Rehabilitation Of Patients Research Articles

INTEGRATIVE ONCOLOGY AS A PROMISING VECTOR FOR THE TREATMENT OF CANCER TREATMENT

The article presents an analysis of the possibilities for early diagnosis, treatment, and rehabilitation of patients with cancer within the framework of integrative oncology. Introduction. Oncological diseases remain one of the most pressing medical challenges of our time, driven by a steady increase in incidence, late-stage diagnoses, and unsatisfactory treatment outcomes. WHO experts predict that by 2050, the number of new cancer cases will rise by 77% compared to 2022. Despite significant advancements in diagnostics and conventional treatments, including surgery, chemotherapy, and radiotherapy, there remains a need for a more holistic approach. This approach would not only target tumor control but also aim to enhance the overall quality of life for patients. Discussion. Timely and accurate diagnosis is a crucial aspect of the fight against cancer. Early detection can significantly improve the chances of successful treatment and patient survival. However, conventional cancer treatments are often aggressive, leading to complications, side effects, and patient disability. Integrative oncology combines traditional therapies with complementary approaches, focusing on maintaining overall patient health, reducing side effects, facilitating restorative rehabilitation, and enhancing quality of life. This comprehensive, integrative approach broadens and strengthens the options for cancer treatment, offering a more holistic care strategy. Conclusion. Integrative oncology represents a promising direction in cancer treatment by providing a comprehensive approach to addressing the disease. The combination of conventional treatments with complementary therapies not only enhances treatment effectiveness but also significantly improves patient quality of life, an essential aspect in the ongoing battle against cancer.

MECHANISMS OF ACTION OF PROTEIN SHAKES IN NORMALIZING METABOLIC PROCESSES, THEIR ROLE IN IMPROVING GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES, AND IN PREVENTING CARDIOVASCULAR DISEASES

This review article delves into the significance of protein shakes, particularly whey protein, in various health and fitness contexts. The primary focus is on their biochemical properties, metabolic benefits, and their role in supporting muscle mass, weight loss, and metabolic health. The article synthesizes findings from multiple studies to highlight the potential of protein shakes in improving glycemic control, reducing inflammation, and enhancing overall health, particularly for individuals with type 2 diabetes, obesity, and sarcopenia. The review also explores the effectiveness of protein shakes in athletic performance and recovery, as well as their impact on glucose metabolism and homeostasis. It underscores the necessity for further research to optimize the use and dosage of protein shakes for diverse populations to fully harness their benefits. Whey proteins are rich in essential amino acids, particularly leucine, which stimulates muscle protein synthesis via the mTOR pathway. This makes them highly effective in muscle building and recovery. Whey protein consumption enhances glycemic control by increasing insulin secretion and improving insulin sensitivity. Studies have shown significant reductions in fasting glucose levels and HbA1c in patients with type 2 diabetes. Protein shakes aid in weight loss by promoting satiety and increasing thermogenesis. They help maintain muscle mass during weight loss, which is crucial for sustaining metabolic rate. Clinical trials have demonstrated their efficacy in reducing body fat and improving metabolic markers. Whey protein, combined with resistance training, significantly improves muscle mass and strength in older adults, helping to prevent sarcopenia. This is essential for maintaining physical functionality and reducing the risk of falls and fractures. In the rehabilitation of patients with severe obesity, protein shakes are effective in reducing body weight, improving metabolic health, and maintaining muscle mass. They play a crucial role in comprehensive rehabilitation programs that include diet and physical exercise. Protein shakes support metabolic adaptations by preserving muscle mass and enhancing thermogenesis, which helps maintain a high metabolic rate and prevent weight regain. Whey proteins enhance muscle mass and strength, speed up recovery after training, and boost endurance. They also support the immune system and reduce oxidative stress, contributing to better overall athletic performance . Proteins shakes aid in regulating blood glucose levels and improving insulin sensitivity, which is crucial for preventing and managing diabetes. Their antioxidant and anti-inflammatory properties further enhance metabolic health.

The Role of the International Classification of Functioning in Early Rehabilitation of Patients with Ischemic Stroke in Kyrgyzstan

The subject of the study is the process of early rehabilitation of patients after stroke. The aim of the study is to assess the role of the International Classification of Functioning (ICF) in the early rehabilitation of patients with ischemic stroke. This classifier was used to analyze the functional state of patients and develop individualized rehabilitation programs aimed at the most complete restoration of lost functions and improving the quality of life. As a result, it was found that the integration of the International Classification of Functioning into clinical practice contributes to a more effective and targeted recovery of patients after stroke. The classifier is a key point in determining short-term and long-term goals for the patient, assessing the rehabilitation potential and prognosis, drawing up and changing an individual medical rehabilitation plan, managing the medical rehabilitation process and forming further recommendations upon discharge, as well as involving related specialists to solve problems with barriers. It is recommended to implement the ICF at all stages of rehabilitation of patients after a stroke.

Impact of upper extremity robotic rehabilitation on respiratory parameters, functional capacity and dyspnea in patients with stroke: a randomized controlled study.

Stroke leads to reduced mobility and functional capacity, also negatively affects respiratory functions and muscle strength. To examine the effects of adding upper extremity robotic rehabilitation to conventional treatment on respiratory parameters, functional capacity, mobility, and dyspnea. Thirty-four stroke patients aged 18-65/years were randomized into Conventional Rehabilitation (CR) or Upper Extremity Robotic Rehabilitation (RR) groups. Both groups received conventional treatment for 5 days/week, for 6 weeks. Additionally, the RR group participated in upper extremity robotic rehabilitation (ExoRehab X, Houston Bionics) twice/week. Respiratory muscle strength (Maximum Inspiratory Pressure-MIP and Maximum Expiratory Pressure-MEP) and respiratory functions (forced expiratory flow first second (FEV1)), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow-25-75% (FEF 25-75%) were assessed. Functional capacity was evaluated with 6-minute walk test (6-MWT), mobility was assessed with Timed Up and Go (TUG) test, and dyspnea was measured using Dyspnea-12 test. Both groups showed improvements in MIP, MEP, 6MWT and TUG scores. Additionally, significant increases were observed in PEF in the CR group and in FVC, FEV1, %FEF 25-75, and reduced dyspnea in the RR group (all p < 0.05). The groups were similar in terms of mean changes, except for FVC (p = 0.004) and FEV1 (p = 0.002), which were significantly higher in RR group. Combining upper extremity robotic rehabilitation with conventional rehabilitation in stroke patients led to similar improvements in respiratory muscle strength, functional capacity, and mobility while also improving some respiratory parameters and reducing the perception of dyspnea. NCT05550311.

NIMG-11. DISCOVERING POSTOPERATIVE APHASIA RECOVERY IN GLIOMA PATIENTS: THE ROLE OF THE RIGHT BROCA’S HOMOLOG AND VERIFICATION

Abstract OBJECTIVE This study aimed to elucidate the neurological mechanisms that support the recovery of postoperative aphasia by examining alterations in language and extended networks in patients with glioma. Additionally, we sought to determine the causal relationship between the right Broca’s homolog and language recovery using neuro-navigated repetitive transcranial magnetic stimulation (nrTMS). METHODS Sixty-two patients with left hemisphere gliomas were retrospectively analyzed and categorized into aphasia and non-aphasia groups based on Aphasia Quotient (AQ) scores. Resting-state functional MRI (rs-fMRI) data were collected and analyzed to investigate differences in functional connectivity (FC) and topological properties of language-related networks. Additionally, eight patients with surgery-induced aphasia were prospectively treated with nrTMS, targeting the node identified from the retrospective analysis. RESULTS Significant increases in FC between the left auditory cortex and the right inferior frontal gyrus in the Executive Control Network were observed in the non-aphasia group. Nodal properties, such as the nodal efficiency of the right Broca’s homolog, were independently associated with postoperative language function. The nrTMS treatment group demonstrated significant improvements in AQ scores, with correlations between increased nodal efficiency and positive language outcomes. CONCLUSION The right hemisphere, specifically the right inferior frontal gyrus, plays a compensatory role in maintaining language function after glioma resection. These findings suggest the therapeutic potential of nrTMS for enhancing postoperative language recovery, offering insights into individualized patient care and rehabilitation strategies for patients with glioma.

Functions of a Complex Variable with a Large Parameter and Construction of Regions

In this article, the aim of the study is to assess the importance of psychological support in the early rehabilitation of patients after a stroke. The study involved 30 patients who had suffered an ischemic stroke. From the results, we see that a stroke dramatically changes a person's life and upon admission, 10% had a severe degree of depression, moderate depression was observed in 73%, and mild depression was in 17%. Daily work with a psychologist during the rehabilitation process significantly improved their psychoemotional state, reducing the level of depression. It also gave motivation for further rehabilitation. So, upon discharge, we observe that 67% of patients increased strength in the affected limbs to a mild degree, the Rivermead mobility index increased significantly and amounted to 12.83.36 points, out of a maximum of 15 points. This suggests that patients have become more mobile and independent. Effective rehabilitation after a stroke requires not only medical and physical therapy, but also the mandatory inclusion of psychological support as part of a comprehensive approach. This increases the chances of successful recovery and adaptation of the patient.

The reliability and validity of a novel clinical tool for distributing rehabilitation patients: a multicenter cross-sectional study in China

This study aimed to assess the reliability and validity of a novel clinical tool for distributing rehabilitation patients (DRP) for measuring a population of rehabilitation patients based on first-hand data from the field survey in China. A multi-stage sampling scheme was used to select 2512 rehabilitation outpatients from 21 medical institutions in seven cities in China. The evaluation indicators of the DRP tool consisted of five clinical indexes on multiple dysfunctions, self-care ability, vital signs, disease status, and disease course. The evaluation of rehabilitation ways of the DRP tool mainly included outpatient rehabilitation treatment, admission to primary healthcare, admission to secondary hospitals, and admission to tertiary hospitals. The mean age of participants was 54.22 years (SD:17.91), and nearly half (48.68%) were male. The majority (70.15%) were diagnosed with orthopaedic disorders. The Cronbach’s alpha (0.66), the Kendall test (Kendall coefficient = 0.86; P < 0.001), and the Kappa test (Kappa = 0.83; Agreement: 90.48%; P < 0.001) reflected acceptable consistency reliability for the indexes on multiple dysfunctions, self-care ability, vital signs, disease status, and disease course in DRP tool. The modified confirmatory factor analysis (CFA) showed the indexes of multiple dysfunctions (β = 0.31; 95%CI = 0.20–0.43), self-care ability (β = 0.99; 95%CI = 0.65–1.33), disease status (β = 0.11; 95%CI = 0.06–0.16), disease course (β = 0.15; 95%CI = 0.09–0.21), and vital signs (β = 0.15; 95%CI = 0.08–0.21) had significantly factor loadings on the rehabilitation ways. The modified CFA exhibited a satisfactory model fit (RMSEA = 0.03; CFI = 0.99; TLI = 0.95; SRMR = 0.01; AIC = 8268.51; BIC = 8373.43). This is the first study to develop a DRP tool using a relatively large sample from seven cities in China. The DRP tool had acceptable reliability and validity in measuring the rehabilitation ways of patients. Our findings provide a starting point for developing a practical tool in rehabilitation clinical practices and could provide advice on building more effective strategies and tools for other low-and middle-income countries that struggle with integrated healthcare.

Comparison of the effectiveness of drug therapy and non-drug technology of post-COVID rehabilitation of workers with intensive computer load

Currently, there is sufficient evidence of the importance and clinical effectiveness of non-drug therapy. The scientific discussion on the priority of the clinical application of pharmacological and non-pharmacological methods of rehabilitation of patients with mononeuropathies has acquired particular importance against the background of neurological post-COVID complications in patients with COVID-19. The study aims to compare the effectiveness of drug therapy and non–drug technology of post-covid rehabilitation of workers with intensive computer workload based on the study of clinical and laboratory parameters. Scientists have conducted a survey of two groups of workers with intensive computer workload who underwent rehabilitation after COVID-19 with the use of drug therapy and non-drug technologies, including balneotherapy, drinking narcotherapy, aerosol inhalations, low-frequency magnetic therapy. The authors have evaluated the effectiveness of therapy based on the results of studies of asthenization, degree of fatigue, latent coronary insufficiency, the state of the blood microcirculation system, immune status, the state of the POL-AOSIS system and endogenous intoxication of patients. Asthenization, the degree of fatigue, and latent coronary insufficiency decreased in the majority of the examined patients after post-COVID non-drug measures. Whereas in patients of the drug group, a decrease in these indicators was noted in a small number of examined patients. The indicators of the immune status of patients after non-drug therapy returned to normal, after drug therapy they only approached the limits of the norm, but did not reach it. After the treatment, the indicators of lipid peroxidation in the group of patients undergoing post-COVID rehabilitation using non-drug technologies decreased more significantly than in the group receiving drug treatment. The content of the antioxidant enzymes catalase and ceruloplasmin and the fat-soluble antioxidant α-tocopherol after treatment increases in both groups, but in the group of drug treatment they do not reach the lower limit of the reference intervals. The decrease in the content of medium-molecular peptides is more pronounced when using non-drug technologies. The application of the proposed non-drug technology for the rehabilitation of patients with post-COVID syndrome who are subjected to intense computer loads during work showed a significantly more pronounced normalization of asthenization, fatigue, latent coronary insufficiency and the state of the blood microcirculation system, immune status, the state of the POL-AOSIS system and endogenous intoxication of patients. The data obtained indicate a high therapeutic effect of the use of non-drug technology. Limitations. The surveyed groups included only persons permanently registered in Kislovodsk. Ethics. The research was conducted in accordance with the principles of biomedical ethics and approved by the local Ethics Committee of the Izmerov Research Institute of Occupation Health, Moscow (Protocol No. 4 dated 04/14/2021). Each participant of the study submitted a voluntary written informed consent signed by him after explaining to him the potential risks and benefits.

Assessment of gnostic and stereognostic functions in patients with liver cirrhosis: A comparative study with healthy controls.

Individuals diagnosed with liver cirrhosis typically experience a variety of symptoms. Decompensation, a critical stage in the disease's progression, is characterized by the emergence of prominent clinical signs. These signs typically include ascites, bleeding tendencies, hepatic encephalopathy, and jaundice. Furthermore, it is noteworthy that regions in the sensorimotor cortex responsible for practical and gnostic functions are closely situated within the parieto-occipital part of the cortex. Liver cirrhosis may also have an impact on this aspect of human motor function. The main objective of the study is to compare the gnostic function and stereognostic function in individuals with liver cirrhosis and those in a healthy population. The patients included in our registry, known as RH7, were enrolled in our study. The first group consisted of 74 liver cirrhosis patients (including 25women and 49men). The control group consisted of a 63healthy population (including 23women and 40 and men). Both groups underwent both the Petrie and kinaesthesia tests. The results of the Petrie test, which compared healthy participants with those with liver cirrhosis, indicate that the healthy population achieved a significant difference in both right and left upper limb compared to those with liver cirrhosis patients (p< 0.05). The healthy population showed a significant difference compared to liver cirrhosis patients in the kinesthesia test (p< 0.05), except for the second attempt with the left upper limb (p= 0.267). According to the LFI, there was no significant difference in either upper limb during both the initial and second attempts of Petrie test (p> 0.05). Patients with liver cirrhosis exhibited significantly poorer gnostic functions compared to the healthy population. This condition also leads to notable impairments in motor functions, affecting both the precision and coordination of movements. Despite these deficits, frailty alone does not appear to be an indicator of worsened gnostic or stereognostic functions. Therefore, while liver cirrhosis has a clear negative impact on motor and cognitive abilities, the presence of frailty does not necessarily exacerbate these specific cognitive deficits. This distinction is crucial for clinical assessments and interventions targeting motor and cognitive rehabilitation in patients with liver cirrhosis.

REHABILITATION IN NEPHROLOGY: HISTORY, CURRENT STATE, PROSPECTS

Rehabilitation assistance at healthcare institutions is a comprehensive package of measures designed to enhance the functional abilities of individuals who experience or may potentially experience limitations in their daily functioning within their surrounding environment. Nephrology is a branch of medical science that studies the etiology and pathogenesis of kidney damage, develops and improves diagnostic methods, treatments, and prevention strategies for congenital and acquired primary and secondary kidney damage at all stages of development. Pediatric urological disorders remain a signifi cant concern due to their high prevalence among children. Chronic kidney disease (CKD) is a particularly worrisome complication, as it is characterized by a relapsing nature and the potential for severe complications. The current system of healthcare is regarded as a costly branch of medical services, with expenditures on therapeutic and rehabilitative care (inpatient and outpatient stages) constituting a signifi cant proportion of the overall costs.The article presents the results of an analysis and a summary of the recommendations set forth in international and Ukrainian medicaltechnologicaldocuments based on evidence- based medicine with regard to rehabilitation care in pediatric nephrology. The methodology for establishing a clinical and rehabilitation patient pathway, comprising an individual rehabilitation patient plan, is presented. This pathway considers the most common urinary diseases among children at the hospital district level. The scientifi c research was conducted within the scientifi c focus of the Department of Pediatrics, Neonatology and Perinatal Medicine of Bukovinian State Medical University and the research project entitled «Chronobiological and Adaptive Aspects and Features ofAutonomic Regulation in Pathological Conditions in Children of Diff erent Age Groups.» The registration number is 0122U002245, and the project will run from January 1, 2022, to December 31, 2026.

Progress and development trends of lower limb exoskeleton rehabilitation robots

Abstract. Currently, as the aging population intensifies, many elderly people are trapped by lower limb dysfunctions caused by diseases such as stroke sequelae, spinal cord injuries, and bone injuries. Research on lower limb exoskeleton robots has made progress both domestically and internationally. Foreign lower limb exoskeleton robot technology is very mature and widely applied; although starting later, domestic development in this field has been rapid. This paper studies the key technologies of lower limb exoskeleton robots from several aspects: the degrees of freedom in human lower limb movement, the cyclic movement of human gait, structural design, driving methods, and interactive control. With the continuous advancement of technology, lower limb exoskeleton robots will become more intelligent and focus more on personalized services and wearing comfort in future development, aiming to bring more convenience and help to disabled individuals, rehabilitation patients, and groups with special needs.

An overview about hand exoskeleton actuation system and thumb motions analysis

Abstract. Stroke patients experience impaired hand function which significantly impacts their daily activities. Robot-assisted training is essential for restoring motor function, with hand exoskeletons serving as assistive devices to support, amplify, replace, or counteract body movements. Designing an exoskeleton that accurately mimics the natural movement of the thumb and provides adequate support is a key challenge in rehabilitation. This paper designs a retrieval model for hand rehabilitation exoskeletons from 2009 to 2023, analyzing the hand anatomy and thumb motion range. It discusses various driving mechanisms for hand exoskeletons, including cable, linkage, pneumatic, gear motor, and hybrid systems. While progress has been made in experimental stages, more research is needed for clinical applications. A universal hand exoskeleton actuation system that meets all patient preferences does not exist. Ongoing research on hybrid drive systems aims to enhance hand exoskeletons for better rehabilitation and daily use for patients with hand dysfunction.

CONTRIBUIÇÕES DA FISIOTERAPIA AQUÁTICA: REABILITAÇÃO EM PACIENTES COM LESÃO MEDULAR ESPINHAL TRAUMÁTICA

Aquatic Physical Therapy (APT) has been reported as applicable in various specialties within the physiotherapy field, culminating in rehabilitation procedures, especially after Spinal Cord Injury (SCI), with beneficial results for individuals with this condition. It tends to be more effective in restoring some or all movement, initially with plegia, presenting a decrease and even absence of strength and balance post-trauma in the vertebral column region, leading to spinal cord injury. The aquatic environment provides the patient with a bombardment of sensory-motor stimuli, further activating neuroplasticity in rehabilitation, as well as reducing pain, providing relaxation of all muscles, and increasing blood supply to the muscles. In addition to being a therapy in a safe environment, an important factor is the reduction of joint impact and improvement in venous return, making it possible to recover movements. Objective: To understand the contributions of aquatic physiotherapy in functional rehabilitation in (SCI). Methodology: Based on bibliographic research, using the electronic databases Bireme, PubMed, and Scielo, with articles published from 2000 onwards. Conclusion: Aquatic physiotherapy and its benefits in health recovery, achieved through the physical properties of water, have been studied since the time of Hippocrates, which, combined with physiotherapy treatment protocols, promote better functional rehabilitation for patients with (SCI).

“Going under the radar”: barriers to continuity in the rehabilitation trajectories of adults with acquired brain injury in North Norway

Purpose Acquired Brain Injury (ABI) is a major cause of disability, but rehabilitation services for adults with ABI discharged home remains deficient. This study explores barriers to continuity in the rehabilitation trajectories of this population in North Norway. Materials and methods Data were generated from focus groups consisting of individuals with ABI and family caregivers (n = 5) and healthcare professionals (n = 14). Purposeful sampling of participants (total n = 19) ensured diverse perspectives. A reflexive thematic analytical approach was applied to identify recurring themes. Results This study reveals significant misalignment between the support needs of home-dwelling adults with ABI and the existing healthcare system in North Norway. Four themes were identified: (1) A lack of awareness of patient rehabilitation needs in hospitals, (2) individuals with ABI slipping through the cracks during transitions, (3) constraints in municipal healthcare services’ capacity, and (4) unclear rehabilitation pathways for individuals with ABI. Conclusions Individuals with ABI need assistance navigating complex healthcare systems, gaining insight into their functional problems, and expressing needs and goals. The findings support calls for a paradigm shift in ABI rehabilitation, advocating for a transition from impairment-focused to reengagement-oriented practices as individuals with ABI transition from inpatient to home settings with increasingly stable residual impairments.

Comprehensive redesign of a rehabilitation program at Runnymede Healthcare Centre.

The redesign of the rehabilitation program at Runnymede Healthcare Centre (RHC) was designed to enhance patient care, staff satisfaction, and rehabilitation capacity. Aligned with RHC's strategic vision to become a centre of excellence for ageing and wellness, the initiative introduced a range of initiatives such as group therapy models, specific, measurable, achievable, relevant and time-bound rehabilitation goals, and enhanced leadership practices under the healthy engagement of older adults in rehabilitation therapy philosophy. Evaluation was integral to the initiative, with patient satisfaction, staff engagement, and key performance indicators continuously measured. Patient satisfaction scores, operational efficiency metrics, and staff engagement scores improved considerably. This project exemplifies how structured change management and embedded evaluation can lead to sustained improvements in patient care, staff experience, and rehabilitation outcomes.

Support and Rehabilitation for Psychiatric Patients with Prolonged Clinical Course: Verification of the Effectiveness of an Artistic Mediated Approach (Theater, Music, Biodanza, Ceramics)

Support and Rehabilitation for Psychiatric Patients with Prolonged Clinical Course: Verification of the Effectiveness of an Artistic Mediated Approach (Theater, Music, Biodanza, Ceramics)

Genetic associations between physical activity levels and functional outcome after ischemic stroke: Insights from Mendelian randomization

ObjectiveThe genetic relationship between daily physical activity (PA) levels and functional outcome after ischemic stroke remains unclear. This study aimed to investigate the genetic associations of PA on functional outcome after ischemic stroke using Mendelian randomization (MR). MethodsWe conducted two-sample MR analyses using genome-wide association studies (GWASs). This included data on light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) from the UK Biobank, and functional outcome after ischemic stroke from the Genetics of ischemic stroke Functional Outcome (GISCOME). The inverse-variance weighted (IVW) method served as our primary MR analysis approach, supplemented by several sensitivity analyses. ResultsIn univariable Mendelian randomization (UVMR) analysis, MVPA was significantly associated with a reduced risk of poor functional outcome (OR = 0.15, 95 % CI = 0.04–0.56, P < 0.01), whereas LPA had no genetic relationship (OR = 0.37, 95 % CI = 0.002–51.40, P = 0.69). In multivariate Mendelian randomization (MVMR) analysis adjusting for potentially confounding traits including hypertension, type 2 diabetes, and smoking, the overall patterns between MVPA and poststroke outcome remained (OR = 0.23, 95 % CI = 0.07–0.78, P = 0.02). ConclusionMVPA is a protective factor for functional outcome after ischemic stroke. This finding is important for the rehabilitation and functional outcome of stroke patients.

Effect of low-intensity muscle strength training on postoperative rehabilitation and adverse events in patients with knee osteoarthritis over 55 years of age: a meta-analysis

BackgroundThis study aimed to study the effect of low-intensity muscle strength training on postoperative rehabilitation of patients with knee osteoarthritis over 55 years of age and the incidence of adverse events by a meta-analysis.MethodsWe searched China National Knowledge Infrastructure (CNKI), WanFang, China Science and Technology Journal Database (VIP), PubMed, Web of science, and Embase databases for articles on the effect of low-intensity muscle strength training on the recovery of patients with knee arthritis. And meta-analysis combined effect was performed in R 4.2.2 software. Quantitative analysis and risk of bias were assessed by Begg’s and Eegger’s test.ResultsMeta-analysis showed that the effect of low-intensity muscle strength training on postoperative knee range of motion in patients with knee arthritis was mean difference (MD) = 5.20, 95% CI=[4.00, 6.40], τ2 = 0.43, P = 0.34; the effect on postoperative muscle strength was standard mean difference (SMD) = 1.24, 95% CI=[0.86, 1.61], τ2 = 0.07, P < 0.01; the effect on postoperative knee joint score was MD = 5.88, 95%CI=[2.09, 9.67], τ2 = 16.60, P < 0.01; the effect on postoperative knee visual analogue scale (VAS) score was MD=-1.12, 95%CI =[-1.43, -0.81], τ2 = 0.09, P < 0.001; the effect on the incidence of adverse events was RR = 0.85, 95%CI= [0.52 1.39], τ2 = 0.79, P = 0.04.ConclusionLow-intensity muscle strength training can improve the muscle strength of the affected limb and knee joint score, reduce the VAS score and the incidence of adverse events in patients with knee osteoarthritis over 55 years of age after surgery, but it has no effect on the postoperative knee range of motion, so it can be considered as appropriate in clinical selection.

Non-pharmacological interventions to support the cognitive rehabilitation of patients admitted to the intensive care unit: An umbrella review.

Critically ill patients experience cognitive impairment throughout their intensive care unit trajectory, in the acute phase and the long-term alike. Cognitive impairment may negatively impact patients' quality of life and rehabilitation outcomes. To provide an overall examination of literature concerning non-pharmacological interventions that can enhance cognitive functioning in critically ill patients or facilitate their rehabilitation pathway during and after their intensive care unit stay. This study was conducted as an umbrella review. A systematic search was conducted in CINAHL, Embase, PubMed and PsychINFO, including all types of peer-reviewed research syntheses published between 2008 and 2023. Eligible studies had to describe interventions capable of improving adult patients' cognitive functioning or supporting their cognitive rehabilitation process throughout the intensive care unit trajectory. All eligible research syntheses were screened systematically; those included were critically appraised. Based on 13 research syntheses, this review summarizes rehabilitative interventions that may be delivered during different phases of critical illness and recovery, in relation to content, delivery and timing. Interventions were: (1) cognitive activities and training, (2) mobilization and physical exercises, (3) emotional, psychological and social support and (4) information. Due to limited evidence, no definitive conclusion can be drawn about which type of intervention is most supportive or effective. Additionally, no recommendations can be made about the optimal timing for intervention delivery. Clinicians involved in developing and implementing cognitive rehabilitation measures should consider designing individualized, multicomponent interventions with a focus on content, delivery and timing.

The system of support for medical decision-making in the formation of a rehabilitation diagnosis in the categories of the International Classification of Functioning, Disability and Health

Introduction. Comprehensive rehabilitation of patients is a key task of the national healthcare system. To create an effective rehabilitation program, it is necessary to establish an accurate rehabilitation diagnosis. Designing an individual medical rehabilitation plan based on a biopsychosocial approach, the practical tool of which was the “International Classification of Functioning, Disability and Health” (ICF), has changed the global concept of rehabilitation. A priority in the field of digital healthcare is the introduction of medical decision support systems, one of the tasks of which is to help in diagnosis and minimize medical errors aimed at improving the quality of medical care. The purpose of the work: to create a software system for making medical decisions in the formation of a rehabilitation diagnosis in the ICF categories. Materials and methods. content analysis was used to study and analyze medical decision-making systems (foreign and domestic) and the ICF; scientific and methodological work was carried out on the development of software for medical decision-making systems. Results. based on the work carried out, software has been developed to automate, systematize, and optimize the process of establishing a rehabilitation diagnosis in patients with ischemic stroke, standardize approaches to individualizing diagnosis formulation taking into account the severity of functional disorders. Research limitations. During the development and description of the software, the capabilities of medical information systems applied in the healthcare of Moscow were used. Conclusion. The biopsychosocial approach is one of the main principles of modern rehabilitation. Digital healthcare facilitates the integration of decision support systems that improve the quality of medical care. The implementation of the developed program into digital platforms of the healthcare system will reduce time costs and unify the procedure for making a rehabilitation diagnosis and all related processes, consistently preserving the necessary information about the patient.