Principles Of Rehabilitation Research Articles

Formation of principles of socio-economic development of inclusive tourism as a multifunctional system

The object of research is the problem of formation of principles for the development of inclusive tourism as a new multifunctional scientific and practical direction, is considered within the framework of the socio-economic sphere. One of the most problematic places for the implementation of this direction is the theoretical and methodological substantiation of the principles of development and implementation of inclusive tourism, which is just beginning to be studied from the point of view of economic efficiency and social protection, appearing in the market of tourist services. In this regard, a significant factor remains the complexity of solving socio-economic problems related to both inclusive tourism and scientific areas related to it, together create an inclusive environment and ensure the systematic development of a new direction. The analysis of the current state of inclusive tourism in the world is carried out, the principles and priority tasks for the development and implementation of this direction are determined on the example of Ukraine. For the unstable social and economic spheres of Ukraine, the procedure for adapting inclusive tourism is complicated by the impact of implementation risks and is a complex and lengthy procedure. During the study, 7 principles of social rehabilitation of people with inclusion were used, which formed the basis of the general concept of development and implementation of inclusive tourism. For their implementation, the factors that contribute to the adaptation of persons with disabilities through inclusive tourism and factors that limit or influence the possibility of organizing inclusive tourism have been identified. Thanks to this, a methodologically informative segment of the development of an inclusive environment is provided and a procedure for assessing both social and economic risks of the project becomes possible. Only if there is a state strategic program for the long-term development of inclusive tourism and a thorough analysis of key risks, it is possible to avoid problems in the future. In comparison with similar well-known methodologies, the proposed approaches allow minimizing risks in the process of creating an inclusive environment and predicting the electoral reaction and socio-economic aspects of introducing inclusive tourism.

Pediatric Revision Anterior Cruciate Ligament Reconstruction: Current Concepts Review.

We present a review of revision anterior cruciate ligament (ACL) reconstruction in pediatric patients, discussing risk factors for rerupture, physical examination and imaging, treatment principles and surgical techniques, postoperative rehabilitation, and clinical outcomes. PubMed, Cochrane, and Embase databases were queried for relevant articles about revision ACL topics. All types of manuscripts, including clinical studies, basic science studies, case series, current concepts reviews, and systematic reviews were analyzed for relevant information. Current concepts on risk factors for rerupture, physical examination and imaging, treatment principles and surgical techniques, postoperative rehabilitation, and clinical outcomes were synthesized. Surgical treatment should be individualized, and the graft type, fixation devices, tunnel placement, and complementary procedures (eg, extra-articular tenodesis) should be tailored to the patient's needs and previous surgeries. Rehabilitation programs should also be centered around eccentric strengthening, isometric quadriceps strengthening, active flexion range of motion of the knee, and an emphasis on closed chain exercises. Despite adherence to strict surgical and postoperative rehabilitation principles, graft refailure rate is high, and return to sports rate is low. Rerupture of the ACL in the pediatric population is a challenging complication that requires special attention. Diagnostic evaluation of repeat ACL ruptures is similar to primary injuries. Although outcomes after revision ACL reconstruction are expectedly worse than after primary reconstruction, athletes do return to sport after proper rehabilitation. Further research is needed to continue to improve outcomes in this high-risk population, aimed at continued knee stability, graft survivorship, and improved quality of life.

Pulmonary rehabilitation principles in SARS-COV-2 infection (COVID-19): The revised guideline for the acute, subacute, and post-COVID-19 rehabilitation

Coronavirus disease 2019 (COVID-19) is a contagious infection disease, which may cause respiratory, physical, psychological, and generalized systemic dysfunction. The severity of disease ranges from an asymptomatic infection or mild illness to mild or severe pneumonia with respiratory failure and/or death. COVID-19 dramatically affects the pulmonary system. This clinical practice guideline includes pulmonary rehabilitation (PR) recommendations for adult COVID-19 patients and has been developed in the light of the guidelines on the diagnosis and treatment of COVID-19 provided by the World Health Organization and Republic of Turkey, Ministry of Health, recently published scientific literature, and PR recommendations for COVID-19 regarding basic principles of PR. This national guideline provides suggestions regarding the PR methods during the clinical stages of COVID-19 and post-COVID-19 with its possible benefits, contraindications, and disadvantages.

Postoperative Rehabilitation of Posterior Cruciate Ligament Surgery: A Systematic Review.

Posterior cruciate ligament (PCL) injuries can be debilitating knee injuries, having involvement in up to 44% of traumatic knee injuries. However, isolated PCL injuries are relatively infrequent. Therefore, effective evidence-based rehabilitation protocols have proven to be elusive. This systematic review aims to summarize the latest evidence on postoperative rehabilitation protocols for patients undergoing PCL reconstruction. Studies included in this paper included those published from 1991 to 2019 with a grade 1 to 5 level of evidence discussing the postoperative PCL rehabilitation. A multidatabase search using largely PubMed and Ovid was conducted using relevant keywords such as "PCL," "postoperative," and "rehabilitation," initially leading to 955 papers, which were narrowed by relevance to 12 final published studies used in the analysis. Through careful review of the evidence, crucial principles of rehabilitation, such as an initial focus on protecting the graft during strengthening, as well as an optimized PCL reconstruction protocol are presented here. Rehabilitation following PCL reconstruction continues to be limited by a lack of high-quality evidence-based publications.

Sensory Attenuation in Sport and Rehabilitation: Perspective from Research in Parkinson's Disease.

People with Parkinson’s disease (PD) experience motor symptoms that are affected by sensory information in the environment. Sensory attenuation describes the modulation of sensory input caused by motor intent. This appears to be altered in PD and may index important sensorimotor processes underpinning PD symptoms. We review recent findings investigating sensory attenuation and reconcile seemingly disparate results with an emphasis on task-relevance in the modulation of sensory input. Sensory attenuation paradigms, across different sensory modalities, capture how two identical stimuli can elicit markedly different perceptual experiences depending on our predictions of the event, but also the context in which the event occurs. In particular, it appears as though contextual information may be used to suppress or facilitate a response to a stimulus on the basis of task-relevance. We support this viewpoint by considering the role of the basal ganglia in task-relevant sensory filtering and the use of contextual signals in complex environments to shape action and perception. This perspective highlights the dual effect of basal ganglia dysfunction in PD, whereby a reduced capacity to filter task-relevant signals harms the ability to integrate contextual cues, just when such cues are required to effectively navigate and interact with our environment. Finally, we suggest how this framework might be used to establish principles for effective rehabilitation in the treatment of PD.

Principles of treatment of late rectal radiation damage in cancer patients

Malignant neoplasms of the pelvic organs in the structure of cancer incidence make up about 30 % of the adult population of our country. The widespread use of radiation therapy, unfortunately, has also increased the frequency of radiation damage to the pelvic organs, which, as a rule, take a chronic course. Late radiation damage to the pelvic organs is a fairly common complication of radiation therapy for prostate cancer. According to various authors, the frequency of such iatrogenic pathological changes is up to 25 %. In fact, some patients who are cured of a malignant neoplasm acquire a new disease that significantly reduces the quality of life and requires treatment. During radiation therapy of prostate cancer, various anatomical formations can fall into the zone of radiation fields: the bladder, rectum, intra-pelvic tissue, neurovascular bundles and pelvic bones. It should be noted that isolated lesions of one organ are rare and in most cases they are combined. A special place in clinical practice is occupied by cases of local radiation injuries of the rectum, including severe complications of radiation and combined treatment associated with the formation of fistulas against the background of radiation-induced intra-pelvic fibrosis in the absence of a relapse of the underlying disease. In addition, this situation is associated with a violation of the psycho-emotional status of patients, a sharp decrease in the quality of life, difficulties in social adaptation in society and family, pain syndrome, and problems of medical rehabilitation. Unfortunately, conservative measures for such local radiation injuries are not always effective, and the results of surgical interventions are far from ambiguous and require careful study of patients, search for an algorithm of indications and acceptable standardization of surgical manipulations. This paper presents the basic principles of diagnosis, comprehensive treatment and rehabilitation of patients with late radiation rectitis, depending on the severity of the pathological process. Given the growth of malignant neoplasms of the pelvic organs, we can assume a relative increase in the number of patients with complications associated with radiation therapy, which require rehabilitation measures. Such patients come to the attention of oncologists, radiologists, coloproctologists, gastroenterologists and therapists, etc. Currently, our country lacks a network of specialized regional departments that deal with this problem, as well as treatment standards, clinical recommendations, and an algorithm for diagnostic and rehabilitation measures for local radiation injuries. In connection with the above, it became necessary to summarize the data of clinical studies based on their own experience.

Principles of Amputation Surgery, Prosthetics, and Rehabilitation in Children.

Pediatric patients may benefit from extremity amputations with potential prosthetic fitting when addressing limb deficiencies, trauma, infection, limb ischemia, or other pathologies. The performance of a quality amputation is a fundamental skill to an orthopaedic surgeon, yet avoidance of pitfalls can be elusive in children. The need for surgical precision and sound decision-making is amplified in pediatric amputations, where the skeleton is dynamic and growing, anatomy can be miniscule and (in the case of congenital anomalies) variable. The principles that guide amputation level and technical approach are unique in children. Despite this, descriptions of these procedures as they should be applied to a growing or congenitally deficient skeleton are lacking. Furthermore, surgeons must also understand the unique prosthetic and psychosocial considerations for children. A collaborative approach between the surgeons, rehabilitation physicians, prosthetists, therapists, and families is essential to ensuring optimal results.

Model of complex rehabilitation for patients with a simple form of schizophrenia

Psychosocial rehabilitation for patients with mental disorders is one of the priority areas of scientific research in modern psychiatric discourse. The key to solving this problem is a multidisciplinary approach, within which it becomes possible to select congruent rehabilitation and psychoeducational techniques, taking into account the clinical and psychopathological content of this nosological form. In this context endogenous procedural mental disorders deserve special attention, as they are characterized by the highest level of social and labor maladjustment. Aim. To investigate the effectiveness of the developed model of complex psychosocial rehabilitation for patients with schizophrenia. Materials and methods. On the basis of Municipal Non-Commercial Enterprise “Regional Clinical Institution for Provision of Psychiatric Care” of Zaporizhzhia Regional Council, 80 patients with a simple form of schizophrenia were selected at the outpatient stage of treatment for the purpose of further examination. Clinical diagnostics of the studied mental pathology was carried out in accordance with the differential diagnostic criteria of the International Classification of Diseases 10 revision (ICD-10). The inclusion criteria for the study contingent were: informed consent to participate in the study, the absence of severe somatic pathology and information about craniocerebral trauma. In order to analyze the effectiveness of the developed model, the study contingent was randomized into the study group (SG) – 40 patients who received complex therapy within the framework of the developed model of psychosocial rehabilitation, and the comparison group (CG) – 40 patients who received treatment in accordance with the current protocols. Results. Based on the formed principles of psychosocial rehabilitation for patients with a simple form of schizophrenia, a comprehensive model of psycho-rehabilitation support for this patient contingent was generated including four stages: psychopharmacological, family intervention, cognitive-behavioural and ergotherapeutic. Analysing the effectiveness of the developed model, statistically significant differences (P < 0.05) were established between the average indicators in the studied groups according to the criteria “socially useful activity, including work and study” (4.18 ± 0.25 and 3.33 ± 0.27 points in SG and CG, respectively) and “relationships with family and other social relations” (4.35 ± 0.24 and 3.60 ± 0.25 points in SG and CG, respectively) in the absence of statistically significant differences in the criteria for “self-care” and “bothering others and aggressive behaviour”. Conclusions. The effectiveness of the complex model of psychosocial rehabilitation for patients with a simple form of schizophrenia in the areas of socially useful activities (study and work) and social relations was developed and proved, which made it possible to increase the effectiveness of therapy for this contingent of patients.

THE ROLE OF “CLINICAL PRACTICE” DISCIPLINE IN PREPARATION OF FUTURE SPECIALISTS OF HIGHER MEDICAL EDUCATIONAL INSTITUTIONS

Резюме. Клінічна практика студентів-медиків одна із найважливіших складових професійної підготовки будь-якого спеціаліста і є центральним елементом викладання і вивчення навчальної програми. Клінічна практика з терапії є процесом закріплення теоретичних знань, практичних умінь і навичок, отриманих в процесі навчання студента, і формування універсальних та професійних компетенцій майбутнього лікаря-терапевта, сімейного лікаря, лікаря загальної практики, тобто набуття досвіду у вирішенні реальних професійних завдань.
 На кафедрі внутрішньої медицини №2 та медсестринства із 2020-2021 навчального року введена вибіркова дисципліна «Клінічна практика в терапії» для студентів 5 курсу медичного факультету (спеціальність «лікувальна справа», «педіатрія»). Клінічна практика в терапії складається із трьох змістових модулів: «Основні методи обстеження та діагностики в кардіології», «Особливості обстеження та діагностики в ревматології, гастроентерології, нефрології. Діагностика основних інфекційних хворіб», «Клінічна практика в пульмонології, ендокринології, гематології».
 На практичних заняттях велика увага приділяється виконанню практичних навичок і умінню розв’язувати ситуаційні задачі. Студенти вдосконалюють свої навички з фізикального обстеження всіх органів і систем та встановлюють ступінь їх порушення, навчаються реєстрації електрокардіограми, проводити серцево-легеневу реанімацію, пікфлуометрію, аспірацію кісткового мозку, інтерпретувати результати лабораторних та інструментальних методів дослідження, обґрунтовувати та формулювати попередній діагноз, призначити лікування і вибрати подальший маршрут пацієнта залежно від діагностованої патології.

Stroke Rehabilitation Principles

Stroke Rehabilitation Principles

Динаміка якості життя осіб похилого віку з старечою астенією та паркінсонізмом під впливом засобів фізичної терапії у постіммобілізаційному періоді після перелому променевої кістки у типовому місці

In old age, due to the spread of age-related diseases, there are changes in the functioning of many organs and systems due to and against the background of polymorbidity, which affects the quality of life and requires correction. The purpose of the study was to determine the dynamics of the quality of life of elderly people with frailty and parkinsonism under the influence of physical therapy in the post-immobilization period after fracture of the radial bone in a typical place. Material and methods. We examined 27 elderly people with frailty and Parkinson's disease in the early postimmobilization period after fracture of the distal metaepiphysis of the radial bone (in a typical place). Group 1 engaged in the principles of outpatient rehabilitation with a predominance of preformed physical factors and group 2 engaged in a developed program of physical therapy, created in terms of patient-centric model of rehabilitation taking into account the specifics of each polymorbid condition using functional body training, massage, nutrition correction, expansion of social activity. The effectiveness of the program was evaluated in the dynamics before and after a month of implementation based on the results of the comparison of quality of life on the questionnaire "Medical outcomes study short form" (SF-36). 36 points were grouped into eight scales: Physical health: Physical Functioning, Role-Physical, Bodily Pain, General Health and Mental Health, Vitality, Social Functioning, Role-Emotional. Results and discussion. At the initial examination the examined people revealed a significant decrease in the results of all scales of physical and mental components of the quality of life of the questionnaire SF-36. The parameters of both groups did not differ statistically significantly (p> 0.05). At retesting, the difference between the results of the physical component of health in the primary and re-study on the physical functioning scale for individuals in group 1 was 18.9%, group 2 – 29.0%, role-physical – 19.8% and 35.5%, respectively, bodily pain – 12.3% and 33.1%, general health – 25.8% and 30.1%. The improvement of the mental component compared to the initial result on the vitality scales in patients of group 1 was 14,0%, group 2 – 27,4%, social functioning – 17,5% and 41,3%, respectively, role-emotional – 15,0% and 23,8%, mental health – 20,5% and 30,2%. The results of testing on all scales were statistically significantly better in individuals of group 1 compared with the result of group 2 (p <0,05). Conclusion. Elderly patients with polymorbid pathology and traumatic bone injuries require the development of pathogenetically based physical therapy programs taking into account and correcting the specifics of each disease, increases the overall effectiveness of rehabilitation and, consequently, quality of life

Динаміка функціональної активності осіб похилого віку з хворобою Паркінсона та синдромом старечої астенії з наслідками перелому шийки стегнової кістки під впливом засобів фізичної терапії

The high risk of fall-risk in patients with Parkinson's disease leads to traumatic consequences, in particular, to the femoral neck fractures. Predictors of fall-risk are old age, sarcopenia, and polymorbidity. All of these conditions are independent indications for carrying out rehabilitation measures; but their combination in one patient should introduce specific features into the recovery process aimed at leveling the signs of each disease. The purpose of the study was to assess the dynamics of functional activity in older people with Parkinson's disease and frailty with the consequences of femoral neck fractures under the influence of physical therapy. Material and methods. We examined 21 elderly patients with Parkinson's disease and frailty in the recovery period after the femoral neck fracture. They were divided into two groups: group 1 practiced according to the principles of polyclinic rehabilitation with a predominance of the use of preformed physical factors and general principles of physical therapy and group 2 practiced according to a developed program of physical therapy with an emphasis on functional training aimed at improving physical qualities, movement stereotype, primarily movement and self-service, taking into account the polymorbidity of the pathology. The developed physical therapy program lasted 3 months; corrective sessions were held three times a week. The program was created taking into account the setting and consistent achievement of individual short- and long-term rehabilitation goals. The effectiveness of the program was assessed based on the results of the Barthel Activities of the daily living Index and the Lawton Instrumental activities of the daily living Scale. Results and discussion. In elderly patients with Parkinson's disease and frailty in the recovery period after the femur neck fracture, a low level of basic (according to the Bartel index) and instrumental (according to the Lawton scale) functional activities is diagnosed, which leads to restrictions in everyday activities and self-care. The developed program of physical therapy revealed a statistically significantly better effect on the indices of the basic and instrumental functional activities of the examined persons in comparison with the general polyclinic program: the increase in the general level of the basic functional activity of the Bartel index in group 1 was 15.52%, in group 2 was 35.59% (p <0.05). Improvement in the overall score of instrumental activity on the Lawton scale in group 1 was 18.70%, in group 2 it was 36.11% (p <0.05). Conclusion. Elderly patients with polymorbid pathology with traumatic bone injuries require the preparation of pathogenetically based physical therapy programs, taking into account and correcting the specificity of each disease, which increased the overall effectiveness of rehabilitation and, as a consequence, the functional activity of patients

Ефективність впливу засобів фізичної терапії на показники неврологічного та функціонального статусу китиці осіб з компресійною нейропатією серединного нерва як постіммобілізаційного ускладнення переломів дистальних відділів кісток передпліччя

The social inconsistency of patients with hand injuries is due to the limitation of the possibilities of professional and labor activity (reduced qualifications, limited opportunities for training and retraining, inability to work in their specialty), which justifies the search for new methods of their rehabilitation. The purpose of the study was to determine the effectiveness of physical therapy on the indicators of the neurological and functional status of the hand in patients with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones. Material and methods. The study involved 56 people with postimmobilization contractures of the wrist joint, complicated by compression neuropathy of the median nerve, as a result of fracture of the bones of the distal forearm. They were divided into two groups: the control group (they practiced according to the principles of polyclinic rehabilitation with a predominance of passive means like manual techniques, preformed physical factors) and the main group (they were engaged in a developed physical therapy program based on the principles of International Classification of Functioning, Disability and Health with a predominance of active means like functional training; massage; warm wet compress combined with post-isometric muscle relaxation, posture treatment; kinesiological taping). The effectiveness of the program was assessed by the presence and degree of pain (VAS and DN4), goniometry results, signs of median nerve irritation (Phalen, Hoffmann-Tinel, Durkan), French Arm Test, ABILIHAND, DASH, Boston carpal tunnel questionnaire. Results and discussion. After the rehabilitation intervention, all examined patients showed a decrease in the intensity of pain at rest and during movement (according to VAS). Signs of compression neuropathy of the median nerve decreased (pain intensity according to the DN4 questionnaire, the prevalence of specific symptoms, the results of a quantitative assessment of the Boston carpal tunnel questionnaire). There was an improvement in the functioning of the upper limb according to the ABILIHAND, DASH, French Arm Test scales. For all the studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p <0.05). However, the patients of the main group showed a better result than the patients of the control group (p <0.05). Conclusion. The developed program of physical therapy with the predominant using of active rehabilitation means revealed a statistically significant better effect on the indicators of the neurological and functional status of the hand in persons with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones

EVALUATION OF THE INFLUENCE OF MOTOR DISORDERS ON THE QUALITY OF LIFE OF PATIENTS WITH COMOBIDITY OF PARKINSON'S DISEASE AND FRAILTY AND THE EFFICIENCY OF THEIR CORRECTION BY PHYSICAL THERAPY

Summary. Purpose of the study: to assess the effect of motor disorders on the quality of life of elderly patients with comobility of Parkinson's disease and frailty and to evaluate the effectiveness of their correction by means of physical therapy.
 Material and methods. 57 elderly people with diagnosed Parkinson's disease in combination with frailty were examined. They were divided into two groups: 1 (practiced according to the principles of polyclinic rehabilitation) and 2 (practiced according to a developed program of physical therapy, which was created from the point of view of a patient-centric model of rehabilitation, taking into account the specifics of each polymorbid state with the use of functional training, massage, ergotherapy, correction food). In the course of physical therapy, we consistently achieved individual short- and long-term goals of rehabilitation in the SMART format. The effectiveness of the program was assessed by the dynamics of the MDS Unified Parkinson's Disease Rating Scale, Schwab-England, PDQ-39.
 Results. The examined persons were found to have significant motor disorders, deterioration in the activity of everyday life and everyday activity and, as a consequence, a decrease in the quality of life. The developed program of physical therapy, created from the point of view of a patient-centric model of rehabilitation with the use of functional training, therapeutic exercises, massage, ergotherapy, nutrition correction, revealed a statistically significant better effect on the indicators of motor functions, the state of daily and household activity and the quality of life in comparison with the general polyclinic program. for all studied indicators (p <0.05).
 Findings. Elderly patients with comorbidity of Parkinson's disease and senile asthenia require the development of individual programs of physical therapy, taking into account and correcting the specificity of each disease, which increases the overall effectiveness of rehabilitation.

REVITALIZATION OF THE URBAN WATERFRONT AREAS

The article presents a strategy for renovation in the riverside area: improvement of water protection functions; rehabilitation of disturbed territories; the use of recreational and urban planning potential of such territories for creating a recreational framework on the waterfront; integration of eco-clusters into the structure of riverside territories and the development of an integrated management system for waterfront zones. As a result of the research, the necessity of rethink the attitude to urban planning within the riverside areas is formulated. Possibilities of sustainable development of riparian territories are determined. Stages of rehabilitation of communal warehousing and industrial territories for sustainable development and rehabilitation of urban areas are proposed. A formalized model of structural renovation of the exploring areas are being built, on the basis of which the identified principles of rehabilitation are being tested. The significance of the obtained results for urban science lies in the development of new approaches to the identification and formation of the structure of territories in the area of interaction with the water area. In the formulation of the basic principles underlying the structural and planning transformations of riparian areas.

STAGES OF REHABILITATION OF PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENT

One of the urgent tasks of modern medicine is organizing the rehabilitation for patients who have suffered a stroke at different stages of rehabilitation. Restoration of impaired functions in such patients occurs in the first 3−5 months from the onset of the disease, that is influenced by a number of factors: duration of the stroke, size of the lesion and pool of lesions, active participation in the process of a patient him−/herself. The main principles of rehabilitation include its early onset in an acute period of stroke; regularity and duration; complexity and multidisciplinarity (formation of multidisciplinary teams); adequacy of rehabilitation measures, i.e. creation of individual programs taking into account the severity of neurological deficit and dysfunction; stages. Different methods of recovery are applied to each patient individually or in combination, or sequentially according to the rehabilitation program, which is based on the analysis of the patient's condition by all members of the multidisciplinary team, taking into account the results of functional testing and objective examination. Medical support, postural correction, kinesitherapy, mechanotherapy (including robotic), field therapy, hardware physiotherapy, massage, acupuncture according to the indications, functional neurotraining and cardiotraining, neuropsychological training are used. The results of research confirm that the integrated use of kinesitherapy, physical factors, balneotherapy, the methods of psychological rehabilitation of patients after stroke provides a faster recovery of neurological deficit, activates non−specific brain systems, restores mental and somatic functions of the body. Therefore, in addition to health, the patient needs to renew his ability to work and social status. Key words: acute cerebrovascular accident, medical rehabilitation, stages of rehabilitation.

Rehabilitation after new coronavirus infection (COVID-19): principles and approaches

The novel coronavirus infection (COVID-19), which quickly became a pandemic in 2020, has presented new challenges for healthcare system. COVID-19, being a contagious infectious disease predominantly affects respiratory system, causes cardiovascular, neurocognitive, renal, gastrointestinal, hepatic, metabolic and mental damages, which is in fact a multisystem disease. Patients with COVID-19, primarily with moderate and severe forms, need appropriate rehabilitation. This article establishes need of development of rehabilitation programs for COVID-19 patients, identifies their problems that leads to restrictions on everyday life, self-service, mobility, communication, interpersonal relationships, and professional activities. Goals and general principles of medical rehabilitation in context of a pandemic at all three stages are presented. Features of rehabilitation approaches are highlighted and important components of individual rehabilitation program for COVID-19 patients are highlighted.

Interval Return to Play Programs for the Tennis Athlete.

General guidelines exist for return to sport after injury. The goal of these guidelines is to outline phases of recovery that will minimize the risk of reinjury and promote an optimal return to function for the athlete. This paper analyzes the current research pertaining to interval return to play programs with a special focus on the tennis athlete. The authors examine the different components of an interval tennis program and work to develop what they feel are the necessary elements of the optimal return to sport guidelines for tennis athletes. These criteria are based on the available literature, research, and preliminary data collection as well as the personal experiences and clinical observations of the authors. Interval sports programs are typically designed to guide the athlete back to competition after an injury. The current research reveals the obstacles present in implementing an appropriate interval sports program including a lack of consensus on which criteria is actually necessary and relevant. Limited research is present for interval tennis programs. Return to sport competition and sports science is continuously evolving. The authors highlight the necessary components in rehabilitation and performance principles for establishing a comprehensive interval tennis program. In addition, the role of technology in sports rehabilitation is assessed as it pertains to return to play. The authors proposed that interval sports program can help guide and direct future clinicians in their rehabilitation of the tennis athlete.

The experience of delivering ‘Rehabilitative Adjudications’ in English prisons

ABSTRACT The study examined the experience of delivering Rehabilitative Adjudications (RAs), a concept which explicitly integrates rehabilitative skills and procedural justice principles within a traditional disciplinary process for responding to rule-breaking in prison. Based on interviews with ten adjudicators, seven themes were identified. Overall, perceptions of RAs were positive, perceived to be a more constructive, rehabilitative, engaging and hopeful way to respond to rule-breaking, and in keeping with efforts to develop a wider rehabilitative prison culture. Existing adjudicator skills were reinforced through the training, and others developed for additional application in practice. A number of recommendations are made for organisations or prisons looking to adopt a RA approach, including suggestions to overcoming barriers that participants faced during the trial.

METHODS OF STRUCTURAL AND PLANNING RENOVATION RIVERSIDE URBAN TERRITORIES

Purpose. The purpose of the article is to identify methods of structural and spatial changes within the existing urban riparian areas. As a result of the research, the need to rethink the attitude to urban planning in general, and within the river space in particular, was formulated. The task is to revitalize the territory within the water area by creating public spaces, restoring the ecological framework through the introduction of ecological clusters and creating green corridors, maintaining economic activity based on industry, with its partial transformation, maintaining the existing system of spaces and structures and their partial redevelopment. Results. The potential of sustainable development of riparian areas in the context of the formation of recreational space in its structure as a result of renovation is revealed. Methods of structural and planning transformations within the water area have been developed. A model of structural transformation of the river space within the city is being built, on the basis of which the identified principles of rehabilitation of the territory are being tested. The significance of the obtained results lies in the development of new approaches to the formation of a holistic recreational river structure; in the formulation of the basic principles underlying the structural and planning transformations and the construction of a model of urban renovation of the riparian zone. The study used grapho-analytical methods, as well as the study and analysis of foreign and domestic experience in the renovation and revitalization of riverside industrial areas. The study analyzed the master plan of the city, identified functional areas within the river space. Conclusion. The expediency of rehabilitation of the territory, introduction of new, actual functions determines the economic, social, cultural, psychological and aesthetic development of the city.