Rehabilitation Of Individuals Research Articles

Effect of telerehabilitation-based core-stability exercise on pain-related disability, pain self-efficacy, and psychological factors in individuals with non-specific chronic low back pain: a randomized controlled study

BackgroundCore-stability exercise is an exercise modality used in the management of patients with low back pain (LBP). Telerehabilitation is a new treatment approach that is gaining traction as an alternative rehabilitation approach. This study determined the effect of telerehabilitation-based core stability exercise (TCSE) and clinical-based core stability exercise (CCSE) on pain-related disability, pain self-efficacy, and psychological factors in patients with non-specific chronic low back pain (CLBP).Materials and methodsFifty participants (24 males and 26 females) with a mean age of 40.28 years participated in this randomized controlled study and were recruited from the out-patients physiotherapy clinic of 2 tertiary hospitals in Lagos State and were allocated into two groups (telerehabilitation-based core stability exercise group and clinical-based core stability exercise group which serves as the control) using computer-generated random number sequence. Pain-related disability, pain self-efficacy, and psychological status were assessed at baseline, and at the completion of the 4th and 8th week. Patients received supervised intervention protocols twice weekly for 8 consecutive weeks. Independent t-test, Mann–Whitney U test, and Friedman test were used in analyzing the data at an alpha level of 5%.ResultsThere was a statistically significant difference (P = 0.0001) noted within each group (telerehabilitation-based core stability exercise group and clinical-based core stability exercise group) in all the outcome measures assessed (Pain Disability Index, Pain Self-efficacy Questionnaire and Depression-Anxiety-Stress scale) but no group was superior to one another when compared.ConclusionTelerehabilitation-based core stability exercise was as efficacious as clinical-based core stability exercise in decreasing pain-related disability, improving pain self-efficacy and psychological factors, and should be incorporated as part of the treatment program in musculoskeletal rehabilitation for individuals with non-specific CLBP.Trial registrationPACTR202208607830603, 16th August 2022—retrospectively registered, https://pactr.samrc.ac.za/

Effect of telerehabilitation-based core-stability exercise on pain-related disability, pain self-efficacy, and psychological factors in individuals with non-specific chronic low back pain: a randomized controlled study

BackgroundCore-stability exercise is an exercise modality used in the management of patients with low back pain (LBP). Telerehabilitation is a new treatment approach that is gaining traction as an alternative rehabilitation approach. This study determined the effect of telerehabilitation-based core stability exercise (TCSE) and clinical-based core stability exercise (CCSE) on pain-related disability, pain self-efficacy, and psychological factors in patients with non-specific chronic low back pain (CLBP).Materials and methodsFifty participants (24 males and 26 females) with a mean age of 40.28 years participated in this randomized controlled study and were recruited from the out-patients physiotherapy clinic of 2 tertiary hospitals in Lagos State and were allocated into two groups (telerehabilitation-based core stability exercise group and clinical-based core stability exercise group which serves as the control) using computer-generated random number sequence. Pain-related disability, pain self-efficacy, and psychological status were assessed at baseline, and at the completion of the 4th and 8th week. Patients received supervised intervention protocols twice weekly for 8 consecutive weeks. Independent t-test, Mann–Whitney U test, and Friedman test were used in analyzing the data at an alpha level of 5%.ResultsThere was a statistically significant difference (P = 0.0001) noted within each group (telerehabilitation-based core stability exercise group and clinical-based core stability exercise group) in all the outcome measures assessed (Pain Disability Index, Pain Self-efficacy Questionnaire and Depression-Anxiety-Stress scale) but no group was superior to one another when compared.ConclusionTelerehabilitation-based core stability exercise was as efficacious as clinical-based core stability exercise in decreasing pain-related disability, improving pain self-efficacy and psychological factors, and should be incorporated as part of the treatment program in musculoskeletal rehabilitation for individuals with non-specific CLBP.Trial registrationPACTR202208607830603, 16th August 2022—retrospectively registered, https://pactr.samrc.ac.za/

Enhancing Awareness and Management of Carpal Tunnel Syndrome Among Medical Professionals and Athletes

Introduction and objective: The objective of this research is to enhance the awareness of carpal tunnel among medical professionals and individuals engaged in sports. The acquired knowledge will enable medical professionals to more effectively identify, treat, and prevent issues related to carpal tunnel. Additionally, individuals engaged in sports will be able to prevent the occurrence of carpal tunnel syndrome in themselves or their pupils, thereby allowing them to engage in long-term and safe physical activity. Review methods: Review and summary of research studies available in open-source format on Google Scholar, PubMed. Abbreviated description of the state of knowledge: Carpal tunnel syndrome is a disease belonging to the group of compression neuropathies. The symptoms of carpal tunnel syndrome typically manifest as an uncomfortable sensation in the thumb, index finger, and half of the ring finger. Such symptoms may include numbness and tingling. In some cases, weakness of the hand muscles may occur, and in rarer instances, atrophy of the hand muscles. The condition of carpal tunnel syndrome is primarily the result of repetitive movements of the fingers and wrist. Such activities include typing, using a mouse, riding a bicycle, or playing a musical instrument. Summary: Carpal tunnel syndrome is a prevalent condition among the general population. This condition may affect individuals who engage in regular physical activity, resulting in diminished efficiency and a notable reduction in the quality of life. The objective of this study is to examine the risk factors, symptoms, and diagnostic methods associated with carpal tunnel syndrome. In the context of sports, we will examine the mechanisms of disease development in athletes and focus on prevention. This encompasses the rehabilitation of individuals at risk of developing the disease and patient education, which will facilitate the minimisation of the appearance or recurrence of disease symptoms.

Three-dimensional exergaming conjunction with vestibular rehabilitation in individuals with Benign Paroxysmal Positional Vertigo: A feasibility randomized controlled study.

To examine the effectiveness of 3D (dimensional)-vestibular rehabilitation therapy (VRT) on gait, balance problems, processing time speed and subjective complaints in patients with Benign Paroxysmal Positional Vertigo (BPPV) compared to a control group (CG). This study aimed to test the feasibility of virtual reality-based 3D exergaming conjunction with vestibular rehabilitation. Twenty-two patients with BPPV (negative DixHallpike/Roll test results, existing dizziness/balance complaints) were randomly allocated to the study group (SG, n:11 3D-VRT) or Control group (CG n:11, no exercise-rehabilitation) for 8 week. The SG performed 3D-VRT for 45 to 50 min/d, 3 times/wk, and the CG did receive only Canalith Repositioning Maneuver (CRM). CRM was applied in both groups before the study. Outcome measures included 10-Meter-Walk-Test (10-MWT) (with/without head turns), Dynamic Gait Index (DGI), Choice-Stepping-Reaction-Time-ped (CSRT-MAT), Fullerton Advanced Balance Scale (FAB), and Visual Analog Scale (VAS). The SG showed significantly improvement in 10-MWT without (p5 = 0.00,η2 = 0.49), with horizontal (p5 = 0.00,η2 = 0.57),vertical (p5 = 0.01,η2 = 0.48) head turns, DGI (p5 = 0.00,η2 = 0.74), CSRT-MAT, FAB (p5 = 0.00,η2 = 0.78) and VAS-dizziness (p5 = 0.00,η2 = 0.65), VAS-balance problem (p5 = 0.00,η2 = 0.43), VAS-fear of falling (p5 = 0.00,η2 = 0.42) compared to the CG. The 3D-VRT were effective in improving gait, balance, processing speed and resolving the subjective complaints in BPPV. The 3D-VRT method is feasible for patients who suffer from residual dizziness or balance complaints after CRM. Furthermore, the 3D-VRT is more accessible and less expensive than other virtual reality applications, which may facilitate further research or clinical use.

Craniofacial and Airway Morphology in Down Syndrome: A Cone Beam Computed Tomography Case Series Evaluation.

Background: Down syndrome (DS) is a genetic condition characterized by an extra copy of chromosome 21, resulting in various physical and cognitive features. This study aimed to comprehensively analyze the dental and craniofacial morphology of individuals with DS using Cone Beam Computed Tomography (CBCT). Methods: Six individuals with DS, comprising five males and one female aged 17 to 35 years, underwent CBCT scanning. Radiographic assessments included dentition, occlusion, paranasal sinuses, airway, skull bones, and suture calcification. Linear and angular cephalometric measurements were performed, and airway analysis was conducted using Dolphin 3D imaging software v.11. Results: The study revealed prognathic maxilla in five patients, prognathic mandible in four, and bimaxillary protrusion in two. Dental findings included microdontia, enamel hypoplasia, and congenitally missing teeth, with maxillary and mandibular third molars most commonly absent. Sinus abnormalities, delayed suture closure, and cervical spine anomalies were also observed. Conclusion: These findings contribute to a deeper understanding of DS-related craniofacial characteristics and emphasize the importance of considering these morphometric features in clinical management strategies for individuals with DS. This study's limited sample size underscores the significance of radiographic assessment in planning interventions such as cosmetic reconstructions, prosthetic rehabilitation, or orthodontic treatment for individuals with DS.

Development and Evaluation of a mHealth app - (ReMiT-MS app) for Rehabilitation of Individuals with Relapsing-remitting Multiple Sclerosis - A Mixed Methods, Pragmatic Randomized Controlled Trial - Study Protocol

Development and Evaluation of a mHealth app - (ReMiT-MS app) for Rehabilitation of Individuals with Relapsing-remitting Multiple Sclerosis - A Mixed Methods, Pragmatic Randomized Controlled Trial - Study Protocol

Provision of Inpatient Rehabilitation to Individuals with Lower-Limb Amputation in Canada: An Epidemiological Analysis

ABSTRACT Objective The aim of this study was to determine the proportion of individuals with major lower-limb amputation (LLA) who received inpatient rehabilitation in Canadian provinces, their rehabilitation length, and their functional independence level at admission and discharge. Methods Major LLA records from April 1, 2006, to March 31, 2012, were obtained from the Canadian Institute for Health Information and linked to National Rehabilitation Reporting System data (Quebec data were unavailable). The proportions of individuals who received inpatient rehabilitation, mean length of stay, and Functional Independence Measure (FIM) scores (admission and discharge) were calculated. Results A total of 16,114 new individuals had major LLAs in nine Canadian provinces over the study period; 18% received inpatient rehabilitation. The mean (SD) length of stay was 37.3 (25.2) days. Nova Scotia and Ontario had the highest provision of inpatient rehabilitation (n = 235, 28.6% and n = 1779, 23.4%, respectively). Newfoundland and Labrador had the longest mean (SD) inpatient rehabilitation stay, 62.6 (36.6) days. Prince Edward Island had the highest FIM scores at admission and discharge (mean = 105.3, SD = 12.8; mean = 111.3, SD = 12.9 days, respectively). Conclusions We found that 18% of individuals with major LLA received inpatient rehabilitation across nine Canadian provinces. Costs and resource demands may prevent inpatient rehabilitation provision. Novel, cost-effective strategies may facilitate the provision of rehabilitation services. Clinical Relevance Despite the benefits of rehabilitation for individuals with major LLA, especially those whose amputations resulted from a traumatic incident, only 18% of patients with major LLA received inpatient rehabilitation across nine provinces between 2006 and 2012. Provinces with longer durations of inpatient rehabilitation reported higher levels of functional independence when patients with LLA were discharged.

Art-methods in psychosocial rehabilitation: resources and opportunities

The article highlights the prerequisites, methods and means of creating a psychotechnology for the rehabilitation of certain segments of the population with its full social content and personal effectiveness, in which reflective thinking, existential freedom, professional competence and humane orientation of the specialist’s personality are important. The purpose of the study is to highlight the heuristic resource potential of the art therapeutic method and its corresponding work techniques in the implementation of psychosocial rehabilitation of individuals aimed at restoring their psycho-spiritual capabilities and social and role functions. The object of study is psychosocial rehabilitation in the complementarity of methods, tools, techniques and procedures for effective psychological work of a socio-humanitarian specialist with a traumatized client and methods, tools, techniques and acts of correct social influence on his or her personality for psychological and functional recovery as a citizen. The subject of the study is the rehabilitation technology of art therapy, gradually implemented and funded, enriched with psycho-spiritual resources and social capabilities of both participants, joint activity – a psychologist or social worker and the personality of a client who has suffered a certain hellish loss, is in a psycho-traumatic state and needs existential and purely human help for psychosocial recovery and personal recovery. In particular, psychosocial rehabilitation is interpreted as a complex multi-stream process aimed at restoring or improving the social functioning and mental health of persons with mental disorders, psychological trauma, or in difficult life situations. It is noted that the expediency of using the art therapy method as a form of psychological rehabilitation, which practices art as a means of expressing emotions, self-knowledge and improving mental health, is emphasized. Art therapy involves the use of various types of artistic creativity, namely drawing, painting, modeling, collage, photography and other artistic forms to help people express their inner feelings, accentuated psycho-mental states and poorly regulated mental tendencies.

Art-methods in psychosocial rehabilitation: resources and opportunities

The article highlights the prerequisites, methods and means of creating a psychotechnology for the rehabilitation of certain segments of the population with its full social content and personal effectiveness, in which reflective thinking, existential freedom, professional competence and humane orientation of the specialist’s personality are important. The purpose of the study is to highlight the heuristic resource potential of the art therapeutic method and its corresponding work techniques in the implementation of psychosocial rehabilitation of individuals aimed at restoring their psycho-spiritual capabilities and social and role functions. The object of study is psychosocial rehabilitation in the complementarity of methods, tools, techniques and procedures for effective psychological work of a socio-humanitarian specialist with a traumatized client and methods, tools, techniques and acts of correct social influence on his or her personality for psychological and functional recovery as a citizen. The subject of the study is the rehabilitation technology of art therapy, gradually implemented and funded, enriched with psycho-spiritual resources and social capabilities of both participants, joint activity – a psychologist or social worker and the personality of a client who has suffered a certain hellish loss, is in a psycho-traumatic state and needs existential and purely human help for psychosocial recovery and personal recovery. In particular, psychosocial rehabilitation is interpreted as a complex multi-stream process aimed at restoring or improving the social functioning and mental health of persons with mental disorders, psychological trauma, or in difficult life situations. It is noted that the expediency of using the art therapy method as a form of psychological rehabilitation, which practices art as a means of expressing emotions, self-knowledge and improving mental health, is emphasized. Art therapy involves the use of various types of artistic creativity, namely drawing, painting, modeling, collage, photography and other artistic forms to help people express their inner feelings, accentuated psycho-mental states and poorly regulated mental tendencies.

Gamified delivery of at-home rehabilitation for individuals with nonspecific low back pain: a randomized controlled trial

Purpose To measure the change in pain and disability during and after a 6-week gamified delivery of home exercise compared to a take-home packet. Materials and Methods A 6-week at-home exercise protocol included participants randomly allocated to a gamified delivery group or packet group. The exercise protocol included the plank, side plank, foot elevated side plank, dead bug, and bird dog completed until discontinuation. The gamified delivery group received on-demand exercise videos and weekly exercise duration leaderboards. The packet group received a take-home packet. Results Forty participants were randomized into a packet group and leaderboard group, and 30 participants completed the study. Disability was significantly lower at 6-weeks (11.29 ± 9.81%) compared to baseline (15.93 ± 11.65%) in the packet group (χ2(2) =10.89, Z= −3.163, p=.002, r=.708). Percent disability was significantly lower at 6-weeks (8.00 ± 5.91%) compared to baseline (13.01 ± 7.17%) in the gamified delivery group (χ2(2) =13.235, Z= −3.399, p= <.001, r= −0.760). Worst pain was higher at baseline (7.05 ± 1.61%) than at 6-weeks (5.75 ± 1.68%) in the packet group (χ2(2) =8.067, Z = 2.760, p=.006, r= −0.617). Worst pain was higher at baseline (6.90 ± 1.33%) than at 6-weeks (5.24 ± 2.38%) in the gamified delivery group (χ2(2) =6.250, Z= −2.810, p=.005, r= −0.628). No significant difference in the change of disability from baseline to 6 weeks was found between groups (p=.483). Conclusions Core exercises completed until failure may improve disability and pain at 6-weeks and positively influence perceived patient improvement. Registry: Clinicaltrials.gov; Registration number: NCT05573932

An exploration of the factors that contribute to involvement in serious organised crime: A rapid evidence assessment

This Rapid Evidence Assessment (REA) explores the factors related to involvement in and desistance from Serious Organised Crime (SOC). There is a need for evidence-based practice to underpin the work and products being developed for the management and rehabilitation of individuals involved (or at risk of being involved) in SOC. The current review sought to increase understanding of the factors associated with organised crime involvement. The REA reflected the wide variety of factors cited in the literature, highlighting a combination of an individuals’ personal background and skills, and the social relationships they develop in different settings of their lives. The challenges when considering the management and rehabilitation of this population have also been highlighted. The findings of this review can inform future research and the shaping of future policies and interventions. The findings could also be used to inform the development of SOC specific interventions, which will target the needs of this population.

The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: a prospective cohort study.

Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD. Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes. There were no consistent statistically significant differences between groups for the lung function outcomes (p\<0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (p\<0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (p=0.005) and six and nine months for maximal expiratory pressure (p=0.027 and p\<0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (p>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (p\<0.05). Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles. Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.

The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries.

Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the paralyzed extremities, expanding the available muscle mass for exercise. Methods: The authors provide an evidence-based approach using expertise from diverse fields, supplemented by evidence from key studies toward the management of electrical stimulation therapies in individuals with SCIs. Literature searches were performed separately using the PubMed, Medline, and Google Scholar search engines. The keywords used for the searches included functional electrical stimulation cycling, hybrid cycling, neuromuscular electrical stimulation exercise, spinal cord injury, cardiovascular health, metabolic health, muscle strength, muscle mass, bone mass, upper limb treatment, diagnostic and prognostic use of functional electrical stimulation, tetraplegic hands, and hand deformities after SCI. The authors recently presented this information in a workshop at a major rehabilitation conference. Additional information beyond what was presented at the workshop was added for the writing of this paper. Results: Functional electrical stimulation (FES) cycling can improve aerobic fitness and reduce the risk of cardiovascular and metabolic diseases. The evidence indicates that while both FES leg cycling and neuromuscular electrical stimulation (NMES) resistance training can increase muscle strength and mass, NMES resistance training has been shown to be more effective for producing muscle hypertrophy in individual muscle groups. The response to the electrical stimulation of muscles can also help in the diagnosis and prognosis of hand dysfunction after tetraplegia. Conclusions: Electrical stimulation activities are safe and effective methods for exercise and testing for motor neuron lesions in individuals with SCIs and other paralytic or paretic conditions. They should be considered part of a comprehensive rehabilitation program in diagnosing, prognosing, and treating individuals with SCIs to improve function, physical activity, and overall health.

Maintenance Pulmonary Rehabilitation: An Update and Future Directions.

The Global Initiative for Chronic Obstructive Lung Disease guidelines recommend pulmonary rehabilitation (PR) for individuals with COPD to improve exercise capacity and health-related quality of life (HRQOL) and reduce symptoms of dyspnea. For cost-effectiveness in COPD care, PR is second only to smoking cessation. However, PR programs typically last 9-12 weeks. The benefits of PR in terms of exercise capacity and HRQOL often decrease toward pre-PR levels as early as 3-6 months after completing PR if patients do not continue to engage in exercise. This review will (1) briefly summarize the efficacy data that informed the 2023 American Thoracic Society (ATS) clinical practice guidelines for maintenance PR, (2) discuss exercise components of maintenance PR studied since 2020 when the last papers were included in the ATS guidelines, (3) explore future directions for delivery of maintenance PR using technology-mediated models, and (4) examine the need for behavior change techniques informed by theoretical models that underpin long-term behavior change. This review will focus on persons with COPD who have completed an out-patient core initial PR program as most of the data on maintenance PR have been published in this patient population. Core PR typically implies a facility-based initial intensive structured program. All patients who complete a core initial PR program should be counseled by PR staff at the discharge visit to engage in ongoing exercise. This usual care is equally as important as referral to a formal PR maintenance program. It is critical to emphasize that usual care after core initial PR means all patients should be supported to participate in regular ongoing exercise, regardless of whether supervised maintenance PR is available. Currently, the optimal frequency, exercise and/or physical activity content, and delivery mode for maintenance PR in persons with COPD and other chronic respiratory diseases remain unknown. Patient safety and degree of in-person supervision required due to the severity of the underlying lung disease need to be considered. Future research of maintenance PR should be underpinned by behavior change techniques. Finally, in the setting of finite resources, balancing the competing priorities of core initial programs with those of maintenance PR programs needs to be achieved.

Evaluation of physical activity before and after respiratory rehabilitation in normal weight individuals with asthma: a feasibility study.

Individuals with asthma spend less time engaging in physical activity compared to the general population. Increasing physical activity has become a patient-centered goal for the treatment of treatable traits of individuals with asthma. There are data showing the possible effects of a pulmonary rehabilitation program on physical activity in obese individuals with asthma but not in normal-weight asthmatics. The objective of this feasibility study is to estimate the number of daily steps and time spent on activity in normal-weight individuals with asthma, measured before and after a pulmonary rehabilitation program. Normal-weight individuals with moderate to severe asthma were evaluated. The individuals measured their daily steps with an accelerometer for 5 days before and after a pulmonary rehabilitation program. The study was registered on ClinicalTrials.gov: NCT05486689. In total, 17 participants were enrolled; one dropout and data on the time in activity of two individuals are missing due to a software error during the download. Data from 16 patients were analyzed. The median number of steps/day at baseline was 5,578 (25th, 75th percentiles = 4,874, 9,685) while the median activity time was 214 min (25th, 75th percentiles = 165, 239). After the rehabilitation program, the number of daily steps increased by a median value of 472 (p-value = 0.561) and the time in activity reduced by 17 min (p-value = 0.357). We also found a significant difference in quality of life, muscle strength, and exercise capacity. The results of this study make it possible to calculate the sample size of future studies whose main outcome is daily steps in normal-weight individuals with asthma. The difficulties encountered in downloading time in activity data do not allow the same for this outcome. ClinicalTrials.gov, identifier NCT05486689.

Exoskeletal-Assisted Walking During Acute Inpatient Rehabilitation Enhances Recovery for Persons with Spinal Cord Injury-A Pilot Randomized Controlled Trial.

Spinal cord injury (SCI) negatively impacts individuals' functional independence, and motor and sensory function. Intense walking training has been shown to facilitate recovery for individuals with chronic SCI. Powered robotic exoskeletons provide therapists with a tool that allows them to conduct walking training with less therapist effort as compared to conventional walking training. Exoskeletal-assisted walking (EAW) has been studied in the chronic SCI population with preliminary reports showing benefits in mobility, health, and quality-of-life outcomes. However, few reports have studied EAW's benefits in the acute (<90 days post) SCI population at a time when neural plasticity is most dynamic and modifiable. The purpose of the study was to conduct a pilot randomized controlled trial (RCT) to understand the effects of incorporated EAW in acute inpatient rehabilitation (AIR) for individuals with SCI on functional, motor, and sensory recovery. The study outcomes included the Spinal Cord Independence Measure (SCIM) III and International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor and sensory scores that were assessed by unblinded assessors. We also recorded EAW session data, including adverse events, walking and up time, step counts, Borg Rating of Perceived Exertion (RPE), and compliance with scheduled EAW training. From August 2019 to July 2022, 16 participants completed the AIR with incorporated EAW, and 12 completed the standard AIR, all with SCI and preserved leg function within 90 days post-injury. During each session, the AIR with incorporated EAW group averaged 34.3 (±9.4) min of up time, 25.4 (±7.7) min of walk time, and 536 (±157) steps. Analysis via two-by-two mixed-effects models showed significant increases in the SCIM total score and ISNCSCI total motor and sensory scores over time for the AIR with incorporated EAW group [SCIM total score: F(1, 26) = 5.59, p = 0.03; total motor score: F(1, 26) = 8.06, p < 0.01; total sensory score: F(1, 19.2) = 5.08, p = 0.04], outperforming the standard AIR group. The AIR with incorporated EAW group showed 13, 14, and 22 points higher changes in the SCIM total score, total motor score, and total sensory score (respectively) by discharge compared with the standard AIR group. Incorporating EAW into AIR may facilitate functional, motor, and sensory recovery for individuals with SCI during AIR better than standard AIR. However, the study had a limited sample size. Further studies are needed to clarify the effects of EAW in AIR.

Beyond Bars: Transformative Strategies for Reducing Prison Congestion in the United States of America

The United States has an excessive number of incarcerated individuals. The number of incarcerated individuals surpasses 2.3 million, which is greater than any other country. This research analyzes the issue of overcrowding in US jails and presents innovative solutions. The paper commences by elucidating the prison system and the philosophical rationales for both punishing and rehabilitating offenders. The essay subsequently examines the imposition of harsh sentences, the government's "War on Drugs" campaign, flawed bail procedures, insufficient rehabilitation and reintegration initiatives, violations of parole and probation terms, challenges in allocating resources, and the accumulation of legal system delays that contribute to prison overcrowding. This analysis explores the ramifications of overcrowding on both convicts and staff, encompassing aspects such as emotional and physical well-being, safety, and the functioning of the prison system. The study suggests an inclusive approach to this key matter. In order to decrease the likelihood of repeat offenses and facilitate the process of reintegrating individuals into society, it suggests implementing more extensive rehabilitation programs that prioritize education, vocational training, and mental well-being. Additionally, it analyzes the potential for expediting jail construction and circumventing public resistance through the privatization of jails. Furthermore, it suggests the deliberate expansion of jails in order to accommodate a greater number of prisoners. It underscores the importance of implementing strategies to enhance the utilization of resources and the provision of services. Furthermore, it emphasizes the importance of overhauling bail procedures to prevent the incarceration of persons who are unable to afford it, thereby compromising the fundamental premise of presumption of innocence. Furthermore, it suggests the reduction of lengthy incarceration periods, particularly for individuals who have committed nonviolent offenses, while promoting alternative forms of punishment and rehabilitation approaches. Furthermore, it underscores the importance of implementing drug courts and restorative justice practices as a means to prevent incarceration of nonviolent offenders. Additionally, it advocates for the implementation of early release initiatives that give priority to the rehabilitation and reintegration of individuals into society, while also incorporating risk assessment and supervision. Final recommendation: Revise parole violation procedures to prioritize rehabilitation and fairness, rather than resorting to incarceration for offenders. Ultimately, the study highlights the urgency of implementing comprehensive prison reform to tackle the issue of excessive overcrowding and guarantee the humane treatment and rehabilitation of criminals. This research analyzes the issue of jail overcrowding in the United States from multiple viewpoints and suggests numerous effective strategies to decrease the number of people in prisons.

Online dance versus online therapeutic exercise on quality of life - a study protocol for a randomized controlled trial investigating social telerehabilitation efficacy in Parkinson disease

Background Social telerehabilitation delivers rehabilitation services over online video conferencing within a social context. The modality of multimodal therapeutic exercises is the most recommended rehabilitation for individuals with PD, although other modalities, such as dance, have shown potential benefits. The investigation of the feasibility and efficacy of these therapeutic strategies in a remote online format is unknown. Methods This is a prospectively registered two-arm randomised controlled trial investigating the efficacy of online dance compared to online multimodal therapeutic exercise by looking at the biopsychosocial PD aspects. Individuals diagnosed with idiopathic PD between 40 and 90 years old, at any stage of disease severity, and without cognitive impairment will be recruited from the community. Participants will be randomly allocated to one of the two social telerehabilitation groups: (1) dance and music or (2) multimodal therapeutic exercise and music. Interventions will occur twice a week for twelve weeks. Each session will last 60 min. Tele-assessments will be conducted pre-, post-, and one-month follow-up through a videoconference platform. Results For feasibility, primary outcomes will include adherence, attendance, adverse events, and participants’ perceptions of enjoyment and socialisation. For efficacy, primary outcomes will investigate well-being by positive affect (by the Positive Affect and Negative Affect Schedule) and persistent anxiety, episodic anxiety, and avoidance behaviour (by the Parkinson Anxiety Scale). Secondary outcomes will include motor severity (by the UPDRS III), functional lower extremity strength (by the Five Times Sit to Stand Test), memory and attention (by the Attention and Recognition Memory Test), and quality of life (by the Parkinson’s Disease Questionnaire 39). Conclusion We hypothesise that both interventions would effectively ameliorate motor symptoms. However, we expect dance to be more enjoyable and improve well-being by increasing positive affect and reducing anxiety signs.

Hyponatremia as a predictor of cognitive deterioration in hospitalized post-stroke patients

PurposeEvidence is scarce regarding the association between hyponatremia and alterations in cognitive function among hospitalized older patients. We aimed to investigate the associations between hyponatremia and the baseline cognitive status, as well as the improvement in cognitive function, in hospitalized post-stroke patients. MethodsThis retrospective cohort study included consecutive hospitalized post-stroke patients. Serum sodium concentrations were extracted from medical records based on blood tests performed within 24 h of admission, with hyponatremia defined as a serum sodium concentration < 135 mEq/L. The main outcomes included admission and discharge scores for cognitive levels, assessed through the cognitive domain of the Functional Independence Measure (FIM-cognition), as well as the score changes observed during the hospitalization period. Multivariate linear regression analyses were used to determine the association between hyponatremia and outcomes of interest, adjusted for potential confounders. ResultsData from 955 patients (mean age 73.2 years; 53.6 % men) were included in the analysis. The median baseline blood sodium level was 139 [137, 141], and 84 patients (8.8 %) exhibited hyponatremia. After full adjustment for confounders, the baseline hyponatremia was significantly and negatively associated with FIM-cognition values at admission (β = -0.009, p = 0.016), discharge (β = -0.038, p = 0.043), and the gain during hospital stay (β = -0.040, p = 0.011). ConclusionBaseline hyponatremia has demonstrated a correlation with decline in cognitive level over the course of rehabilitation in individuals after stroke. Assessing hyponatremia at the outset proves to be a pivotal prognostic indicator.

Mechanisms and benefits of cardiac rehabilitation in individuals with stroke: emerging role of its impact on improving cardiovascular and neurovascular health.

Human and animal studies have demonstrated the mechanisms and benefits of aerobic exercise for both cardiovascular and neurovascular health. Aerobic exercise induces neuroplasticity and neurophysiologic reorganization of brain networks, improves cerebral blood flow, and increases whole-body VO2peak (peak oxygen consumption). The effectiveness of a structured cardiac rehabilitation (CR) program is well established and a vital part of the continuum of care for people with cardiovascular disease. Individuals post stroke exhibit decreased cardiovascular capacity which impacts their neurologic recovery and extends disability. Stroke survivors share the same risk factors as patients with cardiac disease and can therefore benefit significantly from a comprehensive CR program in addition to neurorehabilitation to address their cardiovascular health. The inclusion of individuals with stroke into a CR program, with appropriate adaptations, can significantly improve their cardiovascular health, promote functional recovery, and reduce future cardiovascular and cerebrovascular events thereby reducing the economic burden of stroke.