Rehabilitation Goals Research Articles

The role of Artificial Intelligence (AI) in rehabilitation and in the reduction of the use of imprisonment

Over the past few decades, the criminal justice system has experienced a shift towards risk management (actuarial justice). The New Public Management ideology has also entered the field of criminal policy and currently there is a growing recognition of the importance of adopting an Offender Management System. This new way of managing the criminal justice is increasingly supported by Artificial Intelligence and related digital technologies. The use of these technologies has enormous potential from a rehabilitation perspective. However, the current trend is to use them mainly for security and control purposes. This analysis examines whether the goal of rehabilitation can still be accommodated in a criminal justice system with the aforementioned characteristics. Criminal policy has the responsibility to ensure that the control it imposes on citizens can be balanced by an ethical use of digital technologies, which effectively contributes to rehabilitation and to the reduction in the resort to imprisonment.

Evaluation and Rehabilitation after Adult Lumbar Spine Surgery.

Purpose: With an increase in the proportion of elderly patients, the global burden of spinal disease is on the rise. This is gradually expected to increase the number of surgical procedures all over the world in the near future. As we know, rehabilitation following spine surgery is critical for optimal recovery. However, the current literature lacks consensus regarding the appropriate post-operative rehabilitation protocol. The purpose of this review is to evaluate the optimal protocol for rehabilitation after lumbar spine surgery in adults. Materials and Methods: The goals of rehabilitation after lumbar spine surgery are to improve physical and psychosocial function and may include multiple modalities such as physical therapy, cognitive behavioral therapy, specialized instruments, and instructions to be followed during activities of daily living. In recent years, not only are a greater number of spine surgeries being performed, but various different techniques of lumbar spine surgery and spinal fusion have also emerged. (1) Our review summarizes post-operative rehabilitation under the following headings-1. Historical aspects, 2. Subjective functional outcomes, and (3) Actual rehabilitation measures, including balance. Results: Physical therapy programs need to be patient-specific and surgery-specific, such that they consider patient-reported outcome measures and take into consideration the technique of spinal fusion used and the muscle groups involved in these surgeries. By doing so, it is possible to assess the level of functional impairment and then specifically target the strengthening of those muscle groups affected by surgery whilst also improving impaired balance and allowing a return to daily activities. Conclusions: Rehabilitation is a multi-faceted journey to restore mobility, function, and quality of life. The current rehabilitation practice focuses on muscle strengthening, but the importance of spinal balance is less elaborated. We thus equally emphasize muscle strengthening and balance improvement post-lumbar spine surgery.

The power of compassion: a judicial reflection on wellbeing and the court

This article explores the stress, vicarious trauma, and burnout experienced by judicial officers and their need for protective skills. Compassion is one skill that can be incredibly beneficial. Compassion involves recognising a person’s suffering, and ‘turning towards’ the sufferer. This has been said to be ‘neurologically rejuvenating’. In contrast, empathy alone can lead to distress and generate burnout. There are three pillars of compassionate practice: (1) procedural fairness; (2) judicial engagement; and (3) other therapeutic jurisprudence approaches and court programs. The authors, both experienced judicial officers, have experienced how compassionate practice can inspire offenders to achieve rehabilitation goals. These practices can also be implemented in traditional court lists by judicial officers acknowledging the possibility of suffering of court users and empowering them by judicial engagement and granting them agency. A compassionate approach to justice can improve judicial effectiveness, health, and the fostering of a healthy work environment.

Improving walking via real-time visual feedback after stroke in treadmill training (RE-VISIT): a protocol for randomized controlled trial

BACKGROUND: After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve these goals. Adding dimensions to the visual feedback in addition to the mirror for real-time frontal view is proven to enhance the gait. It is, therefore, important to design additional real-time visual feedback in treadmill training, in particular for the sagittal view involved side. OBJECTIVE: The objective of this study is to test if the real-time sagittal visual feedback during treadmill training is superior to the conventional mirror feedback treadmill training program of equivalent intensity in improving walking speed and balance after stroke. METHODS/DESIGN: The RE-VISIT trial (Real-time Visual feedback after Stroke in Treadmill training) is registered in the Clinical Trial Registry of India (CTRI/2023/10/058299). In this two-arm randomized control trial, which will be a single-blinded study, 42 eligible stroke survivors undergoing rehabilitation will be randomly allocated (1:1 ratio) to either real-time visual sagittal feedback along with front mirror (experimental) group or only front mirror treadmill training (control) group, all the participants will receive 15 sessions of treadmill training for up to 15 min at a safe self-selected speed over 5-6 weeks. The RE-VISIT (experimental) group will receive real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and will be asked to modify their gait pattern. The control group will receive treadmill walking training only with the routine front mirror view feedback. Clinical and gait assessments will be conducted at the baseline, immediately following the final session of training, and at the 9th week during follow-up. The outcome measures of interest are walking speed (primary) and balance (secondary), which will be measured prior to baseline, post 15 sessions of training, and at the 9th week following training. DISCUSSION: This REVISIT trial will provide insight and contribute to the existing innovation and modifications of incorporating real-time visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help the better designing of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed, and balance for those who have greater difficulties in community ambulation. We anticipate that those in the REVISIT training will demonstrate improved walking ability.

Recent research on home rehabilitation and nursing for spinal muscular atrophy

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder. With the emergence of disease-modifying therapies, the prognosis of SMA has significantly improved, drawing increased attention to the importance of home rehabilitation and nursing management. Long-term, standardized home rehabilitation and nursing can delay the progression of SMA, enhance the psychological well-being, and improve the quality of life of both patients and caregivers. This article provides an overview of the goals of home rehabilitation, basic functional training methods, respiratory management, and nutritional management for SMA patients, as well as psychological health issues, emphasizing the significance of obtaining appropriate home rehabilitation and support during the care process.

Long-term outcomes after rehabilitation in Medicare Advantage and fee-for-service beneficiaries.

Financial incentives in capitated Medicare Advantage (MA) plans may lead to inadequate rehabilitation. We therefore investigated if MA enrollees had worse long-term physical performance and functional outcomes after rehabilitation. We conducted a retrospective cohort study of Medicare beneficiaries in the nationally representative National Health and Aging Trends Study. We compared MA and fee-for-service (FFS) beneficiaries reporting rehabilitation between 2014 and 2017 by change in (1) Short Physical Performance Battery (SPPB) and (2) NHATS-derived Functional Independence Measure (FIM) from the previous year, using t-tests incorporating inverse-probability weighting and complex survey design. Secondary outcomes were self-reported: (1) improved function during rehabilitation, (2) worse function since rehabilitation ended, (3) meeting rehabilitation goals, and (4) meeting insurance limits. Among 738 MA and 1488 FFS participants, weighted mean age was 76 years (SD 7.0), 59% were female, and 9% had probable dementia. MA beneficiaries were more likely to be Black (9% vs. 6%) or Hispanic/other race (15% vs. 10%), be on Medicaid (14% vs. 10%), have lower income (median $35,000 vs. $48,000), and receive <1 month of rehabilitation (30% vs. 23%). MA beneficiaries had a similar decline in SPPB (-0.46 [SD 1.8] vs. -0.21 [SD 2.7], p-value 0.069) and adapted FIM (-1.05 [SD 3.7] vs. -1.13 [SD 5.45], p-value 0.764) compared to FFS. MA beneficiaries were less likely to report improved function during rehabilitation (61% [95% CI 56-67] vs. 70% [95% CI 67-74], p-value 0.006). Other outcomes and analyses restricted to inpatient rehabilitation participants were non-significant. MA enrollment was associated with lower likelihood of self-reported functional improvement during rehabilitation but no clinically or statistically significant differences in annual changes of physical performance or function. As MA expands, future studies must monitor implications on rehabilitation coverage and older adults' independence.

Morphometric and DNA sexing accurately in male Javan hawk-eagle (Nisaetus bartelsi) determination at Kamojang Eagle Conservation Center, West Java, Indonesia

Abstract. Withaningsih S, Ilham MF, Rosdianto AM. 2024. Morphometric and DNA sexing accurately in male Javan hawk-eagle (Nisaetus bartelsi) determination at Kamojang Eagle Conservation Center, West Java, Indonesia. Biodiversitas 25: 1167-1173. The Javan hawk-eagle (Nisaetus bartelsi) is a protected and endemic species of eagle in Indonesia whose existence is symbolized by the Garuda Pancasila. Raptors act at the top of the predatory chain and as indicators of environmental health. IUCN data states that N. bartelsi is red-listed as endangered. It is one of Indonesia's most frequently hunted and traded birds, and this trading practice has changed its natural behavior. Therefore, preservation through conservation –one of which is rehabilitation– programs are needed to maintain their sustainability. The ultimate goal of rehabilitation is to release the Javan hawk-eagle back into its natural habitat. In conservation and breeding programs, accurate determination of the sex of raptors is integral to informing conservation decision-making, population management, and research efforts aimed at protecting these iconic birds of prey and their habitats. Therefore, this study aims to determine the sex of male N. bartelsi through morphometric and DNA sexing techniques. The research subjects were seven N. bartelsi rehabilitated at Kamojang Eagle Conservation Center, Garut, Indonesia. Morphometric sexing measurements obtained the following results: two males were consistent upon comparing DNA sexing and Kamonjang Eagle Conservation Centre records observations. Analyses were obtained using primer 2550F/2718R that recognized CHD1-Z and CHD1-W as cleaved. Furthermore, the amplification was successfully read a sexing of N. bartelsi at Kamonjang Eagle Conservation Centre. The analysis primer sets mainly for raptors can assist conservation programs such as breeding programs and data collection for mapping this raptor. In addition, the PCR method can also assist in the accurate management of in-situ and ex-situ conservation.

Rehabilitative goals for patients undergoing lung retransplantation.

Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes.

Mental health professionals are tasked with making difficult clinical decisions in treatment settings. In the forensic system, decision making regarding staff supervised community outings (SSCOs) provides a significant challenge due to the need to balance patient liberties, mental health recovery, and public safety. This study explored the characteristics and rehabilitative nature of SSCOs, characteristics of patients attending SSCOs, and any adverse events that occurred during the outings. Employing a cross-sectional design, 110 patients who participated in SSCOs over a one-year period from a Canadian Forensic Psychiatric Hospital were included. Clinical records were reviewed to capture patient and SSCO variables. Descriptive analyses were used to calculate participant, risk, SSCO, and adverse event characteristics. Qualitative analysis was used to explore the purpose of SSCOs and rehabilitative progress that occurred during the outings. Patients attending SSCOs were comprised of long-stay patients with over half having committed a violent index offence. Almost 75% of patients had a moderate/high risk for violence and 50% of the patients had a moderate/high risk of absconding. During the study period, 463 SSCOs were completed. Most outings focused on developing skills for daily living and staff comments suggested many patients developed skills in these areas. Despite considerable risk profiles and public concern regarding forensic patients having community access, there was a single occurrence of unauthorized leave and no instances of violence or substance use. This research can disrupt stigma, demonstrating that SSCOs support a specific rehabilitative intent, promote community reintegration, and maintain public safety.

Factors associated with the Single Leg Squat test in female soccer players: a cross-sectional study

BackgroundThe Single Leg Squat (SLS) test is widely used in the clinical setting to examine and evaluate rehabilitation goals. It is simple to perform and is proposed to have biomechanical and neuromuscular similarities to athletic movements. The aim of the present study was to investigate whether demographics, previous injuries, and biomechanical and psychosocial factors are associated with the outcome of the SLS, assessed as a total score for all segments and as a separate knee segment in elite and sub-elite female soccer players.MethodsWe conducted a cross-sectional study involving 254 female soccer players (22 yrs; SD ± 4, height 1.69 m; SD ± 0.1, weight 64 kg; SD ± 6) from divisions 1–3 of the Swedish Soccer League. During the preseason, we assessed the participants using the SLS and tested their hip strength and ankle mobility. Demographics, previous injury, sleep quality, fear of movement, anxiety, and perceived stress were assessed with questionnaires. Logistic regression models were built to analyse the association between the outcome of the SLS and the independent variables for the dominant and non-dominant leg.ResultsSignificantly more participants failed the SLS on the dominant leg compared with the non-dominant leg (p < 0.001). The outcome of the SLS associated with various biopsychosocial factors depending on if the dominant or non-dominant leg was tested. The total score associated with hip strength for the dominant (OR 0.99, 95% CI 0.98–0.99, p = 0.04) and the non-dominant leg (OR 0.99, 95% CI 0.97–0.99, p = 0.03). The knee segment associated with division level for the dominant (div 2; OR 2.34, 95% CI 1.01–5.12, p = 0.033. div 3; OR 3.07, 95% CI 1.61–5.85, p = 0.001) and non-dominant leg (div 2; OR 3.30, 95% CI 1.33-8.00, p = 0.01. div 3; OR 3.05, 95% CI 1.44–6.43, p = 0.003).ConclusionsThis study identified that leg dominance, division level, hip strength, and psychosocial factors were associated with the outcome of the SLS when assessed as a total score and as a separate knee segment. This indicates that clinicians need to understand that movement control is associated with factors from several domains. Whether these factors and, the results of the SLS are related to injury need to be studied prospectively.Trial registrationClinical Trials Gov, date of registration 2022-03-01. Clinical trials identifier: NCT05289284A.

Setting restorative goals with a regional outlook: Mine-rehabilitation outcomes influence landscape connectivity

Mining is increasing worldwide and is typically associated with highly negative environmental impacts, such as habitat loss and fragmentation. To counteract these effects and improve restoration practices, decisions, such as setting mine rehabilitation goals, could incorporate the assessment and restoration of landscape connectivity into their regional and local-scale planning. The overarching goal of this work was to assess landscape connectivity for flora and fauna and explore mine-rehabilitation scenarios that can be used as a tool for prioritising biodiversity outcomes. Our study area comprised the Fitzroy Basin (Queensland, Australia), where the disturbance footprints from mining cover a cumulative area of 121,239 ha. We considered two scenarios: rehabilitation to agriculture and restoration to native ecosystems. To compare these scenarios, we created differential maps, which highlighted that restoring to native ecosystems represented connectivity gains over agricultural rehabilitation goals. These maps revealed three ways to prioritise rehabilitation outcomes, giving priority to mines that: 1) presented medium to high connectivity values, 2) covered a large area of influence (contributing to connectivity on a larger scale, regardless of current flow values), and 3) showed a gain of important paths/corridors. We explored four case studies and found that three benefited from restoration outcomes, while the fourth did not benefit by either scenario. Our methods can be used for decision-making in restoration ecology and conservation, including mine rehabilitation priorities and goals, as well as for evaluating connectivity gains or losses.

Clinical utility of MODAPTS during work assessment: Perceptions of South African occupational therapists

Introduction:&#x0D; Clinical utility is an important attribute in selecting an assessment tool. The study aimed to determine the perceptions of South African occupational therapists of the clinical utility of Modular Arrangement of Predetermined Time Standards (MODAPTS) work samples when assessing a client’s work ability. The research objectives were to determine whether MODAPTS is perceived to be credible, practical, useful, and easy to use.&#x0D; Methodology: A quantitative, cross-sectional, descriptive research design was used. Non-probability sampling with elements of voluntary response- and snowball sampling was used to recruit respondents. An electronic questionnaire was developed using Qualtrics, which was distributed electronically via the Occupational Therapy Association of South Africa, WhatsApp and Telegram.&#x0D; Results: Data were based on 52 completed questionnaires, analysed through descriptive statistics. MODAPTS was perceived as practical, useful, credible, and asy to use in practice. Main barriers to the use of MODAPTS included the timeliness of developing work samples, lack of MODAPTS training, and having other more useful and reliable assessment tools. Experienced occupational therapists used MODAPTS more often than inexperienced occupational therapists.&#x0D; Conclusion: Clinical utility of work samples developed using MODAPTS has been confirmed. This supports the use of work samples developed using MODAPTS as part of work assessments as a cost-effective, practical tool.&#x0D; Implications for Practice:&#x0D; •Development of contextually relevant work samples.&#x0D; •Use of MODAPTS work samples as an outcome measure during intervention.&#x0D; •Application during rehabilitation goal setting •Cost effective application of MODAPTS work samples in a variety of settings

Prognosticating Prosthetic Ambulation Ability in People With Lower Limb Amputation in Early Post-operative Phase

ObjectiveTo formulate a prognostication model in the early post-operation phase of lower limb amputation to predict patient's ability to ambulate with a prosthesis post rehabilitation. DesignRetrospective cohort study, using data collected from electronic medical records. Predictive factors and prosthetic ambulation outcomes post rehabilitation were used to develop prognostic models via machine learning techniques. SettingRegional hospital's ambulatory rehabilitation clinic. ParticipantsPatients with major lower limb amputation (N=329). InterventionsNot applicable. Main Outcome MeasuresThe outcome of prosthetic ambulation ability post rehabilitation collected was categorized in 3 groups: non-ambulant with prosthesis, homebound ambulant with prosthesis (AP), and community AP. ResultsIn a 2-class model of non-ambulant and AP (homebound and community), the model with highest accuracy of prediction included ethnicity, total Functional Comorbidity Index (FCI), level of amputation, being community ambulant prior to amputation, and age. The f1-score and area under receiver operator curve (AUROC) of the model is 0.78 and 0.82. In a 3-class model consisting of all 3 groups of outcomes, the model with highest accuracy of prediction required 10 factors. The additional factors from the 2-class model include presence of caregiver, history of congestive heart failure, diabetes, visual impairment, and stroke. The 3-class model has a moderate accuracy with a f1-score and AUROC of 0.60 and 0.79. ConclusionThe 2-class prognostication model has a high accuracy which can be used early post-amputation to predict if patient would be ambulant with a prosthesis post rehabilitation. The 3-class prognostication model has moderate accuracy and is able to further differentiate the walking ability to either homebound or community ambulation with a prosthesis, which can assist in prosthetic prescription and setting realistic rehabilitation goals.

Philosophies in Community Supervision of Gang-Involved Youth and Adults

The wide expansion of community supervision has resulted in large-scale reliance on probation officers to facilitate change among both youth and adults. This is especially true for supervising high-risk populations, such as gang-involved individuals. To understand how probation officers balance the dual goals of public safety and rehabilitation, in-depth interviews with 12 youth and adult officers in Oregon were conducted. Results revealed that both groups had a shared understanding of gang pathways and desistance barriers. However, they held differing views on the factors that drive success and compliance. Youth officers utilize therapeutic philosophies and emphasize restoration through community resources to help youth desist from gang activity. Adult officers endorse law enforcement philosophies, emphasize accountability and personal choices, and center punitive strategies when using interagency collaboration. This study contributes to the literature on role perceptions and decision-making, and suggests that continuity of care in supervision philosophies can yield more successful outcomes for high-risk youth and adults.

Khmer translation and cultural adaptation of the Locomotor Capabilities Index-5.

Mobility is a major goal of prosthetic and orthotic rehabilitation, and use of outcome measures to evaluate mobility is necessary for good clinical practice. To support the use of outcome measures worldwide, work is needed to translate relevant instruments and adapt them for use in multiple cultures. The objective of this research was to use a standardized method to translate the Locomotor Capabilities Index-5 (LCI-5) into Khmer, the national language in Cambodia, and to evaluate its cultural integrity by assessing it with a group of prosthesis and orthosis users. Instrument translation and cultural validation. Two forward translations of the LCI-5 were produced and then reconciled into a single document. The Khmer version was back translated into English, and a group of experts reviewed the back translation. Two rounds of cognitive interviews were conducted with lower-limb prosthetic and orthotic users who provided feedback. During the reconciliation process, minor changes were made to 6 of the 14 items. Changes were most often made to better reflect the conceptual meaning of the original English version. Cognitive interviews resulted in the addition of a new response alternative. Use of a standardized method to translate the LCI-5 resulted in a linguistically and culturally valid Khmer version of the instrument. Following appropriate psychometric testing, this instrument will facilitate measurement of mobility in prosthetic and orthotic clinical practice in Cambodia as well as support national and multinational research.

Peculiarities of the application of physical culture and sports rehabilitation of adolescents aged 12-15 years with Down syndrome in rehabilitation centers for persons with disabilities

In the article, based on the study of scientific literature, an analysis of the peculiarities of physical culture and sports rehabilitation of adolescents aged 12-15 years with Down syndrome in rehabilitation centers for persons with disabilities was carried out. In the course of the obtained data, the problem of the use of physical culture and sports rehabilitation of adolescents aged 12-15 years with Down syndrome in rehabilitation centers for persons with disabilities was identified and considered. It is indicated that physical culture and sports rehabilitation of adolescents aged 12-15 years with Down syndrome is aimed at restoring their cognitive functions, aerobic capacity, development of balance, muscle strength and functional abilities of the body. Among the main goals of physical culture and sports rehabilitation of teenagers with Down syndrome, scientists include: increasing muscle strength; increase in muscle endurance; increasing the stability of the joints in case of hypermobility of the joints; teaching the control mechanisms of postural stability, balance, coordination and controlled abilities; correction of posture and correct body position. The peculiarities of the use of means and methods of physical culture and sports rehabilitation of adolescents aged 12-15 years with Down syndrome in rehabilitation centers for persons with disabilities were analyzed. It is indicated that the means of physical culture and sports rehabilitation in the process of recovery of teenagers with Down's syndrome should ensure improvement of existing and development of new skills of motor functions; development of alternative dynamics in case of impaired motor functions; motivation to improve health. The advantages of using physical culture and sports rehabilitation in the process of restoring the health of adolescents aged 12-15 with Down syndrome in rehabilitation centers for persons with disabilities have been revealed.

Supporting work participation for adults with hand and upper limb conditions: A survey of the British Association of hand therapists.

Musculoskeletal disorders affect over a third of the UK adult population and are a common reason for sick leave from work. The aims of this study were to describe the reported provision of work participation support for adults with hand and upper limb conditions by UK hand therapists, and to identify potential training needs in this area. A previous survey of the Australian Hand Therapy Association was adapted for the UK. The electronic questionnaire was distributed to members of the British Association of Hand Therapists. Eligible individuals were UK-based occupational therapists or physiotherapists whose role included the assessment and/or treatment of patients ≥18 years with hand or upper limb issues. There were 123 participants (17% response rate). The most frequently reported work participation interventions were discussing graded return to work and sign-posting patients to speak with their doctor. The Allied Health Professionals Health and Work Report and Fit Note were not regularly used, and respondents reported low levels of confidence in issuing these documents. Barriers to providing work recommendations included a perceived lack of time, skills, knowledge and training. Facilitators included the patient discussing work as a rehabilitation goal. Development opportunities for UK hand therapists include increasing patient awareness that they can ask for work-related advice and documentation, promoting existing health and work training, developing hand therapy-specific resources, and ensuring access to electronic Fit Notes. International opportunities include the continuation of this survey with a focus on generating exemplar work participation strategies to inform further research.

Neurorehabilitation across the Continuum: From the Neurocritical care unit to home

Children admitted to neurocritical care units often experience new neurodevelopmental disabilities due to both their acquired neurologic injuries and deconditioning from prolonged hospitalizations. Rehabilitation for critically ill children is multifactorial and begins in the intensive care unit itself. The goals of rehabilitation include prevention of complications associated with immobilization and evolving tone, comprehensive evaluation and treatment of functional deficits, and implementation of adaptive strategies with the goal of maximizing recovery. As a child progresses along the medical continuum from the neurocritical care unit to acute care to post-hospitalization settings, their rehabilitative needs and interventions should also evolve.A child in the neurocritical care unit is likely to have sustained an acquired brain injury. Whether resulting from traumatic or non-traumatic causes, all etiologies of pediatric acquired brain injury can result in significant challenges for the child and their family. Post-intensive care syndrome-pediatrics is a clinical construct that that systematically organizes the range of physical, cognitive, psychological, and social symptoms that emerge in both a child and their family members following a critical illness. Ideally, outpatient care for this population evaluates and supports all areas of post-intensive care syndrome-pediatrics through an interdisciplinary clinical care model. Proactive and comprehensive rehabilitation across the continuum provides the opportunity to support the child and their family in all areas affected, thereby minimizing distress, maximizing function, and optimizing outcomes.

The Levels and Associated Factors for Participation and Autonomy Among People with Parkinson´s Disease: A Cross-Sectional Study.

Promoting participation and autonomy (PA) in society has been highlighted as an ultimate goal of rehabilitation for people with chronic diseases by the World Health Organization, but few studies have focused on PA in people with Parkinson's disease (PD). Therefore, this study aimed to determine the level of PA in PD patients and investigate the associated psychological and behavioural factors. PD patients were recruited from the Department of Neurology of the First Hospital Affiliated with Dalian Medical University using convenience sampling for this cross-sectional study. A questionnaire covering social-demographic and disease-related characteristics, Chinese version of Impact on Participation and Autonomy (IPA) Questionnaire, Connor-Davidson Resilience Scale (CD-RISC), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Medical Coping Modes Questionnaire (MCMQ), Social Support Rating Scale (SSRS), Hoehn-Yahr Staging System and Unified Parkinson's Disease Rating Scale (UPDRS) were used for investigation. A multivariate stepwise linear regression analysis was used to determine the factors that influence IPA. A total of 326 PD patients responded to all the questionnaires. The patients had a mean IPA score of 46.6 (SD 21.79). Multiple linear regression analyses revealed that UPDRS II (β = 0.35, p < 0.001) had the strongest correlation with IPA, followed by tenacity, which was the second strongest factor (β = -0.25, p < 0.001). Hoehn-Yahr stage (β = 0.19, p < 0.001) and availability of social support (β =-0.12, p =0.001) were also strong factors. The average level of PA among PD patients was at the lower middle-level. Among PD patients, physical function, psychological resilience and social support were the strongest factors associated with PA. These findings provide valuable insights into PD patients' PA and can help medical professionals identify the early risks of restricted PA among PD patients, implement interventions to promote PA and ultimately achieve rehabilitation.

Assessment of functional outcomes, level of fatigue, and risk of sarcopenia in COVID-19 patients at discharge: A cross sectional study

Background: There is emerging evidence with regards to reduced physical performance in patients recovering from COVID- 19 at time of hospital discharge. Assessing various functional parameters at discharge would shed light on the multi-system affection that could be helpful in formulating rehabilitation goals for the patient. Objectives of the study were to assess the physical performance, functional capacity, muscular strength, level of fatigue, and risk of sarcopenia in COVID-19 patients at discharge using short physical performance battery test, 1 minute sit to stand test, grip strength, fatigue assessment scale, SARC-CalF Scale respectively. Methods: This cross-sectional study comprised of 42 patients diagnosed with COVID-19 recruited from a tertiary care hospital. Demographic details and clinical variables were documented. Participants were assessed for physical performance, muscular strength, level of fatigue, functional capacity, and risk of sarcopenia. Data was analyzed using SPSS version 24. Results: The study comprised of 42 participants including 71.43% males (N=30) and 28.57% females (N=12) having mean age of 49.86±15.83 years. Findings of the assessed parameters were as follows: SPPB=7.57±2.84, 1 MSST=13.17±5.79 repetitions, grip strength=19.44±8.38 kg, FAS=19.79±10.83, SARC-CalF score=5.19±4.83. There was a weak positive correlation found between CT severity score and level of fatigue (r=0.325, p=0.036). Conclusions: This study provides a descriptive information about the functional outcomes of COVID -19 patients at discharge which can further be utilized for development of a tailor-made exercise program.