Rehabilitation Process Research Articles

Customized stiffness control strategy for a six-bar linkage-based gait rehabilitation robot

Abstract Lower limb rehabilitation robots based on linkage-based mechanisms have recently drawn significant attention in the field due to their numerous advantages. The control of previously proposed linkage-based gait rehabilitation robotic orthoses has been achieved using constant speed control without consideration for the interaction forces. However, such an approach can be harmful to people with stroke since the level of disability varies among individuals, and it may cause potential injuries when excessive force is applied by the robot. To overcome this limitation and improve the rehabilitation process, it is necessary to recognize the force exerted by the person during walking and adjust the robot’s assistive torque accordingly, to provide synchronized motion. Thus, in this work, a human-cooperative approach based on a stiffness control strategy for the six-bar linkage-based gait rehabilitation robot is presented. The proposed methodology can serve as a solid foundation for developing a human-cooperative approach for linkage-based lower limb rehabilitation robotic orthoses. The control was validated and tested with eight healthy human subjects. As a result, customized robotic assistance with this mechanism can be provided during training to meet the individual needs of stroke patients, which can lead to increased engagement and contribution, thus improving treatment outcomes.

The Authority of The Integrated Assessment Team For Legal Certainty Regarding Rehabilitation For Suspected Drug Abusers

This study aims to analyze the authority of the Integrated Assessment Team (TAT) in determining rehabilitation for narcotics abuse victims and to identify obstacles in implementing rehabilitation recommendations, especially for those undergoing legal proceedings. The research uses a normative legal method, supported by empirical data, relying on primary legal materials such as laws and regulations, and secondary materials like literature related to the authority of TAT. The findings show that the TAT holds a crucial role in recommending medical and social rehabilitation for narcotics abusers. However, several obstacles hinder the effective implementation of TAT's recommendations, including poor coordination among law enforcement agencies and the limited resources available to support the rehabilitation process. Additionally, the social stigma surrounding narcotics abuse further complicates the rehabilitation process. The discussion emphasizes the need for stronger inter-agency coordination and increased support for rehabilitation programs to ensure better outcomes for narcotics abuse victims. The study concludes that despite the TAT’s authority being clearly regulated, several implementation challenges remain, which require urgent attention to improve the effectiveness of rehabilitation for narcotics abusers within the legal system.

Double Monolithic Protocol: The Solution to FluorescenceLimitations.

The present paper aims to demonstrate the incorporation of the double monolithic protocol (DMP) into a chairside digital workflow to reproduce the fluorescence properties of natural teeth with chairside monolithic restorations when exposed to different light sources. A female patient reporting dissatisfaction with her upper anterior teeth was rehabilitated using seven veneers and a three-element bridge. The DMP was applied to the bridge, which consisted of a primary lithium disilicate framework to which leucite-reinforced glass ceramic veneers were cemented. The fluorescence of the different substrates and ceramic restorations was evaluated throughout the rehabilitation process, under 365 and 405 nm light. The DMP allows chairside procedures to be optimized by achieving predictable, mechanically resistant, and esthetic restorations. The DMP is a new chairside solution for developing ceramic restorations with optimal esthetics and combined mechanical properties, eliminating the need for sintering or glazing procedures.

Psychometric Properties of questionnaires for assessing musculoskeletal disorders in the ankle: a systematic review protocol

Introduction: Ankle musculoskeletal disorders are common among various populations, including athletes and the elderly. However, there’s a lack of specific instruments in the literature that address factors influencing the progression of these disorders. Objective: This review aims to identify and describe questionnaires focusing on these factors, emphasizing their psychometric characteristics, feasibility, and applicability across different populations. Methods: This study is a systematic review protocol developed according to PRISMA-P recommendations. Searches were conducted in various databases, including Medline, Embase, LILACS, PEDro, SCOPUS, CENTRAL, CINAHL, and Web of Science, without time limitation. The results will be analyzed using the Rayyan®️ software, where two researchers will conduct the identification and removal of duplicates, selection, and screening of studies, with discrepancies resolved by a third examiner. Results: The first phase will comprise reading titles and abstracts, followed by a full manuscript analysis. Methodological quality will be assessed using the COSMIN checklist. Psychometric evidence will follow Terwee et al. criteria. The overall synthesis score will combine the consistency of psychometric evidence with methodological quality, categorizing studies according to levels of evidence proposed by the Cochrane Musculoskeletal Group. The article eligibility process will be represented through the PRISMA flowchart, and results will be presented in tables and figures accompanied by descriptive and narrative analysis. Dissemination will include peer-reviewed publication and conferences in rehabilitation-specific contexts. Conclusion: This study aims to compile existing research to streamline the analysis and application of ankle joint assessment questionnaires recommended for clinical use. It will focus on identifying high-quality questionnaires and examining their ability to explore barriers and facilitators in rehabilitation processes. Keywords: Ankle fractures; ankle injuries; patient-reported outcome measures; surveys and questionnaires.

DE-ADDICTION METHODS IN AYURVEDA

De-addiction methods in Ayurveda focus on restoring balance to the mind, body, and spirit to promote overall well-being and reduce dependency on harmful substances. By addressing the root cause of the imbalance through practical methods such as diet, lifestyle changes, and herbal remedies, Ayurveda aims to restore harmo-ny to the Doshas and bring about long-term healing from addiction. Ayurvedic treatments like Dhumapana, Ka-val and Gandusha, Nasya, Shirodhara, and Panchakarma therapy provide practical ways to reduce cravings, puri-fy the body, and rejuvenate the individual, ultimately aiding in the de-addiction process. Yoga and meditation play a significant role in the rehabilitation process for addiction. These ancient practices offer individuals a way to reconnect with their bodies and minds, helping them to develop self-awareness and emotional regulation skills. With its emphasis on natural healing and individualised care, Ayurveda offers a unique and practical ap-proach to combating addiction and promoting long-term recovery.

O RETORNO AO TRABALHO E AO SERVIÇO MILITAR DE ADULTOS AMPUTADOS: UMA REVISÃO DE ESCOPO

The rehabilitation of adult amputees involves, among other objectives, the return to work. In this sense, the present study seeks to investigate how the return to work and the return to military service occur for adults who have undergone amputation, identifying the factors of success and analyzing the impact of Occupational Therapy. This is a scoping review that follows the guide for scoping reviews from the Joanna Briggs Institute and includes 22 articles for final data analysis and collection. The following factors related to successful return to the labor market after amputation were identified: male gender; younger age; use of prosthesis; lower pain levels; unilateral amputations; availability of accessible infrastructure in the workplace; job function adaptations and assistive technologies; and administrative positions. Regarding the return to military service, the rank within the army was shown to be the main determinant in the individual's return to service. It is noteworthy that several demands pointed out by the studies regarding the rehabilitation process and return to work can be addressed by occupational therapists, such as the adaptation of prostheses for the specific tasks of the individual, analysis and adaptation of the work environment, pain management and reduction, work activity training, and spiritual support, since beliefs related to the sacred were indicated as the main factor of success for rehabilitation. However, only two articles mention Occupational Therapy, and in both, the service is characterized as inefficient.

Innovative Approaches to the Training of Social Workers for Work with Psychoactive Substance Dependence: An Interdisciplinary Strategy

The article analyzes the need for implementing an interdisciplinary approach in the education of social workers specializing in assisting individuals, including those dependent on psychoactive substances and those living with HIV. The main focus is on integrating knowledge from medicine, psychology, law, and social work to improve the quality of training and enhance the professional competencies of these specialists. The study highlights existing deficiencies in the educational programs for social workers in the Kyrgyz Republic, particularly in addressing the specific needs of individuals dependent on psychoactive substances. The article proposes an educational module (a teaching and methodological complex) designed to fill the gaps in the education of social workers in the field of addiction services. The pilot testing of this educational module showed its relevance and effectiveness in raising the level of knowledge on issues related to addiction, methods of providing social support, and social accompaniment. It is important to note that the interdisciplinary approach, which combines theoretical knowledge with practical training, helps in understanding the complexities of the issue and improves the outcomes of social adaptation for individuals with psychoactive substance dependence. The main conclusion of the article is that the use of innovative educational models (teaching modules) significantly enhances the quality of social work within the continuum of addiction services. The author stresses the importance of further developing and implementing such educational programs/modules for social workers, as this will overall improve the rehabilitation and socialization process for individuals with psychoactive substance dependence.

The Indirect Effect of an Internet-Based Intervention on Third-Party Disability for Significant Others of Individuals with Tinnitus.

This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged.

Virtual Reality as a Therapeutic Tool in Spinal Cord Injury Rehabilitation: A Comprehensive Evaluation and Systematic Review.

Introduction: The spinal rehabilitation process plays a crucial role in SCI patients' lives, and recent developments in VR have the potential to efficiently engage SCI patients in therapeutic activities and promote neuroplasticity. Objective: The primary objective of this study is to assess a complete review of the extended impacts of VR-assisted training on spine rehabilitation in SCI patients. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) through a single database search in PubMed/Medline between the dates 1 January 2010 and 1 February 2024. MESH terms and keywords were combined in the following search strategy: (Augmented Reality OR VR OR Virtual Reality) AND (Spine OR Spinal) AND Rehabilitation. Included articles were written in English, involved adults with SCI, included an intervention with VR, AR, or any mixed reality system, and assessed changes in outcomes after the intervention. Results: The search produced 257 articles, and 46 of them were allocated for data extraction to evaluate 652 patients. Both when VR training was analyzed and reviewed separately, and when compared to traditional training, the findings exhibited predominantly promising outcomes, reflecting a favorable trend in the study. VR technologies were used in different settings and customizations, and the medium total time of VR training among the studies was 60.46 h per patient. Conclusions: This auspicious outcome of the study further motivates the intervention of VR and AR in the rehabilitation of SCI patients along with ameliorating their overall holistic well-being.

Implementation of a low-cost comprehensive pavement inspection system

Assessing the condition of roads is crucial to the maintenance and rehabilitation process as a country's progress is closely linked to its transport infrastructure. Therefore, it is essential to have well-maintained roads and to be able to control and monitor them properly. Technological advancements have transformed the way pavement inspections are carried out. This study presents an innovative approach that combines stereo cameras and a GPS module for efficient and accurate data collection. This integration of low-cost technologies provides a detailed three-dimensional view of pavements, complemented by accurate geospatial information. The experimental results showed that the 3D images of pavement damage had a relative volume measurement error of 0.80 %. Unlike traditional systems such as LIDAR and ground-penetrating radar, which involve more expensive technologies, the proposed method offers a cost-effective solution. This methodology not only simplifies the inspection process but also improves the planning and execution of road maintenance and repair activities. Its low cost makes it a viable option for various projects and applications in road infrastructure.

Rehabilitation to Improve Outcomes after Cervical Spine Surgery: Narrative Review.

The increasing elderly patient population is contributing to the rising worldwide load of cervical spinal disorders, which is expected to result in a global increase in the number of surgical procedures in the foreseeable future. Cervical rehabilitation plays a crucial role in optimal recovery after cervical spine surgeries. Nevertheless, there is no agreement in the existing research regarding the most suitable postsurgical rehabilitation program. Consequently, this review assesses the ideal rehabilitation approach for adult patients following cervical spine operations. This review covers activities of daily living and encompasses diverse treatment methods, including physiotherapy, specialized tools, and guidance for everyday activities. The review is organized under three headings: (1) historical perspectives, (2) patient-reported functional outcomes, and (3) general and disease-specific rehabilitation. Rehabilitation programs are determined on the basis of patient-reported outcomes, performance tests, and disease prognosis. CSM requires strengthening of the neck and shoulder muscles that have been surgically invaded. In contrast, the CCI requires mobility according to the severity of the spinal cord injury and functional prognosis. The goal of rehabilitation for CCTs, as for CCIs, is to achieve ambulation, but the prognosis and impact of cancer treatment must be considered. Rehabilitation of the cervical spine after surgery is essential for improving physical function and the ability to perform daily activities and enhancing overall quality of life. The rehabilitation process should encompass general as well as disease-specific exercises. While current rehabilitation protocols heavily focus on strengthening muscles, they often neglect the crucial aspect of spinal balance. Therefore, giving equal attention to muscle reinforcement and the enhancement of spinal balance following surgery on the cervical spine is vital.

PENDAMPINGAN PENGAWASAN REHABILITASI RUANG KELAS DAN KANTOR MADRASAH IBTIDAIYAH TASRIHUL ISLAM KABUPATEN BANJAR

Infrastructure improvement through the allocation of funds from the government in order to improve community services is increasingly being carried out in each region. One of the funding provided is the improvement of school infrastructure. Along with these efforts, schools and their officials are expected to be an intermediary for the running of the infrastructure improvement program. They are required to have the ability to carry out technical activities in the implementation of development in the field. In school improvement/rehabilitation activities, supervision in the implementation of physical work is very important and must be mastered so that development can run according to cost, quality and time that is effective and efficient and can be accounted for. Madrasah Ibtidaiyah Tasrihul Islam, located in Sungai Kupang Village, Gambut Subdistrict, Banjar Regency, as a collaborating partner in this Community Service activity, has been assisted through supervision assistance activities for school building rehabilitation. The physical work carried out is the rehabilitation of classrooms and offices. The implementation of the activity was carried out using the method of the community service team going directly to the field to provide assistance to partners to plan and supervise the rehabilitation process of office and classroom buildings. Assistance activities were carried out from May to July 2024. The results of the mentoring activities were that the partners were able to

The patient’s perspective on rehabilitation with wireless accelerometers, activity tracking and motivational feedback following knee replacement: A qualitative study prior to a randomised controlled trial (KneeActivity)

BackgroundAs healthcare systems evolve, individuals are expected to be more involved in managing their health and rehabilitation. A wireless medical accelerometer (SENS motion®) has been developed to collect objective data on physical activity. The number of patients requiring knee replacement is rising, but the motivational effect of medical accelerometers in the rehabilitation after knee replacement remains unexplored. This study aims to employ a user-driven approach to tailor the SENS motion® technology for patients undergoing knee replacement prior to testing the refined technology in a randomised controlled trial. MethodsThe study used a Participatory Design research methodology, emphasising collaboration and user involvement. It was carried out in three sessions, each aimed at refining the SENS motion® system toward the needs of the patient group in focus. The first session involved six healthcare professionals who provided written feed-back. The second and third sessions included testing and subsequent interviews of patients (n = 10). After each session, conducted in iterative processes (plan, act, observe, reflect), SENS motion® system revisions were implemented according to the patient’s wishes. The data collected were then analysed using qualitative content analysis. ResultsPrior to patient testing, healthcare professionals identified functional and technical errors that required modifications. Patient interviews revealed that (1) there were positive attitudes towards the SENS motion® system, (2) patients were motivated by daily step counts and geographical locations, especially when they were familiar with landmarks, and (3) active involvement of family members was found to be feasible, which contributed to a sense of solidarity during the rehabilitation process. ConclusionThis study applied a user-driven approach to customise health technology for postoperative rehabilitation in knee replacement patients. Initially, the technology had both technical and functional problems, but system revisions based on patient feedback improved its acceptance. The refined technology is undergoing testing in a randomised design.

Arsitektur Sistem Informasi Rehabilitasi dan Rekonstruksi Rumah Terkena Dampak Gempa Menggunakan Framework Togaf

The study focuses on the impact of the 2018 earthquake in the Province of West Nusa Tenggara, particularly the extensive damage to hundreds of thousands of houses. It aims to assess the initial phase of post-earthquake housing rehabilitation and reconstruction activities and seeks to enhance their efficiency and effectiveness. One of the main issues identified is the absence of an integrated information system to facilitate data management and coordination among relevant agencies, often leading to errors and delays in implementing activities. To address this, the research utilizes the TOGAF ADM Framework as an architectural design method, providing detailed guidelines for creating a flexible and adaptable information system architecture. Data is collected through in-terviews, document studies, and literature reviews. The research delves into the vision and mis-sion, regulations, and guidelines pertaining to the rehabilitation and reconstruction process, as well as an analysis of the current business processes and assets owned by the BPBD of the Province of West Nusa Tenggara. The expected outcome is the development of an information system ar-chitecture that can overcome obstacles in rehabilitation and reconstruction activities, resulting in a more effective and efficient process. Moreover, it aims to enhance coordination and resource uti-lization. Ultimately, the study concludes that implementing a TOGAF ADM-based information system architecture can offer a comprehensive solution to the challenges encountered in post-earthquake housing rehabilitation and reconstruction. This resulting integrated and opti-mized system is expected to serve as a valuable reference for relevant agencies in other provinces facing similar situations in the future.

Needs analysis for self-help training in the context of cochlear implant rehabilitation

Despite cochlear implantation, CI users experience difficulties in challenging listening situations. In German-speaking countries, there are no interventions to promote specific coping strategies for such situations. The present study examines persistent everyday limitations and the relevance of potential intervention content in order to develop a self-help program for CI rehabilitation. 56 CI users from three German CI centers were recruited and completed an online survey on demographic data, hearing biography, hearing handicap and potentially relevant intervention content. The intervention content presented included the following categories: Medical Aspects, Communication Improvement Aspects, Psychosocial Aspects, Technical Aspects, Specific Aspects. The hearing handicap was moderate to severe in this sample. The content categories presented for the design of a self-help program were all rated as "important". The duration of CI provision correlated significantly negatively with the assessment of the relevance of psychosocial aspects. Further significant correlations were found between the severity of the hearing handicap and the rating of the relevance of aspects for improving communication, psychosocial and technical aspects. A self-help program that takes into account the contents examined could provide promising support for the CI rehabilitation process and will be developed and evaluated subsequently.

Acute effect of different types of moderate intensity physical exercise on affective response and mood state in individuals with substance use disorder

Substance use disorder (SUD) affects a significant percentage of people around the world, negatively influencing aspects of physical and mental health. Physical exercise can promote acute and chronic effects on the affective response and mood of individuals and has shown promising effects in all phases of rehabilitation. The objective of this study was to verify the acute effects of two types of physical exercises at moderate intensity on the mood state and on the affective response of individuals hospitalized for the treatment of SUD. For this purpose, 43 individuals (31 men and 12 women) underwent two physical exercise sessions (one aerobic and one functional) and a control session. Before and immediately after the sessions, subjects answered questionnaires about mood, affective valence, and perceived arousal. Generalized estimating equations (GEE) followed by the Bonferroni post hoc test were used to assess the effect of timing and session on the variables. The results showed significant improvements after both physical exercise sessions in mood (reduction in levels of tension, depression, anger, fatigue, and confusion) and in affective valences (feeling of pleasure and arousal perception), with no changes after the control session. It is observed that different types of physical exercises can positively impact the mental health of individuals undergoing treatment for SUD and should be used as a non-pharmacological strategy in the rehabilitation process.

Application and progress of bionic scaffolds in nerve repair: a narrative review

Nerve injury can result in severe damage and potentially permanent disability, imposing substantial physical, psychological, and economic burdens on affected individuals and their families. Despite advances in surgical repair techniques, the functional recovery of nerves remains suboptimal. The current therapeutic approaches for nerve injury exhibit limited efficacy in restoring function, underscoring the imperative for the development of innovative treatment modalities. In recent years, bionics has emerged as a promising field in medicine, particularly in the treatment and rehabilitation of nerve injuries. We review the advances in the application of bionic technology within the realm of nerve injury treatment, encompassing bionic nerve scaffolds, nerve regeneration materials, and nerve modulation techniques. We delve into how these technologies may facilitate the repair and functional restoration of nerve tissues, as well as the challenges they encounter in clinical translation and their prospective directions for future development. Furthermore, we explore the convergence of bionic technology with existing therapeutic strategies and discuss the potential for interdisciplinary collaboration to catalyze innovation in nerve injury treatment. The integration of bionics with conventional methods may offer a synergistic approach, enhancing the efficacy of nerve repair and rehabilitation processes.

An Implant And Tooth-Supported Fixed Dental Prosthesis For Esthetic And Functional Rehabilitation: A Case Study

Implant-supported prosthesis has emerged as preferred treatment of choice due to their reliable functional and aesthetic outcomes. However, the clinician can encounter several challenges in accomplishing the task. Failure to understand stress factors and stress distribution often lead to bone loss and restoration failure. This case study aims to provide a comprehensive explanation of the entire prosthetic rehabilitation process using a fixed dental prosthesis supported by a tooth and an implant, all in accordance with standard guidelines

Research progress on the timing and implementation of early rehabilitation for critically ill patient

Critical care rehabilitation is an essential component of treating critically ill patients. Implementing early rehabilitation is safe and feasible, with benefits and early rehabilitation is both safe and feasible, with benefits far outweighing potential risks. An individualized rehabilitation plan is necessary for initiating early rehabilitation treatment. This includes identifying the rehabilitation needs of critically ill patients, timely seizing opportunities for rehabilitation intervention, and implementing safe rehabilitation measures through position training, exercise training, respiratory training, and monitoring the rehabilitation process. There remains considerable heterogeneity in the clinical practice of early rehabilitation treatment for critically ill patients. This article provides an updated overview of evidence-based medicine for early rehabilitation treatment of critically ill patients, aiming to offer a reference for clinical medical staff in formulating critical care rehabilitation treatment strategies for these patients.

"Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation

Introduction: It is frequently performed for reasons such as amputation, circulatory system problems, accidents, cancers, infections and surgical interventions due to congenital anomalies, and it affects individuals psychosocially. This research was conducted to better understand individuals' amputation experiences and care needs. Methods: Descriptive phenomenological type research, one of the qualitative research designs, was conducted with 13 participants between November 2023 and January 2024. Results: 10 of the participants are male, 9 are married, 11 do not use prosthesis, and the average age is 54.4. Six themes were obtained in the thematic analysis: "Physical effects", "Socioeconomic effects", "Adaptation and coping", "Emotional effects", Amputation perception" and "Prosthesis Perception". Most of the participants are dependent in their daily living activities. Post-amputation body image impact, emotional difficulties such as loss and helplessness, and feelings of social isolation and dependency have affected many people. Participants frequently emphasized the importance of support systems such as family and healthcare professionals. In particular, receiving support from family members played an important role in the adaptation process of individuals after amputation. Almost all of the participants perceived amputation negatively. However, it was noted that participants using prosthesis used more positive expressions. Many of the participants talked about their desire to use a prosthesis and their hope that the prosthesis would have a positive impact on their lives. Conclusion: Amputation is an important surgery performed due to acute or chronic health problems and affects individuals biopsychosocially. Perioperative preparation and care processes and support systems have a great impact on individuals' ability to adapt to living with an amputated limb. The application of prostheses that make life easier for individuals, gaining new skills and the rehabilitation process are other factors that will facilitate adaptation.