Rehabilitation Department Research Articles

Severe depression episode with an incredible improvement after electroconvulsive therapy

Aim: The primary aim of this article is to present a case study of a patient with severe depressive episode that was refractory to extensive pharmacological treatment, but exhibited remarkable improvement following electroconvulsive therapy (ECT). Materials and Methods: The patient’s medical records were obtained from II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin. Cited literature was searched on the PubMed database using the following keywords: Major depressive disorder or MDD, Electroconvulsive therapy, and Benzodiazepine dependence. Results and conclusions: A 55-year-old woman with recurrent depressive disorder and benzodiazepine dependance, unresponsive to multiple medications, requested an ECT. She was then treated with a cycle of 12 Seizure Electroconvulsive Therapy (SECT) sessions. Initially bedridden with severe anxiety, suicidal thoughts, and no clinical improvement despite maximal pharmacotherapy, she exhibited significant improvement after three SECT sessions. Her anxiety decreased, suicidal ideation resolved, and symptoms of anergy and anhedonia diminished. At the end of the SECT cycle, the patient's mood stabilised, and her activity level and social engagement increased. At discharge, she showed no suicidal ideation, tendencies, or psychotic symptoms.This case demonstrates the effectiveness of ECT in treating severe, pharmacologically resistant depressive episodes. It highlights the importance of considering patient requests in conjunction with clinical assessments to achieve positive outcomes. Raising awareness about ECT's safety and efficacy among the public and mental health professionals is crucial for optimizing treatment strategies for severe depression. Proper qualification and timely administration of ECT can significantly enhance treatment outcomes beyond pharmacotherapy alone.

Features of therapy of localized scleroderma in a severe comorbid patient

Localized scleroderma is an autoimmune chronic connective tissue disease characterized by the appearance of foci of local inflammation in various areas of the skin, followed by the formation of sclerosis and/or atrophy of the skin and underlying tissues in them. Among systemic connective tissue diseases, scleroderma occupies the second place in terms of frequency, mainly female patients. The authors observed a severe comorbid patient S., 75 years old, who was hospitalized at the Federal Center of Brain Research and Neurotechnologies of the FMBA of Russia in the department of medical rehabilitation for patients with impaired central nervous system function № 1 from 02.11.2022 to 03.01.2022 with a diagnosis of the underlying disease: the consequences of an ischemic stroke in the basin of the left middle cerebral artery from 02.23.2021, cardioembolic pathogenetic variant. Right-sided hemiparesis. Complex motor aphasia. After consulting a dermatovenerologist, a diagnosis was added to the concomitant diseases: localized scleroderma. Limited plaque shape. Patient S. external treatment was carried out (fluticasone ointment 0.005 % applied to the affected areas of the skin 1 time a day in a thin layer for 4 weeks), upon discharge, a course of physiotherapy at the place of residence was recommended.

Effects of core training based on respiratory therapy on elderly stable COPD patients in the rehabilitation hospital: a study protocol for a randomised controlled trial

IntroductionElderly stable chronic obstructive pulmonary disease (COPD) patients frequently experience walking dysfunction. Research indicates that balance training holds promise for enhancing walking stability in these individuals, whereas respiratory therapy (RT)...

Are Hyperlipidaemia and Insulin Resistance Risks For Sarcopenia?

To investigate whether insulin resistance and lipid metabolism disorders could be associated with sarcopenia. Cross-sectional descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation, Sanliurfa Training and Research Hospital, Sanliurfa, Turkiye, from December 2023 and May 2024. The study included 135 patients who met the inclusion and exclusion criteria. Data such as age, gender, body mass index (BMI), lipid profile, fasting blood glucose, C-peptide, and insulin levels were collected. Following sarcopenia screening, participants were divided into two groups for further examination, and the correlation between sarcopenia and other parameters was assessed. BMI levels were significantly higher in the sarcopenia group (p = 0.003). Triglyceride levels were also significantly elevated in the sarcopenia group (p = 0.001). The number of patients with dyslipidaemia in the sarcopenia group was higher compared to the non-sarcopenia group (p = 0.003). Correlation analysis revealed a positive association between sarcopenia and BMI, insulin resistance, high triglyceride levels, and the presence of dyslipidaemia (p = 0.002, p = 0.032, p = 0.002, p = 0.004, respectively). This study suggests that high triglyceride levels may represent a risk factor associated with sarcopenia and that sarcopenia may be associated with conditions such as high BMI, insulin resistance, and dyslipidaemia. Controlling lipid levels could be beneficial in reducing the risk of sarcopenia. Chronic disease, Hyperlipidaemia, Hypertriglyceridaemia, Insulin Resistance, Sarcopenia.

Bio-Mechatronics Development of Robotic Exoskeleton System With Mobile-Prismatic Joint Mechanism for Passive Hand Wearable-Rehabilitation

The World Health Organization (WHO) estimates that 15 million people are affected by stroke each year, causing deterioration of the upper limb, which is reflected in 70-80% of them, decreasing the performance of daily activities and quality of life, mainly affecting hand functions. Thus, the purpose of this study is to present a high-quality alternative to recover muscle tone and mobility, consisting of a hand-exoskeleton for passive rehabilitation. It covers a motion protocol for each finger and pressure sensors to give a safety pressure range during the gripping function. The bio-design method covers standards (ISO 13485 and VDI 2206) based on biomechanic and anthropometric fundamentals, where Fusion 360 was used for mechanical development and electrical-electronic circuit schematics. The prototyping process was based on 3D printing using polylactic acid (PLA); also, the actuators were servomotors DS3218, the pressure sensors were RP-C7.6-LT, and the microcontroller was Arduino Nano. The system has been validated by the Institute of Research in Biomedical Sciences (INICIB) at the Ricardo Palma University, where the novelty of this work lies in the introduction of a new mobile-prismatic joint mechanism. In conclusion, favorable results were achieved regarding the complete flexion and extension of the fingers (91.6% acceptance rate, tested in 100 subjects), so the next step proposes that the wearable device will be used in the Physical Medicine and Rehabilitation Departments of Medical Centers. Doi: 10.28991/ESJ-2024-08-06-02 Full Text: PDF

Metaphorical Perceptions of University Students Experiencing Kahramanmaraş Pazarcık and Elbistan Earthquakes on the Concept of 'Earthquake': The Case of Physiotherapy and Rehabilitation Department

Purpose: This study was carried out to determine the metaphorical perceptions of the earthquake of Physiotherapy and Rehabilitation students who experienced the Kahramanmaraş, Pazarcık and Elbistan earthquakes. Methods: In the study, phenomenology research design based on qualitative research approach was used. The participants of the research consist of 120 students who experienced the February 6 Kahramanmaraş Pazarcık-Elbistan earthquakes, studying at Hasan Kalyoncu University Physiotherapy and Rehabilitation Department in the 2022-2023 academic Results: The students reproduced a total of 51 metaphors. As a result of the analysis of these metaphors, 9 categories were determined. It is seen that a large number of metaphors have been produced in this study about ‘doomsday’, ‘death’, ‘helplessness’ and ‘disaster’. The most metaphors were produced in the categories of ’End of life’ (f:31), ‘Natural event’ (f:20), ‘Despair-related’ (f:18) and ‘State of Health’ (f: 16). Conclusion: It is seen from the metaphors that Kahramanmaraş Pazarcik and Elbistan earthquakes have more negative effects on the minds of Physiotherapy and Rehabilitation students. Since the impact of the earthquake will continue for some time on the educational life and psychosocial state of the students, it is important to establish a professional team and their supporting. Putting a course in the curriculum specifically in the ‘earthquake’ plan and in the ‘disaster’ plan in general may contribute to their being able to get through this process with less impact.

Experiences of Psychologists and Sport Therapists Conducting Open and Closed Therapy Groups

Few studies compare differences between open and closed therapy groups. Different characteristics of both formats, which have been theoretically and practically substantiated to date, are presumably responsible for different therapeutically relevant effects. The present analysis documents and analyzes therapists' experiences with both open and closed group formats and provides information relevant to the selection of group format. To this end, psychologists and sport therapists in a department for behavioral orthopedic rehabilitation were asked in open, guided interviews about their experiences during a changeover from closed to open groups. Their responses were analyzed using qualitative content analysis. Characteristics of open and closed groups identified in the literature were largely confirmed, but differences not yet identified in the literature were also discovered. These relate to everyday therapeutic practice and therapist motivation. Additionally, similarities and differences between sport and psychotherapy groups are highlighted. In sum, closed groups are characterized by high group cohesion and deeper relationships in the course of therapy. Closed group sessions can build on each other and are structured. Open groups have a consistent level of energy and stronger dynamics over time and offer a wide range of contact opportunities. Different patient roles in group therapy must be kept in mind in both formats. Both group forms have characteristics that can be used for different therapeutic goals and indications and are therefore justified in a therapeutic context. These empirical findings suggest that therapists can strategically choose a specific group form for the support of specific types of patients or for reaching specific therapy goals.

Analysis of Burn Casualties in the Swords of Iron War

Abstract The Swords of Iron (SOI) War is an armed conflict between Israel and Hamas, which has been taking place in Gaza from October 2023 until the present time of writing this article. This war is characterized by urban close contact combat. The combat equipment, weaponry, and protective measures employed, differ markedly from those in previously documented major conflicts, significantly impacting the types of injuries sustained by soldiers. This study examines the number of injured soldiers in combat, field mortality rates, incidence of burns and trauma, demographic details of the injured, causes and distribution of injuries, burn characteristics, hemodynamic status, and injury severity. This is a retrospective, registry-based cohort study. Military personnel treated by IDF medical teams with burn injuries from the ground maneuver in Gaza between October 27th, 2023 to April 2024 were included in the analysis. Diagnosis of burn injuries was made in the prehospital setting and recorded in the patient’s casualty cards and the IDF trauma registry and/or in the hospitals, and then recorded by the Israel National Trauma Registry. A total of 2,627 documented military personnel were included. Of them, there was a total of 249 burn casualties. They were all male combat soldiers and their mean age was 22 years. Most of the burn injuries were combined with other injuries, only 12% were defined as in shock state, and 14% received whole blood in the field. The burn degree was second and third degree for most cases. A third (34%) of burn injured soldiers had surgery (Table 2), and half of the total were sent to rehabilitation departments following their initial hospitalization. An analysis of total body surface area (TBSA)% affected by burns among SOI War casualties reveals a higher proportion of severe burns exceeding 20% TBSA, compared to previous conflicts. Additionally, a higher proportion of personnel suffered from second and third degree burns. This is likely attributed to the operational mode of the IDF in Gaza, where urban close-contact warfare exposes soldiers to heightened risks of explosive and blast injuries. A significant percentage of live casualties had TBSA percentages that were not life-threatening, which underscores the importance of updating emergency burn treatment protocols and employing rapid evacuation and medical response systems in the field. Most of the wounded that suffer from significant burns had other significant and life-threatening injuries, making the appropriate protective measures and the preparation for rapid evacuation the best way to improve burn casualty survival. The significance of this research lies in the timely analysis of accumulated combat data to derive lessons and conclusions relevant to ongoing and future conflicts, and to understand the clinical implications arising from combat situations. Given the relatively high prevalence of burn injuries, understanding their etiology, severity, and consequences is essential for developing effective prevention and treatment courses.

PHYSICAL REHABILITATION FOR YOUNG MEN WITH GRADE I AND II OBESITY

The goal of this study is to study the role of exercise and dietary modification in the treatment of obesity in young men. Materials and methods. A study was conducted with 10 young men aged 25 to 30 who had a body mass index (BMI) exceeding 30 kg/m², indicative of obesity. The primary intervention combined diet therapy with increased physical activity. Most participants also had obesity-related comorbidities, including arterial hypertension, autonomic-vascular dystonia, type II diabetes, and spinal osteochondrosis. Patient motivation was considered crucial in program development, and thus only individuals with a high motivation level were selected for participation. Results and discussion. Based on data from dynamic observations, we can state that the physical therapy program studied has a positive effect on body weight reduction in cases of mild forms of alimentary obesity. After three months of participation, an average weight loss of 8.5% was observed, which represents a very favorable outcome. The results indicate that physical exercises combined with dietary adjustments positively influence weight loss dynamics in young men with grade 1 alimentary obesity. Weight loss occurred most rapidly during the first month of the program. Conclusion. The physical therapy program for grade 1 obesity involves a comprehensive approach, combining physical exercises conducted in a medical rehabilitation department with a specially designed dietary plan. This program is recommended for individuals with mild forms of alimentary obesity and a body mass index (BMI) up to 35 kg/m². After three months of implementing this approach, participants showed an average reduction in excess body weight of 8.5%. This physical therapy program may be effectively used for managing grade I obesity.

Learning program enhances rehabilitation professionals’ perceived ease of using 3d printing: a pilot randomized controlled trial

The pilot study evaluated whether a learning program enhances a positive perception of 3D printing technology in rehabilitation professionals. Physical therapists, occupational therapists and speech-language-hearing therapists were recruited from a rehabilitation department in a middle-sized hospital. Participants were randomized to the control group (n = 13) or the intervention group (n = 14). An eight-week learning program consisted of a lecture on using a 3D printer and related software, a group discussion to integrate 3D printing into their clinical practices, and the implementation in their workplace. Outcome measures included the perception of 3D printing technology assessed by the Japanese version of the modified Technology Acceptance Model questionnaire for 3D printing technology (TAM-J). Assessment time points were pre-and post-intervention. As a result, all participants in the intervention group became capable of producing 3D-printed customized assistive devices. In the within-group analyses, the intervention group showed significant improvements in the TAM-J perception ease of use score (p = 0.012) with a large effect size (r = 0.75). Between-group analyses showed that the intervention group gained an additional improvement in the TAM-J perception ease of use score (p = 0.027) with a moderate effect size (r = 0. 43), indicating a significant improvement in the perceived ease of use of 3D printing technology in the intervention group. These observations suggest the 3D printing learning program could provide rehabilitation professionals with a positive perception of the technical aspect of 3D printing in their workplace.

Microstomia- A Review Of Published Case Reports On The Proposed Management Of Microstomia

Introdcution: microstomia, or the reduction of oral opening, can indeed present challenges for patients across various contexts, from eating and speech to prosthetic treatment. It's essential for clinicians to understand the underlying causes and tailor their approach accordingly. By synthesizing existing evidence, this review aims to provide insights into the effectiveness and feasibility of different prosthetic interventions, thereby guiding clinicians in their decision-making process for optimal patient care. Materials and methods: published case reports and case series reporting on prosthetic rehabilitation of microstomia patients were included in the present review. Only cases with a reduction in the size of the oral aperture were included, and cases with reduced mouth opening with a normal oral aperture (e.g., oral submucous fibrosis, temporal-mandibular joint ankylosis, etc.) Were excluded. Case reports: (case report1) a 93-year-old woman without teeth was referred from the local hospital to the department of oral rehabilitation at the faculty of dentistry, university of otago, dunedin, new zealand. The woman's surgeries on her lower lip resulted in a significant reduction in the vertical opening distance between her upper and lower lips, now at 30 mm. This condition, known as microstomia. (case report 2) a 62-year-old male patient, completely without teeth, presented to the prosthodontic department due to functional difficulties. Discussion: a planned and step-by-step approach is crucial when dealing with cases of microstomia. The outcome greatly depends on the complexity of the case and the utilization of recommended materials and equipment hence, diagnosis and treatment planning play pivotal roles in the management process. Conclusion: although the utilization of flexible denture materials holds promise in enhancing patient comfort and treatment outcomes, further research is warranted to evaluate their long-term success rates. Longitudinal studies can furnish valuable insights into the durability, stability, and overall performance of these materials over time, assisting clinicians in decision-making and optimizing patient care.

Test–retest Reliability and Responsiveness of the Machine Learning-based Short-form of the Berg Balance Scale in Persons with Stroke

ObjectiveTo examine the test–retest reliability, responsiveness, and clinical utility of the machine learning-based short-form of the Berg Balance Scale (BBS-ML) in persons with stroke. DesignRepeated measures design. SettingA department of rehabilitation in a medical center. ParticipantsThis study recruited two groups: 50 persons who were more than 6 months post-stroke to examine the test–retest reliability, and 52 persons who were within 3 months post-stroke to examine the responsiveness. Test–retest reliability was investigated by administering assessments twice at a 2-week interval. Responsiveness was investigated by gathering data at admission and discharge from hospital. InterventionsNot applicable. Main outcome measureBBS-ML. ResultsThe BBS-ML exhibited excellent test–retest reliability (intraclass correlation coefficient = 0.99), acceptable minimal random measurement error (minimal detectable change % = 13.6%), and good responsiveness (Kazis' effect size and standardized response mean values ≥ 1.34). On average, the participants completed the BBS-ML in around 6 minutes per administration. ConclusionsOur findings indicate that the BBS-ML appears an efficient measure with excellent test–retest reliability and responsiveness. Moreover, the BBS-ML may be utilized as a substitute for the original BBS to monitor the progress of balance function in persons with stroke.

Investigation of personality type and physical activity level in physiotherapy and rehabilitation department students

Aims: The aim of this study is to examine the relationship between personality types and physical activity levels among undergraduate students in the department of physiotherapy and rehabilitation. Methods: The participants’ physical activity levels were assessed using the short form of the International Physical Activity Questionnaire (IPAQ). To evaluate the participants’ personality traits, the Eysenck Personality Questionnaire-Revised/Short Scale was used. The relationship between individuals’ personality traits and physical activity levels was determined using Spearman’s rank correlation analysis. Results: The study included 180 undergraduate students from the department of physiotherapy and rehabilitation. The results revealed a strong correlation between severe metabolic equivalent (MET) (r: 0.246, p: 0.001), moderate MET (r: 0.196, p: 0.009) and total MET (r: 0.202, p: 0.007) with psychoticism. Additionally, a strong correlation was observed between extraversion and walking MET (r: 0.180, p: 0.017) as well as total MET (r: 0.196, p: 0.009). Conclusion: Students with personality traits of psychoticism and extraversion tend to be physically more active.This study shows that physical-activity levels may be predicted by personality traits on Turkish physiotherapy and rehabilitation students.

The Effect of Nomophobıa on Anxıety and Qualıty of Lıfe in Physıotherapy and Rehabılıtatıon Department Students

Objective. While smartphones provide convenience to individuals, they also cause many problems. One of these problems is smartphone addiction, known as nomophobia. The aim of our study is to investigate the impact of nomophobia on anxiety and quality of life among students in the Department of Physiotherapy and Rehabilitation.. Methods. The study included 211 students enrolled at Sakarya University of Applied Sciences, Department of Physiotherapy and Rehabilitation. Participants completed a data collection form to provide their demographic characteristics. They also completed the Turkish Nomophobia Scale to assess nomophobia levels, the Beck Anxiety Scale to evaluate anxiety levels, and the SF-36 Quality of Life Scale to measure their quality of life levels. Results. In our study, the nomophobia scale score was found to be 77.28. The distribution of the nomophobia scale according to the cut-off points is 30% mild, 45% moderate, and 25% extreme. We identified a statistically significant relationship between nomophobia and anxiety (p < 0.05). Additionally, there was a statistically significant association between nomophobia and quality of life parameters, excluding vitality/energy, mental health, and social functioning (p < 0.05). However, no statistically significant relationship was found between anxiety and quality of life. Conclusion. The anxiety levels of nomophobic individuals increase in parallel with their nomophobia, leading to a decrease in their quality of life. Necessary information should be provided and awareness should be raised in order to prevent nomophobia, which is especially common in the young population.

The relationship between ultrasound and electrodiagnostic findings in relation of the severity of carpal tunnel syndrome

IntroductionCarpal tunnel syndrome is the most common compression neuropathy. Grading the severity of carpal tunnel syndrome is an important factor in deciding on the type of treatment. This study aims to determine the relationships between the findings of the electrodiagnosis and ultrasonography methods based on the severity of carpal tunnel syndrome.MethodsIn this prospective clinical study, 50 patients (96 wrists) who were referred to the Physical Medicine and Rehabilitation Department of the Shohada Tajrish Hospital, Tehran, Iran (from March 2021 to November 2022) were studied. All patients with a history and clinical examination related to CTS underwent electrodiagnosis studies. Based on the results of electrodiagnosis, patients were divided into three groups: mild, moderate, and severe. All eligible patients underwent ultrasound at the cross-section of the wrist (at the level of the pisiform bone, the entrance of the canal) and the middle of the forearm.ResultsIn this study, the cross-sectional area of the median nerve was measured in 96 wrists of 50 patients with a mean age of 51.78 ± 9.80 years. The mean CSA of the median nerve in the mild, moderate, and severe groups was reported as 0.12 ± 0.03, 0.14 ± 0.02, and 0.21 ± 0.06, respectively. The mean WFR in different groups of CTS was reported as 1.85 ± 0.56, 1.93 ± 0.56, and 2.45 ± 0.49, respectively. A significant relationship between ultrasound findings, including CSA-inlet and WFR, and electrodiagnosis findings was presented (P value < 0.05).ConclusionBased on our findings, there is a statistically significant relationship between the sonographic findings, including the mean CSA-inlet and WFR, and the severity of CTS based on the electrodiagnosis study. Our findings revealed that as disease severity increases, sonographic parameters also increase significantly.

The Effect of a Modified Tenodesis Wrist-hand Orthosis on Hand Function in Patients With Tetraplegia.

An individual experiencing tetraplegia faces functional limitations due to impaired hand function. The use of an affordable tenodesis wrist-hand orthosis (WHO) can enable finger flexion with active wrist extension, thereby enhancing the three-jaw chuck grasp and overall hand functionality. To assess hand function and satisfaction in patients with tetraplegia using a modified tenodesis wrist-hand orthosis (WHO), utilizing the Duruöz Hand Index (DHI) and the Orthotics and Prosthetics User Survey (OPUS) satisfaction with device and services subscales. The study was conducted at a tertiary care center in central India, enrolling patients with tetraplegia admitted to the Department of Physical Medicine and Rehabilitation. A modified tenodesis wrist-hand orthosis (WHO) was designed using low-temperature thermoplastic components. Twenty-two individuals with a minimum wrist extensor power of grade 3/5 were included in the study. These patients were provided with the modified tenodesis WHO and underwent daily training sessions for a period of 2 weeks. Duruöz Hand Index (DHI) scores were assessed at baseline, 6 weeks, and 12 weeks postenrolment. Patient satisfaction was evaluated using the Orthotics and Prosthetics User's Survey (OPUS) satisfaction with device and services subscales. The analysis of the DHI scores indicated a significant enhancement in functional abilities at both 6-week and 12-week follow-ups compared to the baseline assessment. Notably, the most substantial progress at 6 weeks follow-up was observed in tasks such as buttoning a shirt, while significant improvement at the 12-week mark was noted in activities like turning a key in a lock. The median OPUS device satisfaction score was 50, corresponding to a Rasch score of 68.8. Additionally, the median OPUS satisfaction score for services stood at 46, with a Rasch score of 72.7. Patients expressed the highest satisfaction levels with the courteous demeanor of the staff, prompt scheduling of appointments, and accurate fitting of the orthosis. The study findings indicate that the modified tenodesis WHO is an effective and satisfactory therapeutic device for improving hand function in patients with tetraplegia. The findings encourage further investigation and application of the modified tenodesis WHO in clinical practice.

Cardiovascular disease history as a predictor for adverse outcomes in frail older adults admitted to acute geriatric settings: 12-month outcomes from an Australian frailty registry

Abstract Introduction Frailty is common in older adults with cardiovascular disease (CVD), with prevalence between 25-62% (1). The incidence of CVD increases with age, yet the outcomes of frail older adults with a history of CVD who present to acute geriatric settings, is not well understood. Purpose To report the association of CVD and rehospitalisation and/or mortality at 12 months in a cohort of frail older adults enrolled in an Australian frailty registry. Methods A convenience sample of participants enrolled in the frailty registry, with 12-month follow-up completed. The frailty registry is a prospective cohort study of adults admitted to the rehabilitation and aged care departments at two Australian hospitals. Frailty was assessed using the Clinical Frailty Scale (CFS), a score of 1-4 is ‘non-frail’, 5-6 is ‘mild-moderately frail’ and 7-9 is ‘severely frail’ (2). For this study, ‘CVD’ was defined as having a history of either heart failure, stroke, or atrial fibrillation. The cumulative incidence of first rehospitalisation and/or death during the first 12 months post discharge was estimated using one minus the Kaplan-Meier estimate of the survival function. Association between CVD (history of CVD, and type of CVD condition) and the composite endpoint were analysed. Adjusted Hazard Ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox models incorporating variables of interest and potential confounders. Results A total of 592 participants were included, median age was 82 years, 59% (n= 349) were female. The majority were frail with 50% (n= 295) classified as mild-moderately frail and 21% (n= 123) classified as severely frail. Almost half (45%, n= 265) had a history of CVD. The incidence of frailty (CFS score ≥5, mild-severely frail) was higher in those with CVD compared to those without CVD (76% vs 66%). A history of CVD was significantly associated with higher rate of first readmission or death within 12 months, compared to no history of CVD (p=0.017) (Figure 1). Of the three CVD conditions, heart failure was the only independent predictor of the composite endpoint (HR 1.60 [CI 1.14 -2.24], p=0.007). A CFS score of mild-moderately frail (HR 1.51 [CI 1.18 - 1.93, p=0.001) and severely frail were also independent predictors of the composite endpoint (HR 1.83 [CI 1.35- 2.48], p=&amp;lt;0.001) (Table 1). Conclusions A history of CVD has a significant impact on adverse outcomes in frail older adults admitted to acute geriatric settings. Frailty according to the CFS was independently predictive of rehospitalisation and mortality in this cohort. Heart failure was the only independent predictor of the composite endpoint. These findings underscore the importance of identifying and addressing CVD and in the context of frailty, emphasising the need for targeted interventions to improve outcomes in this vulnerable population.Figure 1.Table 1.

Assessment of Risk Factors of The Patients With Lateral Epicondylitis

Background: Lateral epicondylitis, is prevalent in the world of sports; however, this injury still causes confusion among healthcare professionals. Numerous studies have evaluated treatment options, but few have taken into consideration the extent to which tennis players, themselves, understand this ailment. Objectives: To identify the risk factors associated with lateral epicondylitis. Materials and methods: An observational case control study design was carried out among 120 patients attended at outdoor Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka from April 2018 to march 2019. Sixty (60) patients with lateral epicondylitis as case group and another 60 patients without lateral epicondylitis as control group. Data was collected using a structured interviewer- administered questionnaire, enquiring about demographic data and details of risk factors. Result: The mean age was found 39.4:6.3 years in case group and 36.97.4 years in control group. Twenty- seven (45.0%) patients had more than 2 hours of use hand in case group and 12(20.0%) in control group. More than half (53.3%) patients had moderate VAS scale in case group and 9(15.0%) in control group, Nine (15.0%) patients were found past history of recurrent injury in case group and not found in control group. The difference was statistically significant (p&lt;0.05) between two groups. Patients having use hand more than 2 hours 3.273 (95% CI 1.453% to 7.36%) times more likely to developed lateral epicondylitis. Conclusion: Use of hand with repetitive wrist extension more than 2 hours was significantly associated with lateral epicondylitis. J Dhaka Med Coll. 2023; 32(1) : 77-84

Healthcare professionals' knowledge and perceptions of post-stroke rehabilitation in the peripandemic period: an online cross-sectional survey.

The COVID-19 pandemic has profoundly affected healthcare systems, particularly post-stroke rehabilitation centers. The elevated severity of strokes and delayed hospital admissions caused numerous hurdles to rehabilitation administration during the peri-pandemic period. This study surveyed healthcare professionals' knowledge and perceptions of post-stroke rehabilitation during this period. An online cross-sectional survey was administered from September 17, 2023 to February 23, 2024, utilizing the SurveyMonkey platform. The questionnaire included 30 questions addressing participant baseline characteristics, knowledge of definitions and experiences, post-stroke rehabilitation procedures, obstacles encountered during the peri-pandemic period, and the utilization of telerehabilitation. Only complete responses from health professionals were considered. This report utilized convenience sampling. Data were analyzed via descriptive statistics and chi-square tests, with a significance threshold of p < 0.05. A total of 79 health professionals, predominantly physiatrists, neurologists, and physiotherapists, from eight countries participated in the study. Over half of the participants (64.6%) indicated the existence of a dedicated department for post-stroke rehabilitation. Significant obstacles comprised an absence of advanced rehabilitative treatments (60.8%), inadequately skilled workers (50.6%), and restricted space for rehabilitation (46.8%). Telerehabilitation was regarded as a feasible option by 45.6% of participants; nonetheless, obstacles, including patients' telecommunication proficiency and the possibility of diagnostic inaccuracies, were acknowledged. Complementary therapies, such as music and dance therapy, received favorable evaluations from 67.1% to 63.3% of respondents, respectively. The pandemic reduced rehabilitation admissions due to infection concerns (75.9%) and increased multimorbidity cases among patients (48.1%). The study underscores the pandemic's negative effect on post-stroke rehabilitation, emphasizing the necessity for multidisciplinary, customized therapy and enhanced integration of telerehabilitation to overcome access barriers. Addressing obstacles regarding infrastructure, training, and access to advanced approaches, particularly in a post-pandemic context, is essential to improving rehabilitation outcomes.

The Efficacy of Exercise-Based Rehabilitation in Treating Ulnar Wrist Pain

Background: Exercise-based rehabilitation effectively treats ulnar wrist pain, enhancing pain relief, grip strength, and mobility. Targeted exercises lead to significant pain reduction and functional recovery. Aim of the study: This study aimed to assess the efficacy of exercise-based rehabilitation in treating ulnar wrist pain. Methods: This cross-sectional study was conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2023 to December 2023. This study includes 60 patients with ulnar wrist pain who were divided into two groups: Group A (30 patients) received rehabilitation therapy, and Group B (30 patients) received no therapy. Result: The mean age was 45.2 ± 10.5 years in Group A and 43.2 ± 9.7 years in Group B (P = 0.4466). Gender distribution was balanced, as were the mean pain durations (P = 0.7200). At baseline, Group A's mean VAS score was 7.8 ± 1.2 and Group B's was 7.6 ± 1.4 (P = 0.5548). After 12 weeks, Group A's pain score decreased significantly to 2.5 ± 0.7, while Group B's remained at 6.6 ± 1.2 (P &lt; 0.0001). Group A's grip strength increased from 18.5 ± 3.5 kg to 33.0 ± 2.8 kg, compared to Group B's 20.5 ± 3.8 kg (P &lt; 0.0001). Group A also showed greater wrist ROM and PRWE score improvements. Conclusion: This study concludes that exercise-based rehabilitation significantly reduces pain, enhances grip strength, and improves wrist range of motion in patients with ulnar wrist pain.