Therapy Program Research Articles

Psycho Social Challenges Experienced by Flood Victims in Charsaadda, Pakistan

Flood victims face a complicated set of emotional, social, and mental challenges that require advanced knowledge and personalized treatments. The July 2010 flood severely disrupted Pakistani society, inflicting chaos and structural damage and needing a new framework for the people of Khyber Pakhtunkhwa. This research investigates the social and psychological effects of the floods on residents of Charsadda, Pakistan. The information was gathered from people affected by floods in Charsadda, Pakistan. Purposive sampling methods were used to choose responders. N = 377 flood victims were selected from four villages in Union Council Agra. The data for this research was gathered from flood victims using a closed-ended questionnaire. The study emphasizes the enormous social and emotional hardship that flood victims experience, extensive property destruction and health issues. They lacked zeal for their well-being and exhibited excessive emotional reactions. The study suggests focusing social rehabilitation on financial aid and interest-free loans, conducting training sessions and building adequate therapy programs for future calamities. Psychological treatment can offer comfort and support to those impacted. Those who are impacted can find comfort via psychological treatment.

Effectiveness of a Smartphone-Based Stress Management Program for Depression in Hospital Nurses During COVID-19 in Vietnam and Thailand: 2-Arm Parallel-Group Randomized Controlled Trial.

During the COVID-19 pandemic, health care professionals experienced high levels of depression. However, extant research has not highlighted effective internet-based psychological interventions to improve the mental health in this population during the pandemic. It remains unclear whether self-guided, internet-based cognitive behavioral therapy (iCBT) programs are effective in improving the mental health of health care workers during the COVID-19 pandemic. The aim of this study was to evaluate the effectiveness of a smartphone-based iCBT stress management program for reducing the depression experienced by nurses in Vietnam and Thailand. From March to April 2022, a 2-arm, parallel-group randomized controlled trial was implemented. One arm offered a 7-week self-guided iCBT program, and the other offered treatment as usual as a control arm. Full-time nurses were recruited from 6 hospitals: 2 hospitals in Vietnam and 4 hospitals in Thailand. The primary outcome of this program was the severity of depression measured by the Depression Anxiety Stress Scale-21 items. Follow-up surveys were conducted to measure the change in depression severity at 3 months (July-August 2022) and at 6 months (October-November 2022) after baseline. Mixed modeling for repeated measures was used to test the effects of the intervention compared with the control for the follow-up. A total of 1203 nurses were included in this study: 602 in the intervention group and 601 in the control group. The follow-up rate at 3 and 6 months ranged from 85.7% (515/601) to 87.5% (527/602). The completion rate for the program was 68.1% (410/602). The group difference in depression was significant at the 3-month follow-up (coefficient=-0.92, 95% CI -1.66 to -0.18; P=.02) and nonsignificant at the 6-month follow-up (coefficient=-0.33, 95% CI -1.11 to 0.45; P=.41). The estimated effect sizes were -0.15 and -0.06 at the 3- and 6-month follow-ups, respectively. Our study shows that the smartphone-based iCBT program was effective in reducing depression at the 3-month follow-up among hospital nurses in Vietnam and Thailand during the COVID-19 pandemic. However, the effect size was small, and therefore, these results may not be clinically meaningful. UMIN Clinical Trials Registry UMIN000044145; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050128. RR2-10.20944/preprints202303.0450.v1.

Patient and clinic staff perspectives on the implementation of a long-acting injectable antiretroviral therapy program in an urban safety-net health system

BackgroundLong-acting injectable cabotegravir plus rilpivirine (LAI CAB/RPV) has several potential benefits over daily oral formulations for HIV treatment, including the potential to facilitate long-term adherence and reduce pill fatigue. We aimed to assess facilitators of and barriers to LAI CAB/RPV implementation and delivery through the perspectives of physicians and clinical staff, and the experiences of LAI CAB/RPV use among people living with HIV (PLWH) at a Ryan-White supported safety-net clinic in North Texas.MethodsWe conducted semi-structured interviews with recruited clinic staff (physicians, nurses, and support staff) involved with LAI CAB/RPV implementation and PLWH who switched to LAI CAB/RPV and consented to participate in individual interviews. Data were collected from July to October 2023. Our interview guide was informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM), and Proctor Implementation Outcomes frameworks. Qualitative data were analyzed using a rapid qualitative analysis approach to summarize key themes.ResultsWe recruited and interviewed 15 PLWH who transitioned to LAI CAB/RPV and 11 clinic staff serving these patients. PLWH conveyed that emotional and informational support from family or a trusted clinician influenced their decision to switch to LAI CAB/RPV. PLWH also reported that injectable treatment was more effective, convenient, and acceptable than oral antiretroviral therapy. Clinic staff and physicians reported that staff training, pharmacist-led medication switches, flexible appointments, refrigeration space and designated room for injection delivery facilitated implementation. Clinic staff cited medication costs, understaffing, insurance prior authorization requirements, and lack of medication access through state drug assistance programs as critical barriers.ConclusionsOur study offers insights into real-world experiences with LAI usage from the patient perspective and identifies potential strategies to promote LAI CAB/RPV uptake. The barriers to and facilitators of LAI CAB/RPV program implementation reported by clinic staff in our study may be useful for informing strategies to optimize LAI CAB/RPV programs.

The Impact of Horse-Assisted Therapy on Socio-Emotional Behaviors in Children with Autism

Animal-assisted therapy for children with autism (ASD) is a form of complementary therapy, integrating methods from various other types of therapy. AAT, or animal-assisted therapy, is a series of interventions that are based on the behavioral traits of animals, especially dogs and horses, which are the most common in this context. These interventions can be integrated into conventional treatments such as behavioral therapy, play therapy, music therapy, occupational therapy, speech therapy, and art therapy, depending on the individual needs of patients. The objective of this study was to examine the effects of an already existing Equine Assisted Therapy (EAT) program on social communication skills, executive functions and motor skills in children diagnosed with autism spectrum disorders. The research adopted an observational design to analyze how often certain behaviors occur in the presence or absence of horses in a group intervention program. This research included 16 children diagnosed with autism spectrum disorder (ASD), aged between 9 and 14 years (12 boys and 4 girls), who were selected from an School Center for Inclusive Education. The conclusions drawn from our results showed that the horse-assisted therapy, implemented in our experiment, recorded a notable improvement in all the behavioral parameters analyzed. Improvements were observed in Attention in Activity (21.2%), Communication (18.3%) and Compliance (9.1%) during activities, Physical Movements, with a difference of 34.1%, Affective State (23.33%), Visual Control (45%), Functional Skills and Response to Command (46.66%), Social Attention (33.5%) and Dynamic Motor Skills (35.55%) during activities. And the biggest difference was observed in Vocalizations, with a difference of 53%. Our results strongly support the fact that complementary therapy of autism spectrum disorders with the help of horses is an effective form of intervention, which can bring substantial improvements in therapeutic outcomes.

Older Adults Experience with a Layperson-Supported Digital Mental Health Intervention for Depression: Qualitative Insights on Engagement.

This qualitative study examines the experiences of older adults with Empower@Home, an older adult-centered, layperson-supported internet-based cognitive behavioral therapy (iCBT) program for depression, with a focus on engagement-related factors. Adults aged 50 or older with at least mild depressive symptoms were recruited from multiple resources. A random subset of participants was invited for a semi-structured qualitative interview during a post-intervention assessment conducted over the phone (N = 148). Interviews were recorded and transcribed verbatim. Transcripts were coded in a multi-phase, team-based approach utilizing inductive coding techniques, followed by thematic analysis to identify key themes. Six key themes regarding engagement emerged: the importance of a structured, skills-based, and self-paced approach; the essential role of weekly coaching for accountability, web interface's ease of use and accessibility; narrative engagement dynamics; enhanced learning through multimodal instruction; and tailoring challenges in iCBT. Older adult-centered, layperson-supported, and multimodal iCBT can effectively engage older adults in managing their mental health. iCBT programs can be integrated into various community aging settings. By leveraging each setting's strengths and involving a range of professionals, these programs can play an important role in enhancing older adults' mental health.

Investigating the Maintained Motor Skill Achievements in a Visual Praxis Based Occupational Therapy Program: Single Blind Randomized Follow up Study.

To examine the long-term effects of Visual Praxis Based Occupational Therapy Program on the motor skills of children with Specific Learning Disabilities. Ninety-six boys and girls were divided into two groups: Experimental (n = 48) and Control (n = 48). The Experimental group received Visual Praxis Based Occupational Therapy Program in two weekly sessions for 8 weeks. All participants were assessed with the Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form at three-time points; pre-test, post-test, and follow-up. The experimental group showed superior results, Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form's Fine Motor Precision, Fine Motor Integration, Bilateral Coordination, Balance, Speed and Dexterity, Upper Extremity Coordination and Total Score significantly increased after the intervention (p ≤ 0 0.05) and the scores were maintained at the follow-up (p > 0.05). The Visual Praxis Based Occupational Therapy Program intervention provided a retained positive effect in the development of motor skills in children with Specific Learning Disabilities.

Use of a surgical referral algorithm within a standardized shoulder physical therapy program to assist clinical decision-making

Purpose Determine (a) utility of a shoulder referral algorithm, (b) patients improving ≥15% on the Western Ontario Rotator Cuff(WORC) score with standardized Physical Therapy(PT) +home exercises, and (c) presenting characteristics among PT-Only, PT + Surgical Consult and Surgery participants. Materials and Methods Prospective cohort study of patients 30–65 years old with shoulder pain. A standardized PT program assessed pain, ROM, strength and exercise tolerance (i.e., referral algorithm) at 2-, 6- and 12-weeks to determine if a surgical consultation might be beneficial. A blinded research assessor evaluated pain, ROM, strength and WORC score at 6-, 12-weeks and 6-months. The proportion improving WORC scores ≥15% and group differences were also evaluated. Results 32/128 (25%) participants underwent consultation with 16 (12.5%) undergoing surgery. WORC scores improved ≥15% by 12-weeks in most PT-Only/PT + Surgical Consult participants (n = 77[70%]) and was maintained at 6-months. Surgery participants used more NSAIDs (p = 0.01), injections (p = 0.002) and trended to higher opioid use (p = 0.06). PT + Surgical Consult/Surgery participants (n = 16/32; 50%) knew diagnostic imaging results more than PT-Only (n = 26; 31%) (p = 0.02). Surgery participants presented with worse pain, ROM, strength and WORC scores than PT-Only (p < 0.05). Conclusions The algorithm identified those with worse symptomology (25%), 50% of whom underwent surgery. WORC scores improved ≥15% in most participants (70%). Presenting characteristics were significantly worse between PT-Only and Surgery participants.

Essential Occupational Therapy Competencies for Low Vision and Blindness.

Background. The prevalence of low vision and blindness in persons across the lifespan means that occupational therapists will encounter these conditions across all areas of practice. Practitioners must be equipped with competencies necessary to recognize and respond to vision loss-related concerns. Purpose. This study sought to identify essential occupational therapy competencies when providing services to people with low vision and blindness. Method. The study employed a three-phase modified Delphi methodology administered through online surveys and focus group. Respondents included people with low vision or blindness, professionals with special expertise in low vision/blindness, and occupational therapists in other practice areas. Data were analyzed using an iterative, consensus-generating strategy involving quantitative analysis of competencies, qualitative input, and expert panel review. Findings. The process yielded a 51-item competency framework organized into six domains. Implications. The framework provides the foundation for a common curriculum for Canadian occupational therapy programs and for the creation of educational resources.

Telerehabilitation Guidelines for Patients with Breast Cancer (Ukrainian Language Edition)

The document covers current advancements in telerehabilitation, including regulatory frameworks, clinical aspects of postmastectomy pain syndrome, and the role of the International Classification of Functioning, Disability and Health in managing patients with breast cancer. It details the Telerehabilitation Platform, describing its structural and functional components, including software modules and administrative subsystems. The guidelines also outline methods for evaluating telerehabilitation effectiveness and discuss patient-centered telerehabilitation programs for various stages, from preoperative to long-term care. Nine appendices provide additional resources such as questionnaires, physical therapy programs, and equipment requirements.

Telerehabilitation Guidelines for Patients with Breast Cancer

This article provides a comprehensive analysis of the current developments in telerehabilitation, focusing on the regulatory and legal frameworks for delivering telerehabilitation services, the clinical manifestations of postmastectomy pain syndrome, and the role and significance of the International Classification of Functioning, Disability, and Health (ICF) in the telerehabilitation of patients with breast cancer (BC). The document also explores telerehabilitation interventions for BC. A detailed description of the software and hardware tools is provided, including the structural and functional overview of the Telerehabilitation Platform (TRP), software modules such as "Telerehabilitation," "Medical Reports," the Administrative Subsystem, the Information-Analytical Subsystem, which encompass the PM&amp;R physician’s digital workspace, the PM&amp;R Expert Subsystem, and the Patient’s digital workspace. It also covers existing and prospective scales for evaluating the effectiveness of telerehabilitation, as well as the specifics of working with identified patients in accordance with the eHealth (Electronic Healthcare System of Ukraine) requirements. The guidelines conclude with organizational and methodological aspects for implementing telerehabilitation programs, including initial and stage-specific rehabilitation assessments, basic ICF sets, and various patient-specific telerehabilitation programs. These include a patient-centered program for the preoperative stage of telerehabilitation and individualized programs for the post-acute and long-term phases. The eight appendices include questionnaires, physical therapy programs, protocols, diaries, and requirements for the equipment and staff of the telerehabilitation/telemedicine office, among other resources.

Development and integration of a music therapy program in the neurologic inpatient setting: a qualitative study

Purpose Explore facilitators and barriers to development and integration of an inpatient music therapy (MT) program from the perspective of the patient, family member, and health care professional. Materials and methods This qualitative study recruited patients on acute neurosciences/neurorehabilitation units having participated in the hospital MT program, their family, and members of their health care team. Semi-structured individual interviews and focus groups were conducted with 35 participants (14 patients, 5 family members, 16 health care professionals). Interviews/focus groups were audio recorded and transcribed verbatim. Data were coded in duplicate and a codebook was developed through an iterative process. Results Four dominant themes emerged from the data: (1) facilitators of program operations; (2) barriers to program establishment; (3) perceived positive impact on patient outcomes; and (4) opportunity for improvement. Facilitator sub-themes included a love for music that encouraged participation, broad appeal of MT, and support of the health care team. Conclusions Patients, health care professionals, and family members accepted MT as a treatment modality. While there is growing evidence for MT in neurorehabilitation, practical challenges remain in developing inpatient MT services, including funding, and optimal integration of music therapists into existing care teams.

Addressing Bias in the Occupational Therapy Admissions Process

This study investigated the impact of a workshop in reducing unconscious bias in admissions committee members of an occupational therapy program to determine if workshop participation increased the number of underrepresented students in the program. A convenience sample of 50 committee members was used. A Wilcoxon matched pairs signed rank test indicated a significant increase in the post-test survey question scores. A chi-square test of independence revealed a significant increase in the number of students in the program from underrepresented groups. These results suggest that an online workshop can reduce perceived bias and increase diversity in an occupational therapy program.

Effects of Songwriting Group Music Therapy Program among Informal Caregivers of Older Adults with Dependency.

Informal caregivers of older people face demanding responsibilities that can negatively affect their wellbeing, highlighting the relevance of interventions that address their specific needs. This study aimed to assess the effects of a group music therapy program based on different songwriting approaches applied to informal caregivers of older adults with dependency. A sample of 113 caregivers participated, being assigned either to the intervention (n = 60) or the control group (n = 53). The intervention group caregivers received 10 weekly sessions of the songwriting program, while the control group continued with their usual care service. Psychological symptoms and health-related quality of life (HRQoL) were assessed at baseline and follow-up using the State-Trait Anxiety Inventory, Beck Depression Inventory-II, Zarit Burden Interview, and SF-36. Group × Time interactions revealed significant improvements in the intervention group compared to the control one in trait anxiety (p = 0.022), social functioning (p = 0.013), role limitations due to physical problems (p = 0.020), and physical component summary (p = 0.022). These findings provided valuable evidence on this novel intervention, showing positive effects for caregivers' wellbeing. The current research emphasizes the importance of considering music therapy as a potential intervention among caregiver support programs.

Opportunities, Risks, Strengths and Weaknesses of Robotic Systems in Early Neurological Rehabilitation.

Given the conference's focus on innovative healthcare solutions, our investigation into robotic assistance systems highlights crucial advancements in early motor rehabilitation, aligning closely with emerging healthcare priorities. In combination with conventional therapy, the assistance systems offer new possible therapy programs. They can be used to mobilize and move patients as early as possible. The paper discusses the possibilities that arise from their use and considers the obstacles that arise. As part of a qualitative survey, nine expert interviews from different fields were conducted to guide them on robotic assisted living systems. The results obtained were summarized by coding into categories and evaluated. Our analysis of 148 coding points from nine expert interviews reveals significant insights into the strengths and weaknesses of robotic systems in neurorehabilitation. Each point was meticulously categorized to reflect its impact on both practice and patient outcomes, highlighting the practical implications of our findings. The results of the survey and the literature indicate a positive effect of robotic assistance systems in early rehabilitation. Their use requires intensive monitoring and studies on the long-term application of the systems.

Neurodiversity and Inclusive Education: A Therapeutic and Pedagogical Approach from Music Therapy in Early Childhood Education from a Systematic Review

Neurodiversity from the perspective of inclusive education has generated intervention processes that have been addressed from music therapy in the expression of human diversity in this research addresses the therapeutic approach of intervention from music in the comprehensive care of neurodivergent students. The objective was focused on analyzing the designs and implementations of the effectiveness of music therapy programs in students who present neurodiversity situations through the therapeutic and pedagogical strategies reported from scientific evidence. The method used refers to the systematic review from the PRISMA statement through the analysis of three categories of variables. The discussion focused on the reports and evidence generated from the interventions with music at the level of increasing cognitive, emotional, social and relational development in early childhood education students. In conclusion, it was identified that the promotion of emotional regulation skills, communication dynamics and social integration lead to increased levels of adaptation and inclusion that lead to improved academic success and inclusion in neurodivergent students.

Correction to effects of a visual perception-based occupational therapy programme on reading and motor skills in children with developmental dyslexia: Single blind randomised crossover study design.

This study aimed to examine the effects of a visual praxis-based occupational therapy (VPOT) programme on reading and motor skills for children with developmental dyslexia (DD). Forty-two children were included in the study. Additionally, before VPOT, the Reading-Aloud and Reading-Comprehension Test 2 (ORSRC-2) and the Bruininks-Oseretsky Motor-Proficiency-Test-2-Brief Form (BOT2-BF) were applied to the participants. According to the study design, VPOT was applied to two sessions per week for 8 weeks to group A. During this period, group B was accepted as the control group. At the end of these 8 weeks, evaluation tests were applied to both groups. Then, group A was defined as the control group and Group B as the intervention group, and VPOT was applied to Group B. At the end of another 8 weeks, evaluation tests were applied to both groups for the third time. When the final ORSRC-2 results were examined, VPOT was found to be an effective programme for improving reading skills. Additionally, when the final BOT2-BF results were examined, VPOT was determined to be effective in improving motor skills (p < 0.05). We believe that it is important to carry out comprehensive studies such as the VPOT programme to solve problems in the physical and learning activities of children with DD.

Administrative Analysis of the Home-Based Older Persons Upstreaming Prevention Physical Therapy Program: A Pilot Observational Study.

Introduction Traditionally, physical therapist (PT) services do not commence until an injury, fall, or health issue has already occurred although there is increasing evidence that preventative programs administered by PTs may decrease the fall risk among elderly individuals.The purpose of this study was to examine billing, reimbursement, and administrative outcomes of the previously established and investigated prevention-based screening and intervention HOP-UP-PT (Home-based Older Persons Upstreaming Prevention-Physical Therapy) program delivered by a physical therapist in the home of older adults after being referred by a community partner. A randomized controlled trial of the HOP-UP-PT program demonstrated an 8-fold reduction in falls for participants at moderate and high fall risk compared to those who did not participate in the program. Methods Aprospective observational study was performed to examine administrative and payment outcomes of HOP-UP-PT participation. Participants were referred into the HOP-UP-PT program via a local community center. Physician authorization for physical therapy participation was obtained for each participant as required for payment under United States' Center for Medicare and Medicaid Services (CMS)guidelines. The HOP-UP-PT program is preventative physical therapy delivered in the person's home with five in person visits (approximately one per month) followed by a monthly telehealth visit and a final in-person visit.Interventions included a balance program, home safety recommendations, health coaching, and addressing individual risks of falling or becoming homebound. A retrospective analysis was performed on the administrative andinsurance payment data from this study which was then analyzed descriptively. Results Six participants with four different insurances completed the 7-month program (mean age=77 years) in 2021. The physical therapy visits were submitted to the participants' Medicare Part B plan. One participant's physical therapy visits were not submitted for payment as the health system did not have an active agreement with that health insurer. Due to the unclear status of telehealth visits in 2021, these services were not submitted to the insurance company for payment.All other PT visits were paid by the insurance companies. The mean amount paid for the initial evaluation code was $102.83 and the mean payment for the ~15 minute treatment codes was $25.90 per unit. Initial pilot data demonstrated a potential for a4.2% positive operating margin when considering salary costs and travel.The mean delay from the initial referral into the HOP-UP-PT program until the physician provided written authorization for physical therapy was 69.7 days. Conclusion This study demonstrated initial evidence that payment for prevention-focused outpatient physical therapist services delivered in the home was feasible, however delays and costsin procuring physician authorization was a substantial barrier to prevention-focused physical therapy. A 4.2% operating margin demonstrated that, when efficiently operated, similar programs are likely to be viable. Furthermore, if telehealth services would have been paid, the operating margin was estimated to increase to 32%. Physical therapists are highly qualified to deliver efficient, effective preventative services which has the potential to reduce falls and institutionalization and subsequent healthcare cost savings.

Transforming the Effectiveness and Equity of a Psychological Therapy Service: A Case Study in the English NHS Talking Therapies Program

To work with a psychological therapies service to implement a recovery plan, as required by a government body, aimed at improving patient outcomes (effectiveness) and decreasing practitioner variability (equity). A case-study utilizing components of a learning health system, including nationally mandated patient outcome data, comprising three 18-month phases: (1) retrospective baseline; (2) improving patient outcomes (management-led); and (3) reducing practitioner variability (clinician-led). Primary analyses focused on 35 practitioners (NPR = 35) who were constant across the three phases and their patients in each phase (NPA = 930, 1226, 1217, respectively). Reliable improvement rates determined patient outcomes and multilevel modeling yielded practitioner effects. To test generalizability, results were compared to the whole practitioner sample for each phase: (1) NPR = 81, NPA = 1982; (2) NPR = 80, NPA = 2227; (3) NPR = 74, NPA = 2267. Ethical approval was granted by the Health Research Authority. Patient outcomes improved in successive phases for both the core and whole practitioner samples with the largest impact occurring in the management-led intervention. Practitioner variability decreased in successive phases in both the core and whole practitioner samples except in the management-led intervention of the whole sample. Compared with the management-led intervention, the practitioner-led intervention yielded a decrease in practitioner effect exceeding 60% in the core sample and approaching 50% in the whole sample. The implementation of multiple components of a learning health system can lead to improvements in both the effectiveness and equity of a psychological therapy service.

Treatment results of lymphoblastic lymphomas from progenitor cells according to ALL IC-BFM 2002/2009 protocols: monocenter clinical trial

Introduction. The acute lymphoblastic leukemia (ALL) therapy programs developed by the BFM group (Berlin-Frankfurt-Munster) are used to treat lymphoblastic lymphomas from precursor cells (LBL) and are the most effective treatment methods in the world.Aim. To assess the treatment results of LBL in children according to the ALL IC-BFM 2002/2009 protocols in a clinical trial of a single center.Materials and methods. From 2002 to 2022 a retrospective and prospective study included 70 patients aged 2 to 17 years with newly diagnosed LBL, with a median age of 9.4 years. There were 1.5 times more male patients than female (43:27). LBL from T-cells progenitor (T-LBL) was diagnosed in 61 patients (87 %), and LBL from B-cells progenitor (B-LBL) — in 9 (13 %). 59 (84.3 %) patients were included in the intermediate risk (IR) group and 11 (15.7 %) patients — in high-risk (HR) group. There were no patients in the study cohort who met the criteria of the standard risk group (SR).Results. The 10-year OS in the group of patients treated according to the ALL IC-BFM 2002/2009 protocols was 95.4 ± 2.6 %; the 10-year RFS — 91.9 ± 4.9 %; the 10-year EFS — 86.7 ± 5.6 %. When analyzing survival rates depending on the prognostic risk group, the 10-year OS for patients of the intermediate risk group was 96.6 ± 2.6 %, and for patients of the high-risk group — 90.9 ± 8.7 %.Conclusions. The obtained results confirm the high effectiveness of the ALL IC-BFM 2002/2009 protocols in the treatment of LBL.

Bilateral hip stability variation in the functional ambulation and kinetic parameters after total hip arthroplasty during leveled walking.

This study determines gender variation, comparing the significance level between men and women related to functional ambulation characteristics after hip arthroplasty. The study focuses on the broader female pelvis and how it affects the rehabilitation regimen following total hip arthroplasty. In this cross-sectional study, 20 cases of right hip arthroplasty were divided into 10 male and 10 female cases, aged 40-65years. The functional ambulation parameters (walking cadence, gait speed, stride length, and gait cycle time) were acquired from the GAITRite device, as well as kinematic values for hip frontal plane displacement and kinetic parameters for ground response force in the medial-lateral direction. An independent t-test showed a significant difference in the kinematic parameter variables for the anterior superior iliac spine, more significant trochanter displacement, and hip abduction angle between the operated and non-operated limbs for each group separately. Regarding the functional ambulation parameters, there was a significant difference in the walking cadence between the operated and non-operated limbs of both male and female groups. Moreover, the output variables of ground reaction force measures revealed significant differences between their operated and non-operated limbs. The linear regression model used was consistent with the current results, demonstrating a weak negative correlation between the abduction angle of the operated hip and gait speed for both male and female groups. Based on the findings, we draw the conclusion that improving a rehabilitated physical therapy program for the abductors of both male and female patients' operated and non-operated limbs is essential for normalizing the ground reaction force value, avoiding focus on the operated hip, and reducing the amount of time that the operated hip's abductors must perform. This involves exposing the surgically repaired limb to the risk of post-operative displacement or dislocation, particularly in female patients.