Participation In Rehabilitation Program Research Articles

Stroke Rehabilitation in India: Addressing Gender Inequities.

Gender inequality has a significant and complex impact on stroke recovery and rehabilitation outcomes. Moreover, the influence of gender on post-stroke recovery is multifactorial, primarily biological, social, and behavioral issues. The recovery paths for men and women may have different outlines in relation to stroke occurrence, injury sites, and hormonal effects. These collectively influence the effective summarization of recovery strategies and outcomes. Furthermore, societal and cultural elements play a significant role in shaping access to resources, social support networks, and participation in rehabilitation programs, which consequently affect the outcomes. Considering the gender-specific nuances is important in developing effective rehabilitation strategies. Furthermore, effective stroke rehabilitation programs are needed to achieve equitable and improved recovery outcomes for all stroke survivors and to create inclusive interventions that consider these differences.

Health Behaviours after Returning to Work in Patients Who Experienced Hand Finger Amputation as a Result of Work Accidents

Background: Many organizations face health behavior related issues such as anxiety, depression, traumatic stress disorder in their employee performance, particularly in those who had experienced hand-finger amputation as a result of work accidents. Such issues reduce their overall productivity when they return to work. Aim: The objective of this research was to measure the impact of rehabilitation program participation, psychological support, workplace accommodations and self-efficacy in daily tasks on the health behaviour of patients who experienced hand finger amputation as a result of work accidents. Method: The study used cross-sectional data, collected from 210 respondents across organizations in Adana, Turkey. The empirical results were checked using Statistical Package for Social Science (SPSS) version 21. Results: The findings of this study confirmed that rehabilitation participation program, psychological support, and self-efficacy in daily tasks had a significant and direct impact on the health behaviour of patients who experienced hand-finger amputation as a result of work accidents. However, the study also reported there was no significant and direct impact of workplace accommodations on the health behaviour of patients who experienced hand-finger amputation as a result of work accidents. Conclusion: The findings of this research would contribute to the body of literature in the form of new rationale development and would provide practical solutions to improve employees' health behaviour.

Strategi Implementasi Program Desa Bersinar dalam Penanganan Desa Zona Merah Narkoba: Studi Kasus di Desa Ringinarum, Kabupaten Kendal

Handling drug trafficking in rural areas is a serious challenge in Indonesia, especially in villages classified as "red zones". Ringinarum Village, Kendal Regency, is a clear example of a village that faces a significant drug threat. This research aims to analyze in depth the strategy for implementing the Bersinar Village Program in dealing with villages that fall into the red zone category, with a special focus on Ringinarum Village. Using a qualitative approach and case study method, this research evaluates the effectiveness of the Bersinar Village Program in increasing community awareness and participation in rehabilitation efforts. The research results show that this program has succeeded in increasing public awareness of the importance of drug treatment, as well as increasing their active participation in rehabilitation programs. Collaboration between the Kendal Regency National Narcotics Agency (BNN) and village officials is the key to success, with the vital role of village officials as the main driver. This research confirms the importance of adapting programs to local contexts for higher effectiveness in dealing with drugs in rural areas.

Illness representation in patients with multiple sclerosis: A preliminary narrative medicine study.

The development of personalized interventions aimed at coping with multiple sclerosis is enriched by the understanding of patients' representations of the illness. The aim of this study was to investigate the association between patients' illness representations versus contextual factors (i.e. presence/absence and type of caregiver, engagement, frequency and type of rehabilitation), fatigue, pain, and neurological impairment. Interviews of 28 patients were analysed through an automated text analysis procedure. After a systematic labelling procedure four illness representations were identified: daily life, search for meaning of the disease, relationship to people and the diagnosis, coping and physical growth. Findings showed that the representation of the relational aspects of the illness was associated with the caregiver's presence, while the representation related to coping and growth tended to be associated with participation in rehabilitation programs. Moreover, the representation related to daily life was associated with lower levels of fatigue compared to the representation related to coping and growth, and with higher levels of neurological impairment compared to the representations related to coping and growth and the relational aspects of the illness. Exploring illness representations is a key step that can help health professionals to get an integrated perspective that could be useful in designing and calibrating interventions according to specific patient needs.

Cardiac Rehabilitation in Geriatric Individuals

Background: The aim of the study is a current review in the field of cardiac rehabilitation in geriatric individuals. Methods: Literature searches were conducted using PubMed, Embase and Scopus. Additional articles were identifed by searching reference lists. Results: Aging is a physiological condition in the normal process of life and leads to changes in all organs and systems. The aging process significantly affects the cardiovascular, pulmonary, musculoskeletal, and metabolic systems. Cardiac rehabilitation provides numerous psychological and physiological benefits to older adults. All comorbidities, frailty status, and social and financial factors should be comprehensively evaluated while planning cardiac rehabilitation programs that consist of the main components of exercise training, risk factor management, and psychosocial counseling in older adults. Conclusions: Regular participation in cardiac rehabilitation programs can reduce morbidity and mortality rates and improve cardiorespiratory fitness and overall health outcomes by modifying coronary artery disease risk factors in older adults with chronic conditions, including cardiovascular disease, stroke, and respiratory disease

The Influence of Assertiveness and Social Support from Families of Social Rehabilitation Program Participants on Islamic Communication Skills in Medan Class 1 Penitentiary

Social rehabilitation program, conveying religious messages and maintaining crucial aspects of religion and society. Effective communication is needed to build good relationships with other people, convey opinions and aspirations, and resolve conflicts with social rehabilitation program participants. This research aims to see the influence of assertive communication and social support from families of social rehabilitation participants on Islamic communication skills in the Class 1 Penitentiary in Medan. Based on the results of the research and discussion, several conclusions can be drawn as follows: First, assertiveness influences the Islamic communication skills of Social Rehabilitation Program Participants in Medan Class 1 Penitentiary. The results of this research identify that the better the level of assertiveness a person has, the Islamic communication skills of the inmates of class I Penitentiary in Medan will improve. Second, family social support influences the Islamic communication skills of Social Rehabilitation Program Participants in Medan Class 1 Penitentiary. The results of this research identify that the better the level of family social support received by a prison inmate will improve the Islamic communication skills of class I Medan Penitentiary inmates. Third, assertiveness and Social Support together have a significant effect on Islamic Communication Skills in Medan Class 1 Penitentiary, Participants in the Social Rehabilitation Program.

Digital health intervention in patients undergoing cardiac rehabilitation: systematic review and meta-analysis.

Cardiovascular disease (CVD) continues to be the foremost mortality internationally. Cardiac rehabilitation has proven as an effective program in reducing CVD burden. Participation in cardiac rehabilitation programs is very low. Digital health intervention emerged as an alternative method to deliver Cardiac rehabilitation. This review aimed to investigate the impact of digital health intervention on the outcomes of interest. the following databases: PubMed, CINAHL, Scopus, and Cochrane Library have been searched to retrieve randomized controlled trials that examine the impact of digital health intervention on blood pressure, body mass index, lipid profile, blood glucose, Six-Minute Walk Test, and peak oxygen consumption. filters were set to include studies published in English between 2000-2023. Nineteen studies were included in this review. Six-Minute Walk Test (MD = 16.70; 95% CI: 6.00 to 27.39, p = 0.000) and maximal oxygen consumption (SMD = 0.27; 95% CI: 0.08 to 0.45, p = 0.004) significantly improved following digital health intervention, after employing the sensitivity analysis significant improvement was observed in systolic (MD = -2.54; 95% CI: -4.98 to -0.11, p = 0.04) and diastolic blood pressure (SMD = -2.0182; 95% CI: -3.9436 to -0.0928, p = 0.04) favoring experimental groups. Subgroup analysis revealed significant improvement in quality of life after three months of follow-up (SMD = 0.18; 95% CI: 0.05 to 0.31, p = 0.00), no significant differences have been observed in body mass index, lipid profile, and blood glucose. The findings emphasize the significant impact of digital vs CBCR or usual care on physical capacity, blood pressure, and quality of life. Despite the non-statistically significant differences in body mass index and lipid profile, the comparable effect between the two methods suggests the superiority of digital over CBCR or usual care due to its convenient nature, accessibility, and cost-effectiveness.

The Clinical Outcome of Cardiac Rehabilitation in Coronary Artery Disease Patients with Regard to the Presence of Left Ventricular Systolic Dysfunction.

Background: Despite the use of advanced treatment techniques, coronary artery disease (CAD) still remains the main cause of left ventricular (LV) dysfunction and heart failure. Participation in cardiac rehabilitation (CR) programs can lead to a number of beneficial effects, but some patients do not demonstrate the expected improvement. The aim of this study is to evaluate the impact of CR on changes in exercise capacity with regard to the presence of LV dysfunction. Methods: A group of 428 patients with CAD were consecutively admitted to an outpatient comprehensive cardiac rehabilitation program comprising 24 exercise sessions of interval training on cycle ergometers, three times a week for 45 min, and a health education. The patients were compared in two subgroups, i.e., with LV systolic dysfunction (LVEF < 50%, n = 175) and LVEF ≥ 50% (n = 253). Results: In the LVEF < 50% group, the exercise capacity improved by 1 ± 0.78 MET (median 1.15 MET), and 0.86 ± 0.77 MET (median 1.08 MET) in the LVEF ≥ 50% group. Women with LVEF < 50% demonstrated a significant increase in exercise capacity by 1.2 MET, while those with LVEF ≥ 50% did not display any such increase. All men, regardless of LVEF, exhibited a similar improvement in exercise capacity greater than 1 MET. Conclusions: An outpatient eight-week cardiac rehabilitation program based on 45 min aerobic interval training sessions three times a week appears less effective for women with CAD and EF ≥ 50%. In this group, the proposed training intervention is insufficient in improving exercise capacity to an extent that could indicate a reduction in mortality risk.

Socioeconomic profile of families with spina bifida children in Turkey

BackgroundSpina bifida’s prevalence and incidence vary across geographical regions with sociodemographic characteristics and socioeconomic status of the populations having a significate influence over its epidemiology. This study aimed to outline the socioeconomic profile of families with spina bifida children, based on sociodemographic characteristics.MethodsBetween August and December 2022, 86 surveys completed by parents of children that underwent spina bifida repair in our institution were included in this analysis. The first part of the survey included questions based on sociodemographic characteristics. The second part of the survey was based on care provided by the families, regular follow-ups, participation in rehabilitation programs, and type of burdens perceived by the caregivers.ResultsA close look at the highest level of parent education showed that more than half of them were only middle school graduates. Occupational status in the perioconceptional period revealed that 77% of mothers were housewives/unemployed. 23% had a history of induced or spontaneous abortion. A high number of consanguine marriages were registered with 58% of the subjects being biologically related. 53% of the spina bifida children came from families with low household income. Only 15% of the spina bifida children had access to physiotherapy and 18% to rehabilitation programs.ConclusionsChildren with spinal dysraphism were more likely to come from families resulted from consanguineous marriages, with at least two children, low level of parent education and household income. Emotional and financial burden perceived by caregivers should be addressed in order to diminish the numerous challenges that this group of families encounter.

Patients' experiences and perspectives regarding the use of digital technology to support exercise-based cardiac rehabilitation: a qualitative interview study.

Despite the well-known benefits of exercise-based cardiac rehabilitation for the secondary prevention of cardiovascular disease, participation in cardiac rehabilitation programmes and adherence to secondary prevention recommendations remain limited. Digital technologies have the potential to address low participation and adherence but attempts at implementing digital health interventions in real-life clinical practice frequently encounter various barriers. Studies about patients' experiences and perspectives regarding the use of digital technology can assist developers, researchers and clinicians in addressing or pre-empting patient-related barriers. This study was therefore conducted to investigate the experiences and perspectives of cardiac rehabilitation patients in Austria with regard to using digital technology for physical activity and exercise. Twenty-five current and former cardiac rehabilitation patients (18 men and 7 women, age range 39 to 83) with various cardiac conditions were recruited from a clinical site in Salzburg, Austria. Semi-structured qualitative interviews were audio-recorded and transcribed verbatim. The analysis followed a descriptive phenomenological approach, applying the framework analysis method. The sample was diverse, including interviewees who readily used digital devices to support their physical activity, exercise and health monitoring, and interviewees who did not. Simplicity, convenience and accessibility were highlighted as important facilitators for the use of digital technology, while annoyance with digital devices, concerns about becoming dependent on them, or simply a preference to not use digital technology were commonly stated reasons for non-use. Interviewees' views on data protection, data sharing and artificial intelligence revealed wide variations in individuals' prior knowledge and experience about these topics, and a need for greater accessibility and transparency of data protection regulation and data sharing arrangements. These findings support the importance that is attributed to user-centred design methodologies in the conceptualisation and design of digital health interventions, and the imperative to develop solutions that are simple, accessible and that can be personalised according to the preferences and capabilities of the individual patient. Regarding data protection, data sharing and artificial intelligence, the findings indicate opportunity for information and education, as well as the need to offer patients transparency and accountability in order to build trust in digital technology and digital health interventions.

Adoption of community-based land rehabilitation programs (CBLRP) and its effect on livelihoods in Offa district, south Ethiopia

Land degradation is a major issue in Ethiopia and has a significant impact on agriculture and subsistence. Community-based land restoration projects are essential to address this issue. This study aimed to evaluate the implementation of a community-based land restoration programs and its impact on livelihoods in the Offa District of south Ethiopia. Four Kebeles were randomly selected for the study and 133 household heads (52 program participants and 81 non-participants) were selected using a simple random sampling method. Data was collected by using an interview schedule, focus-group discussions, and key informant interviews. Data were analyzed using a binary logistic regression model, propensity score matching, participation index (PI), t-test, and chi-square test. The results showed that the implemented land rehabilitation measures had higher crop production and farm income for most adopter households compared to their counterparts. The logistic regression model revealed that the slope of farmland, gender of household heads, family size, perception of rehabilitation, access to training, and farm experience positively influenced household participation in the community-based land rehabilitation programme (CBLRP) in the study area. However, the age of the respondents, access to education, size of farmland, frequency of extension contact positively and ownership of livestock negatively influenced household participation. Propensity score matching revealed that CBLRP resulted in higher crop output and farm revenue for most participating families than counterparts. Based on these findings, it is recommended that agricultural and rural development offices, non-governmental organizations, and other stakeholders should consider the factors that influence household participation in rehabilitation programs in the study area to effectively address the issue of the households’ participation at various levels of rehabilitation programs.

Optimization of Cardiorespiratory Fitness and Quality of Life in Women with Chronic Heart Failure after a Cardiac Rehabilitation Program

Introduction: Women with heart failure (HF) tend to experience a greater symptom burden and lower quality of life, possibly due to phenotypic differences and unique gender-associated risk factors. Despite evidence on the effects of cardiac rehabilitation programs (CRP) in the general population, there is underrepresentation of women in these programs. Additionally, the impact of CRP on cardiorespiratory variables obtained through cardiopulmonary exercise testing (CPET) and health-related quality of life (HRQoL) in women with HF remains unknown. Objective: To assess the impact of a CRP on cardiorespiratory fitness (CRF) in cardiorespiratory variables obtained through CPET and HRQoL in women with HF. Methods: A quasi-experimental study included HF patients who completed a CRP from June 2019 to December 2023. The CRP involved nutritional assessment, psychosocial evaluation, educational sessions, and concurrent training. It comprised 30 minutes of aerobic resistance training at 65-80% of heart rate reserve (HRR) and 30 minutes of strength training at 30-50% of 1-repetition maximum (1RM), with a frequency of 3 sessions per week for 4 to 6 weeks. CPET was conducted at the beginning and end of the program, analyzing cardiorespiratory variables. HRQoL was assessed using the SF-36 questionnaire. Gains in CRF and HRQoL at the end of the program in both men and women were analyzed. Results: Out of 217 included patients, 29.9% were women. At the program's onset, women showed lower exercise tolerance than men (workload 5.4±2.57 METs vs. 6.62±2.53 METs) and worse HRQoL (62.03%±18.37 vs. 68.38%±18.37). However, post-intervention, they optimized their CRF (%predicted VO2 [%VO2p] initial 56.62%±20.11 vs final 80.12%±30.32, p=&lt;0.001). Significant improvements in cardiorespiratory variables were observed in both cases: delta METs-load 3.02, p=&lt;0.001, delta peak oxygen consumption (VO2peak) 1.83 ml/kg/min, p=&lt;0.001, delta oxygen pulse (PO2) 1.21, p=0.021, delta cardiac power output (CPO) 1917, p=0.004, with a rightward shift in ventilatory thresholds and improvement in HRQoL (62.03%±18.37 vs. 78.81%±12.9, p=&lt;0.001) post-CRP. The only variable with no significant changes in either case was VE/VCO2 slope (delta -0.51, p=0.736). Additionally, in women with reduced left ventricular ejection fraction (&lt;50%), variables with no significant improvement included CPO (delta 959.22, p=0.283) and time to recovery of VO2 kinetics (TRCVO2) (delta -0.74, p=0.957). In patients with preserved left ventricular ejection fraction (≥50%), variables with no significant change included PO2 (delta 1.08, p=0.173), TRCVO2 (delta 26.82, p=0.099), and the first ventilatory threshold (VT1) (delta 0.09, p=0.504). Program attendance was 87.5% in both groups. Conclusion: Implementing a CRP in women with HF resulted in significant improvements in all evaluated cardiorespiratory variables (except for VE/VCO2 slope) and quality of life. These findings support the importance of ensuring women's access and participation in cardiac rehabilitation programs. Addressing existing barriers is crucial to maximize the long-term benefits of CRP in the female population with HF.

Scientific and Practical Conference with International Participation «Mental Health of the Family: Russian Traditions and Modern Approaches to Assistance», 26.01.2024, Moscow

Scientific and Practical Conference with international participation «Mental Health of the Family: Russian Traditions and Modern Approaches to Assistance»м тир, held FSBSI «Mental Health Research Centre» on January 26, 2024 in Moscow as part of the XXXII International Christmas Educational Readings «Orthodoxy and Domestic Culture: Losses and Gains of the Past, the Image of the Future». The conference comprehensively covered the traditional values of families in Russian society, as well as the problems that arise in families whose members suffer from mental disorders and behavioral disorders. The achievements and possibilities of helping family members with mental and behavioral disorders, as well as the provision of psychiatric, psychological, social and spiritual assistance by various institutions through the prism of biopsychosocial, spiritual and family-oriented approaches were discussed. The issues of volunteer participation in rehabilitation programs for families, the contribution of public organizations and their interaction with state and religious institutions in the aspect of psychosocial rehabilitation of patients with mental disorders and behavioral disorders, as well as issues of multidisciplinary interaction of specialists in the field of family prevention of mental disorders were considered. The exchange of scientific and practice-oriented achievements of domestic and foreign psychiatry in the field of family prevention of mental disorders, behavioral disorders and addiction diseases, the introduction of new technologies of assistance allows to improve the quality and effectiveness of psychiatric and narcological care provided to families that include persons with mental disorders and behavioral disorders.

Feasibility of tele-rehabilitation in low resource setting: perceived barriers and facilitators among physiotherapy professionals

Background: Robust evidence illustrates the significance and efficacy of telerehabilitation to optimize the participation in rehabilitation program taking into account organisational, geographical and transportation aspects. Despite knowing the remarkable benefits, there exist an array of challenges to implement telerehabilitation services in a setting with meagre resources. In order to augment the uptake of telerehabilitation services, our study aims to explore the perceived barriers and facilitators to telerehabilitation among Physiotherapy professional in a resource limited setting. Methods: A cross-sectional survey was conducted among physiotherapy professionals in Maharashtra using a questionnaire with a content validation index of 0.95. The survey sought to ascertain the awareness, barriers, facilitators and strategies to improve practice of telerehabilitation. Results: A total of 450 Physiotherapists were invited, of which, 201 participated in the study. The major barriers to telerehabilitation were inaccuracy in obtaining adequate information (n=149, 74%), lack of face-to-face monitoring (n=131, 65%) and physical limitation in older adults (n=114, 57%); on the other hand, the facilitators were reduced transportation time to hospital/clinic (n=132, 67%) and improved accessibility to healthcare services (n=125, 62%). The factors that enabled the patients to participate were flexible appointment schedule (n=139, 69%) and minimal transportation costs (n=129, 64%). Furthermore, the participants majorly considered encouraging patients’ appropriate environment, insurance coverage, training and upskilling of clinicians as the strategies to improve practice. Conclusions: The implementation of telerehabilitation program has been limited due to perceived constraints associated with various organizational, geographical and patient factors. However, physiotherapists reported strategies to improve practices could be implemented to accelerate the utilization of telerehabilitation services.

Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities.

Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.

Behavioral theories and models to enhance compliance in cardiac rehabilitation programs for acute myocardial infarction – A narrative review

Acute myocardial infarction (AMI) is a serious and common illness that affects the cardiovascular system. Its sudden onset, high fatality rate, and recurrence rate significantly impact patients’ safety and quality of life. Owing to considerable improvement in living standards, AMI has become a major cause of death and disability, seriously increasing the burden on society. The cardiac rehabilitation program, which involves a multidisciplinary approach to assist patients with daily life guidance, diet guidance, exercise guidance, disease knowledge guidance, medication guidance, psychological guidance, risk factor control guidance, and other comprehensive guidance, has been proven to play a decisive role in the recovery of patients’ cardiac function and the improvement of their quality of life. In addition, these programs help reduce treatment costs and prevent the reoccurrence of disease as well as adverse effects in cardiac patients. However, the introduction and execution of these initiatives are currently in their early stages, characterized by a gradual pace and encountering numerous challenges. Specifically, in the context of AMI, there have been documented instances of reduced engagement, adherence, and compliance with rehabilitation programs, even within industrialized nations. Diverse treatment phases and models have been designed to enhance patient care, patient participation, compliance, and effectiveness of rehabilitation programs. Participation in post-myocardial infarction management CR programs has been reported under par levels which is posing a great threat and burden on society. Various theories and models of behavioral change are proposed to improve patient participation and compliance in cardiac rehabilitation. These theories and models have been utilized in the past to improve patient health and can also improve patients’ perception, and behavior toward active participation in cardiac rehabilitation programs.

State-religious relations in crisis situations: The support by Russian religious organizations for a special military operation

The article is devoted to the consideration of the specifics of state-religious relations in crisis situations using the example of the reactions of Russian religious organizations, their leadership and representatives, regarding support for a special military operation of the Armed Forces of the Russian Federation in Ukraine. The starting point of the article is the thesis about the fundamental support by the largest religious organizations of Russia of the foreign policy course of the President of the Russian Federation V. V. Putin, including a special military operation. Forms of support include public speaking (reports, interviews, lectures, sermons, communication with parishioners); acceptance by the governing bodies of a religious organization of documents confirming support; providing humanitarian and other assistance to military personnel and members of their families, the population of new constituent entities of the Russian Federation, and refugees; spiritual care for military personnel; participation in social and psychological rehabilitation programs; coordination of the religious life of believers in new constituent entities of the Russian Federation; cooperation with the Russian Ministry of Defense and other government bodies in matters relating to a special military operation. These examples will demonstrate different levels of interaction between the state and religious organizations during a special military operation, revealing the general specifics of the model of state-religious relations in crisis situations in the Russian Federation.

The effects of employers’ disability and unemployment insurance costs on benefit inflows

In Finland, large firms are partially liable for the costs of disability and unemployment benefits paid to their former workers. To estimate the effects of such cost liabilities, we exploit a reform that extended this cost-sharing to cover a new group of blue-collar workers. We show that experience rating in disability insurance reduces inflows to sickness and disability benefits and increases participation in vocational rehabilitation programs, whereas employers’ unemployment insurance costs reduce excess layoffs of older workers who can qualify for extended unemployment benefits until retirement age. We find no evidence of spillover effects: employers’ cost liabilities in one benefit type do not affect inflows to other types of the benefits.

Benefits from Incorporating Virtual Reality in Pulmonary Rehabilitation of COPD Patients: A Systematic Review and Meta-Analysis.

Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation. Patient participation in Pulmonary Rehabilitation (PR) programs has a beneficial effect on disease management, improving patients' functional capacity and quality of life. As an alternative to traditional programs or as a complementary activity, the inclusion of virtual reality (VR) games is proposed. The aim of this research study was to investigate the effectiveness of incorporating VR in the pulmonary rehabilitation program of patients with COPD. A systematic literature search was performed for randomized controlled trials (RCTs) in the electronic databases Google Scholar, PubMed, and Pedro from January 2014 to March 2022. The search involved screening for studies examining the effectiveness of enhancing PR with VR. The PEDro (Physiotherapy Evidence Database) scale was chosen as the tool to assess the quality of studies. A meta-analysis was performed where possible. Six studies were included in this systematic review. The PEDro scale showed five studies of good methodological quality and one of fair quality. The variables examined were: aerobic capacity for exercise, lung function, anxiety and depression, with non-significant improvement for the MRC Dyspnea scale, marginally non-significant improvement regarding 6MWT (p = 0.05) and significant improvement for FEV1 (p < 0.05). There was variability noted in the VR applications and the proposed rehabilitation that the experimental groups followed. The application of VR is recommended for COPD patients, in combination with conventional PR. VR was found to be effective in increasing therapeutic effect and should be considered as a mean of increasing accessibility to PR. Therefore, further research, as well as additional RCTs regarding the effectiveness of VR in patients with COPD, seems necessary.

Parent-reported health-related quality of life in pediatric childhood cancer survivors and factors associated with poor health-related quality of life in aftercare

PurposeDespite advances in cancer treatment, there is a prevalence of pediatric childhood cancer survivors still at risk of developing adverse disease and treatment outcomes, even after the end of treatment. The present study aimed to (1) explore how mothers and fathers assess the health-related quality of life (HRQoL) of their surviving child and (2) evaluate risk factors for poor parent-reported HRQoL in childhood cancer survivors about 2.5 years after diagnosis.MethodsWe assessed parent-reported HRQoL of 305 child and adolescent survivors < 18 years diagnosed with leukemia or tumors of central nervous system (CNS) with the KINDL-R questionnaire in a prospective observational study with a longitudinal mixed-methods design.ResultsIn agreement with our hypotheses, our results show that fathers rate their children’s HRQoL total score as well as the condition-specific domains family (p = .013, d = 0.3), friends (p = .027, d = 0.27), and disease (p = .035, d = 0.26) higher than mothers about 2.5 years after diagnosis. Taking variance of inter-individual differences due to family affiliation into account, the mixed model regression revealed significant associations between the diagnosis of CNS tumors (p = .018, 95% CI [− 7.78, − 0.75]), an older age at diagnosis, (p = .011, 95% CI [− 0.96, − 0.12]), and non-participation in rehabilitation (p = .013, 95% CI [− 10.85, − 1.28]) with poor HRQoL in children more than 2 years after being diagnosed with cancer.ConclusionBased on the results, it is necessary for health care professionals to consider the differences in parental perceptions regarding children’s aftercare after surviving childhood cancer. High risk patients for poor HRQoL should be detected early, and families should be offered support post-cancer diagnosis to protect survivors’ HRQoL during aftercare. Further research should focus on characteristics of pediatric childhood cancer survivors and families with low participation in rehabilitation programs.