Rehabilitation Of Patients Research Articles

Measuring multifidus muscles atrophy after midline lumbar fusion with cortical bone trajectory screws due to spinal instability and spondylolisthesis: a retrospective case series.

This study aimed to assess the impact of midline lumbar fusion with cortical bone trajectory screws (MIDLF/CBT) on the multifidus muscles, focusing on the evaluation of their postoperative atrophy. MIDLF/CBT is a relatively new technique increasingly used to treat spinal instability. Despite its reduced invasiveness compared to traditional posterior lumbar interbody fusion with traditional pedicle screws (PLIF/TP), concerns remain about potential damage to the multifidus muscles that are crucial for spinal stability. Understanding the extent of muscular atrophy post-MIDLF/CBT is vital for improving surgical outcomes, and potentially patient rehabilitation strategies. This study retrospectively analysed preoperative and postoperative MRI scans of patients who underwent MIDLF/CBT for degenerative segmental spondylolisthesis. The bilateral width of the multifidus muscles at the operated segment and adjacent segments was measured using axial T2-weighted MRI scans. Statistical comparisons were made using a paired t test, with significance set at p < 0.05. The study included 16 patients with an average age of 57 ± 10 years, 10 of whom (62.5%) were women, and featured a mean follow-up period of 37 ± 25 months. Postoperative measurements showed a significant reduction in the width of the multifidus muscles at the operated segment (mean difference -3.3mm, p = 0.02) and the inferior adjacent segment (-7.4 mm, p < 0.01). A decrease in muscle width at the superior adjacent segment was also observed, although this was not statistically significant. Our study concluded that MIDLF/CBT results in significant multifidus muscle atrophy at and below the operated segment, potentially impacting postoperative rehabilitation and recovery. These findings highlight the need for further research comparing MIDLF/CBT to other spinal stabilisation techniques. Additionally, incorporating functional electromyographic assessments of paraspinal muscles could provide deeper insights into the long-term consequences of spinal surgeries and helpdevelop new approaches and strategies to mitigate paravertebral muscles atrophy, thus enhancing patient outcomes.

Steps to Facilitate the Use of Clinical Gait Analysis in Stroke Patients: The Validation of a Single 2D RGB Smartphone Video-Based System for Gait Analysis

Clinical gait analysis plays a central role in the rehabilitation of stroke patients. However, practical and technical challenges limit their use in clinical settings. This study aimed to validate SMARTGAIT, a deep learning-based gait analysis system that addresses these limitations. Eight stroke patients took part in the study at the Human Performance Research Centre of the University of Konstanz. Gait measurements were taken using both the marker-based Vicon motion capture system and the single-smartphone-based SMARTGAIT system. We evaluated the agreement for knee, hip, and ankle joint angle kinematics in the frontal and sagittal plane and spatiotemporal gait parameters between the two systems. The results mostly demonstrated high levels of agreement between the two systems, with Pearson correlations of ≥0.79 for all lower body angle kinematics in the sagittal plane and correlations of ≥0.71 in the frontal plane. RMSE values were ≤4.6°. The intraclass correlation coefficients for all derived gait parameters showed good to excellent levels of agreement. SMARTGAIT is a promising tool for gait analysis in stroke, particularly for quantifying gait characteristics in the sagittal plane, which is very relevant for clinical gait analysis. However, further analyses are required to validate the use of SMARTGAIT in larger samples and its transferability to different types of pathological gait. In conclusion, a single smartphone recording (monocular 2D RGB camera) could make gait analysis more accessible in clinical settings, potentially simplifying the process and making it more feasible for therapists and doctors to use in their day-to-day practice.

The impact of nurses' stress situation coping on somatization: a mediated moderation model.

The purpose of this study is to investigate the impact of nurses' stress situation coping levels on somatization symptoms, the mediating effect of depression, and the moderating effect of perceived social support. As a core part of the global healthcare system, nurses are crucial to patient health and rehabilitation outcomes. However, due to heavy workloads, unreasonable staffing structures, and constant exposure to occupational risks in their workplaces, these factors often place nurses in a high-intensity, high-stress environment, which directly affects their physical and mental health and professional burnout. Coping with stress situations is an important means to help individuals effectively manage stress, reduce negative impacts, and maintain mental health. However, research on the impact of nurses' stress situation coping methods on somatization symptoms is limited. This study conducted a cross-sectional survey from December 2022 to April 2023, and finally included 293 nurses working on the front line of tertiary hospitals. Data was collected through questionnaires and analyzed using SPSS 24.0 and the SPSS macro program's Models 7 and 14. This study is an observational study, strictly prepared and presented according to the STROBE checklist. The somatization symptom scores of the nurses were (27.27 ± 7.33) points, the stress situation coping scores were (59.90 ± 9.64) points, the perceived social support scores were (65.64 ± 12.90) points, and the depression scores were (4.42 ± 4.12) points. The somatization symptom scores of the nurses were positively correlated with the stress situation coping scores and depression scores, and negatively correlated with the perceived social support scores, with correlation coefficients of 0.200, 0.851, and -0.302, respectively. The stress coping level of the nurses had a direct positive impact on somatization symptoms (β = 0.081, p = 0.009), and a direct positive impact on nurse depression (β = 0.202, p = 0.001). Depression had a significant positive impact on somatization symptoms (β = 0.823, p = 0.000), and depression played a mediating role. Perceived social support had a significant negative impact on depression (β = -0.383, p = 0.000). Perceived social support had a significant moderating effect on the relationship between the stress situation coping level and depression (β = -0.121, p = 0.003). In this study, the stress situation coping methods of nurses had a positive impact on somatization symptoms, had a complete mediating effect on the depression level of nurses, and perceived social support had a significant moderating effect in the pathway from the stress situation coping methods of nurses to depression-mediated somatization symptoms.

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.

Effectiveness of virtual reality in cardiac rehabilitation patients for exercise capacity and negative emotions: A systematic review and meta-analysis.

The significance of virtual reality (VR) technology as an alternative or complementary modality to traditional cardiac rehabilitation is of increasing interest. Numerous studies have examined the effects of virtual reality technology in cardiac rehabilitation patients, but the results have been inconsistent. We conducted a systematic search of the Cochrane Library, Web of Science, PubMed, Embase, Scopus, ProQuest, OVID, CINAHL, SinoMed, CNKI, WanFang, VIP Database, and ReadShow databases following the Program for Systematic Review and Meta-Analysis guidelines. The search included studies published up until June 30, 2024. The Cochrane Risk of Bias Tool was used to examine the methodological quality of the included randomized controlled studies. When feasible, a meta-analysis was performed to calculate the pooled effects using Review Manager (version 5.3). Otherwise, narrative summaries were performed. A total of 11 studies with 1093 patients were included. The results of systematic review and meta-analysis showed that virtual reality technology improved patients' exercise capacity (mean difference: 53.26, 95% confidence interval [CI]: 45.14-61.37; P < .00001); anxiety (standardized mean difference [SMD]: -0.39, 95% CI: -0.69, -0.08, P = .01); depression (SMD: -0.48, 95% CI: -0.79, -0.17; P = .003); stress (SMD: -0.72, 95% CI: -1.03, -0.40; P < .00001); emotional tension (SMD: -0.81, 95% CI: -1.15, -0.47; P < .00001); emotional tension (SMD: -0.64, 95% CI: -0.98, -0.30; P = .0002), and intrapsychic stress (SMD: -0.56, 95% CI: -0.90, -0.23; P = .0009). Virtual reality-based interventions can be effective in improving patients' exercise capacity and negative emotions. However, further research is needed to determine the efficacy of VR for other clinical outcomes.

The rehabilitation potential of the personality of a patient with stroke: determination of factors and components influencing the recovery

Improving the rehabilitation of patients with impaired cognitive and personal status is an urgent task, since such disorders can lead to disability and a decrease in the quality of life. These changes often occur because of acute vascular catastrophes, such as Cerebrovascular Accident (CVA). This article presents an analysis of native and foreign publications devoted to the study of emotional disorders in the early recovery period after stroke. The authors aim to verify the most congruent factors and components of the personality and emotions that affect the rehabilitation potential of patients with stroke. The results of this study can be used to develop more effective and adapted rehabilitation programs for patients with stroke. Taking into account these factors in the process of rehabilitation treatment, which affect the overall rehabilitation potential, medical professionals can develop more personalized and targeted treatment plans, which contributes to improving the quality of life of patients and their early return to normal activities.

A Multimodal Patient-Centered Teleprehabilitation Approach for Patients Undergoing Surgery for Breast Cancer: A Clinical Perspective

Breast cancer is the most common malignancy among women worldwide, and advances in early detection and treatment have significantly increased survival rates. However, people living beyond breast cancer often suffer from late sequelae, negatively impacting their quality of life. Prehabilitation, focusing on the period prior to surgery, is a unique opportunity to enhance oncology care by preparing patients for the upcoming oncological treatment and rehabilitation. This article provides a clinical perspective on a patient-centered teleprehabilitation program tailored to individuals undergoing primary breast cancer surgery. The proposed multimodal program includes three key components: patient education, stress management, and physical activity promotion. Additionally, motivational interviewing is used to tailor counseling to individual needs. The proposed approach aims to bridge the gap between diagnosis and oncological treatment and provides a holistic preparation for surgery and postoperative rehabilitation in breast cancer patients. The aim of this preparation pertains to improving mental and physical resilience. By integrating current evidence and patient-centered practices, this article highlights the potential for teleprehabilitation to transform clinical care for breast cancer patients, addressing both logistical challenges and holistic well-being.

The use of a vascularized fibular flap in the treatment and surgical rehabilitation of military trauma patients

Aim. The purpose of the work is to demonstrate the possibilities of using a vascularized fibular flap to replace bone defects in the treatment of acute military trauma and its consequences at the rehabilitation stage. Materials and methods. An anatomical feature description of the vascularized fibular flap with a cutaneous component. Clinical cases of the vascularized fibular flap use to reconstruct bone and soft tissue defects after military injuries. In the presented cases, vascularized fibula osteocutaneous flaps were used. Results. Two clinical cases of reconstruction using the fibula flap are presented. The first case presents a patient with a total mandibular defect resulting from a gunshot wound. The second case presents a patient with consequences of a mine-shrapnel injury of the left forearm and an ulnar defect of about 12 cm in length and the resultant inability to perform rotational movements. Vascularized fibula osteocutaneous flaps were used for reconstruction in both cases being transferred to the recipient site, and microvascular anastomoses were performed for flap reperfusion. Conclusions. Adding a free fibula flap to the reconstructive surgeon’s arsenal enables one-stage reconstructions of large wounds with bone defects after injuries or oncological resections without significant musculoskeletal functional loss to donor limbs.

The association of C-Mill with traditional physical therapy rehabilitation in a multiple sclerosis patient: a case report

The association of C-Mill with traditional physical therapy rehabilitation in a multiple sclerosis patient: a case report

Multidisciplinary Approach to Smile Design of a Patient With Osteogenesis Imperfecta With Clear Aligners and Prosthetic Restorations.

Osteogenesis imperfecta (OI) is an autosomal dominant disease that affects the teeth and the musculoskeletal system. Orthodontic treatment in OI patients may be risky due to the fragility of dental hard tissues. Clear aligners may be considered a suitable orthodontic treatment method for these patients. A 30-year-old female OI patient with Angle Class I malocclusion, open bite, and crowding underwent prosthetic treatment after 15 months of clear aligner orthodontic treatment. Aesthetic rehabilitation was achieved with clear aligner treatment and prosthetic restorations. It is possible to obtain more aesthetic results with orthodontic treatments before prosthetic restorations in the oral rehabilitation of patients with skeletal and dental malocclusions. In orthodontic treatments in adult patients with systemic diseases, the use of clear aligners both minimizes the risk and provides a more comfortable process.

The role of cognitive motivation and self-regulation in coping with occupational demands

Cognitive motivation (COM) in conjunction with self-regulation (SR) was demonstrated to be positively linked to mental health in educational and clinical contexts. We introduce COM and SR in the occupational context and hypothesize these traits—based on their conceptual link to hardiness - to counteract health-risking stressors. Data from two large cross-sectional studies in Germany comprise a sample of 1,022 psychosomatic rehabilitation in-patients and a healthy sample of 298 employees of various occupations. Using bootstrapping in correlation analyses, we found in both samples COM and SR to be especially associated with an active, meaningful, and persistent coping style (0.31 ≤ r ≤ 0.57). Analyses via structural equation modeling found COM cross-sectionally predicting occupational coping via SR in both samples. We discuss COM and SR as personal resources with respect to Conservation of Resources Theory and provide ideas for promoting these variables in patients and employees.

Rehabilitation Technologies by Integrating Exoskeletons, Aquatic Therapy, and Quantum Computing for Enhanced Patient Outcomes

Recent advancements in patient rehabilitation integrate both traditional and modern techniques to enhance treatment efficacy and accessibility. Hydrotherapy, leveraging water’s physical properties, is crucial for reducing joint stress, alleviating pain, and improving circulation. The rehabilitation of upper limbs benefits from technologies like virtual reality and robotics which, when combined with hydrotherapy, can accelerate recovery. Exoskeletons, which support and enhance movement, have shown promise for patients with neurological conditions or injuries. This study focused on implementing and comparing proportional–integral–derivative (PID) and fuzzy logic controllers (FLCs) in a lower limb exoskeleton. Initial PID control tests revealed instability, leading to a switch to a PI controller for better stability and the development of a fuzzy control system. A hybrid strategy was then applied, using FLC for smooth initial movements and PID for precise tracking, with optimized weighting to improve performance. The combination of PID and fuzzy controllers, with tailored weighting (70% for moderate angles and 100% for extensive movements), enhanced the exoskeleton’s stability and precision. This study also explored quantum computing techniques, such as the quantum approximate optimization algorithm (QAOA) and the quantum Fourier transform (QFT), to optimize controller tuning and improve real-time control, highlighting the potential of these advanced tools in refining rehabilitation devices.

Studying the impact of probiotic agents on the pathogenetic and clinical features of generalized periodontitis

Generalized periodontitis remains one of the most prevalent dental diseases, complications of which significantly deteriorate patients’ quality of life. Currently, the use of probiotic agents is considered a promising direction to enhance the effectiveness of non-surgical treatment of this pathology. Studying the impact of different probiotics on the pathogenetic and clinical features of generalized periodontitis will allow proposing optimized protocols for comprehensive treatment, reducing patient rehabilitation periods and improving the overall dental health of the population. The aim of this study is to examine the influence of various probiotic agents on the pathogenetic and clinical characteristics, treatment effectiveness of generalized periodontitis in adult patients by analyzing professional scientific literature. The literature review provides a brief overview of various probiotic groups and discusses pathogenetic mechanisms of their interaction with the microbiota of oral biofilms. The immunomodulatory mechanisms of probiotics on local and systemic immune responses in patients with generalized periodontitis, inhibition of enzymes responsible for bone tissue resorption, are presented. The analysis results of scientific sources regarding the dynamics of changes in clinical symptoms, microbiological, immunological, and biochemical parameters of saliva and blood serum in individuals with generalized periodontitis receiving comprehensive rehabilitation using probiotic agents compared to patients treated with traditional protocols are provided. The study highlights statistical differences in clinical and laboratory indicators of periodontitis progression at different treatment intervals. Conclusions. The use of probiotic agents for treating patients with generalized periodontitis significantly influences the clinical course of the disease by altering the species composition of dental biofilms and modulating local immune and inflammatory reactions. However, the known results of experimental and clinical studies often have conflicting findings regarding the efficacy of specific probiotic strains and the duration of inflammatory process stabilization over extended periods after treatment, which means a further study is required.

Sequential transcranial electrical stimulation in patients with dyscirculatory encephalopathy associated with post-COVID syndrome

BACKGROUND: The primary hypothesis for the use of sequential transcranial electrical stimulation therapy in the rehabilitation of patients with dyscirculatory encephalopathy associated with post-COVID syndrome is the potential synergistic effect on the central nervous system. Specifically, the method combines brain micropolarization — involving neocortex neurons and diencephalic brain stimulation — affecting limbic system structures. This synergy is expected to improve connections between cortical and subcortical structures, as well as neurohumoral regulation. AIM: To study the effectiveness of complex medical rehabilitation involving sequential transcranial electrical stimulation therapy in patients with dyscirculatory encephalopathy associated with post-COVID syndrome. MATERIALS AND METHODS: An open, prospective, randomized comparative study included 142 patients with dyscirculatory encephalopathy: 79 female (55.6%) and 63 male (44.4%) patients, aged 59 (45–69] years. The average disease duration was 8.4 years, with a period after coronavirus infection of 3.6 months. After randomization, patients in Group 1 (comparison group 1, n=48) received brain micropolarization; Group 2 (comparison group 2, n=46) received diencephalic brain stimulation; and Group 3 (main group, n=48) received both therapies sequentially. Treatment outcomes were evaluated based on changes in clinical symptoms over time and a battery of neuropsychological tests. RESULTS: In Group 3, which received sequential transcranial electrical stimulation therapy, all symptoms of dyscirculatory encephalopathy showed a significant improvement (1.2–1.6 times) compared to baseline (p 0.05–0.001). For brain micropolarization alone (Group 1), there was an average reduction in the severity of symptoms such as cranialgia, memory and attention deficits, irritability, and sleep disturbances by 1.2–1.4 times. In Group 2, diencephalic brain stimulation resulted in an improvement in tinnitus, fatigue, work productivity, and dizziness by 1.3–1.4 times. In the main group, there was an overall alleviation of all psychophysiological issues (1.1–2.0 times; p 0.05–0.01); in comparison groups 1 and 2, improvement was 1.1–1.5 times and 1.2–1.8 times, respectively. CONCLUSION: Medical rehabilitation using a combined approach (sequential application of brain micropolarization and diencephalic brain stimulation) alongside pharmacological support in patients with dyscirculatory encephalopathy associated with post-COVID syndrome is shown to be the most effective due to the pronounced neurotropic effect of the physical factors involved, allowing for the correction of a whole range of neurological, neuropsychological, and motor disorders.

REABILITAÇÃO E AUTOCONFIANÇA: O PAPEL DA FISIOTERAPIA NA VIDA DE AMPUTADOS DE MEMBROS INFERIORES

Physiotherapy plays a fundamental role in the rehabilitation and adaptation process of amputees. By providing physical, emotional and educational support to amputees, multidisciplinary work enables patients to recover by promoting lost functionality until they adapt to the physical and emotional transformations and are able to live fully and actively again. In addition, the physiotherapeutic approach is multifaceted and involves several techniques, including gait training, strengthening exercises, manual therapy and psychological support. These interventions are essential to help patients overcome the challenges related to the use of the prosthesis and the recovery of functionality. Thus, the main objective of this study is to analyze the importance of physiotherapy in the rehabilitation of patients using lower limb prostheses, highlighting the gains in mobility, adaptation to the prosthetic device and quality of life, emphasizing as a focus of the problem what are the impacts of physiotherapy on the rehabilitation of lower limb amputees in terms of mobility, adaptation to the prosthesis and quality of life? This study is characterized as a mixed approach (quantitative and qualitative) field research, carried out in a rehabilitation center specialized in lower limb prostheses in Brazil. This mixed approach allowed a more comprehensive analysis, combining numerical data with subjective perceptions of the participants. Thus, continuous and personalized physiotherapy monitoring based on measurements and field research reiterated the beneficial benefits of adaptation to the prosthesis in the lower limbs when considering the fit, comfort and functionality, and when taking into account the gait training and the established strengthening exercises. Transtibial and femoral amputation has represented not only a surgical intervention, but also a long readaptation treatment, that is, a milestone in the lives of affected individuals, which brings significant challenges. Rehabilitation begins in the preoperative period, progresses to the prosthesis fitting, and continues beyond these events, being crucial for the functional/emotional recovery of patients. Understanding the various stages of treatment and having a comprehensive rehabilitation plan are essential factors for promoting a new quality of life, which is possible for amputees, as demonstrated in the evaluations completed by patients portrayed in the various graphs representing responses to the questionnaires applied. The aim is therefore to carry out continuous and personalized physiotherapy monitoring to promote significant improvements in mobility, self-confidence and quality of life of amputee patients who use lower limb prostheses; and through treatment, a key factor for successful adaptation to the prosthesis, to facilitate the return to daily activities and promote greater functional independence. The research should also demonstrate improvements in the emotional well-being of patients, with a reduction in symptoms of depression and anxiety when considering the necessary psychological monitoring.

Stress test protocols applied without treadmill and bicycle ergometer: procedures and interpretation

The article highlights the possibility of application of exercise tests without special equipment. The methodological features of conducting tests and their interpreting options are shown. Changed body position tests have been updated. The definitions of stress tests and exercise tests have been clarified. A classification of ergometers and indicators of monitored parameters has been worked out. Examples of medical reports are given. The application possibilities of stress tests were considered in real clinical practice at the stages of treatment and rehabilitation of patients with a wide range of nosologies. Tables for independently determining the exercise test results are presented. The methods can be used in pediatric practice. The article is addressed to a wide range of practitioners and functional diagnostics specialists.

Efficacy of low-temperature argon plasma in the rehabilitation of patients undergoing radiation therapy for breast cancer

Background: During radiation therapy for breast cancer, healthy tissues are damaged, leading to both systemic and local reactions, including radiation dermatitis with such symptoms as erythema, dryness, peeling, and pain. Disturbances of the microcirculation lead to hypoxia and fibrosis. The use of low-temperature argon plasma is a promising method for preventing acute radiation-induced skin damage, which is crucial for maintaining quality of life, preventing complications, and minimizing long-term effects. Aim: To evaluate the effectiveness of low-temperature argon plasma used in the complex medical rehabilitation of patients undergoing external radiation therapy for breast cancer. Materials and methods: A prospective, randomized interventional study was conducted involving 60 breast cancer patients undergoing radiation therapy. All patients received a course of medical rehabilitation, including general magnetic therapy, exercise therapy, balance response training on a biofeedback simulator, nutritional support, and sessions with a medical psychologist. In the main group (n = 30), rehabilitation included low-temperature argon plasma treatment. Outcomes were assessed using the RTOG scale for acute complications of radiation therapy and laser Doppler flowmetry. Results: After completing radiation therapy and complex medical rehabilitation, statistically significant differences were observed between the main group and the comparison group (which did not receive low-temperature argon plasma treatment) in the severity of radiation reactions on the RTOG scale (p = 0.016) and in peripheral blood flow parameters. Conclusion: Low-temperature argon plasma supports nutritional blood flow and active mechanisms for microcirculatory regulation, preserving skin blood supply and preventing severe acute radiation dermatitis.

Bilateral Rectus Sheath Block with Continuous Bupivacaine Infusions After Elective Open Gastrectomy: A Randomized Controlled Trial

Background and Objectives: Multimodal analgesia has been shown to be effective in facilitating early postoperative gastrointestinal function and rehabilitation in patients undergoing open gastrectomy. We conducted a clinical trial to investigate the effectiveness of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion in comparison with placebo following elective open gastrectomy. Materials and Methods: Patients indicated for elective open gastrectomy were screened, enrolled, and randomised between October 2021 and September 2023. The patients were randomised to either Group A (intervention—continuous bupivacaine) or Group B (control—NaCl saline). The primary outcome measures were the quantity of an opioid analgesic administered during the initial 72 h post-surgery and the level of postoperative pain as indicated by the visual analogue scale (VAS). Mann–Whitney U test was used for quantitative analysis while Pearson Chi-square was used for categorical variables. Results: A total of 60 patients completed the trial, with 30 patients in each of the two groups. Patients in Group A reported lower median VAS pain scores at all observed time points following surgery (p &lt; 0.001). No patient in Group A required rescue opioid analgesia, although non-steroidal anti-inflammatory drugs were necessary during the initial 12 h postoperatively. Clinically, Group A patients had a significantly shorter time to first gas (p = 0.001), a shorter time to first bowel movement (p &lt; 0.001), a shorter time to first out-of-bed activity (p &lt; 0.001), and a shorter overall hospitalisation duration (p &lt; 0.001) compared to Group B patients. Conclusions: Bilateral RSB with continuous bupivacaine infusion is effective in managing pain and can reduce the use of opioid analgesics in the postoperative period. Furthermore, it promotes early recovery, and a shorter hospital stay.

Цифровое здравоохранение в медицинской реабилитации после инсульта: менеджмент телемедицинских технологий.

The development of digital technologies leads to a digital transformation of the healthcare system. Recently, digital healthcare has been developing dynamically, including its component part – telerehabilitation after a stroke. However, the novelty of technologies, their diversity, low awareness of doctors and healthcare organizers, and other reasons, do not allow healthcare organizations to use all their tools to manage organizational, managerial and medical problems of medical rehabilitation after a stroke. The aim of the study is to systematize information on telemedicine and cross-cutting digital technologies used in organizing medical rehabilitation of patients who have suffered a stroke, as well as the development of approaches to manage of these technologies to constantly improve the quality of healthcare and increase patient satisfaction. Materials and methods. The study used methods of information retrieval, analytical and synthetic research, etc. Results. The study showed that the development of technologies leads to an increase in the use of cross-cutting digital technologies in telemedicine rehabilitation of stroke patients. The results indicate the possibility of improving the quality and accessibility of medical care using telerehabilitation and cross-cutting technologies, expanding medical coverage, and improving therapeutic results in recovery of patients’ health. The PDCA cycle can be used to manage telerehabilitation and digital technologies. Findings. The introduction of digital technologies into telemedicine practice can reduce the workload of health workers and improve manageability with respect to a patient-centric approach. The use of quality management system principles and PDCA cycle can provide the standardization of telerehabilitation management, improve the quality of healthcare and patient satisfaction, contributing to the sustainable development of healthcare organizations.

THE ANALYSIS STUDY OF DIAGNOSIS AND MANAGEMENT OF ACUTE CORONARY SYNDROME: A COMPREHENSIVE SYSTEMATIC REVIEW

Introduction: Acute coronary syndrome (ACS) represents a spectrum of conditions with significant morbidity and mortality rates worldwide. Optimal management of ACS is critical, involving a combination of pharmacological therapies, interventional procedures, and comprehensive rehabilitation programs. This systematic review evaluates various management strategies for ACS, focusing on their efficacy, safety, and clinical outcomes to guide improved patient care practices. Methods: This systematic review was conducted in adherence to PRISMA 2020 guidelines. A comprehensive literature search was performed in major databases, including PubMed, ScienceDirect, Embase, Cochrane Library, Web of Science, studies published from 2018 onwards that evaluated ACS management strategies. Inclusion criteria were original research articles providing insights into treatment methods such as medication regimens, surgical interventions, and supportive therapies. The studies were assessed for bias across parameters like temporal precedence, participant selection, confounding factor handling, and retention rates. Results: From an initial set of 1916 publications, eight studies met the inclusion criteria after thorough screening. These studies highlighted various ACS management approaches, revealing that pharmacological treatments combined with early revascularization strategies improved patient survival and reduced complication rates. Assessment of bias showed consistent rigor in administration protocols and outcome assessments across the majority of studies. However, participant retention and confounding factor management were areas where inconsistencies were observed. The overall findings suggest that a multidisciplinary approach encompassing medication, timely intervention, and structured rehabilitation yields the best patient outcomes. Conclusion: This systematic review underscores the importance of comprehensive, multidisciplinary management in ACS care. Effective treatment strategies should address timely diagnosis, therapeutic interventions, and follow-up plans that include patient education and rehabilitation. Further research is needed to refine management protocols and overcome challenges in confounding factor control and participant retention for future studies.