Rehabilitation Process Of Patients Research Articles

Nurses' Descriptions of Interdisciplinary Interactions in Stroke and Geriatric Rehabilitation Units: A Case Example of the Registered Practical Nurse.

To analyse how nurses describe their interactions with other interdisciplinary team members within stroke and geriatric rehabilitation. A secondary analysis of cross-sectional ethnographic interview data was conducted using Elo and Kyngäs' (2008) deductive content analysis. Between April 12 and July 25, 2022, semi-structured interviews were conducted with 31 registered practical nurses recruited through convenience sampling from three tertiary hospital sites in Southwestern Ontario. Interview transcripts were reviewed to identify described interactions between nurses and interdisciplinary team members and were coded for: who were the interdisciplinary team member(s) involved; what content was addressed; and where, when, and why the interaction occurred. Categories representing how nurses describe their interactions with interdisciplinary team members were as follows: (1) arising from the unique roles owned by either the nurse or interdisciplinary team member(s); (2) requiring open communication to achieve patient goals and improve patient care; (3) occurring within what is perceived to be either the therapists' or nurses' physical space; and (4) contributing to supportive team environments that are mutually beneficial. While nurses view other interdisciplinary team members as 'owning' certain roles and physical spaces within rehabilitation, they also recognised their 'owned' spaces and roles. Unique contributions of all team members were valued as necessary to provide holistic, person-centred patient care and positive team-based support. Nurses' descriptions of their interactions with interdisciplinary team members demonstrated their essential contributions to team-based patient care and acknowledged nurse contributions to the rehabilitation process for patients. Findings elucidate the nature of interprofessional interactions and 'ownership' within the rehabilitation process. Results are beneficial for policymakers, educators, and healthcare organisations aiming to optimise the nursing role within rehabilitation spaces. The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). No patient or public contribution.

Managing the rehabilitation of patients following joint replacement using remote support tools

The article considers the approach to the development of an intelligent decision support system based on artificial intelligence technologies to manage the rehabilitation process in patients who have undergone joint endoprosthetic surgery. The paper focuses on the advantages of using complex intelligent systems in various industries requiring personalised approaches to the object, including medicine. The prospects for their further development are considered. The creation of a digital twin reflecting the key parameters of the object and its development trajectory from the moment of the first interaction with the system is proposed. The system, developed on the basis of software and instrumental environments, provides the possibility of remote observation and correction of the recovery plan by specialists, which represents a significant advantage compared to traditional methods. In order to ensure the adaptability of the system and the actualisation of the proposed solutions, control over the patient's condition and adaptation of treatment programmes is achieved by means of periodic and unscheduled checking of the object indicators. This is achieved by comparing the indicators obtained as a result of video data analysis with the normalised indicators of the system. The developed system analyses video recordings, performs movement analysis and adapts rehabilitation measures depending on the obtained data on the patient's motor activity in real time. The proposed method offers the potential to enhance the precision and personalisation of rehabilitation approaches, thereby facilitating greater accessibility and efficacy in treatment. The integration of artificial intelligence elements into clinical practice presents a promising avenue for optimising rehabilitation processes.

Therapeutic Garden Design at Marzoeki Mahdi Hospital

Abstract Mental disorders is characterized by clinically significant disturbance in a person’s cognition, emotional regulation, or behavior. Dr. H. Marzoeki Mahdi Hospital (RSMM) is one of the mental hospitals that provides psychosocial rehabilitation services. Psychosocial rehabilitation consists of various activities to hone the patient’s ability so that they live independently. One of the activities is vocational and occupational therapy. The hospital garden is a necessity in the patient rehabilitation process so it needs to be designed to make it can be utilized optimally. The research objectives are to identify and analyze activities, user needs, potentials and constraints on the site; determine the design concept and create a therapeutic garden design for psychosocial rehabilitation at Marzoeki Mahdi Hospital. This research uses a descriptive method with stages such as preparation, research and analysis, concept and design. Data was collected through surveys, interviews, questionnaires and literature studies. The proposed design is a therapeutic garden to support psychosocial rehabilitation. The design concept applies one of patients rehabilitaion activities, namely socializing, which is depicted in a circular pattern and rehabilitation activities carried out repeatedly are depicted in a repetitive pattern. In addition, a symmetrical pattern is also applied which illustrates organized life and firmness. Based on this pattern, spaces are designed to support rehabilitation activities, namely the welcome area, active therapy area, passive therapy area and parking area.

A home-based tele-rehabilitation exercise system for patients after knee replacement surgery

BackgroundKnee arthritis is a destructive disorder that affects the knee joints and causes pain and reduced mobility. Drug treatments, weight loss, and exercise control the symptoms of the disease, but these methods only delay the disease process and eventually, knee joint replacement surgery will be needed. After surgery, with the help of a proper physiotherapy program, full recovery takes an average of 6–12 months. However, currently, there is no similar tool to facilitate this process in Iran.ObjectiveThe purpose of this research is to design and develop the prototype of a rehabilitation system for patients after knee replacement surgery, which provides patients with information and appropriate physiotherapy programs.MethodsThis study was development-applied and was done in three stages. In the first stage, the needs and content of education and therapeutic exercises were prepared in the form of a checklist, and then the necessity of each item was checked in the evaluation sessions. In the second stage, the prototype of the system was developed using Adobe XD software and based on the requirements approved from the previous stage. In the third stage, the usability of the program was analyzed from the point of view of experts using the exploratory evaluation method with Nielsen’s 13 principles of usability.ResultsAt first, the system requirements were extracted and prepared in two checklists of content (51 exercises) and capabilities (60 items). Then after a survey of experts based on the Delphi technique, content information (43 exercises) and functional and non-functional requirements (53 items) were obtained. A survey of experts helped to finalize the information elements, categorize them, and prepare the final version of the checklists. Based on this, the system requirements were classified into 11 categories, and the training content was classified into 3 training periods. Finally, the design and development of the system was done. This system has admin, physician, and patient user interfaces. The result of usability showed that this system is efficient and there are only a few problems in the feature of helping users to detect and recover from errors.ConclusionIt seems necessary to develop a system based on the principles of usability by therapists and rehabilitation specialists to train and monitor the remote rehabilitation process of patients after knee joint replacement at home. And the importance of involving stakeholders in the design and development of remote rehabilitation systems is not hidden from anyone. Kara system has all of the above.

Understanding the family burden and caregiver role in stroke rehabilitation: insights from a retrospective study.

Stroke negatively impacts both patients and their families, who must face multiple changes after the onset of the disease. Family caregivers must face new problems with a possible sense of inadequacy, stress and burden. Our retrospective study aimed to assess the burden of caregivers during the rehabilitation process of patients with Stroke. This study included patients with a diagnosis of stroke and their caregiver, who attended the Day Hospital of the IRCCS Neurolesi Center "Bonino-Pulejo", Messina, Italy, between January 2018 and October 2019, using electronic recovery system data. The final sample consisted of 30 patients and their caregivers. Significant improvements were observed in patients' cognitive and mood scores, reflecting the efficacy of rehabilitation therapies. Additionally, a correlation emerged between patients' reported anxiety levels and caregivers' reported depression levels, highlighting a dynamic interaction between the emotional states of the two groups. The study highlights the intricate interplay between caregiver characteristics, patient outcomes, and family dynamics in the context of caregiving. Targeted interventions aimed at improving family resilience and coping mechanisms are crucial to optimizing the well-being of both caregivers and patients.

Peningkatan Kualitas Hidup Pasien Stroke melalui Edukasi Terapi Wicara dan Stroke Home Care

Common problems experienced by stroke patients include brain disorders, resulting in limb weakness and impaired focal nerve function, including speech disorders. The family plays a crucial role in the patient's rehabilitation process; therefore, they need to enhance their understanding of speech therapy and home care for stroke patients. This community service aims to increase family knowledge regarding speech therapy and home care. Methods employed in this service include lectures, question-and-answer sessions, and interactive discussions. Participants consisted of 23 families of stroke patients treated at Garut Hospital. The results of this service demonstrated that health education effectively increased participants' knowledge about speech therapy and home care for stroke patients. Prior to the service, 17.4% had good knowledge, with an average score of 68.39. After participating in the service, 100% of participants demonstrated good knowledge, with the average score increasing to 85.43. The study found a significant positive effect of education on speech therapy and home care knowledge among participants, with a p-value of 0.001.

Predictive factors reducing the effectiveness of the rehabilitation process in patients with congenital orofacial clefts combined with malformations in other organs and systems

Relevance. The successful completion of the rehabilitation process for patients with complex congenital defects, specifically those with a combination of orofacial clefts (OFC) and malformations in other organs and systems, presents a significant challenge. This challenge is pertinent not only to medical practice but also to the socio-psychological development of the child.Objective. To identify predictive factors that diminish the success of the rehabilitation process in patients with congenital OFC combined with malformations in other organs and systems by systematising and addressing these factors at various stages of specialised care.Materials and methods. An analysis of medical records was conducted for 2,475 patients with congenital orofacial clefts (OFC) over a 24-year period (1998-2022) who were under dispensary observation at the "Bonum" Center in Yekaterinburg. Among these patients, 823 (33.25%) had OFC combined with malformations in other organs and systems. A comprehensive study was conducted among these 823 individuals within the framework of dynamic observation and treatment, focusing on patients who had reached 18 years of age and were subsequently removed from dispensary observation. The study included an examination of staged treatment and discharge summaries, alongside the clinical characteristics of the restored midface area following surgical correction of OFC amidst correction for concomitant congenital malformations.Results. Among the 823 individuals surveyed, a retrospective study registered 591 (71.81%) who had completed the main stages of comprehensive specialised care amidst concomitant malformations, while the remaining 232 (28.19%) continue to receive combined rehabilitation. Within the 591 patients, a subgroup of 123 (20.81%) individuals who had reached 18 years of age, completed the full cycle of medical-social rehabilitation at the "Bonum" Center, and were removed from dispensary observation due to age, was selected and studied in detail. Questionnaires, parent interviews, and analysis of the results obtained were conducted. The study identified predictive factors reducing the effectiveness of the rehabilitation process in patients with congenital orofacial clefts (OFC) combined with malformations in other organs and systems.Conclusion. The multifaceted study conducted has facilitated the identification and systematisation of predictive factors that reduce the success of the rehabilitation process. Consequently, this enables the enhancement of comprehensive specialised treatment outcomes for this category of patients.

Association Between Changes in Smoking Habits and Incident Fracture After Acute Ischemic Stroke.

Survivors of stroke, particularly the older population, are at an increased risk of falls and incident fractures. Smoking is a widely recognized risk factor for fractures. However, the association between changes in smoking habits before and after an index stroke and increased risk of fracture remains unelucidated. Using the Korean National Health Insurance program, patients with ischemic stroke between 2010 and 2016 were enrolled. Individuals were classified by smoking habits: "never smoker," "former smoker," "smoking quitter," "new smoker," and "sustained smoker." The primary outcome was the composite outcome of the vertebral, hip, and any fractures. Multivariable Cox proportional hazards regression analysis was conducted, using the never-smoker group as the reference. Among 177 787 patients with health screening data within 2 years before and after ischemic stroke, 14 991 (8.43%) patients had any fractures. After multivariable adjustment, the sustained smokers had a significantly increased risk of composite primary outcomes of any, vertebral, and hip fractures (adjusted HR [aHR], 1.222 [95% CI, 1.124-1.329]; aHR, 1.27 [95% CI, 1.13-1.428]; aHR, 1.502 [95% CI, 1.218-1.853], respectively). Additionally, the new smoker group exhibited a similar or higher risk of any fractures and hip fractures (aHR, 1.218 [95% CI, 1.062-1.397]; aHR, 1.772 [95% CI, 1.291-2.431], respectively). Sustained smokers had a significantly increased risk of vertebral and hip fractures after an ischemic stroke. The risk of any hip fractures was higher in new smokers after ischemic stroke. As poststroke fractures are detrimental to the rehabilitation process of patients with stroke, physicians should actively advise patients to stop smoking.

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study.

Monitoring of gait patterns by insoles is popular to study behavior and activity in the daily life of people and throughout the rehabilitation process of patients. Live data analyses may improve personalized prevention and treatment regimens, as well as rehabilitation. The M-shaped plantar pressure curve during the stance phase is mainly defined by the loading and unloading slope, 2 maxima, 1 minimum, as well as the force during defined periods. When monitoring gait continuously, walking uphill or downhill could affect this curve in characteristic ways. For walking on a slope, typical changes in the stance phase curve measured by insoles were hypothesized. In total, 40 healthy participants of both sexes were fitted with individually calibrated insoles with 16 pressure sensors each and a recording frequency of 100 Hz. Participants walked on a treadmill at 4 km/h for 1 minute in each of the following slopes: -20%, -15%, -10%, -5%, 0%, 5%, 10%, 15%, and 20%. Raw data were exported for analyses. A custom-developed data platform was used for data processing and parameter calculation, including step detection, data transformation, and normalization for time by natural cubic spline interpolation and force (proportion of body weight). To identify the time-axis positions of the desired maxima and minimum among the available extremum candidates in each step, a Gaussian filter was applied (σ=3, kernel size 7). Inconclusive extremum candidates were further processed by screening for time plausibility, maximum or minimum pool filtering, and monotony. Several parameters that describe the curve trajectory were computed for each step. The normal distribution of data was tested by the Kolmogorov-Smirnov and Shapiro-Wilk tests. Data were normally distributed. An analysis of variance with the gait parameters as dependent and slope as independent variables revealed significant changes related to the slope for the following parameters of the stance phase curve: the mean force during loading and unloading, the 2 maxima and the minimum, as well as the loading and unloading slope (all P<.001). A simultaneous increase in the loading slope, the first maximum and the mean loading force combined with a decrease in the mean unloading force, the second maximum, and the unloading slope is characteristic for downhill walking. The opposite represents uphill walking. The minimum had its peak at horizontal walking and values dropped when walking uphill and downhill alike. It is therefore not a suitable parameter to distinguish between uphill and downhill walking. While patient-related factors, such as anthropometrics, injury, or disease shape the stance phase curve on a longer-term scale, walking on slopes leads to temporary and characteristic short-term changes in the curve trajectory.

An IMU-Based Ground Reaction Force Estimation Method and Its Application in Walking Balance Assessment.

Walking is one of the most common daily movements of the human body. Therefore, quantitative evaluation of human walking has been commonly used to assist doctors in grasping the disease degree and rehabilitation process of patients in the clinic. Compared with the kinematic characteristics, the ground reaction force (GRF) during walking can directly reflect the dynamic characteristics of human walking. It can further help doctors understand the degree of muscle recovery and joint coordination of patients. This paper proposes a GRF estimation method based on the elastic elements and Newton-Euler equation hybrid driving GRF estimation method. Compared with the existing research, the innovations are as follows. 1) The hardware system consists of only two inertial measurement units (IMUs) placed on shanks. The acquisition of the overall motion characteristics of human walking is realized through the simplified four-link walking model and the thigh prediction method. 2) The method was validated not only on 10 healthy subjects but also on 11 Parkinson's patients and 10 stroke patients with normalized mean absolute errors (NMAEs) of 5.95%±1.32%, 6.09%±2.00%, 5.87%±1.59%. 3) This paper proposes a dynamic balance assessment method based on the acquired motion data and the estimated GRF. It evaluates the overall balance ability and fall risk at four key time points for all subjects recruited. Because of the low-cost system, ease of use, low motion interference and environmental constraints, and high estimation accuracy, the proposed GRF estimation method and walking balance automatic assessment have broad clinical value.

Evaluation of the effectiveness of complex medical rehabilitation of patients with polyposis rhinosinusitis associated with atopic dermatitis using ICF

BACKGROUND: In medical rehabilitation of patients with polyposis rhinosinusitis, aimed at solving the urgent strategic task of public health care to achieve and maintain an optimal level of functioning of persons suffering from partial disability through the development of effective methods of restoration of impaired functions and prevention of complications, there is a need to adequately assess the effectiveness of the measures taken. In this regard, it should be noted that the International Classification of Functioning, Disability and Health (ICF) serves as the gold standard for assessing the patient's quality of life and the effectiveness of rehabilitation measures. The category of human functioning acts as a system-forming basis and starting point of the patient's rehabilitation process in the ICF. In practice, the ICF is based on the biopsychosocial model of health (disease) assessment, which considers psychological and social factors of health (disease) and biological disorders in close interrelated unity. AIM: To evaluate the effectiveness of complex medical rehabilitation of patients with polyposis rhinosinusitis associated with atopic dermatitis using dynamic changes in the main domains of the ICF. MATERIALS AND METHODS: The study was performed with 89 patients with polyposis rhinosinusitis associated with atopic dermatitis. All patients were divided into 4 groups by simple fixed randomisation. The first group (control, n=22) received only basic therapy, including endonasal application of nasonex 2 doses 2 times a day, daily twice daily washing of the nasal mucosa, as well as the use of desensitising (antihistamines, topical glucocorticoids and moisturising and emollient agents) and detoxifying agents. Patients in the second group (comparison group 1, n=22) were additionally subcutaneously administered dupilumab at a dose of 300 mcg once a fortnight. In the third group (comparison group 2, n=23) against the background of dupilumab administration the combined effect of alternating magnetic field and low-intensity laser radiation of red spectrum was performed. Patients of the fourth group (the main group, n=22) received a course of phototherapy in addition to the scope of treatment of patients of the third group. The results of medical rehabilitation of patients with polyposis rhinosinusitis associated with atopic dermatitis were evaluated according to the dynamics of specialised categories of ICF, which most accurately characterise the patient's condition from the perspective of the biopsychosocial model of the disease. RESULTS: Changes in the estimated parameters of ICF at comparable initial values had different character and were determined by the scheme of medical rehabilitation. Minimal changes were recorded in the control group. The use of dupilumab was accompanied by positive dynamics of the parameters after 1 month with a significant increase in the shifts after 6 months, indicating the recovery of a number of mental and physical functions, as well as the ICF categories characterising the organism structures, activity and participation of the patient. Supplementation of biological therapy with course magnetolaser influence was accompanied by an increase in positive changes, which were confirmed in 6 months after rehabilitation. The maximum dynamics of the considered ICF categories was noted in the 4th group, where dupilumab administration was supplemented with complex use of therapeutic physical factors. CONCLUSION: The obtained results prove the high informativeness of the system approach realised with the help of ICF in assessing the effectiveness of medical rehabilitation measures. The comparative evaluation of rehabilitation results convincingly showed the advantages of the complex programme including dupilumab target therapy in combination with physiotherapeutic effects.

Returning-to-work after mental health-associated sick leave: a qualitative interview study exploring the experiences of general practitioners in Germany

Background and aimPsychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders.This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work.MethodsThis qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method.ResultsGPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers.They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave.ConclusionWe conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context.

Prediction of Physical Activity Patterns in Older Patients Rehabilitating After Hip Fracture Surgery: Exploratory Study.

Building up physical activity is a highly important aspect in an older patient's rehabilitation process after hip fracture surgery. The patterns of physical activity during rehabilitation are associated with the duration of rehabilitation stay. Predicting physical activity patterns early in the rehabilitation phase can provide patients and health care professionals an early indication of the duration of rehabilitation stay as well as insight into the degree of patients' recovery for timely adaptive interventions. This study aims to explore the early prediction of physical activity patterns in older patients rehabilitating after hip fracture surgery at a skilled nursing home. The physical activity of patients aged ≥70 years with surgically treated hip fracture was continuously monitored using an accelerometer during rehabilitation at a skilled nursing home. Physical activity patterns were described in our previous study, and the 2 most common patterns were used in this study for pattern prediction: the upward linear pattern (n=15) and the S-shape pattern (n=23). Features from the intensity of physical activity were calculated for time windows with different window sizes of the first 5, 6, 7, and 8 days to assess the early rehabilitation moment in which the patterns could be predicted most accurately. Those features were statistical features, amplitude features, and morphological features. Furthermore, the Barthel Index, Fracture Mobility Score, Functional Ambulation Categories, and the Montreal Cognitive Assessment score were used as clinical features. With the correlation-based feature selection method, relevant features were selected that were highly correlated with the physical activity patterns and uncorrelated with other features. Multiple classifiers were used: decision trees, discriminant analysis, logistic regression, support vector machines, nearest neighbors, and ensemble classifiers. The performance of the prediction models was assessed by calculating precision, recall, and F1-score (accuracy measure) for each individual physical activity pattern. Furthermore, the overall performance of the prediction model was calculated by calculating the F1-score for all physical activity patterns together. The amplitude feature describing the overall intensity of physical activity on the first day of rehabilitation and the morphological features describing the shape of the patterns were selected as relevant features for all time windows. Relevant features extracted from the first 7 days with a cosine k-nearest neighbor model reached the highest overall prediction performance (micro F1-score=1) and a 100% correct classification of the 2 most common physical activity patterns. Continuous monitoring of the physical activity of older patients in the first week of hip fracture rehabilitation results in an early physical activity pattern prediction. In the future, continuous physical activity monitoring can offer the possibility to predict the duration of rehabilitation stay, assess the recovery progress during hip fracture rehabilitation, and benefit health care organizations, health care professionals, and patients themselves.

Effectiveness of Chinese Herbal Medicine in Postoperative Fatigue Syndrome Following Total Joint Arthroplasty or Hip Fracture Surgery: Evidence from Randomized Controlled Trials.

There is no high-quality, evidence-based protocol for the treatment of postoperative fatigue syndrome (POFS) after total joint arthroplasty (TJA) or fracture surgery with Chinese herbal medicine (CHM). The purpose of this study was to explore the efficacy of CHM in the treatment of POFS after TJA or hip fracture surgery (HFS). We searched six databases to obtain randomized controlled trials (RCTs) of CHM for the treatment of POFS after TJA or HFS. The retrieval time limit was from the establishment of each database to August, 2022. According to the Cochrane Handbook for Systematic Reviews version 5.1, we used RevMan 5.3 to evaluate the quality of the studies. Stata 14.0 software was used to merge and analyze the data. The weighted mean difference (WMD) was the effect estimate for statistical analysis. We also performed subgroup analyses according to different types of surgeries. A total of 11 RCTs were included in this study, comprising 430 cases in the CHM group and 432 cases in the control group (CG). The meta-analysis results showed that there was no significant difference in the Brief Profile of Mood States (BPOMS) score (WMD=0.08, 95% confidence interval (CI): -0.29 to 0.45, P=0.688), Christensen Fatigue scale (CHFS) score (WMD = 0.15, 95% CI: -0.09 to 0.39, P=0.214) or Identity-Consequence Fatigue Scale (ICFS) score (WMD=-0.40, 95% CI: -1.84 to 1.05, P=0.589) between the CHM group and the CG on the first postoperative day. The use of CHM significantly reduced the BPOMS score (WMD=-0.85 and WMD=-3.01, respectively), CHFS score (WMD=-1.01 and WMD= -1.45, respectively), and ICFS score (WMD=-3.51 and WMD=-5.26) on postoperative days 3 and 7. Compared with the CG, the CHM group had significantly increased serum transferrin and IgG levels on postoperative days 3 and 7. The subgroup analysis results suggested that the application of CHM in HFS patients improved fatigue symptoms on postoperative days 3 and 7, while the application of CHM to treat POFS in TJA patients had great inconsistency in the evaluation of different indicators. The application of CHM improved the fatigue status of POFS patients after TJA or HFS and increased the levels of transferrin and IgG in serum, which is conducive to promoting the postoperative rehabilitation process of patients. The subgroup analysis results showed that the application of CHM to intervene in POFS in HFS patients had obvious benefits.

Physiotherapy Rehabilitation for Accelerating the Recovery of Patient with Anterior Cruciate Ligament Total Reconstruction and Meniscal Repair: A Case Report

Background: The Anterior Cruciate Ligament (ACL) is a ligament that functions to limit the movement of the tibia toward the anterior and excessive rotation, while the meniscus serves as shock absorption, load transmission, and the stabilizer of the knee joint. About 22% to 86% meniscal tear incidences occurring along with ACL injuries is. The study aims to determine the role of physiotherapists in the postoperative rehabilitation process of patients of ACL Reconstruction (ACLR) and meniscal repair in preventing postoperative complications and functional abilities of patients. Case Report: The patient was a 35-year-old adult male who suffered a complete tear in the ACL and meniscus of the left knee. The patient underwent ACLR and meniscal repair with arthroscopic surgery 2 years after injury with Bone-Pattelar tendon-bone autograph. 2 weeks post-surgery the patient visited the physiotherapy polyclinic with medical conditions of difficulty in bending and straightening the knee, still feeling pain and thick in the knee area. Results: The physiotherapist program was conducted three times and it was a home program-based exercise. The physiotherapist program and outcomes used in the first phase focused on exercises to improve ROM (Goniometer), oedema management (Medline), pain reduction (Numerical Rating Scale), activation exercises, and surrounding muscle strength (Sphygmomanometer), and improve functional ability (Tegner Lysholm Knee Scale) as well as the provision of home programs Performed by regular monitoring of exercise intensity using isometric, isotonic, and isokinetic exercises, which were given according to the concept of progressive loading. Conclusion: This case study shows that surgery combined with a comprehensive physiotherapy program plan in ACLR and meniscal repair cases, as well as adding home-based exercise programs with intense monitoring, generate more effective results. Keywords: physiotherapy rehabilitation, anterior cruciate ligament total, meniscal repair Correspondence: Suryo Saputra Perdana. Physiotherapist Profession Education Department, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Sukoharjo, Central Java, Indonesia. Email: suryo.saputra@ums.ac.id. Mobile: +6281298563988.

Operative Technique for Sacral Insufficiency Fractures Causing Spinopelvic Dissociation: A Case Report.

We present a case of a 54-year-old man with atraumatic, U-type sacral insufficiency and L5 compression fractures leading to spinopelvic dissociation, inability to ambulate, and bowel/bladder compromise. The patient underwent L3-4 percutaneous pedicle screw fixation with bilateral iliac bolts and percutaneous iliosacral screw fixation. Postoperatively, the patient had return of bowel/bladder function and independent ambulation at 2.5 years. Atraumatic spinopelvic dissociation is an underappreciated pathology in older patients. Here, we describe the result of our preferred treatment strategy, triangular osteosynthesis, to preserve function and independence. Despite optimal, prompt treatment, these injuries pose a difficult rehabilitation process for patients.

The Use of Kinematic Features in Evaluating Upper Limb Motor Function Learning Progress Based on Machine Learning.

Evaluating progress throughout a patient's rehabilitation process helps choose effective treatment and formulate personalised and evidence-based rehabilitation interventions. The evaluation process is difficult due to the limitations of current clinical assessments. They lack the ability to reflect sensitive changes continuously throughout the rehabilitation process. Kinematic features have been extracted from individual's movement to address this problem due to their sensitivity and continuity. However, choosing appropriate kinematic features for rehabilitation evaluation has always been challenging. This paper exploits the application of kinematic features to classify movement patterns and movement qualities. 12 kinematic features were firstly extracted from a 7-segment triangle pattern of motion to monitor the learning progress with more numbers of drawing attempts. A statistical analysis was then conducted to compare the selected kinematic features with the clinically validated normalised jerk. Two supervised machine learning models were finally developed to classify movement patterns and movement qualities based on the selected kinematic features. The study was based on data recorded from 14 participants using a single position sensor. 6 kinematic features were able to reflect sensitive changes during the experiment and all kinematic features contributed to the classification tasks. Consistent with the literature, the results indicated that features based on movement velocity were the most beneficial in the classification tasks.

Does employer involvement in primary health care enhance return to work for patients with stress-related mental disorders? a cluster randomized controlled trial

BackgroundStress-related disorders have become a major challenge for society and are associated with rising levels of sick leave. The provision of support to facilitate the return to work (RTW) for this patient group is of great importance. The aim of the present study was to evaluate whether a new systematic procedure with collaboration between general practitioners (GPs), rehabilitation coordinators (RCs) and employers could reduce sick leave days for this patient group.MethodEmployed patients with stress-related diagnoses seeking care at primary health care centres (PHCCs) were included in either the intervention group (n = 54), following the systematic intervention procedure, or the control group (n = 58), receiving treatment as usual (TAU). The intervention included a) a training day for participant GPs and RCs, b) a standardised procedure for GPs and RCs to follow after training, c) the opportunity to receive clinical advice from specialist physicians in the research group. Outcome measures for RTW were sick leave days.ResultsThe median number of registered gross sick leave days was lower for the control group at six, 12 and 24 months after inclusion, but the difference was not statistically significant. The control group had significantly fewer net sick leave days at three months (p = 0.03) at six months (p = 0.00) and at 12-months follow-up (p = 0.01). At 24 months, this difference was no longer significant.ConclusionsThe PRIMA intervention, which applied a standardized procedure for employer involvement in the rehabilitation process for patients with stress-related disorders, actually increased time to RTW compared to TAU. However, at 24 months, the benefit of TAU could no longer be confirmed. The study was registered on 16/01/2017 (ClinicalTrials.gov, NCT03022760).

Evaluation of wearable sports rehabilitation medical measurement system based on the internet of things

AbstractSports rehabilitation medicine uses sports training and rehab treatment to improve physical function recovery after illnesses, injuries, disabilities, or surgeries. It involves restoring muscle strength, joint range of motion, flexibility, and coordination while reducing pain and soreness, and improving cardiopulmonary function. Wearable IoT devices with sensors and wireless communication tech collect and transmit physiological information for analysis and processing. These devices monitor health, provide exercise training, and assist with rehab in daily wear equipment. The Internet of Things technology can provide a more accurate, convenient and personalized rehabilitation treatment method, accelerating the recovery and rehabilitation process of patients. This project would utilize Internet of Things technology to construct a medical measurement system for sports rehabilitation through measurement algorithms for sports rehabilitation data. Through comparative experiments, the accuracy of the exercise rehabilitation data measurement algorithm based on Internet of Things technology in measuring patient body data was studied and tested. After experimental verification, the actual heart rates of the 10 subjects were 76, 80, 79, 83, 72, 81, 77, 71, 72, and 78, respectively. The data measured using Internet of Things based algorithms were 75, 80, 80, 83, 73, 81, 78, 71, 72, and 77, respectively. Based on this, it could be concluded that the measured values of the algorithm were very close to the actual values, indicating that the algorithm had quite accurate heart rate measurement ability. Therefore, the sports rehabilitation medical testing system constructed by applying this algorithm had strong and accurate data measurement performance.

A Smart Iot-Based Prototype System For Rehabilitation Monitoring

Smart healthcare is growing significantly in the healthcare sector due to the Internet of Things. A remote monitoring system is one of the smart healthcare implementations for rehabilitating stroke patients. Nowadays, as the COVID-19 pandemic continues tospread, patients undergoing home rehabilitation have difficulty meeting with their physicians due to movement constraints. In addition, the healthcare facilities are devoted to treating patients with COVID-19. As a result, physicians and patients could not frequently meet to gather their rehabilitation progress. This study involves developing a prototype to monitor a post-stroke patient's rehabilitation process using the Arduino Nano 33 Bluetooth Low Energy (BLE) and force-sensing resistor (FSR). The prototype analyzes critical aspects of the rehabilitation process based on handgrip, heart rate, sleep, and step tracking measurements. The results of the handgrip, heart rate, sleep, and step tracking measurements are evaluated for various types of subjects and six testing approaches showed an accurate and consistent results. However, experiments partially success with a small error is detected while tracking the steps of each subject. Several recommendations are highlighted to improve the prototype using othersensors such as force sensing resistor and flex sensor for handgrip force transducer, electromyogram (EMG) sensor for stroke-patients rehabilitation, and others.