Multidisciplinary Rehabilitation Team Research Articles

THE STRUCTURE AND CONTENT OF THE COURSE "INNOVATIONS IN SOCIAL WORK" (FROM THE TEACHING EXPERIENCE)

The topic relevance is determined by the requirements for the training of social work specialists for innovative activities in conditions of modern challenges. The article aims to characterize the structure and content of the course "Innovations in Social Work" for the 2nd (master's) level of higher education, specialty 231 "Social Work" (from teaching experience). Scientific methods applied: generalization, abstraction, explanation, systematization, system-structural, and descriptive analysis. The author notes the importance of a systematic approach to the development of the general concept of the training course. It is justified by taking into account not only theoretical and practical aspects of innovative activity, but also regulatory and legal ones. The structure of content modules tested in the teaching process is proposed: 1) theory of innovative activity; 2) regulatory and legal support of innovations; 3) innovation as a factor in overcoming social problems of our time. A brief overview of the lectures and recommendations for seminars are provided. Considering the absence of thematic sections on innovations in the field of social protection of the population in cross-sectoral normative documents, special attention is paid to the Plan for the implementation of the Ukraine Facility 2024-2027. The reforms for the next 4 years are presented in this document. It is emphasized that some of them are considered in the module No.3 ("Social work in multidisciplinary rehabilitation teams", "Implementation of the veteran's assistant institute", "Evolution of the deinstitutionalization reform in Ukraine") with logical transition to module No.3. The proposed structure and content of the course "Innovations in Social Work" can contribute to the formation of program learning outcomes defined by the educational standard., Special emphasis is placed on the challenges of teaching innovative activities: taking into account the requirements of the standard of higher education and the professional standard, the interdisciplinary nature of knowledge, the incompleteness of legal support for innovative activities in the field of social work. Both the theoretical and legal and educational issues of teaching the course "Innovations in social work" are among the directions of further scientific research.

Clinical Outcomes and Cost Implications of a Community Psychosocial Rehabilitation Service for Severe and Persistent Mental Illness in Nova Scotia, Canada.

Introduction: Individuals with severe and persistent mental illness (SPMI) present distinct challenges in mental healthcare due to the chronic and complex nature of their conditions. This study was conducted to assess the clinical efficacy and potential cost-effectiveness of a multidisciplinary community-based psychosocial rehabilitation team serving individuals with SPMI in Nova Scotia, Canada. Method: This study was conducted to evaluate the effects of a community-based psychosocial rehabilitation program on individuals with severe and persistent mental illness (SPMI) in Nova Scotia, Canada. This research focused on clinical outcomes and potential cost savings following a one-year intervention, offering critical insights into the benefits of community-based care for this population. A cohort of 137 clients accepted into the community rehabilitation service (Connections Dartmouth) between September 2016 and September 2020 was analyzed. Each participant received one year of community rehabilitation intervention. Using data from the Canadian Medical Service Insurance (MSI) billing system, this research compared the use of inpatient services and Emergency Department visits in the year prior to and the year following the intervention. The findings provide valuable evidence on the role of community rehabilitation in reducing healthcare utilization for individuals with SPMI. Results: The results demonstrated a statistically significant reduction in mean admission rates and length of inpatient admissions in the year following rehabilitation compared to the pre-rehabilitation year. A substantial percentage of patients experienced no inpatient admissions (88% vs. 60%) or Emergency Department visits (82% vs. 67%) in the post-rehabilitation year, compared to the pre-rehabilitation year. There was a significant reduction in inpatient days by 90%, translating into substantial cost savings. The findings highlight the potential economic benefits of community rehabilitation for people with SPMI. Conclusions: This uncontrolled study suggests that community rehabilitation is associated with positive clinical outcomes for individuals with SPMI in terms of reduced inpatient service use and associated costs. Further research, including controlled studies and cost-effectiveness studies, into the community psychosocial rehabilitation services in the Canadian setting is needed.

Analysis of legislative basis for medical rehabilitation in Russia

Background. In recent years, there have been significant changes in the regulatory documentation related to medical rehabilitation, caused by the need to consolidate the principles for rehabilitation of patients in post-COVID period and standardize the procedures used for it. Therefore, it is important to analyze the existing regulatory framework and the proposed changes that will come into force in the near future.Objective: to assess the regulatory legal acts governing the provision of medical rehabilitation in Russia.Material and methods. Regulatory legal acts and their drafts were obtained through the reference and legal systems “Kontur Standard”, “ConsultantPlus”, and the Federal Portal of Draft Regulatory Legal Acts. The following electronic libraries, databases and other sources were used to collect secondary information: eLibrary, Google Scholar, PubMed/MEDLINE, Yandex and social networks.Results. Article 41 of the Constitution of the Russian Federation guarantees the right to health protection and medical care. Within the latter the use of medical rehabilitation can be considered. Going down to the next level, the term “medical rehabilitation” is found in Federal Law dated November 27, 2011 No. 323-FZ “On the fundamentals of health protection of citizens in the Russian Federation”. However, the requirements in the field under consideration are specifically described in Orders of the Ministry of Health of Russia No. 788n and 878n, which establish a three-stage provision of medical rehabilitation and give specific time instructions for the frequency and duration of care prcedures. The conditions for the transition of patients between the stages of medical rehabilitation are presented, and creating interdisciplinary rehabilitation teams is specified.Conclusion. The analysis of innovations in the regulatory framework showed no fundamental changes in the regulation of medical rehabilitation. At the moment, there is a need to expand it by regulating the activities of multidisciplinary rehabilitation teams. A more detailed elaboration of normative documentation regulating the provision of medical rehabilitation to children is necessary.

LIFE AFTER STROKE AND THE KEY ROLE OF COORDINATED REHABILITATION FROM THE PERSPECTIVE OF THE STROKE SURVIVOR FAMILIES

Introduction. Stroke significantly affects the lives of survivors, requiring adaptation to lost capabilities while impacting physical, mental, and emotional well-being. Stroke is a leading cause of acquired disability in adults and a significant contributor to mortality, particularly among older individuals and in low-income countries. A stroke is described as a neurological deficit caused by acute damage to the central nervous system. Aim. The study's main aim was to explore the use of coordinated stroke rehabilitation before, during, and after hospital discharge. It examined components of coordinated rehabilitation, focusing on the needs of the client's family. This study was conducted as part of the GAJU 066/2022/S project and approved by the ethics committee under 6/2022. Materials and methods. This study used a qualitative research approach and semi-structured interviews with family members caring for stroke patients. The data collected was then analyzed using various coding strategies with the assistance of ATLAS.ti software. This rigorous methodology ensured the reliability and validity of the study's findings. Results. The effects of strokes are profound, not only on patients but also on their families and caregivers. Adapting to life after a stroke necessitates significant changes in family dynamics, values, and norms. The importance of effective communication and support from healthcare staff during patient hospitalization cannot be overstated. Respondents highlighted the role of quality care and communication in ensuring a positive hospital stay. However, they also pointed out certain deficiencies, such as delayed stroke diagnosis and inadequate information about post-discharge care and rehabilitation. The study underscored the importance of at-home rehabilitation in familiar environments for functional improvement. Conclusions. Life after a stroke presents a substantial challenge for patients and their families, requiring physical, psychosocial, and emotional adaptation. Coordinated rehabilitation facilitates post-stroke adjustments for patients and families and increases overall quality of life. Improved coordination and communication among healthcare providers, development of multidisciplinary rehabilitation teams, and effective post-discharge monitoring and support systems are essential for comprehensive care tailored to the needs of the patient and their families. Stroke patient family members advocate for enhanced support and services for better rehabilitation and for coping with post-stroke challenges.

Joubert syndrome: a rare cause of hypotonia with developmental delay

Joubert syndrome is a rare autosomal recessive disorder. It is characterized by congenital ataxia, hypotonia, developmental delay, and at least one of the following features: neonatal respiratory disturbances and abnormal eye movements; including nystagmus and oculomotor apraxia. Molar tooth appearance is an essential finding for the diagnosis of Joubert syndrome. Here we presented a case of an 18-month-old male who presented with developmental delay and marked hypotonia. The main purposes of the case report were to highlight the benefit of a multidisciplinary rehabilitation team approach and describe the clinical features associated with Joubert syndrome. Brain magnetic resonance imaging showed a thick, elongated, and abnormally oriented superior cerebellar peduncle showing a molar tooth appearance with elongated bat-wing-shaped 4th ventricle and hypoplasia of the vermis suggestive of JS. Hypotonia during infancy and developmental delay with or without learning disability, associated with abnormal breathing patterns and abnormal eye movements (nystagmus) along with the radiological presence of a molar tooth sign on the brain MRI is an essential component to confirm the diagnosis.

Assessing the efficacy of a graded pulmonary rehabilitation protocol in mechanically ventilated patients following brainstem hemorrhage.

The objective of this study is to assess the impact of an early-graded pulmonary rehabilitation training program on patients undergoing mechanical ventilation due to brainstem hemorrhage. Eighty patients receiving mechanical ventilation due to brainstem hemorrhage at our hospital's neurosurgery department between August 2022 and October 2023 were enrolled as participants. A sampling table was generated based on the order of admission, and 80 random sequences were generated using SPSS software. These sequences were then sorted in ascending order, with the first half designated as the control group and the second half as the intervention group, each comprising 40 cases. The control group received standard nursing care for mechanical ventilation in brainstem hemorrhage cases, while the intervention group underwent early-graded pulmonary rehabilitation training in addition to standard care. This intervention was conducted in collaboration with a multidisciplinary respiratory critical care rehabilitation team. The study compared respiratory function indices, ventilator weaning success rates, ventilator-associated pneumonia incidence, mechanical ventilation duration, and patient discharge duration between the 2 groups. The comparison between patients in the observation group and the control group regarding peak expiratory flow and maximum inspiratory pressure on days 1, 3, 5, and 7 revealed statistically significant differences (P < .05). Additionally, there was a statistically significant interaction between the main effect of intervention and the main effect of time (P < .05). The success rate of ventilator withdrawal was notably higher in the observation group (62.5%) compared to the control group (32.5%), with a statistically significant difference (P < .05). Moreover, the incidence rate of ventilator-associated pneumonia was significantly lower in the observation group (2.5%) compared to the control group (17.5%) (P < .05). Furthermore, both the duration of mechanical ventilation and hospitalization were significantly shorter in the observation group compared to the control group (P < .05). Early-graded pulmonary rehabilitation training demonstrates effectiveness in enhancing respiratory function, augmenting the ventilator withdrawal success rate, and reducing both the duration of mechanical ventilation and hospitalization in mechanically ventilated patients with brainstem hemorrhage. These findings suggest the potential value of promoting the application of this intervention in clinical practice.

Cardiac rehabilitation centers in Romania: Where are we now?

Purpose: In 2024, Romania is still facing a critical challenge with high cardiovascular disease mortality rates despite extensive research and policy initiatives. Our study sought to examine the actual state of cardiac rehabilitation in Romania by identifying the healthcare facilities that provide and deliver cardiac rehabilitation services. Methods: The research began with a comprehensive investigation into cardiac rehabilitation centers across Romania. This involved leveraging search engines to identify these facilities. Keywords like “cardiac rehabilitation”, “cardiovascular rehabilitation”, and “cardiac rehabilitation centers” were instrumental in pinpointing relevant information, which included names, geographical locations, and contact details of the centers. Upon identification of potential centers, our research team initiated direct engagement with these facilities via telephonic interviews. Results: The data collected in 2024 was compared to previous findings from a 2017 research report to evaluate the progress and impact of prevention efforts over time. While the number of cardiac rehabilitation centers has grown (69.2% increase in the nationwide count of cardiac rehabilitation centers/facilities), an uneven geographic distribution persists, exacerbated by disruptions during the COVID-19 pandemic. Among the cardiac rehabilitation centers identified, 23% are located in balneoclimatic resorts, but the majority of cardiac rehabilitation centers are located in Bucharest. Overall, 65.3% of all identified centers in Romania belong to the private healthcare sector. Among these private centers, 41.1% offer cardiac rehabilitation programs as continuous inpatient care, with durations ranging from 5 to 16 days. All cardiac rehabilitation centers are equipped with the necessary equipment to perform basic cardiological investigations as well as physio-kinesiological rehabilitative procedures, in addition to aerobic physical training (53.8%). In 33.3% of the identified centers, diabetologists and psychologists/psychotherapists are integral members of the multidisciplinary cardiac rehabilitation team, while only 19.2% of the centers include a dietitian/nutritionist. Regarding costs, there is significant variation depending on the geographical area. In Bucharest, a single rehabilitation session costs between 100 to 400 lei (20 to 80 €), and a rehabilitation program spanning 4-6 weeks can cost up to 3350 lei. Comparing costs identified in 2017, we have observed an increase ranging from 47% to 188% in 2024. Conclusions: Despite an increase in the number of cardiac rehabilitation centers, their prevalence remains inadequate to fulfill the demands of the population. Telerehabilitation emerges as a promising solution, with limited adoption in only one center. Cost variations across regions pose a barrier to patient participation. Our article proposes strategies including decision algorithms for personalized recommendations, expanding cardiac rehabilitation centers, and advocating for comprehensive cost reimbursement. The urgent need for collaborative efforts is emphasized, envisioning innovative solutions like mobile applications to foster a sense of community and optimize cardiac rehabilitation, ultimately improving cardiovascular health outcomes in Romania. Keywords: cardiac rehabilitation, telerehabilitation, cardiac rehabilitation centers, healthcare disparities, cardiovascular health

Early integrated rehabilitation and vocational rehabilitation in 435 patients with breast cancer: A comparison between the intervention group and control group in a prospective study.

11007 Background: Return to work is beneficial both for breast cancer (BC) patients and for society. This study explored the impact of early integrated and vocational rehabilitation on sick leave and disability one year after the start of cancer treatment in BC patients. Methods: The subjects of our prospective study were 435 employed female BC patients (26-65 (mean 52) years of age), who participated in the pilot study on the individualized integrated rehabilitation in 2019-2022 and were followed for at least one year. There were 211 patients in the control group and 224 in the intervention group. The patients completed three questionnaires (EORTC QLQ - C30, B23, and NCCN): before, half and one year after the start of cancer treatment. The control group received the standard rehabilitation programme, offered to all BC patients before the start of the study. The multidisciplinary rehabilitation team reviewed the documentation of the patients from the intervention group before, half and one year after the start of treatment and recommended appropriate interventions according to the patient's needs in compliance with the institute’s new clinical pathway (psychologist, general practitioner, nutritional treatment, physical rehabilitation, kinesiologist-guided online exercises, gynaecologist, analgesia, vocational rehabilitation). Data on the patients’ demographics and needs reported in questionnaires, the extent of the disease and cancer treatment were collected. These data and the frequency of sick leave and disability retirement one year after the start of treatment in both groups of patients were analysed using the chi-square and ANOVA test. Results: The patients from the intervention group had 50 calendar days shorter sick leave compared to the control group (p = 0.002). Patients without metastatic disease from the intervention group had 52 calendar days shorter sick leave compared to the control group (p = 0.002). The intervention group treated with chemotherapy had 43 calendar days shorter sick leave compared to the control group (p = 0.029). The difference in sick leave of the group of patients who did not receive chemotherapy was statistically borderline significant (50 calendar days, p = 0.053). The patients in the intervention group had a better work ability (p &lt; 0.001) and less disability (p &lt; 0.001) than the patients in the control group one year after the start of treatment. Conclusions: One year after the beginning of cancer treatment, patients from the intervention group had shorter sick leave, better work ability, and a lower proportion of disability compared to the control group.

Let the records speak: an exploration of rehabilitation services offered in primary healthcare, Johannesburg metropolitan district

BackgroundPrimary healthcare in South Africa aims to transform the national health system by emphasising community-based care and preventive strategies. However, rehabilitation services, particularly for individuals with disabilities and chronic non-communicable diseases, are often overlooked in primary healthcare. This study aimed to investigate the provision of primary healthcare rehabilitation services in the Johannesburg Metropolitan District by exploring client sociodemographics and variations in services provided by rehabilitation professionals.MethodsA retrospective review of clinic rehabilitation records from 2011 to 2020 was conducted at nine provincially funded community health centres (CHCs) offering rehabilitation services. Stratified sampling facilitated record selection based on rehabilitation service type and year. A specifically designed data extraction tool captured demographics, disabilities, rehabilitation received, and referral sources. Descriptive analysis used means, standard deviations, and frequencies.ResultsThe findings show a diverse client population with a wide age range, with a significant proportion falling into the < 5 years and 30–49 years age groups. Neuromusculoskeletal and movement-related disabilities were most prevalent, affecting approximately two-thirds of clients. Referral sources were often undocumented, and inconsistent discharge information with no record of patient follow up, highlighted the need for improved documentation practices. Clinic visits were the primary service delivery mode, followed by limited home visits and outreach services. Occupational therapy and physiotherapy were the most used services. Speech and language therapy services were underused, and some CHCs lacked audiology services. There were variations in the number of individual and group sessions provided by the different rehabilitation services, and there were age- and disability-specific differences in service use.ConclusionThis study offers insights into rehabilitation service provision in the Johannesburg Metropolitan District and enhances our understanding of rehabilitation services in primary healthcare settings. It underscores the importance of a multidisciplinary rehabilitation team to address diverse rehabilitation needs, improving documentation and discharge practices, expanding service delivery models, and reducing disparities in service use. The findings inform strategies for optimising service delivery, workforce, resource allocation, and intersectoral collaboration to ultimately enhance the quality and accessibility of integrated rehabilitation services.

Exposure to Meta-Analysis During Graduate and Postgraduate Trainings Predicts the Good Knowledge and Use of Randomized Controlled Trials, Systematic Reviews, and Meta-Analyses Among Nigerian Physiotherapists.

Background Evidence-based practice (EBP) is essential for physiotherapy as an integral part of the multidisciplinary rehabilitation team. Randomized controlled trials (RCTs), systematic reviews, and meta-analyses are the gold standard in the hierarchy of evidence. However, the extent of knowledge, attitudes, and professional use of RCTs and meta-analyses among physiotherapists in Nigeria remains unclear. Therefore, this study aimed to describe and explore the predictors of Nigerian physiotherapists' knowledge, attitudes, and professional behaviors toward RCTs, systematic reviews, and meta-analyses. Methods In this observational study, an electronic version of an adapted questionnaire assessing the knowledge, attitudes, and professional use of RCTs and meta-analyses was shared across electronic platforms of Nigerian physiotherapy professional organizations. Results We found good overall knowledge (76 {80.8%}) and attitude (83 {88.3%}) towardthe use of RCTs, systematic reviews, and meta-analyses for evaluating health interventions. Exposure to meta-analysis during graduate and postgraduate training (odds ratio {OR}, 7.102; 95% CI, 1.680-30.021; p = 0.008) and the presence of a medical library at the workplace (OR, 0.264; 95% CI, 0.070-0.997; p = 0.049) were significant predictors of good knowledge of RCTs, systematic reviews, and meta-analyses. Self-rated (OR, 56.476; 95% CI, 1.356-2357.430; p = 0.034) and overall levels of knowledge (OR, 0.013; 95% CI, 0.000-0.371; p = 0.011) predicted the good use of RCTs, systematic reviews, and meta-analyses among respondents. Discussion To equip physiotherapy practitioners with the requisite skill in using RCTs, systematic reviews, and meta-analyses, graduate and postgraduate trainings should prioritize education on the use of RCTs, systematic reviews, and meta-analyses to inform clinical decisions and practice, while capable workplaces may set up medical libraries to ease access and enhance the use of RCTs, systematic reviews, and meta-analyses.

The ROCK trial—a multidisciplinary Rehabilitation intervention for sudden Out-of-hospital Cardiac arrest survivors focusing on return-to-worK: a pragmatic randomized controlled trial protocol

IntroductionMost cardiac arrest survivors are classified with mild to moderate cognitive impairment; roughly, 50% experience long-term neurocognitive impairment. Postarrest challenges complicate participation in society and are associated with social issues such as failure to resume social activities and impaired return to work. The effectiveness of rehabilitation interventions for out-of-hospital cardiac arrest survivors are sparsely described, but the body of evidence describes high probabilities of survivors not returning to work, returning to jobs with modified job descriptions, returning to part-time employment, and often in combination with extensive unmet rehabilitation needs. Hence, there is a need to develop and test a pragmatic individual targeted intervention to facilitate return to work (RTW) in survivors of OHCA. The overall aim of the ROCK trial is to evaluate the effectiveness of a comprehensive individually tailored multidisciplinary rehabilitation intervention for survivors of OHCA on RTW compared to usual care.Methods and analysisThe ROCK trial is a two-arm parallel group multicentre investigator-initiated pragmatic randomized controlled superiority trial with primary endpoint measured 12 months after the cardiac arrest. Adult survivors who were part of the labour force prior to the OCHA and had at least 2 years until they are qualified to receive retirement state pensions are eligible for inclusion. Survivors will be randomized 1:1 to usual care group or usual care plus a comprehensive tailored rehabilitation intervention focusing on supporting RTW. After comprehensive assessment of individual rehabilitation needs, the intervention is ongoingly coordinated within a multidisciplinary rehabilitation team, and the intervention can be delivered for up until 12 months. Data for the primary outcome will be obtained from the national register on social transfer payments. The primary outcome will be analysed using logistic regression assessing RTW status at 12 months adjusting for the intervention and age at OHCA, sex, marital status, and occupation prior to OHCA.DiscussionThe ROCK trial is the first RCT to investigate the effectiveness of a rehabilitation intervention focusing on return to work after cardiac arrest.Trial registrationClinicalTrials.gov NCT05173740. Registered on May 2018

Реабилитационный диагноз у недоношенных детей с перинатальной патологией нервной системы на основе Международной классификации функционирования

Aim. To determine the main categories of the International Classification of Functioning, Disability and Health that constitute a rehabilitation diagnosis in a premature infant with perinatal lesions of the nervous system. Key points. One of the urgent tasks in the formation of a unified approach to the rehabilitation and habilitation of premature babies when they are transferred from the first or second stage of rehabilitation is to assess the child's rehabilitation status and establish a rehabilitation diagnosis. For this purpose, we used the International Classification of Functioning, Disabilities and Health. Studied domains include nervous system structures; vision and related functions; hearing and vestibular functions; neuromuscular and movement-related functions; skeletal, digestive, and metabolic functions; child mobility; and environmental factors. The article describes a clinical case of a 9.5-month-old patient, born at 30 weeks' gestation, who was admitted to a rehabilitation course at a day hospital with a complaint of delayed motor development. After establishing the rehabilitation diagnosis, the infant's average rehabilitation potential was determined and a favourable rehabilitation prognosis was predicted on the basis of the rehabilitation results. The positive effect of the rehabilitation activities was associated with the emergence of new skills and improvement in the rehabilitation status of the child. Conclusion. Formulating a rehabilitation diagnosis involves assessing the patient's current situation, which makes it possible to set rehabilitation goals, form a multidisciplinary rehabilitation team, justify the use of rehabilitation methods and evaluate the outcome of rehabilitation interventions. Keywords: premature children, rehabilitation diagnosis, rehabilitation potential, International Classification of Functioning, psychological development.

Availability of rehabilitation for victims of mine-explosive injury in the conditions of territorial community.

Aim: The aim of the study was to determine the needs for long-term rehabilitation of persons with damage as a result of a mine-explosive trauma and the availability of rehabilitation for these persons in the territorial community. Materials and Methods: Research materials included domestic and foreign scientific sources and normative legal acts on the topic. Research methods included the content analysis, bibliosemantic, data summarization, medical and statistical. Results: The needs for long-term rehabilitation are determined by combined damage, among which damage to the limbs (34.78%-65.22%) [10], craniocerebral injuries (7.9%-12.7%) [11], the acoustic system (40.5%) [16], injuries of bones and soft tissues of the face (10.85%) [18]. Іn 2018, for the first time, 1.2 per 10,000 adult population of participants of the Anti-Terrorist Operation/Joint Forces Operation were recognized as persons with disabilities [7]. Permanent limitations of life activities were caused mainly by brain and limb injuries. In general, long-term rehabilitation is available to persons with injuries in the territorial community in accordance with European approaches. At the same time, the participation of the general practitioner-family doctor is limited by regulatory requirements only to refer the patient to rehabilitation specialists and other specialists. Conclusions: High needs for long-term rehabilitation of persons brain and limb injuries as a result of mine-explosive trauma have been established. There is a need to expand the participation of general practitioners-family doctor in the organization and implementation of rehabilitation as a full-fledged member of a multidisciplinary rehabilitation team, which requires making appropriate changes to regulatory acts.

Psychological support of patients with motor disorders at the second stage of medical rehabilitation

The article presents the results of a literary review on the problem of the organization of differentiated psychological support at the second stage of medical rehabilitation of patients with the consequences of motor disorders that arose as a result of stroke or developed against the background of degenerative and dystrophic diseases of large joints and spine. The psychological consequences of motor disorders, patients’ characteristics, and possible approaches to psychocorrection are analyzed. It was revealed that regardless of the nosology of motor disorders, the targets of psychocorrection at the second stage of medical rehabilitation of patients are signs of anxiety and depression in the current emotional state, while the specific targets in the case of stroke are disorders of higher mental functions, and in the case of degenerative and dystrophic diseases of large joints and spine — subjective perception of pain syndrome. As the main guidelines for the systematic work of a psychologist as part of a multidisciplinary rehabilitation team at the second stage of medical rehabilitation of the studied contingent of patients, the following are indicated: determining the basic targets of psychocorrection, selecting relevant and nosology-sensitive motor disorders correction methods, and increasing the effectiveness of psychocorrection through the use of high-tech virtual and augmented reality tools.

Актуальні тенденції в індивідуальних програмах реабілітації дітей із церебральним паралічем: важливий крок до поліпшення якості життя (огляд літератури)

Approaches to treating and rehabilitating children with cerebral palsy now focus on maximizing their environment and increasing their independence in everyday life. The study of different techniques allows us to consider the needs and goals of families when developing individualized treatment and rehabilitation programs, contributing to the optimal development of the child. Purpose - to study the criteria for developing individual rehabilitation programs, analyzing the examination of children with cerebral palsy, evaluating family-centered care, researching multidisciplinary rehabilitation teams, and analyzing the provision of medical and rehabilitation services and their impact on the quality of life of children with cerebral palsy. A comprehensive and structured search of scientific sources in scientometric databases such as PubMed, Google Scholar, Scopus, Cochrane Library, EMBASE, MEDLINE, and specialized journals in pediatrics and neurology was performed to conduct a systematic literature review. The literature search and analysis were conducted over the past 10 years (from 2012 to 2022). For the bibliometric analysis, the method of data analysis using the VOSviewer program was used. Several important aspects related to the provision of rehabilitation services to children with cerebral palsy and their relationship with classification systems and other aspects are considered and analyzed. The influence of the provision of rehabilitation services by a multidisciplinary rehabilitation team on the functional state of children with cerebral palsy according to the level of the classification system of basic motor functions is substantiated. The study also investigated how the provision of medical and rehabilitation services affects the quality of life of children with cerebral palsy. All of these aspects of the study aimed to improve the provision of services to children with cerebral palsy and their functional status and quality of life. Conclusions. The research demonstrates the need for an in-depth analysis of the examination of children with cerebral palsy and the introduction of family-oriented care. It was found that the development of multidisciplinary rehabilitation teams is effective in achieving the best results in developing children with cerebral palsy. The importance of further research to improve individual rehabilitation programs and improve the quality of life of these children is also substantiated. No conflict of interests was declared by the author.

Rehabilitation of Adult Patients with Pulmonological Manifestations of Long COVID: a Review

INTRODUCTION. The most common symptoms in patients who have had a new coronavirus infection (COVID-19) are associated with pulmonary lesions (shortness of breath, chest pain, cough) and the same complaints persist in the majority of those suffering from long COVID the occurrence and prevalence of which in the population is inextricably linked with the number recovered from COVID-19.&#x0D; AIM. To study the current state of the problem of diagnosis, treatment and rehabilitation of patients with pulmonological manifestations of long COVID at the stage of a specialized rehabilitation hospital in order to formulate basic practical recommendations for the management of this category of patients.&#x0D; MATERIALS AND METHODS. During the period from January 1, 2021 to December 1, 2022, we performed a systematic search of the MEDLINE, Cyberleninka, and eLIBRARY.RU databases on the topic of pulmonary manifestations of long COVID and methods of their rehabilitation in adult patients that gave 678 matches. After further filtering steps according to the methodology outlined in the PRIZMA guidelines, we selected 60 publications for the final analysis.&#x0D; RESULTS. Pulmonary manifestations of long COVID, including, first of all, shortness of breath, rank second after fatigue in terms of frequency of occurrence in long COVID. Diagnostic findings include radiologic pulmonary tissue changes recorded in a proportion of patients under one year, restrictive abnormalities on spirometry, and impaired pulmonary diffusion capacity. Many patients who have had COVID-19 recover quite quickly, but some of them have a long-term symptom complex of dyspnea and physical fatigue, for which rehabilitation in a specialized centers is indicated.&#x0D; The most effective treatment is possible with the involvement of a multidisciplinary rehabilitation team in the rehabilitation process and the appointment of rehabilitation programs created in accordance with the conceptual basis of respiratory rehabilitation, including, first of all, a wide range of methods of therapeutic physical culture.&#x0D; The most effective treatment is possible by involving a multidisciplinary rehabilitation team in the rehabilitation process and prescribing rehabilitation programs designed in accordance with the conceptual framework of respiratory rehabilitation, including, above all, a wide range of therapeutic physical education techniques.&#x0D; CONCLUSION. Current knowledge of the clinical picture, diagnosis, treatment and rehabilitation measures in long COVID is constantly reassessed and expanded. This literature review gives an analysis of research papers focused on the treatment and rehabilitation of pulmonary manifestations in adults, combining the etiopathogenetic and syndromic approaches characteristic of the “classical Russian therapeutic” and, closest to it, the “German” schools. The information extracted both from documents published by World Health Organization (WHO) and from local Russian and European clinical guidelines will allow a specialist engaged in the rehabilitation of adults with pulmonary manifestations of long COVID to create an effective and personalized individual rehabilitation plan for each patient.

Standardization of rehabilitation medical cards for adult patients with musculoskeletal and peripheral nervous systems dysfunction

Currently, each rehabilitation institution solves the problem of registration of rehabilitation medical records empirically, based on the existing realities of a particular institution.&#x0D; The study examined the development of a medical history template for the in- and outpatient medical rehabilitation of patients with peripheral nervous system (PNS) and musculoskeletal system (MSA) dysfunction.&#x0D; The medical history template corresponded to the currently approved forms 003/y (Medical record for inpatient care) and 025/y (Medical record for outpatient care) but supplemented with chapters, allowing entry of information in accordance with the requirements of the Ministry of Health of the Russian Federation Order for medical rehabilitation of adults (No. 788n dated July 31, 2020). Additional chapters, forms, and appendices designed to include specific information about the rehabilitation process included the physical and rehabilitation medicine doctor examination list, multidisciplinary rehabilitation team members, examination lists, rehabilitation routing scale blank, list of MDRC discussions, individual patient management forms, standard rehabilitation discharge form, and list of rehabilitation quality criteria for adult patients with MSA/PNS dysfunction. Validated scales and test forms were also included.&#x0D; The unification of rehabilitation medical records for patients with MSA/PNS impairment makes it easier for the staff of the rehabilitation departments and centers to file medical records in accordance with the current legislation.

The application of a multidisciplinary methodological approach to the training of physical therapists in the process of rehabilitation of a patient with a gunshot wound to the spinal cord

rehabilitation is one of the key areas of medicine, especially during periods of full-scale war, when militaries and civilians require long-term rehabilitation interventions. The use of a multidisciplinary approach in rehabilitation made it possible to expand the scope and opportunities of rehabilitation treatment and improve the recovery of patients. A physical therapist plays an important role in a multidisciplinary team and carries out rehabilitation measures to eliminate, stop or reduce pain, restore body functions, achieve a normal level of health, physical independence and activity, optimal physical condition and well-being. The training of qualified physical therapists is an important component of successful rehabilitation. The article presents the results of the cooperated work of specialists of the multidisciplinary team of the Military Medical Clinical Treatment and Rehabilitation Center of city Irpin, and physical therapy higher education applicants of the Department of Physical Rehabilitation and Sports Medicine of the Bogomolets National Medical University. The aim of the work was to improve the practical skills of physical therapy higher education applicants by integrating them into the work process of a multidisciplinary rehabilitation team for the rehabilitation of a patient with a gunshot wound to the spinal cord. Higher education applicants took part in the rehabilitation examination and had the opportunity to expand practical skills in this direction. The team of specialists conducted the following rehabilitation tests and obtained results - according to the ASIA scale, the degree of damage to the patient's spinal cord is complete - there is no sensitivity and motor function of the S4-S5 segments, according to the modified Rankin scale 5 points, which corresponds to severe functional disability; according to the Barthel index, 10 points, which corresponds to the patient's complete dependence on external assistance, according to manual muscle testing, the strength of the muscles of the upper shoulder girdle corresponded to 3 points - the full amplitude of movement against the force of gravity. On the basis of the obtained results, the multidisciplinary team determined the main violations according to the domains of the international classification of functioning, and in accordance with them, the higher education applicants developed the key goals of rehabilitation and methods that must be included in the rehabilitation process. Physical therapy higher education applicants conducted rehabilitation interventions aimed at improving patient mobility and self-care, prevention of bedsores, contractures, improvement of the musculoskeletal system, and increased tolerance to physical exertion. After six weeks of the rehabilitation process, repeated rehabilitation examinations were carried out, positive dynamics were admitted according to the Rankin scale, according to the Barthel index and manual muscle testing. The higher education applicants survey showed that while working in a multidisciplinary team, physical therapist higher education applicants managed to expand their knowledge, practical skills and acquire the necessary components for work and close interaction with all team members, to increase the effectiveness of rehabilitation measures for a patient with a spinal cord injury.

Barriers and facilitators in providing home-based rehabilitation for stroke survivors with severe disability in the UK: an online focus group study with multidisciplinary rehabilitation teams

ObjectivesIn the UK, over 20% of stroke survivors leave hospital with severe disability. Limited evidence-based clinical guidance is available to support the rehabilitation of these individuals. Our previous research has...

OCCUPATIONAL THERAPY AND PHYSICAL THERAPY IN INCLUSIVE EDUCATION

In the context of solving the tasks of inclusive education, the competencies of physical therapists and occupational therapists, defined by the Standard of Higher Education of the second (master's) level of higher education in the field of knowledge 22 Health care, specialty 227 Physical therapy, occupational therapy, in particular effective cooperation with all members of the multidisciplinary rehabilitation team and other health, education and social policy professionals involved in providing services to patients/clients.&#x0D; The purpose of the research is to reveal the content and tasks of physical therapy, occupational therapy in an inclusive educational space. In order to achieve the set goal, the following research tasks must be solved: to reveal the state of scientific study of the problem of using methods of physical therapy, occupational therapy in inclusive education; to analyze the task of the team of psychological and pedagogical support of a child with special educational needs; determine the types of health-preserving technologies in educational institutions with an inclusive form of education; to analyze the content, forms and methods of adaptive physical education in an inclusive educational space.&#x0D; Conclusions:&#x0D; &#x0D; The introduction of an inclusive form of education in Ukraine significantly actualized the need for the use of occupational therapy and physical therapy in corrective and developmental assistance for children with disabilities of different age and nosological groups. At the same time, the support of children with special educational needs in the implementation of the tasks of the individual development program by a multidisciplinary team of specialists in an inclusive educational space has become an important direction of ensuring their special educational needs.&#x0D; The use of various types of health-preserving technologies is an important condition for the effective functioning of inclusive education. In order to preserve, strengthen and increase the physical, mental and social health of pupils of inclusive groups of special education, such main groups of health-preserving technologies are used as: organizational-pedagogical, psychological-pedagogical and educational-educational. Organizational and pedagogical ones are used to determine the structure of the educational process, which is able to prevent overwork, hypodynamia, etc.&#x0D; Among the types of health-preserving technologies that are used in the inclusive educational space of primary schools, it is appropriate to single out: physical culture and health, medical and preventive technologies, and technologies for ensuring optimal mental and social health of preschoolers.&#x0D; The effectiveness of the introduction of AFV in the work with pupils of special educational institutions who have normative development and their peers with special needs of different nosological groups depends on ensuring an optimally favorable, barrier-free educational environment in special educational institutions. The results of AFV directly depend on taking into account and realizing the potential opportunities and needs of each child, individual characteristics, preservation and strengthening of his health. At the same time, it is necessary to take into account that regardless of the psychophysical development of preschoolers and their state of health, each of them has resource opportunities, the use of which can positively affect the quality of life.&#x0D;