Rehabilitation Methods Research Articles

Rebuilding Stability: Exploring the Best Rehabilitation Methods for Chronic Ankle Instability.

Background: Chronic Ankle Instability (CAI) is a common condition characterized by repeated episodes of ankle "giving way" and impaired balance, leading to functional limitations. Various rehabilitation techniques, including balance training, proprioceptive exercises, whole-body vibration (WBV), and novel approaches like stroboscopic vision, are used to address these deficits. This review evaluates the effectiveness of different rehabilitation interventions for CAI management. Methods: A review was conducted by analyzing 11 randomized controlled trials that investigated the impact of balance and proprioceptive training programs on CAI. The primary outcomes assessed were the Star Excursion Balance Test (SEBT), Cumberland Ankle Instability Tool (CAIT), and Foot and Ankle Ability Measure (FAAM). Methodological quality was assessed using the PEDro scale, and the risk of bias was evaluated with the ROB 2 tool. Results: All rehabilitation interventions demonstrated significant improvements in SEBT, CAIT, and FAAM scores. However, no single intervention was found to be consistently superior. Traditional balance training, strength exercises, BAPS, and WBV all provided meaningful functional gains. Stroboscopic vision training showed similar effectiveness compared to conventional approaches. The evidence supports a combination of balance and strength training for optimal recovery. Conclusions: Balance and proprioceptive exercises are effective in managing CAI, with improvements in both dynamic stability and subjective outcomes. No intervention stands out as the best, but personalized programs incorporating various methods are recommended. Future research should explore the long-term effects and potential synergies of combined interventions.

Marginal Bone Loss and Clinical Evaluation of Angled Implants: A Retrospective Study

Aim: The volume of the edentulous crest and its proximity to critical anatomical structures are important limiting factors for implant surgery. Surgical procedures with complications can be avoided by placing angled implants. The aim of this clinical study was to evaluate marginal bone loss and the complications of angled implants. Materials and Methods: Fifty-eight dental implants were examined in 32 patients (16 females, 16 males) with cone beam computed tomography (CBCT) images from patients with angled implants and complete edentation. The marginal bone loss in angled implants that were functional for 15 to 30 months was evaluated according to factors such as implant angle, connection type, opposing arch restoration type and planning of superstructure restoration. Marginal bone loss measurements were recorded from CBCT sections. Results: It was determined that 3.44% of the implants placed had an inclination of less than 15°, 75.86% had an inclination between 15° and 30° and 20.68% had an inclination of more than 30°. While there was no marginal bone loss on the mesial and distal surfaces, the average marginal bone loss was 0.66 on the buccal surfaces and 0.93 in the lingual region. Only one of the implants examined failed. No pain or infection was observed in any of the implants examined. Conclusion: According to the results of this retrospective clinical study, further clinical studies with larger sample sizes are needed to evaluate angled implants supported by full arch fixed prostheses as a predictable and valid treatment method in the prosthetic rehabilitation of edentulous jaws.

SPECIFICS OF PHYSICAL REHABILITATION OF CHILDREN WITH CEREBRAL PALSY

Cerebral palsy (CP) is an umbrella term that covers a group of diseases that manifest themselves mainly in impaired movement, balance and posture. The number of children affected by this disease is constantly growing around the world. Today, cerebral palsy is one of the most common forms of childhood disability, affecting approximately 2-3 children per 1000 births. Purpose. to analyse and systematise the specifics of physical rehabilitation of children with cerebral palsy. Materials and methods. To achieve the objectives of the study, the researchers analysed scientific literature and systematised information using electronic databases such as PubMed, Google Scholar and others. Research results. The main approaches and methods of physical rehabilitation for children with cerebral palsy are traditional physiotherapy, hydrotherapy, botulinum therapy, robotic systems and therapy using virtual reality technologies. The main aspects of physiotherapy are assessment and planning, improving mobility and correcting posture, rehabilitation after surgery, and involvement in everyday life. Hydrotherapy uses the therapeutic properties of water to improve the physical functions and general well-being of children with this disease. The methods of hydrotherapy include swimming, exercises in a hydromassage pool, therapeutic exercises in water, and physiotherapy techniques. Botulinum toxin therapy (BT) is a spasticity treatment with the highest level of scientific evidence, which has been used for ~30 years in patients with cerebral palsy (CP). Botulinum toxin type A is used during botulinum therapy, which is a neurotoxin that blocks the transmission of nerve impulses to the muscles. This leads to a temporary weakening of the muscles, which helps to reduce spasticity and alleviate symptoms. Robotic systems and virtual reality (VR) technologies are innovative approaches used to rehabilitate children with cerebral palsy (CP). These technologies offer new opportunities to improve physical function and quality of life for children. Conclusions. Among a large number of traditional methods of physiotherapy, scientists highlight the high efficiency of Bobath therapy in the physical rehabilitation of children with cerebral palsy. This is also confirmed by the research of Vitalia Kashuba and Bozhena Bukhovets, who developed a physical rehabilitation programme that included Bobath therapy. Hydrotherapy, or water therapy, is an important part of the rehabilitation of children with cerebral palsy. It uses the healing properties of water to improve the physical functions and overall well-being of children with this disease. Research by Aikaterini Bayraktariadou, Konstantinos Chandolias and others demonstrates that hydrotherapy, either as an individual treatment or in combination with a standard exercise programme on land, can significantly contribute to improved mobility, increased exercise endurance and a better quality of life. Botulinum toxin is widely used in the rehabilitation of children with cerebral palsy. A study by Farid Hareb and others shows that botulinum toxin therapy can be an effective method for improving the quality of life of children with cerebral palsy, helping to reduce spasticity and improve their motor function. Also, robotic technologies and VR have recently been actively introduced into the physical rehabilitation of children with cerebral palsy. Research by Hyun Cho Chang, Menekseoglu Ahmet Kivanc, and Rocio Llamas-Ramos confirms the feasibility of combining traditional physiotherapy with robotic systems and virtual reality.

CURRENT TRENDS IN THE REHABILITATION OF PATIENTS WITH LOWER LIMB AMPUTATION

Amputation of a lower limb is a serious intervention that has a profound impact on a person's life and ability to work. The loss of a limb often causes significant physical and psychological changes that require comprehensive rehabilitation. The patient faces new physical limitations, such as loss of mobility, changes in balance and the need to adapt to prostheses. According to a report by the Wall Street Journal, since the beginning of the Russian-Ukrainian war, the number of people in need of amputation in Ukraine has risen to levels not seen since the First World War. The publication estimates that between 20,000 and 50,000 Ukrainians have lost one or two limbs. Therefore, the study of current trends in the rehabilitation of patients with lower limb amputation in the context of war in Ukraine is extremely relevant. Purpose. To analyse and systematise current trends in the rehabilitation of patients with lower limb amputation. Materials and methods. To achieve the objectives of the study, the researchers analysed scientific literature and systematised information using electronic databases such as PubMed, Google Scholar and others. Research results. Today, physical therapy for patients with lower limb amputation is characterised by a combination of traditional rehabilitation methods and innovative approaches. Kireev and others developed an algorithm that includes rehabilitation activities at 4 main stages. Preoperative rehabilitation, stage I, is aimed at improving postoperative outcomes. It has been suggested that the preoperative programme used in the treatment of young patients with lower limb amputation should consist of chest physiotherapy, muscle and joint mobility training, focusing on maintaining strength and function. During the second stage, before prosthetics, the rehabilitation process includes the aforementioned therapeutic gymnastics and physiotherapy, as well as massage and kinesiotaping. Important issues in preparing an amputated stump for prosthetics include preparing the postoperative wound and scar, controlling edema, preventing muscle atrophy, and preventing the formation of contractures in the joints of the amputated lower limb. In addition to the above-mentioned traditional methods, innovative approaches are actively used at the stage of training with a prosthesis: robotic prostheses, biofeedback technologies, and VR technologies. Giacomo Valle's research has shown that the use of a robotic prosthesis in combination with biofeedback technology not only increases the patient's movement speed, but also increases his or her confidence. Research by Rami L. Abbas demonstrated the feasibility of using VR technologies, which showed a significant improvement in the balance markers, TUG, DGI and BBS tests (P < 0.05). Lifelong rehabilitation, stage IV, involves monitoring the patient for psychosocial adaptation, stump skin pathologies, pain, musculoskeletal disorders, cardiovascular diseases, other chronic diseases, health, and ensuring the use of appropriate footwear for the contralateral limb. Conclusions. Thus, the current trends in combining traditional methods with innovative approaches in the rehabilitation of patients with lower limb amputation are appropriate and justified. It is through the use of therapeutic gymnastics, massage and kinesiotaping in combination with the use of biofeedback technologies, robotic systems and virtual reality that the best results are achieved.

MODERN VIEWS OF USE OF TELEREHABILITATION IN URINARY TRACT DYSFUNCTION IN PATIENTS WITH MULTIPLE SCLEROSIS

Multiple sclerosis is a chronic disease of the nervous system that often leads to various disorders, including urinary tract dysfunction. This significantly affects the quality of life of patients, causing physical and psychological complications. The term "bladder rehabilitation" summarizes treatment options aimed at restoring its function in patients with neurourological symptoms. A strong contraction of the sphincter of the urethra and/or pelvic floor, as well as anal dilatation, manipulation of the genital area, and physical activity reflexly inhibit urination. A comprehensive physical therapy program for patients with pelvic disoders includes pelvic floor vibration massage, training in proper breathing patterns, pelvic floor muscle relaxation and stabilization exercises and should last several months, during which the patient regularly visits the doctor. The pandemic and war have created barriers that affect almost every aspect of life, treatment and rehabilitation, especially for people with chronic neurological conditions. Traditional rehabilitation methods used to correct urinary tract dysfunction have their limitations, including difficulties in accessing specialists, especially in remote areas. This stimulates the development and implementation of telerehabilitation as an alternative approach. Telerehabilitation involves the use of digital technologies for the remote provision of medical services and patient monitoring. It allows doctors to monitor the condition of patients, provide recommendations and adjust treatment without the need for personal visits. Considering the existing data and our own clinical experience, we consider it appropriate to use telerehabilitation for the correction of disorders of the lower urinary tract, especially in the conditions of war, when access to rehabilitation centers may be difficult. In the department of medical rehabilitation of the University Clinic of the Kharkiv National Medical University, we successfully conducted telerehabilitation using Google Meet video conferencing for 10 patients with urinary incontinence on the background of multiple sclerosis, whose EDSS was no more than 4.0. When conducting online classes under the guidance of a physical therapist, patients noted a desire to strictly follow the recommendations and perform regular exercises. All patients kept a urination diary, according to which the frequency of urination was reduced by an average of 20-25%, which had a positive effect on their quality of life. Although our observations are not representative, in combination with existing studies, we consider telerehabilitation to be a promising direction in complex therapy and rehabilitation of this pathology. Conclusion The use of telerehabilitation for urinary tract dysfunction in patients with multiple sclerosis is a promising direction that requires further research. This approach can significantly improve the quality of life of patients, reduce the burden on the health care system and provide a more affordable and convenient treatment. A multidisciplinary team should be involved, including a neurologist, a urologist, a gynecologist, and a physical therapist to select the optimal tactics of drug treatment and physical therapy. A promising direction of further research is the development of standard protocols for conducting telerehabilitation for patients with lower urinary tract dysfunction against the background of multiple sclerosis and other pathologies.

Innovations in Sports: A Key to Enhancing Rehabilitation Outcomes

Introduction and purpose: Traditional rehabilitation methods often have limitations in improving motor function and cognitive abilities. This review aims to provide an updated overview of innovative methods in rehabilitation, focusing on the role of immersive and interactive technologies in enhancing rehabilitation outcomes. The literature suggests that these technologies can improve upper limb mobility, grip strength, and manual dexterity, as well as cognitive function, attention, and spatial awareness. Additionally, innovative balance and gait rehabilitation programs have been shown to improve functional mobility and reduce the risk of falls. The use of these technologies in combination with other rehabilitation modalities, such as electrostimulation and robotic assistance, may lead to even greater improvements in motor function and cognitive abilities. While more research is needed to fully understand the benefits and limitations of these innovative approaches, the existing evidence suggests that they have the potential to revolutionize rehabilitation and improve quality of life for patients. Materials and Methods: A literature review was conducted using PubMed with search phrases immersive and interactive technologies and rehabilitation. Description of the state of knowledge: Traditional rehabilitation methods often have limitations in improving motor function and cognitive abilities.Upper extremity impairment is a common and debilitating consequence of stroke. Summary: imersive and interactive technologies have the potential to improve upper limb mobility, grip strength, and manual dexterity, as well as cognitive function, attention, and spatial awareness. Innovative balance and gait rehabilitation programs have been shown to improve functional mobility and reduce the risk of falls. The use of these technologies in combination with other rehabilitation modalities may lead to even greater improvements in motor function and cognitive abilities.

Role of Non-Mesh Grafts in Surgical Treatment of Stress Urinary Incontinence

Stress urinary incontinence refers to a multifactorial disease characterized by involuntary urination associated with a sudden increase in intra­abdominal pressure. Millions of females around the world suffer from stress incontinence each year. Conservative methods of treatment and physical rehabilitation are considered to be ineffective, thereby driving the need for surgical treatment. Sling surgeries comprise a widely used surgical technique for the treatment of stress urinary incontinence due to their affordability and minimal time investment. Introduction of synthetic polypropylene mesh prostheses in the treatment of stress incontinence made them the most common material. However, the accumulated experience and complications associated with the use of mesh grafts contribute to the recent decline in the popularity of synthetic slings and give rise to the search for and development of alternative materials for the surgical treatment of stress urinary incontinence. Since the need for treatment of urinary incontinence remains high, fascia autograft surgeries have been proposed, even though they require an additional surgical procedure and expose the patient to complications at the donor site of the graft. In addition, surgeons use allografts and xenografts, and regenerative technology is developing in this field. Considering high social significance of this problem, the present paper is aimed at reviewing the scientific literature concerning grafts for the treatment of stress incontinence.

Utilizing Virtual Reality in the Treatment of Subacromial Impingement Syndrome: Enhancing Efficacy Through Integration with the Simple Shoulder Test and Pain Arch Test

<span lang="ES">Subacromial impingement syndrome (SIS) is a prevalent cause of shoulder pain and dysfunction. This study investigates the impact of virtual reality (VR) therapy on shoulder function, joint dysfunction, and pain in SIS patients, comparing its effectiveness to traditional rehabilitation methods. Materials and Methods: Over 50 weeks, 288 participants with SIS were recruited and divided into two groups: an experimental group (EG) receiving VR-augmented therapy and a control group (CG) undergoing conventional rehabilitation. Recovery was assessed using the Painful Arch Test and Simple Shoulder Test (SST) at key intervals (T0, T1, T2, and T3). Statistical analysis was conducted to evaluate recovery times and functional improvements. Results: The EG showed significantly faster recovery with a mean duration of 6.04 weeks compared to 7.01 weeks for the CG (p = 0.0041), as determined by the Welch Two Sample t-test. The 95% confidence interval (0.3137 to 1.6330) confirmed the reliability of these findings. The VR group demonstrated sustained functional improvements, as evidenced by narrower interquartile ranges and more stable SST scores over time, particularly by Session 18, indicating reduced variability and faster recovery compared to the CG. Conclusion: VR therapy significantly accelerates recovery in SIS patients, offering faster and more consistent outcomes compared to conventional rehabilitation. These findings highlight the potential of VR as a non-invasive and effective treatment for improving shoulder function in SIS. Further research is warranted to explore its long-term efficacy and potential for personalized rehabilitation programs.</span>

Impact of core muscle strengthening on knee pain, patient outcomes, physical function, and cartilage thickness in knee osteoarthritis: Protocol for a randomized controlled trial

Knee Osteoarthritis (KOA) is a degenerative condition that significantly impacts individuals, causing disability. Routine rehabilitation methods primarily involve knee and hip strengthening exercises. While there is limited evidence supporting the potential benefits of core muscle strengthening in KOA rehabilitation, further research is needed to examine the effects of a structured core muscle strengthening protocol on pain, functional abilities, quality of life, and knee cartilage health. This double-blind, randomized controlled trial seeks to investigate the impact of integrating core muscle strengthening into routine rehabilitation. The study will randomly assign 80 participants to either routine rehabilitation or experimental groups, with both groups receiving routine rehabilitation combined with core strengthening exercises in the experimental group over a twelve-week period. The outcomes measured will include pain levels, patient-reported outcomes, physical functional abilities, core muscle and leg muscle strength, and cartilage height of the femur and tibia. Follow-up assessments will occur in the 4th, 8th, and 12th weeks. This novel study aims to provide valuable insights into the role of core strengthening in KOA rehabilitation, potentially influencing rehabilitation approaches and managing disease progression.•Incorporating core muscle strengthening into routine rehabilitation for KOA could open new possibilities for KOA management.•This study employs outcome measures recommended by OARSI for a thorough evaluation.•Additionally, it will investigate the impact on cartilage health, offering fresh insights into disease progression and the effects of exercise

Effect of intermittent theta burst stimulation on upper limb function in stroke patients: a systematic review and meta-analysis.

Stroke is a serious health issue that affects individuals, families, and society. Particularly, the upper limb dysfunction caused by stroke significantly reduces the quality of life for patients and may lead to psychological issues. Current treatment modalities are not fully effective in helping patients regain upper limb motor function to optimal levels. Therefore, there is an urgent need to explore new rehabilitation methods to address this issue. The purpose of this meta-analysis and systematic review is to explore the effects of intermittent theta burst stimulation (iTBS) on upper limb function in stroke patients. We searched PubMed, Cochrane Library, Embase, Web of Science, PEDro and China National Knowledge Internet as of April 8, 2024. Retrieved a total of 100 articles. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were calculated. The study included a total of 9 trials and involved 224 patients. The results demonstrate that compared to the control group, iTBS therapy significantly improved Fugl-Meyer assessment-upper extremity (FMA-UE) scores (SMD = 0.88; 95% CI = 0.11-1.66; P = 0.03, I 2 = 84%), Action Research Arm Test (ARAT) scores (SMD = 0.83; 95% CI = 0.16-1.50; P = 0.02, I 2 = 57%), and Barthel Index (BI) scores (SMD = 0.93; 95% CI = 0.53-1.32; P < 0.0001, I 2 = 0%) in stroke patients. The comprehensive evidence suggests that iTBS has superior effects in improving upper limb function and activities of daily living in stroke patients.

Potential preservative mechanisms of cardiac rehabilitation pathways on endothelial function in coronary heart disease.

Cardiac rehabilitation, a comprehensive exercise-based lifestyle and medical management, is effective in decreasing morbidity and improving life quality in patients with coronary heart disease. Endothelial function, an irreplaceable indicator in coronary heart disease progression, is measured by various methods in traditional cardiac rehabilitation pathways, including medicinal treatment, aerobic training, and smoking cessation. Nevertheless, studies on the effect of some emerging cardiac rehabilitation programs on endothelial function are limited. This article briefly reviewed the endothelium-beneficial effects of different cardiac rehabilitation pathways, including exercise training, lifestyle modification and psychological intervention in patients with coronary heart disease, and related experimental models, and summarized both uncovered and potential cellular and molecular mechanisms of the beneficial roles of various cardiac rehabilitation pathways on endothelial function. In exercise training and some lifestyle interventions, the enhanced bioavailability of nitric oxide, increased circulating endothelial progenitor cells (EPCs), and decreased oxidative stress are major contributors to preventing endothelial dysfunction in coronary heart disease. Moreover, the preservation of endothelial-dependent hyperpolarizing factors and inflammatory suppression play roles. On the one hand, to develop more endothelium-protective rehabilitation methods in coronary heart disease, adequately designed and sized randomized multicenter clinical trials should be advanced using standardized cardiac rehabilitation programs and existing assessment methods. On the other hand, additional studies using suitable experimental models are warranted to elucidate the relationship between some new interventions and endothelial protection in both macro- and microvasculature.

Родительская приверженность лечению детей с психическими расстройствами как клинико-психологическая проблема

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;A child&amp;rsquo;s illness is a major challenge that imposes restrictions on all family members. Not all parents of sick children strictly follow medical prescriptions, which emphasizes the importance of developing recommendations to improve parental adherence to treatment. It is necessary to distinguish between the terms adherence and compliance, where the former emphasizes active participation, and the latter &amp;mdash; the actual implementation of prescriptions without an emphasis on involvement. The purpose of the study is to systematize approaches to the problem of adherence to treatment to operationalize the concept of &amp;ldquo;parental adherence to treatment&amp;rdquo;.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;The analysis of Russian and foreign studies of the concept of parental adherence was conducted. Russian works were selected based on relevance and availability of an evidence base for the study. Due to the low prevalence of the term in Russian studies, foreign sources had a great influence on the operationalization of the concept. Foreign sources were selected depending on the development depth of the problem and the representativeness of the sample to actualize the problematic of the phenomenon of parental treatment adherence in the field of clinical psychology. The following electronic resources were used for the analysis: eLIBRARY.ru, PubMed, ResearchGate, ConnectedPapers and others.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;The main components of the phenomenon of parental adherence to treatment are identified: following the recommendations of doctors and establishing trusting relationships between parents, medical personnel and the child. Such relationships contribute to more effective treatment and accompany the child in the rehabilitation process. Given the possible difficulties with accepting treatment, interpersonal interaction between parents and doctors helps to individualize the treatment plan taking into account the characteristics of each family. The authors provide a definition of the phenomenon of &amp;ldquo;parental adherernce to treatment&amp;rdquo;.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions. &lt;/strong&gt;Currently, the problem of increasing the level of parental treatment adherence is emphasized by the parents&amp;rsquo; lack of knowledge of child rehabilitation methods and their emotional rejection of the diagnosis. Therefore, operationalizing the concept of parental adherence to treatment will aid in formulating more useful recommendations on treating a child for parents.&lt;/p&gt;

Secondary Sarcopenia in Patients with Locomotor Disorders: Prevalence, Diagnosis and Medical Rehabilitation. A Review

INTRODUCTION. The development of rehabilitation methods for patients with sarcopenia, a generalized age-associated loss of skeletal muscle mass and strength, is important, since sarcopenia leads to pronounced weakness, functional and motor disorders and an increased risk of death in the elderly. AIM. To analyze the prevalence, features of pathogenesis, diagnosis of secondary sarcopenia, including against the background of motor disorders due to stroke, as well as methods of treatment and medical rehabilitation of such patients. MAIN CONTENT. Among the secondary forms, sarcopenia is of the greatest clinical importance against the background of the consequences of acute cerebrovascular accident (ACA), due to muscular atrophy associated with paralysis and immobility, spasticity, inflammation and denervation of muscles, malnutrition and intestinal absorption of protein and vitamin D. Recent studies show that the prevalence of sarcopenia in stroke patients in emergency hospitals is 8.5–33.8 %, according to other data — more than 42 %. Muscle weakness after a stroke contributes to a decrease in physical functions and the development of disability, and sarcopenia leads to adverse outcomes 90 days after a stroke. According to the meta-analysis, which included 7 cohort studies with a total sample of 1,774 patients who underwent ACA, 27.1 % of them had sarcopenia. Moreover, the presence of sarcopenia negatively affected the clinical and functional outcomes of ACA, as well as the results of medical rehabilitation (odds ratio: 2.42, 95 % confidence interval: 1.76–3.33, p 0.001). CONCLUSION. Despite the prevalence and relevance of this pathology, rehabilitation programs for patients with sarcopenia against the background of the consequences of ACA have not been developed. Isolated foreign publications demonstrate the effectiveness of certain methods of physical therapy and electrical stimulation, but the evidence base for their effectiveness is low.

Noninvasive ventilation outside the intensive care unit for respiratory rehabilitation after on-pump cardiac surgery: a prospective randomized controlled trial

BACKGROUND: Сardiac surgery with cardiopulmonary bypass is associated with a high risk of postoperative respiratory complications. Perioperative damage to the lungs caused by ischemia and reperfusion, mechanical ventilation, trauma, etc., is a trigger for aseptic inflammation in the lungs, and it makes compromised lungs an easy target for infection. Actively developed methods of protecting the lungs, such as lung-protective ventilation, are limited to the perioperative and resuscitation stages and do not exhaust the entire range of respiratory support required in the later stages of postoperative hospitalization. This indicates the need for methods of respiratory rehabilitation following transfer from the intensive care unit. AIM: To evaluate the effectiveness of respiratory rehabilitation using noninvasive mask lung ventilation performed outside the intensive care unit in cardiosurgical patients compared to standard breathing exercises. MATERIALS AND METHODS: This prospective, randomized, single-center study included 60 patients aged 62±12 years who underwent cardiac surgery with cardiopulmonary bypass (86±17 min) with bypass grafting of 2±1 coronary arteries and required mechanical lung ventilation for more than 6 hours following surgery. After transfer from the intensive care unit, patients in the control group (n=30) underwent standard respiratory rehabilitation, and those in the main group (n=30) additionally received four sessions of noninvasive mask lung ventilation. RESULTS: The patients in the main group had a more rapid respiratory function recovery and, thus, reduced postoperative hospitalization time (10 [8; 15]) compared to those in the standard group (14 [13; 20]). CONCLUSION: The use of noninvasive mask lung ventilation outside the intensive care unit along with the standard respiratory activation protocol is safe and speeds up respiratory rehabilitation and reduces postoperative hospitalization of patients after coronary bypass surgery.

The Role of Oriental Medicine Methods in Complex Rehabilitation of Patients with Neuropsychological Manifestations of Post-Covid Syndrome

The Role of Oriental Medicine Methods in Complex Rehabilitation of Patients with Neuropsychological Manifestations of Post-Covid Syndrome

Effectiveness of physiotherapy rehabilitation approaches for Parkinson's disease: A Durrës case study.

The article's significance lies in the substantial rise in the risk of developing Parkinson's disease (PD), necessitating the exploration of various approaches to rehabilitation and medical treatment. The purpose of the article is to detect the direct effect of physiotherapy for patients with PD and to identify how it helps in slowing down cardio-pulmonary failure, improving the posture, balance, bradykinesia and tremor. The research utilised clinical data from 407 PD patients aged 30-100 years at the Central Polyclinic of Durrës, spanning 2011-2022, and included a systematic literature review and statistical analysis comparing physiotherapy outcomes with European Union standards. The research demonstrates the efficiency of physiotherapy in the short and long term in the treatment of PD for patients and medical personnel. All information can be used to increase the functional abilities of patients and minimise complications after physiotherapy and to estimate the effectiveness of different exercises in delaying PD. Older adults, particularly those aged 71-80, are most affected by PD, with males more likely to be diagnosed. Physiotherapy rehabilitation improves motor symptoms, posture, and balance in 30-80-year-olds, but its effectiveness declines with age. Advanced rehabilitation methods in Italy lead to better outcomes, suggesting the potential for improvement in Durres disease. The study emphasises the need for improved rehabilitation strategies for older patients by recommending tailored programs, advanced methods, standardisation, training, and long-term monitoring. Further research should concentrate on the long-term sustainability of physiotherapy benefits, the development of targeted interventions for older patients, and the integration of innovative therapeutic approaches.

Impact of whole-body vibration training on ankle joint proprioception and balance in stroke patients: a prospective cohort study

BackgroundAlthough whole-body vibration (WBV) training is acknowledged for its benefits in enhancing motor functions across several neurological disorders, its precise influence on ankle joint proprioception and balance in stroke patients is still not well understood. This research seeks to assess the impact of WBV training on ankle joint proprioception and balance in stroke patients, thereby filling this important research void.MethodsIn this prospective cohort study, thirty-five stroke patients were randomly assigned to either the WBV group (n = 17) or a control group (n = 18) using a random number table method. The control group received daily general rehabilitation for four weeks, while the WBV group received an additional 30 min of WBV training each day with the Trunsan S110 Vibration Training System. Blinded outcome assessments were conducted at baseline and post-treatment, utilizing the Berg balance scale (BBS), Functional reach test (FRT), Romberg test length (RTL) and area (RTA), and completion rates of ankle joint dorsiflexion-plantar flexion (DP) and inversion-eversion (IE) tests. Follow-up assessments were performed after four weeks of intervention, focusing on RTL, RTA, DP, and IE as primary outcomes.ResultsAnalysis of intra-group changes from baseline to post-treatment revealed significant improvements across the BBS, FRT, RTL, RTA, and DP and IE assessments (p < 0.001). Notably, the WBV group showed significant enhancements compared to the control group in DP and IE (p < 0.001 and p < 0.05, respectively), with mean values increasing from 13.556 to 16.765 (23.7%) and from 5.944 to 8.118 (36.6%), respectively. However, WBV did not provide additional benefits over the control treatment for balance recovery parameters such as BBS, FRT, RTL, and RTA (p > 0.05).ConclusionsThis study demonstrates that WBV therapy is equally effective as conventional methods in enhancing proprioception and balance in stroke patients, but it does not provide additional benefits for balance recovery. WBV significantly improves proprioceptive functions, particularly in DP and IE parameters. However, it does not surpass traditional rehabilitation methods in terms of balance recovery. These findings indicate that WBV should be incorporated into stroke rehabilitation primarily to enhance proprioception rather than to optimize balance recovery.Trial registrationThis study was retrospectively registered in the ISRCTN Registry on 29/07/2024 (https://www.isrctn.com/, ISRCTN64602845).

Enhancing Motor Function in Children with Cerebral Palsy: A Comparative Study of Pediatric Tuina and Conventional Rehabilitation

ObjectiveThis study explores the impact of combining Pediatric Tuina (PT) with conventional rehabilitation on motor function in children diagnosed with cerebral palsy (CP). MethodsThis controlled trial involved 115 CP-affected children aged 1 month to 13 years. They were allocated into an experimental group (n = 57) receiving PT and conventional rehabilitation, and a control group (n = 58) receiving only conventional rehabilitation for three months. The GMFM-88 scale was employed for evaluating motor function at the start and end of the treatment period. ResultsCompared to the conventional rehabilitation group, the combination of PT and standard rehabilitation therapy showed significant improvement in motor function among children with CP after 3 months. There were no significant differences in baseline characteristics between the two groups. Children in the PT combined with the standard rehabilitation therapy group exhibited more prominent improvements in motor function (supine and rolling: experimental group 47.88 ± 5.02 vs control group 42.86 ± 10.30; sitting: experimental group 45.16 ± 18.52 vs control group 35.59 ± 18.97; total score: experimental group 147.88 ± 75.59 vs control group 118.90 ± 77.87; P = 0.045). Furthermore, there was a significant increase in scores for children after the combination therapy (pre-treatment 105.39 ± 85.76 vs post-treatment 147.88 ± 75.59; P = 0.045). ConclusionPT, when used in conjunction with conventional rehabilitation methods, significantly enhances motor function in children with CP. The study advocates for further extensive research to validate and understand the broader implications of PT in CP treatment.

Pharyngostoma reconstruction after laryngectomy and radiotherapy: A retrospective study and literature review

BackgroundThe occurrence of pharyngocutaneous fistula or pharyngostoma after oncologic head and neck surgery is a serious complication. It is the most common complication after major hypopharyngeal and laryngeal ablative surgery. AimThe purpose of this study is to review the surgical approach and evaluate the results regarding reconstruction methods of pharyngostoma, caused after laryngectomy and radiotherapy. Patients & MethodsThe total patient number is 15. Pharyngostoma caused swallowing difficulties, as well as frequent aspiration pneumonia. The intervention interval from laryngectomy to pharyngeal reconstruction varied between one to three years, depending on the symptoms’ severity and after the complete failure of conservative rehabilitation methods. Pharyngostoma reconstruction was performed mainly with pectoralis major myocutaneous flap in eleven cases. The radial forearm free flap (RFF) and the anterolateral thigh free flap (ALT) were also used in the rest four cases. ResultsThe postoperative course was uncomplicated and in most cases the feeding with soft food started after a barium meal between 15-20 days postoperatively. Complications include wound dehiscence and leak treated conservatively and one case of carotid rupture. ConclusionsThe gold standard for pharyngostoma reconstruction, after laryngectomy and cervical radiotherapy, remains the use of pectoralis major myocutaneous flap. In cases of extensive neck radionecrosis free flaps are preferable. Reliable and stable cover of the large vessels of the neck beside with the reconstruction of the digestive tract and the function of swallowing are issues, which are analysed in corelation with the avoidance of stenosis and swallowing difficulties.

Peer support needs, preferences and experiences of adults with acquired neurological disability: a scoping review protocol

IntroductionPeer support is a promising adjunct to traditional rehabilitation methods for helping adults with acquired neurological disability adjust to and navigate life with a disability. However, there is limited guidance...