impact participation in aftercare interventions, probably due to low variance and potentially the successful inclusion within the German healthcare system. These findings emphasize the importance of considering diverse motivation profiles derived from the Social Cognitive Theory of Social Class. The study contributes to our understanding of the social determinants of health and has implications for reducing health disparities by highlighting the motivational aspects, including solipsistic and contextualist motives, associated with social class.

Assisting autonomous precision medical rehabilitation through gesture recognition devices

With the aging of the population and the increase of various chronic diseases, there is a growing demand for effective and accessible medical rehab solutions. In order to overcome the above problems, this project innovatively adopts the gesture recognition technology to design and fabricate the realization of an autonomous accurate medical rehab gesture recognition assistance system. In terms of hardware, this paper uses Arduino as the main controller, Paj7620 as the gesture recognition device, and OLED 0.96 display as the system display. In terms of software, this paper utilizes Arduino IDE software to successfully write the code and realize all the functions. In terms of combining with actual medical rehab needs, the team chose elbow fracture rehab as a typical type of rehab, and designed a three-device obtuse triangle placement scheme for precise monitoring of rehab training. Initial simulation test results show that over 70% of participants reported an improvement in their rehabilitation outcomes, and about 90% found the system easy to use. The results of this project will directly benefit patients requiring long-term rehabilitation.

Analysis and Evaluation of Treatment and Rehabilitation Measures for Children with Cerebral Palsy

The study is devoted to the analysis of disability in children with cerebral palsy in the Kyrgyz Republic. Social impairment is typical for children with cerebral palsy, caused in most cases by multiple types of disability - restrictions on physical independence and mobility; ability to obtain an education, and master the basics of professional activity in the future, readiness for integration into society. In addition, there are problems about the impact of medical, demographic, socio-economic factors, as well as health care resources on morbidity statistics and the incidence of cerebral palsy. The article analyzes the activities of the rehabilitation center for children with musculoskeletal disabilities in the city of Osh for 2021-2023. In order to assess the quality of medical rehabilitation, an analysis and assessment of the medical history of the Center for Medical Rehabilitation from 2021-2023 was also carried out. The interviewing was carried out using a questionnaire specially developed by us, including 12 questions. When analyzing the medical history of children diagnosed with cerebral palsy who underwent medical rehabilitation at the center, it was revealed that the main causes of this condition are: birth injuries, intrauterine infection, premature birth, low birth weight, neuroinfection and severe meningococcal infection before the age of years, anemia, congenital malformations and various somatic diseases. The data obtained confirm the need to create a unified database of children with cerebral palsy (CP). This will improve the organization of medical and social rehabilitation of children suffering from cerebral palsy. The joint database will help collect information on the reasons, characteristics and effectiveness of various rehabilitation methods, which in turn will contribute to more effective management and care of this vulnerable group of children.

Children’s Health Protection Issues in the Kyrgyz Republic

A review of the current system for the health and development of children and adolescents in the Kyrgyz Republic revealed a number of key issues. There is a lack of coordination among public, private, non-governmental, and international organizations for the advancement of current condition of children and adolescents. The staff of the health care system, education, social protection and other government agencies, whose activities, one way or another, are related to working with children, need to improve their skills, taking into account the expansion of policies in the field of health protection and development of children and adolescents. There is limited use of available factual data to improve the quality of medical care, habilitation and rehabilitation, disease prevention (overweight and underweight, tuberculosis, diseases of the reproductive system, psycho-emotional disorders, etc.) violence, and trauma. Environmental risks remain high (clean water, safe environment and living conditions). There is very low participation of the civil sector in decision-making and implementation of a program in the field of health care and development of children and adolescents.

COVID-19-Associated Cerebellitis: A Case Report and Rehabilitation Outcome.

The COVID-19 pandemic has brought attention to neurological complications, including cerebellitis, characterized by inflammation of the cerebellum. Despite its rare occurrence, cerebellitis has been associated with COVID-19 infection, albeit the pathogenic mechanisms remain unclear. We present the case of a 22-year-old male with acute onset ataxia and dysarthria during a SARS-CoV-2 infection. Diagnostic evaluations ruled out other causes, confirming cerebellitis. Treatment included steroid therapy, vitamin supplementation, physiotherapy, and intravenous immunoglobulins. Rehabilitation focused on enhancing balance, coordination, and daily activities. The patient showed significant improvement in functional abilities, with increased autonomy in daily activities and improved ambulation. Despite persistent mild symptoms, the multidisciplinary rehabilitation approach led to remarkable progress. This case underscores the importance of recognizing and managing neurological complications, such as cerebellitis, in COVID-19 patients. A comprehensive approach combining medical treatment and rehabilitation is essential for optimizing outcomes. Further research is needed to elucidate the pathogenesis and optimal management strategies for such complications.

Intelligent ankle–foot prosthesis based on human structure and motion bionics

The ankle–foot prosthesis aims to compensate for the missing motor functions by fitting the motion characteristics of the human ankle, which contributes to enabling the lower-limb amputees to take care of themselves and improve mobility in daily life. To address the problems of poor bionic motion of the ankle–foot prosthesis and the lack of natural interaction among the patient, prosthesis, and the environment, we developed a complex reverse-rolling conjugate joint based on the human ankle–foot structure and motion characteristics, the rolling joint was used to simulate the rolling-sliding characteristics of the knee joint. Meanwhile, we established a segmental dynamics model of the prosthesis in the stance phase, and the prosthetic structure parameters were obtained with the optimal prosthetic structure dimensions and driving force. In addition, a carbon fiber energy-storage foot was designed based on the human foot profile, and the dynamic response of its elastic strain energy at different thicknesses was simulated and analyzed. Finally, we integrated a bionic ankle–foot prosthesis and experiments were conducted to verify the bionic nature of the prosthetic joint motion and the energy-storage characteristics of the carbon fiber prosthetic foot. The proposed ankle–foot prosthesis provides ambulation support to assist amputees in returning to social life normally and has the potential to help improve clinical viability to reduce medical rehabilitation costs.

Promising technologies for pre-sterilization ultrasonic cleaning of medical devices for patient safety in physiotherapy and medical rehabilitation

Promising technologies for pre-sterilization ultrasonic cleaning of medical devices for patient safety in physiotherapy and medical rehabilitation

The role of nursing medical workers in carrying out third level medical rehabilitation for adult population

Rehabilitation is specialized health care, and its importance for human health and high quality of life is constantly growing today. According to the Russian Ministry of Health, up to 25 million people need rehabilitation. Currently, nursing staff play a significant role in the organization of medical rehabilitation and the implementation of specific rehabilitation programs. The priority of tasks for the development of medical rehabilitation is determined by the state program «Health Development».

Ultrasonographic Assessment of the Diaphragm.

Mechanical ventilation injures not only the lungs but also the diaphragm, resulting in dysfunction associated with poor outcomes. Diaphragm ultrasonography is a noninvasive, cost-effective, and reproducible diagnostic method used to monitor the condition and function of the diaphragm. With advances in ultrasound technology and the expansion of its clinical applications, diaphragm ultrasonography has become increasingly important as a tool to visualize and quantify diaphragmatic morphology and function across multiple medical specialties, including pulmonology, critical care, and rehabilitation medicine. This comprehensive review aims to provide an in-depth analysis of the role and limitations of ultrasonography in assessing the diaphragm, especially among critically ill patients. Furthermore, we discuss a recently published expert consensus and provide a perspective for the future.

Change in Walking Parameters of Paralympic Athletes Diagnosed with Cerebral Palsy Using WALKBOT Training System at Recovery Stage of Rehabilitation

INTRODUCTION: The publication is devoted to studying the rehabilitative effect of the Walkbot innovative training system on restoring the walking function in Paralympic athletes diagnosed with cerebral palsy (CP). The novelty of the developed Walkbot robot-assisted training system (TS) and insufficient experience of its use in rehabilitation practice require investigations on contingents of patients with musculoskeletal disorders in CP to develop protocols and programs of the rehabilitation use of the Walkbot TS. AIM: Study of effectiveness of rehabilitation use of the Walkbot robotic TS to restore the walking function in Paralympic athletes with spastic cerebral palsy. MATERIALS AND METHODS: The study was conducted at the Medical Rehabilitation Center ‘Sergievskie Mineral Waters’ in 2023. Forty Paralympic athletes (all men) aged 30-35 years were examined. The experimental group (EG) and control group (CG) included 20 Paralympic athletes each with standardization of the groups by the main parameters. The classes were conducted for 60 minutes according to the rehabilitation program. In the experimental group, besides exercise therapy (ET), the participants also exercised on the robotic Walkbot TS to restore the walking function, namely, they used Go world game with the known tasks symbolizing counties of the world, Go palace game that permits to take a walk around the palace, when patients move to the right or left as they choose; Go undersea game occurring against the background of a fairy sea world where they must go through the route controlling the direction of movement. The Paralympians of the control group used the standard rehabilitation program including ET with no training and gaming technologies. RESULTS: The obtained results showed a pronounced improvement in the parameters of motor actions in Paralympians of the EG, while in the CG, positive rehabilitation changes were 2–3 times less expressed. At the initial and final rehabilitation stages, an increase of the tolerated duration of classes was recorded: by 5 times in the EG and 3 times in the CG, post-rehabilitation increase in the EG was 23.4% compared to that in CG. After training on the Walkbot TS, the volume of the performed load increased 5.9 times in the EG and 2.1 times in the CG. The increase in the EG made 64.5% compared to the CG, which indicated an increase in speed-strength qualities and endurance of para-athletes. At the end of rehabilitation, the amount of steps on the Walkbot TS in the EG increased 5.9 times (in the CG — 2.9 times), increase in the EG made 48.3% compared to the CG. CONCLUSION: The experiment established a complex multisided positive effect of training sessions on the Walkbot TS in the EG versus the effect of only exercise therapy in the CG. The obtained data suggest that training on the Walkbot TS confer a significant restorative and normalizing effect on the neurophysiological mechanisms of functioning of the central parts of the motor cortex.

Torture Survivors in Asylum – Ignoring the Obvious

ABSTRACT Torture is prohibited at all times and in all circumstances and states shall not return asylum seekers to their country of origin if there is any substantial risk of persecution upon return. The future risk of torture is therefore a central element in any asylum assessment. This notwithstanding, the torture experience of asylum seekers is seldom addressed during the asylum interview, hardly ever documented and rarely given particular consideration during the asylum assessment. Torture survivors seeking asylum are therefore in a paradoxical situation, on the one hand universally acknowledged to be highly vulnerable and potentially worthy of protection and medical rehabilitation, and on the other hand having their torture experiences under-communicated and ignored. Based on research into the Norwegian immigration authorities, I will explore how ignorance is produced and maintained in everyday interaction with asylum seekers through the theoretical lens of ignorance. I argue that, during the Norwegian asylum procedure, the current paradox of hyper-visibility versus failure to acknowledge the torture experience is caused by the street-level bureaucrats’ inability to give consequence to and make bureaucratic and procedural sense of the torture experience. This inability is owing to a number of individual and structural forms of ignorance that range from bureaucratic obfuscation and rearrangement of the knowledge – ignorance assemblages, the strategic ignoring of facts, to a lack of knowledge and competency and, as such, an inability to know. However, rather than concluding that immigration bureaucracies produce indifferent street-level bureaucrats, I document the many attempts to care and to do better that do as an integral part of the ignorance that permeates the asylum system.

Medical Rehabilitation as a Pillar of Quality of Life: A Bibliometric Mapping of Contemporary Research

Medical Rehabilitation as a Pillar of Quality of Life: A Bibliometric Mapping of Contemporary Research

Review on the Use of Brain Computer Interface Rehabilitation Methods for Treating Mental and Neurological Conditions.

This review provides a comprehensive examination of recent developments in both neurofeedback and brain-computer interface (BCI) within the medical field and rehabilitation. By analyzing and comparing results obtained with various tools and techniques, we aim to offer a systematic understanding of BCI applications concerning different modalities of neurofeedback and input data utilized. Our primary objective is to address the existing gap in the area of meta-reviews, which provides a more comprehensive outlook on the field, allowing for the assessment of the current landscape and developments within the scope of BCI. Our main methodologies include meta-analysis, search queries employing relevant keywords, and a network-based approach. We are dedicated to delivering an unbiased evaluation of BCI studies, elucidating the primary vectors of research development in this field. Our review encompasses a diverse range of applications, incorporating the use of brain-computer interfaces for rehabilitation and the treatment of various diagnoses, including those related to affective spectrum disorders. By encompassing a wide variety of use cases, we aim to offer a more comprehensive perspective on the utilization of neurofeedback treatments across different contexts. The structured and organized presentation of information, complemented by accompanying visualizations and diagrams, renders this review a valuable resource for scientists and researchers engaged in the domains of biofeedback and brain-computer interfaces.

Hearing Assessment of Free-Ranging Owls and Implications for Wildlife Rehabilitation: 31 Cases (2014-2023).

Owls, members of the avian order Strigiformes, are nocturnal birds of prey that are found worldwide except for Antarctica. Traumatized, free-ranging owls are commonly presented to veterinary hospitals and wildlife rehabilitation facilities with the goal of providing medical care and rehabilitation to enable release back into their natural habitat. Minimal guidelines exist for the release of wildlife, and whereas a need for functional vision is described in raptors, assessing and evaluating hearing is usually not mentioned. This can be problematic for nocturnal predators because hearing is the primary sense utilized by owls when hunting and navigating in their dark environment. The brainstem auditory evoked response (BAER) test is a minimally invasive, objective assessment of hearing commonly used in companion animals. To the authors' knowledge, routine or standardized BAER evaluation has not been reported in traumatized, free-ranging owls. In the following retrospective study, 31 free-ranging owls presented to the University of Georgia Veterinary Teaching Hospital for known or suspected trauma or being found in a debilitated state underwent BAER testing to assess for the presence of complete sensorineural hearing loss. Similar to assessment of hearing in companion animals, the BAER test was elicited using a broad click stimulus delivered at 85 dB nHL. In all owls, qualitative assessment and peak latency measurements of the BAER test reflected hearing ability. This study highlights the importance of hearing in nocturnal raptors, how BAER testing can aid in decision making regarding rehabilitation, and provides a foundation for further investigation of hearing loss in traumatized owls. We suggest that veterinarians working with free-ranging owls in a rehabilitation setting should consider BAER testing as part of routine diagnostic testing.