Physical Rehabilitation Center Research Articles

Frequency and Factors Associated with Disabilities among Leprosy Patients Admitted to the Kindia Disability Prevention and Physical Rehabilitation Centre (Pirp) in Guinea from 2017 to 2021.

This study aims to estimate the prevalence and analyze the factors associated with leprosy-related disabilities at the Kindia Disability Prevention and Physical Rehabilitation Centre (PIRP) in Guinea. It is a cross-sectional study using routine data from the centre from 2017 to 2021. Of 115 patients, 76% had a disability, 49% of which were grade II and 27% grade I. The age range of 15 to 30 years was the most represented (43.5%), with the average age (standard deviation) being 38 (16.5) years. Children under 14 years of age represented 3.5% of the total. Most (89%) patients had newly diagnosed leprosy. The majority (66.1%) had never come in contact with people with leprosy symptoms. Almost all (99.1%) patients had type 1 reactions on admission. Patients with multibacillary leprosy were in the majority (83.5%), and those with symptoms lasting 7-12 months represented 56.5% of the sample. In total, 79.1% of the patients received corticosteroid therapy, and 92.1% were reported cured at discharge. This neglected tropical disease continues to be a challenge in Guinea, even though leprosy care is free.

The effects of perceived therapist guidance and advice on adherence to home-based exercise programs in mothers of children with cerebral palsy in Rwanda

BackgroundThe alarming prevalence of non- or poor adherence to Home-based Exercise Programs (34–79.2 %, HEP) in parents of Children with Cerebral Palsy (C-CP) is a global health concern due to its detrimental effect on treatment outcomes. ObjectiveTo examine whether Perceived Therapist Guidance and Advice (TGA) or social support moderate the effects of PTSD, depression, parenting stress, low self-efficacy, the burden of care, or the effects of perceived family stigma on adherence to HEP. MethodA stratified random sample of 301 mothers of C-CP attending the largest seven physical rehabilitation hospitals or centres in Rwanda participated in this study. Data were collected using validated measures of all investigated constructs. We conducted hierarchical multiple linear regressions, and the nature of moderation was scrutinized using the process macro 4.1 model number 1 within SPSS version 28. ResultsThe prevalence of adherence to HEP in the present sample was 32.9 %. Mothers' TGA and social support were positively associated with adherence to HEP; whereas mothers' stressors, including PTSD, parenting stress, depression symptoms, low self-efficacy, burden of care, and family stigma were negatively associated with adherence to HEP. In addition, TGA significantly moderated the associations of the different mothers' stressors with adherence to HEP, leading to increased HEP adherence for mothers with high stressor levels. Social support did not moderate any of these associations. Our respondents often reported poor family and friends’ social support due to family stigma-related to caring C-CP. ConclusionsTherapists play a vital role by providing education, support, and counselling to parents, emphasizing the importance of adherence, and addressing any stigma-related concerns, especially for mothers who experience high levels of stress. Therapists should be aware that mothers of C-CP frequently relied solely on their support to improve adherence to HEP.

Prevalence of Spinal Segmental Sensitization Syndrome in Outpatients Attending Physical Medicine and Rehabilitation Centers for Chronic Musculoskeletal Pain: A Multicenter Study

ObjectiveTo determine the prevalence of spinal segmental sensitization (SSS) syndrome, a regional pain disorder, among patients visiting physical medicine and rehabilitation centers (PM&RCs) for chronic musculoskeletal pain (CMSP). DesignAn observational, descriptive, cross-sectional study conducted from March to July 2023. SettingSeven PM&RCs from 5 cities, representing 3 care systems: Social Security (SS), Ministry of Health (MH), and private practice (PP). ParticipantsAll patients, regardless of age, attending a physiatry consultation for CMSP for the first time and who provided informed consent to participate were included. Nonprobabilistic sampling was employed. InterventionsNot applicable. Main Outcome MeasureWe estimated the overall prevalence of SSS syndrome as a percentage among patients with CMSP, stratified by health care institution, sex, age, and occupation type. We also recorded the spinal segments involved and any concomitant painful disorders (CPDs). SSS syndrome was diagnosed using standardized criteria. ResultsOf the eligible participants, 319 with CMSP were enrolled; 73.4% were women, and the median age of participants was 56.9 (range, 13-89y) years. The overall prevalence of SSS syndrome was 53.3%. Of these, 69.1%, 42.2%, and 13.8% were in the SS, MH, and PP systems, respectively. The most affected were female participants (56.4%), those aged 50-64 years (60.4%), and those with active jobs (58.8%). Most commonly, the lumbosacral and lumbar segments were affected, followed by the lower and middle cervical levels. Spine pathologies were the most common CPDs. ConclusionThe prevalence of SSS syndrome was high among patients who visited PM&RCs for CMSP and varied according to the care system. Further research on SSS syndrome is warranted to relieve the burden it poses on patients with CMSP and ensure proper diagnosis in clinical practice.

ЗОНИ ВІДПОЧИНКУ ТА РЕКРЕАЦІЇ В РЕАБІЛІТАЦІЙНИХ ЦЕНТРАХ: СТВОРЕННЯ СЕРЕДОВИЩА ДЛЯ ВІДНОВЛЕННЯ

Rehabilitation - one of the most difficult and intricate directions of modern medicine and health care - is the process of recovering health and restoration of patient who suffered from injuries, diseases or underwent operations. The modern approach to rehabilitation is marked by the importance of creating optimal conditions for the physical, psychological and social recovery of patients in rehabilitation centers. There are more and stricter requirements on physical rehabilitation center activities and their role in health preservation and rehabilitation, with creating an easy and suitable environment being pivotal factors to a successful rehabilitations. The main aspects of the organization and design of recreation areas in rehabilitation centers are considered, in particular, their functional and architectural planning. The importance of creating a natural and specially organized recreational environment for increasing the efficiency of the rehabilitation process and maintaining the psychophysical condition of patients is noted. The article analyzes the impact of the natural environment, ecological aspects and the effectiveness of the use of recreational areas in rehabilitation centers on the overall quality of medical services and the achievement of positive results. With this publication, we aim foremost at comprehending and dissecting the facets that shape leisure spots within rehab facilities, devising proposals for enhancing their layout while improving therapy outcomes as well as patient satisfaction. The tasks are solved: to determine the main principles and requirements for the creation of rest and recreation areas in rehabilitation centers; analyze modern approaches to the organization and design of recreation areas in medical institutions and rehabilitation centers; to study the impact of created recreation areas on the psychophysiological state of patients and their rehabilitation; substantiate recommendations for optimal design and arrangement of rest and recreation areas in rehabilitation centers.

The End of the X-waiver: Excitement, Apprehension, and Opportunity.

With the passage of the MAT act (Mainstreaming Addiction Treatment) and the MATE Act (Medication Training and Expansion), the Drug Enforcement Agency "X-waiver" program governing the office-based prescription of buprenorphine for opioid use disorder has been immediately eliminated. The move was championed by vocal organizations with a rightful concern about buprenorphine access but was opposed by most physicians. Nonetheless, buprenorphine can now be prescribed like any schedule 3 medication. Studies show that despite rising opioid overdoses, buprenorphine prescription increases have been slow to rise and are particularly absent in rural communities. The elimination of the X-waiver may theoretically improve buprenorphine prescribing rates for opioid use disorder in rural areas, by nurse practitioners and physician assistants, and by resident physicians in teaching programs. It may also help decrease discrimination against individuals with opioid use disorder in postacute-care settings like nursing homes, physical rehabilitation centers, and in prisons and jails. Concerns include the elimination of the only focused opioid use disorder education many physicians receive (X-waiver courses) and a literature base showing that interest, rather than the X-waiver itself, remains the biggest barrier to recruiting more buprenorphine prescribers. Concerns also exist over the harms of precipitated withdrawal when buprenorphine is initiated inappropriately. The change of the elimination of the X-waiver brings about a new opportunity for Family Medicine and its parent organizations to champion the inclusion of opioid use disorder treatment within the chronic disease care models well-known to our integrated care settings.

Association of Level of Amputation and Use of Prosthesis with Depression: A Multi-Centered Study

Background: Amputation is the surgery of “Removal of limb or its part from the body” due to medical reasons. The loss of a limb is indubitably a distressing lifetime experience. Several studies have shown that depression is higher in patients with amputations. The objective of this study is to determine the association of depression with level of amputation, use of prosthesis and sociodemographic characteristics. Methods: A cross-sectional research study was conducted in three physical rehabilitation centers of Quetta in a time span of three months. Non probability convenient sampling was used to collect data from 54 participants having traumatic or non-traumatic unilateral amputation. Depression was measured using the validated tool, Hospital Anxiety and Depression Scale (HADS). Results: Total 54 participants, Males =47(87%) and Females = 7(13%) and were surveyed. Among them 44(81.5%) were married. Majority of the patients 30(55.5%) were between the age of 15-45 while 28 (51.9%) were educated. Majority of the participants (91%) were with lower-limb amputation. Trans-tibial Amputation (TTA) and Trans-Femoral Amputation (TFA) were 27(50%) and 20(37%) respectively. Use of prosthesis was found among 38(70.4%) patients, while 16(29.6%) did not use prosthesis. Statistically significant relationship was found between married participants and depression (p-value 0.047). Our results showed that depression was less in patients using prosthesis compared to the ones not using prosthesis. Conclusion: Structured psychological and psychosocial support to the patients with amputations is needed before and after surgery, involving multidisciplinary teams. More emphasis should be given to the mental health of the married participants, as they showed higher levels of depression.

Randomized controlled trial to compare conventional physiotherapy with task-oriented exercises after total hip replacement.

Different interventions are used during rehabilitation after hip replacement surgery, but it is unclear if task-oriented exercise is more effective than conventional physiotherapy. This study compared the effectiveness of conventional physiotherapy (CPT) programme with task-oriented exercise (TOE) on hip pain, function, static and dynamic balance during the early rehabilitation stage after total hip replacement. This randomized controlled parallel-group trial was executed in an inpatient physical medicine and rehabilitation centre. The study included 40 patients who were randomly classified into CPT and TOE groups (n= 20 in each). Hip pain (assessed by visual analogue scale), function in the operated leg (assessed by modified Harris Hip Score, mHHS), static balance (assessed by Abili Balance analyser system) and dynamic balance (assessed by Berg Balance Scale) were evaluated at baseline and after 18 days of rehabilitation. Cohen's effect size (d) was calculated. Greater pain reduction (p< 0.05; d= 0.08) was observed after TOE (1.6 ± 0.68 scores) compared with the CPT programme (2.2 ± 0.83 scores). Hip function assessed by the modified mHHS improved more (p< 0.05; d= 0.30) in the TOE group (73.45 ± 6.23 scores) than in the CPT group (54.90 ± 6.28 scores). Static balance improved significantly in both groups after the interventions but did not differ significantly between the groups. The improvement in dynamic balance was significantly greater (p< 0.05; d= 0.45) after TOE (50.55 ± 1.57 scores) than after CPT (38.55 ± 3.43 scores). Both interventions reduced pain and improved function of the operated leg and static and dynamic balance. The effect on hip function was superior for TOE compared with CPT.

Pelvic Floor Muscle Training versus Functional Magnetic Stimulation for Stress Urinary Incontinence in Women: A Randomized Controlled Trial.

There is strong evidence that specific pelvic floor muscle training (PFMT) reduces stress urinary incontinence (SUI), but the application of functional magnetic stimulation (FMS) is still under discussion. To evaluate and compare the effects of FMS and PFMT on pelvic floor muscle function, urinary incontinence symptoms and quality of life (QoL) in women with SUI. A randomized controlled, parallel-group trial was executed in an outpatient physical medicine and rehabilitation centre. The study included 68 women and was fully completed by 48 women (n = 24 in each group) aged 29-49 years, with SUI, who were randomly assigned to PFMT and FMS groups. The symptoms of urinary incontinence and their impact on quality of life were assessed with two questionnaires: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the Incontinence Impact Questionnaire-Short Form (IIQ-7). Perineometer (Pelvexiser) was used to measure the resting vaginal pressure, pelvic floor muscle (PFM) strength and endurance. All outcome measures were taken at baseline and after 6 weeks of interventions. Cohen's effect size (d) was calculated. A significant improvement (p < 0.05) of ICIQ-SF and IIQ-7 was observed in both groups with a high effect size in the PFMT group (d = 1.56 and d = 1.17, respectively) and the FMS group (d = 1.33 and d = 1.45, respectively). ICIQ-SF and IIQ-7 scores did not differ significantly between groups after the 6-week treatment period. Resting vaginal pressure, PFM strength and endurance increased (p < 0.05) in both groups with a medium (d = 0.52) to large (d = 1.56) effect size. No significant difference between groups was found in any measurement of perineometry. PFMT and FMS significantly improved SUI symptoms and the quality of life of the study participants. None of the applied interventions was superior to the other in the short-term effect.

Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study

IntroductionThis study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain. Method40 individuals who applied to Kırıkkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance. ResultPain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05). ConclusionAs a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.

Inpatient rehabilitation therapy in stroke patients with reperfusion therapy: a national prospective registry study

BackgroundLittle is known about the rate of real-world inpatient rehabilitation therapy (IRT) after stroke. We aimed to determine the rate of inpatient rehabilitation therapy and its associated factors in patients who undergo reperfusion therapy in China.MethodsThis national prospective registry study included hospitalized ischemic stroke patients aged 14–99 years with reperfusion therapy between January 1, 2019, and June 30, 2020, collecting hospital-level and patient-level demographic and clinical data. IRT included acupuncture or massage, physical therapy, occupational therapy, speech therapy, and others. The primary outcome was the rate of patients receiving IRT.ResultsWe included 209,189 eligible patients from 2191 hospitals. The median age was 66 years, and 64.2% were men. Four in five patients received only thrombolysis, and the rest 19.2% underwent endovascular therapy. The overall rate of IRT was 58.2% (95% CI, 58.0–58.5%). Differences in demographic and clinical variables existed between patients with and without IRT. The rates of acupuncture or massage, physical therapy, occupational therapy, speech therapy, and other rehabilitation interventions were 38.0%, 28.8%, 11.8%, 14.4%, and 22.9%, respectively. The rates of single and multimodal interventions were 28.3% and 30.0%, respectively. A lower likelihood of receiving IRT was associated with being 14–50 or 76–99 years old, female, from Northeast China, from Class-C hospitals, receiving only thrombolysis, having severe stroke or severe deterioration, a short length of stay, Covid-19 pandemic and having intracranial or gastrointestinal hemorrhage.ConclusionAmong our patient population, the IRT rate was low with limited use of physical therapy, multimodal interventions, and rehabilitation centers and varied by demographic and clinical features. The implementation of IRT remains a challenge for stroke care, warranting urgent and effective national programs to enhance post-stroke rehabilitation and the adherence to guidelines.

Screening of therapeutic potentials of proprioceptive exercises and topical glucosamine sulfate on pain and functional disability in knee osteoarthritis

Purpose: To compare the effects of proprioceptive exercises and topical glucosamine sulfate on knee osteoarthritis in terms of reducing pain and functional disability.&#x0D; Methods: A single-blinded randomized clinical trial (IRCT20220115053712N1) was conducted at Muhammad Physical Therapy Clinic and Rehabilitation Center, Multan, Pakistan, from November 2021 to April 2022. Eighty-four patients enrolled and were randomized into two groups; patients in Group A were treated with proprioceptive exercises while those in Group B were treated with topical glucosamine sulfate. The Numerical Pain Rating Scale (NPRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale were used to measure pain and functional activities at baseline, 9th and 18th sessions.&#x0D; Results: The results showed that both interventions were effective, but more in Group A (p &lt; 0.05). Group A also showed highly significant improvement in relieving the pains associated with osteoarthritis when compared to Group B (p ≤ 0.001).&#x0D; Conclusion: Proprioceptive exercises are more efficient than topical glucosamine sulfate for managing knee osteoarthritis, improving functional outcomes and lowering pain intensity.

What it is like to be an older person with memory complaints: the perception of women seen at a Physical Rehabilitation Center

Resumo Objetivo Conhecer e compreender o que é ser uma pessoa idosa que apresenta queixas de memória, por meio do olhar de mulheres atendidas em um Centro de Reabilitação Física. Método Estudo descritivo exploratório de caráter qualitativo com população composta por idosas acima de 60 anos que apresentavam alteração da função cognitiva, verificada por meio do instrumento Miniexame do Estado Mental (MEEM) e queixas subjetivas de memória. Foi aplicado um questionário para a caracterização das participantes e realizada uma entrevista semiestruturada áudio gravada baseada em uma pergunta orientadora. As entrevistas transcritas na íntegra foram analisadas com a Análise do Conteúdo de Bardin. Resultados As 19 participantes apresentavam idade entre 62 e 84 anos, com média de 72,37 (±6,72) anos. Por meio da leitura das falas relacionadas as respostas da pergunta orientadora e análise, foi possível identificar duas categorias: (1) sentimentos que as idosas vivenciam devido a queixa de memória; (2) situações da vida diária que são afetadas pela queixa de memória. Conclusão Ser uma idosa que apresenta queixas de memória se mostra como algo difícil, promove diversas mudanças no cotidiano, altera situações que costumavam ser comuns, sendo necessárias readaptações tanto da idosa que sofre com a dificuldade de memória, quanto para os indivíduos que estão a sua volta.

O que é ser uma pessoa idosa que apresenta queixas de memória: a percepção de mulheres atendidas em um Centro de Reabilitação Física

Abstract Objective To understand what it is like to be an older person with memory complaints from the perspective of women seen at a Physical Rehabilitation Center. Method A qualitative exploratory descriptive study was conducted involving a population of older women aged &gt;60 years who had impaired cognitive function, as measured by the Mini-Mental State Examination (MMSE), and subjective memory complaints was carried out. A questionnaire was applied to characterize the participants and an audio-recorded semi-structured interview based on a guiding question was conducted. The transcribed interviews were analyzed using Bardin's Content Analysis. Results The age of the 19 participants ranged from 62 to 84 years, with mean of 72.37 (±6.72) years. Reading and analysis of the discourse produced in response to the guiding question revealed two categories: (1) feelings the older women experienced due to memory complaints; (2) daily life situations affected by memory complaints. Conclusion Being an older woman with memory complaints was reported as challenging, promoting changes in daily life, impacting situations that used to be routine, and requiring readjustments both for the older individual with memory impairment and those around them.

Impact of duration and social support on anxiety amongst amputees

Background: Anxiety may be defined as “apprehension, uneasiness or tension that stems from an anticipation of danger, which may be external or internal”. Amputation is “A removal of the limb or its part owing to medical causes/reasons”. Low-level of social support, religiosity &amp; self-efficacy, may have a role in commencement and continuation of mental health condition. Empathy &amp; support are imperative for helping amputees to cope-up with an uncertainty, emotions, mobility issues, and to en-able them to adjust to new normality. Objective: The aim of study was to find an impact of duration and social support on anxiety amongst amputees. Study Design: Cross-sectional study. Place and duration of Study: Physical Rehabilitation Centers of Quetta. Duration of this study was 3 months. Methodology: Primary data was taken from all amputees visiting rehabilitation centers, through structured adopted questionnaire “Hospital Anxiety and Depression Scale” (HADS), with the help of trained data collectors along with principal investigator. Results: 54 subjects were included in this research, of whom. Majority 49 were earning/receiving up to 30000 Pk Rs monthly. Regarding no of dependents, majority (57.5%) had 9 or above no of dependents.

Telehealth Physical Therapy for Sports Medicine Rehabilitation: What Is Its Role in the Postpandemic Era?

Background:The adoption of telehealth visits for physical therapy (PT) has accelerated because of the COVID-19 pandemic. Patient reception of virtual PT at the outbreak of the pandemic was positive, but it is unclear how telehealth visits compare to in-person visits in the postpandemic era.Purpose:To evaluate utilization trends and patient satisfaction with virtual PT compared with in-person PT during and after the COVID-19 pandemic.Study Design:Cross-sectional study; Level of evidence, 3.Methods:We identified 59,461 in-person and 2016 telehealth visits at a single physical rehabilitation center between March 2020 and December 2021. Patient socioeconomic and demographic variables, including insurance status, were compared between telehealth users and in-person visitors. A total of 1012 patient satisfaction surveys were available and analyzed using the top-box method. Univariable statistics (t test or Mann-Whitney U and chi-square tests) were used for group comparisons.Results:Overall, telehealth users when compared with in-person visitors were older (median age, 47 vs 42 years, respectively; P < .001), and a higher proportion was female (60.6% vs 54.8%; P < .001), was White (69.7% vs 66.6%; P = .023), spoke English as their primary language (99.2% vs 98.1%; P = .001), and had Medicare insurance (20.3% vs 16.1%; P < .001). Telehealth patients more often lived out-of-county (50.7% vs 45.8%; P < .001) and in small towns rather than in urban areas (1.0% vs 0.3%; P < .001). When we compared telehealth use before and after official reopening of the PT center in September 2020, telehealth users in the postpandemic era had an out-of-county rate of 58.7%, and 68.7% were female. Patient satisfaction survey results demonstrated that telehealth patients compared with in-person patients were less likely to recommend visits to others (75.0% vs 89.1%, respectively; P = .008) and had lower overall assessment of their visits (71.7% vs 88.6%; P = .001). Accordingly, there was a significant reduction in telehealth visits from 2020 to 2021 (from 6.9% to 0.9% of visits; P < .001).Conclusion:We noted a decline in telehealth PT use during the postpandemic era, consistent with reduced patient satisfaction when compared with in-person visits. Telehealth is a useful option for populations with limited time or access to care and may serve a role in a hybrid care model. Further studies on long-term outcomes after telehealth PT are warranted to evaluate its efficacy.

Degree of pain, most frequent musculoskeletal disorders and sociodemographic characteristics of patients treated at a physical therapy and rehabilitation center located in Villa El Salvador, Lima, Peru

Objective: To describe the socioeconomic characteristics of, the most frequent pathologies and symptoms of, and the subjective pain assessment by patients treated at a physical therapy and rehabilitation center located in the district of Villa El Salvador, Lima, Peru.Materials and methods: A descriptive, prospective and cross-sectional study conducted in 366 patients over 18 years of age, of both sexes, who attended their first physical therapy. Results: The patients reported moderate pain intensity in the pre-physical therapy and rehabilitation sessions assessment. Low back pain was the most frequent pathology, followed by neck pain and painful shoulder. Regarding the education level, most patients had secondary and technical education. Moreover, a statistical association was found between pain intensity and sex (p = 0.049), as well as between pain intensity and profession/occupation (p = 0.012).Conclusions: The patients who attended the physical therapy and rehabilitation service reported moderate pain before beginning their sessions. Based on the results of the socioeconomic characteristics, it is necessary to keep up preventive and promotional health measures to avoid possible risk factors that exacerbate musculoskeletal disorders which may interfere with patients’ future recovery and possible relapse.

Determinants of Anxiety in Amputees Owed to Traumatic &amp; Non-Traumatic Causes in Quetta

Objective: To find out the causes and factors of anxiety among amputees suffering from traumatic and non-traumatic causes. Methodology: This descriptive cross-sectional study was conducted in Quetta from the month of May 2018 to July 2018. This study included those clients with amputations as a result of Traumatic &amp; non-traumatic causes and the data was collected from them. This study involved a total of 54 participants. All amputees who visited the three Physical Rehabilitation Centre were included during data collection process. A structured adopted questionnaire using the Hospital Anxiety and Depression Scale (HADS) according to the inclusion &amp; exclusion criteria &amp; then tabularized and analyzed by applying Chi square test. Results: This study involved a total of 54 participants of whom 7(13%) were females and 47(87%) males. Among amputees 36(66.7 %), amputations were due to Traumatic injuries and 18(33.3%) were due to non-traumatic amputations. In traumatic, the majority was due to RTA with 25(46.3 %) and in non-traumatic causes diabetes stood first with 13(24.1%) amputation. Traumatic are more anxious than non-traumatic. There is a significant relationship between marital status and anxiety level (p-value 0.047). Statistically significant relationships between amputation and anxiety level were noticed, p value=0.049. Conclusion: Amputation has a significant association with anxiety level. Traumatic experiences make people feel more anxious than non-traumatic ones. Socio-demographics has association with levels of anxiety. It is recommended to do regular or annual screening of these patients following amputation.

Attachment insecurity predicts outcomes in an ACT-CBT group therapy for adults in a physical rehabilitation centre.

Adapting to chronic illness or disability is accompanied by acute and ongoing illness stressors. Psychological factors such as emotional distress and low self-efficacy are common experiences in chronic illness and disability and interfere with adaptation and psychosocial outcomes such as health-related quality of life. Transdiagnostic group psychotherapy may provide a parsimonious approach to psychological treatment in rehabilitation care by targeting shared illness stressors across mixed chronic illnesses and disabilities, and shared processes that maintain psychological symptoms. Attachment theory may explain individual differences in outcomes and help identify individuals at risk of poor health-related quality of life trajectories. Adults (N=109) participated in an 8-week process-based ACT-CBT psychotherapy group at a tertiary care physical rehabilitation centre between 2016 and 2020. Participants completed measures of emotional distress, self-efficacy, health-related quality of life, and attachment at pre- and post-treatment. Multilevel analyses indicated that patients improved on most outcomes at post-treatment. Attachment anxiety at pre-treatment was associated with more positive outcomes. Reliable change indices suggest clinically meaningful change for the majority of participants, but most were not recovered. Results provide proof-of-concept for the transdiagnostic group intervention and suggest that a longer course of treatment may be clinically indicated. Results warrant replication with larger and more diverse samples, and more robust designs.

Validity study of a triaxial accelerometer for measuring energy expenditure in stroke inpatients of a physical medicine and rehabilitation center

ABSTRACT Purpose Establish the validity of a triaxial accelerometer (Dynaport®) for evaluating the energy expenditure of patients with stroke sequelae at a rehabilitation hospital Methods This is a cross-sectional study with 24 stroke inpatients of a rehabilitation hospital. The participants were assessed on energy expenditure by an ergospirometer system and the triaxial accelerometer simultaneously during a walk test. The data collected by both devices were compared by intraclass correlation coefficient (ICC) and Bland-Altman limits of agreement Results An almost perfect agreement (ICC = 0,94) in the energy expenditure measured by the accelerometer compared to the results of the ergospirometer system was found during the exercise test. The Bland-Altman analysis has shown suitable limits of agreement. Post hoc analyses with the maximum volume of oxygen and the total energy expenditure measured by the ergospirometer system evidenced significant correlation with the energy expenditure measurements by the accelerometer Conclusion Our results evidence that the triaxial accelerometer Dynaport® and its built-in software are valid for estimating the energy expenditure of stroke sequelae during a walk exercise.

Photobiomodulation Therapy Combined with Static Magnetic Field (PBMT-SMF) on Spatiotemporal and Kinematics Gait Parameters in Post-Stroke: A Pilot Study.

Background: Gait deficit is a major complaint in patients after stroke, restricting certain activities of daily living. Photobiomodulation therapy combined with a static magnetic field (PBMT-SMF) has been studied for several diseases, and the two therapies are beneficia. However, their combination has not yet been evaluated in stroke. Therefore, for PBMT–SMF to be used more often and become an adjunctive tool in the rehabilitation of stroke survivors at physical therapy rehabilitation centers and clinics, some important aspects need to be clarified. Purpose: This study aimed to test different doses of PBMT–SMF, to identify the ideal dose to cause immediate effects on the spatiotemporal and kinematic variables of gait in post-stroke patients. Methods: A randomized, triple-blinded, placebo-controlled crossover pilot study was performed. A total of 10 individuals with hemiparesis within 6 months to 5 years since the occurrence of stroke, aged 45–60 years, were included in the study. Participants were randomly assigned and treated with a single PBMT–SMF dose (sham, 10 J, 30 J, or 50 J) on a single application, with one dose per stage at 7-day intervals between stages. PBMT–SMF was applied with a cluster of 12 diodes (4 of 905 nm laser, 4 of 875 nm LEDs, and 4 of 640 nm LEDs, SMF of 35 mT) at 17 sites on both lower limbs after baseline evaluation: plantar flexors (2), knee extensors (9), and flexors (6). The primary outcome was self-selected walking speed, and the secondary outcomes were kinematic parameters. Gait analysis was performed using SMART-D 140® and SMART-D INTEGRATED WORKSTATION®. The outcomes were measured at the end of each stage after the single application of each PBMT–SMF dose tested. Results: No significant differences (p > 0.05) in spatiotemporal variables were observed between the different doses, compared with the baseline evaluation. However, differences (p < 0.05) were observed in the kinematic variable of the hip in the paretic and non-paretic limbs, specifically in the minimum flexion/extension angulation during the support phase (HMST–MIN) in doses 10 J, 30 J, and 50 J. Conclusions: A single application of PBMT–SMF at doses of 10 J, 30 J, and 50 J per site of the lower limbs did not demonstrate positive effects on the spatiotemporal variables, but it promoted immediate effects in the kinematic variables of the hip (maximum and minimum flexion/extension angulation during the support phase) in the paretic and non-paretic limbs in post-stroke people.