Rehabilitation Process Research Articles

Effects of Platelet-Rich Plasma Combined with Physical Therapy on IL-1β, TGF-β1, and MMP-3 in Patients with Knee Osteoarthritis.

The occurrence of osteoarthritis in the knee joint is regulated by a complex network, and there is currently no specific therapeutic drug available. Functional exercises and treatments targeting inflammatory factors have shown the potential to alleviate knee osteoarthritis to some extent. Therefore, the aim of this study was to assess the intra-articular injection (IAI) of autologous platelet-rich plasma (PRP) combined with physical therapy (PT) in treating knee osteoarthritis. A total of 128 patients with knee osteoarthritis were included in the study, including 64 males and 64 females. A total of 128 patients were divided into sodium hyaluronate group (HA group), PRP group, PRP + PT group, and PT group, with 32 cases in each group. Visual analog scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Japanese Orthopaedic Association (JOA) were employed to evaluate the recovery of patients from pain and osteoarthritis. Color Doppler ultrasound imaging technology was utilized to assess joint effusion, synovial membrane thickness, and articular cartilage thickness in patients with knee osteoarthritis. Enzyme-linked immunosorbent assay (ELISA) was employed to detect the levels of interleukin-1β (IL-1β), transforming growth factor-β1 (TGF-β1), and matrix metallopeptidase 3 (MMP-3) in the synovial fluid. Compared to the HA group, the PT group, PRP group, and PRP combined with PT (PRP + PT) group all showed reduced VAS and WOMAC scores, increased JOA scores, decreased joint effusion, synovial membrane thickness, and articular cartilage thickness in the knee joint. Additionally, levels of IL-1β and MMP-3 in the synovial fluid decreased, while TGF-β1 levels increased (P < 0.05). Compared with the PT group, the VAS and WOMAC scores of the knee joint in the PRP group decreased, JOA scores increased, joint effusion, synovial thickness, and articular cartilage thickness decreased, but there was no statistically significant difference (P > 0.05), and the PRP + PT group showed decreased VAS and WOMAC scores, increased JOA scores, reduced joint effusion, synovial membrane thickness, and articular cartilage thickness in the knee joint. Moreover, levels of IL-1β and MMP-3 in the synovial fluid decreased, while TGF-β1 levels increased (P < 0.05). No severe adverse reactions were observed in any of the four groups, but the pain rate in the PRP + TP group was significantly lower than PT group, PRP group, and PRP + PT group (P < 0.05). The efficacy of intra-articular injection of PRP combined with exercise therapy in the treatment of knee osteoarthritis is superior to that of single interventions such as simple interventions of HA, PRP injection, and PT. Furthermore, intra-articular injection of PRP combined with exercise therapy demonstrates enhanced effectiveness in improving the inflammatory levels associated with knee osteoarthritis and facilitating the rehabilitation process.

Prenatal ultrasound diagnostics and sociopsychological support as rehabilitation measures in patients with congenital cleft palate complicated by anomalies of other organs and systems

BACKGROUND: Prenatal ultrasound diagnostics and sociopsychological support in the early rehabilitation of children with congenital cleft palate combined with malformations of other organs and systems complement the unified algorithm of dynamic monitoring and rehabilitation treatment of these patients. Thus, predicting the choice of techniques and the system of rehabilitation prescriptions became possible. AIM: To present the experience of prenatal ultrasound diagnostics and sociopsychological support during pregnancy for the early rehabilitation of a patient with cleft palate combined with malformations of other organs and systems. MATERIALS AND METHODS: The study was conducted in the Multiprofile Clinical Medical Center “Bonum” in Yekaterinburg. For 24 years, from the analysis of medical records of the organizational and rehabilitation process of 2,475 patients with congenital cleft lip and/or palate receiving comprehensive care (1998–2022), 823 (33.25%) patients who had with cleft palate and malformations of other organs and systems were enrolled in this study. The discharge epicrises of the pregnancy and the timing of intrauterine ultrasound diagnostics of the fetus were studied, and the history of childbirth and anamnesis of newborns and timing of their routing and registration in the specialized “Bonum” Center were analyzed. At the time of the initial outpatient appointment at the center, parents’ responses to a survey on the nature of emotional and psychological experiences during the prenatal ultrasound examination of the fetus, period of “bearing” pregnancy, and birth of a baby with a complex anatomical and physiological pathology were analyzed. RESULTS: Ultrasound examination of the fetus during uterine development registered 292 (35.48%) of 823 cases of a combination of congenital cleft palate and anomalies of other organs and systems. The main forms of malformations in the fetus were established in the second (n=99, 33.90%) and third (n=185, 63.36%) trimester pregnancy screening. Mothers who were told about the results of ultrasound diagnostics of the fetus showed anxiety and emotional lability. The use of psychocorrectional and socially significant measures during the diagnosis of fetal pathologies and at the time deciding whether to continue pregnancy, as well as the newborn period, which relieved the psycho-emotional tension of parents, was proposed. CONCLUSION: Early rehabilitation of patients with congenital cleft palate combined with malformations of other organs and systems should be provided as an integral part of the complex rehabilitation therapy. Sociopsychological support of the family from the period of prenatal diagnosis of the fetus who had multiple malformations is necessary at all stages of pregnancy and rehabilitation treatment of the child.

Moving between positions: a qualitative study of mentoring relationships in chronic eating disorders

PurposeEating disorders (ED) are chronic and challenging-to-treat conditions, often persisting over extended periods. Some patients with EDs require prolonged intensive rehabilitation services, which may include weekly home visits by paraprofessional mentors serving as support persons, providing guidelines, emotional care, and assistance. This study aims to enhance our understanding of the nature of the relationship formed between mentors and patients with EDs.Design & MethodsFifteen in-depth qualitative interviews were conducted with patients and paraprofessional mentors. Interviews were analyzed using a descriptive phenomenological approach by two researchers to enhance reliability.FindingsQualitative analysis highlighted that mentors play a crucial role in patients’ rehabilitation. Mentors adapt two positions (investigative and embracing) to address the encountered difficulties, including conflicts, tension, and confusion associated with (in)equality and reciprocity in the mentoring relationship.Practice ImplicationsParaprofessional mentors can assist people with ED in their rehabilitation process. To support patients with EDs effectively, it is crucial to train and supervise the mentors in navigating between roles and dealing with boundaries, secrets, lies, and exposure to various aspects of the rehabilitation process. Additionally, we recommend further research using quantitative and empirical tools to complement the qualitative findings presented.

INNOVATION AND DIGITAL TRANSFORMATION IN HEALTHCARE. PROCESS OPTIMIZATION OF REHABILITATION ACTIVITIES IN IN REHABILITATION CARDIOLOGY IN SUPPORT OF PATIENT AND TEAM

Abstract Physical activity is a treatment for preventing and treating a wide range of diseases; its prescription must be precise and accurate in order to optimize the effects avoiding at the same time clinical risks due to frequent patients’ frailty.To deploy a “comprehensive digital rehabilitation” means to digitalize the whole process: from clinical and instrumental evaluations to the subsequent coherent prescriptions of the rehabilitation and care–related activities, from the case management planning – described in the individual rehabilitative project – to the individual rehabilitative program – that takes shape in semi–automated scheduling and in digitalized reporting. The deployed software must be easy to use and reliable, and must ensure safety, guaranteeing the exchange of clinical information among the team members. For all these reasons, we have pre–set pathways that, starting from the main and secondary clinical diagnosis (using the ICD classification) and based thereafter on the WHO ICF classification, the rehabilitation processes are governed in a standardized tailored granularity for each single patient by the aid of a computerized expert system. Even if it what just stated appears an oxymoron, thanks to the digital transformation and the adoption of the Internet of Things, it is possible to easily implement a personalized rehabilitation program through a shared and standardized ontology, providing benefits both to the patient and to the rehabilitation team. Based on this, the rehabilitation services that can be provided have been defined, providing not only those provided for by national and regional nomenclators but also those peculiar to the activities in our Institutes. The digital gym goes beyond the concept of equipment in a gym space; the gym space becomes both physical and virtual. The goal is the networking of "basic" and innovative rehabilitation equipment, even placed in different environments, through the philosophy of IoT, that path of technological development whereby, through the Internet network, potentially every object of daily experience acquires its own identity in the digital world. All this will allow for real–time feedback of data and measurements for the development of a personalized digital record. The digital platform, telemedicine and cloud computing, begin to enable an integration of people, equipment and data.

I.L. MAYAK AS A REVIEWER OF SCIENTIFIC LITERATURE ON THE HISTORY OF ANCIENT ROME

The subject of this study is a part of the scientific heritage of the Honored Professor of Moscow University, Iya Leonidovna Mayak (1922-2018), represented by her reviews on national and foreign monographs on Roman history, published in 1958-1999. The article deals with I.L. Mayak’s motives for writing the reviews, the methodological foundations of her analysis, her requirements for the source base and the historiographical rating of classical studies, their structure and the logic of presentation. It is noted that I.L. Mayak was opposed to dogmatism in the application of the theory of socio-economic formations as well as a hypercritical attitude to sources related to archaic Rome, the spread of which she considered to be the methodological consequence of Kantianism. It is shown that I.L. Mayak not only monitored the diffi cult process of rehabilitation of the ancient tradition as a source for studying the archaic Rome, but herself actively promoted this process, in particular by means of reviewing other people’s works. Th e study considers the requirements set out by I.L. Mayak for classical studies such as the need to provide a terminological analysis of sources data, to trace changes in the content of concepts over time, to show the possibility of various interpretations of the given facts. In the formulation of theoretical constructions I.L. Mayak considered essential to provide a concept against the background of the concepts introduced by predecessors, and if the problem was debatable, to indicate the view clearly and definitely. The analysis of reviews written by Iya Leonidovna allows us to conclude that they make it possible to expand our understanding of her academic views, especially on those problems of Roman history, which she did not directly examine in her monographs and articles, in particular, on the issue of preserving polis paradigm in the late Roma n Empire. Reviews by I.L. Mayak reflect her image memorable to many generations of historians: she was respectful to colleagues, however critical of their work, delicate in remarks, stringently academic in expressing her thoughts. The article shows the polemic sharpness and dialogic character of the reviews by I.L. Mayak.

Virtual Analysis for Spinal Cord Injury Rehabilitation

Background Spinal cord injuries (SCI) are debilitating conditions affecting individuals worldwide annually, leading to physical, emotional, and cognitive challenges. Effective rehabilitation for SCI patients is crucial for restoring motor function and enhancing their overall quality of life. Advances in technology, including machine learning (ML) and computer vision, offer promising avenues for personalized SCI treatment. Aims This paper aimed to propose an automated and cost-effective system for spinal cord injury (SCI) rehabilitation using machine learning techniques, leveraging data from the Toronto Rehab Pose dataset and Mediapipe for real-time tracking. Objective The objective is to develop a system that predicts rehabilitation outcomes for upper body movements, highlighting the transformative role of ML in personalized SCI treatment and offering tailored strategies for improved outcomes. Methods The proposed system utilized data from the Toronto Rehab Pose dataset and Mediapipe for real-time tracking. Machine learning models, including Support Vector Machines (SVM), Logistic Regression, Naive Bayes, and XGBoost, were employed for outcome prediction. Features such as joint positions, angles, velocities, and accelerations were extracted from movement data to train the models. Results Statistical analysis revealed the ability of the system to accurately classify rehabilitation outcomes, with an average accuracy of 98.5%. XGBoost emerged as the top-performing algorithm, demonstrating superior accuracy and precision scores across all exercises. Conclusion This paper emphasizes the importance of continuous monitoring and adjustment of rehabilitation plans based on real-time progress data, highlighting the dynamic nature of SCI rehabilitation and the need for adaptive treatment strategies. By predicting rehabilitation outcomes with high accuracy, the system enables clinicians to devise targeted interventions, optimizing the efficacy of the rehabilitation process.

Trajectory patterns and influencing factors of supportive care needs in stroke patients: A longitudinal study.

To investigate the trajectory patterns and influencing factors of supportive care needs in stroke patients. A longitudinal study. In total, 207 stroke patients who received treatment at the Department of Neurology in a hospital in Xuzhou between July 2022 and July 2023 were recruited using convenience sampling. Questionnaires including supportive care needs, hospital anxiety and depression scale, and the Barthel index were investigated at baseline and at 1, 3, and 6 months. A latent class growth model was applied to identify the supportive care needs trajectories. Multiple logistic regression was used to determine the predictors for membership. This study adheres to STROBE reporting guidelines. Three patterns of supportive care needs trajectories were identified: A high needs slow decline group (20.8%), a medium needs stable group (56.5%) and a medium needs rapid decline group (22.7%). Based on further analysis, the findings indicated that age, education level, monthly income, comorbidity, activities of daily living, anxiety and depression were associated with the trajectory categories of supportive care needs with stroke patients. This study demonstrates heterogeneity in changes in supportive care needs among stroke patients. Healthcare providers need to consider these different categories of needs and develop individualized care measures based on the characteristics of different patients. Healthcare providers should be aware of the fluctuations in care needs of stroke patients at various stages. Additionally, the study aimed to identify patients' specific needs based on their circumstances, monitor the rehabilitation process and establish a more personalized and optimized care plan through multidisciplinary collaboration. The ultimate goal was to alleviate symptomatic distress and address the long-term care needs of patients. No patient or public contribution.

Hope as experienced by people with acquired brain injury in a rehabilitation—or recovery process: a qualitative systematic review and thematic synthesis

Hope as experienced by people with acquired brain injury in a rehabilitation—or recovery process: a qualitative systematic review and thematic synthesis

Comparison of the Clinical Effectiveness of Telerehabilitation with Traditional Rehabilitation Methods in Multiple Sclerosis Patients: A Systematic Review.

Background: The rehabilitation process for multiple sclerosis (MS) patients is long and complex, which can lead to reduced rehabilitation outcomes and reduced quality improvement. Thus, there is a need to use new methods to boost traditional rehabilitation. Innovations such as telerehabilitation can be helpful to remove the obstacles to treatment, but evidence for their effectiveness is limited. The objective of this work was to compare the clinical effectiveness of telerehabilitation with traditional interventions in MS patients. Methods: Seven bibliographic databases (PubMed, Cochran Library, Scopus, Science Direct, Web of Science, Embase, and ProQuest) were used in this research. The initial search resulted in the extraction of 8,239 articles; after the review of the title, abstract, and full text, 11 articles were selected. In addition, backward reference list checking of the selected studies was conducted. Studies that were related to our objectives were included. Quality assessment was performed using the CONSORT checklist. Then, data extraction was done using the form set by the researcher in Word 2016 software. Results: Overall, telerehabilitation achieved more positive effects compared to traditional rehabilitation on physical (n = 6), cognitive (n = 3), cognitive, and physical outcomes (n = 2), respectively. Synchronous telerehabilitation was more effective than other modalities (n = 8). In four studies, virtual reality-based telerehabilitation was used. Also, telerehabilitation in home offered better clinical outcomes compared to rehabilitation center (n = 9). Conclusions: This review provides evidence for the potential effectiveness of telerehabilitation for the improvement of clinical outcomes in MS patients. However, more robust randomized controlled trials are needed to confirm the observed positive effects.

Characteristics and Neural Mechanisms of Sleep-Wake Disturbances After Traumatic Brain Injury.

Sleep-wake disturbances (SWDs) are one of the most common complaints following traumatic brain injury (TBI). The high prevalence and socioeconomic burden of SWDs post-TBI have only been recognized in the past decade. Common SWDs induced by TBI include excessive daytime sleepiness (EDS), hypersomnia, insomnia, obstructive sleep apnea (OSA), and circadian rhythm sleep disorders. Sleep disturbances can significantly compromise quality of life, strain interpersonal relationships, diminish work productivity, exacerbate other clinical conditions, and impede the rehabilitation process of TBI patients. Consequently, the prompt regulation and enhancement of sleep homeostasis in TBI patients is of paramount importance. Although studies have shown that abnormal neural network function, neuroendocrine changes, disturbance of sleep-wake regulators, and immune inflammatory responses related to brain structural damage induced by TBI are involved in the development of SWDs, the exact neuropathological mechanisms are still poorly understood. Therefore, we systematically review the current clinical and experimental studies on the characteristics and possible neural mechanisms of post-TBI SWDs. Elucidating the neural underpinnings of post-TBI SWDs holds the potential to diversify and enhance therapeutic approaches for these conditions. Such advancements could hasten the recuperation of TBI patients and ameliorate their overall quality of life. It is our aspiration that departments specializing in neurosurgery, rehabilitation, and neuropsychiatry will be able to recognize and address these conditions promptly, thereby facilitating the healing journey of affected individuals.

Fostering the discussion of planetary health in occupational therapy and physiotherapy.

Occupational therapists and physiotherapists aim to promote health, prevent various diseases and help people in their rehabilitation processes. So far, there is a paucity of understanding of the big picture of how the new paradigm of planetary health (PH) is connected to the education and practice of these professionals. This research aimed to address this gap by investigating and deploying a bibliometric analysis to elucidate the pivotal role of occupational therapists and physiotherapists in addressing PH challenges. The ultimate goal is to construct a comprehensive framework crosschecking the bibliometric analysis and the collection of 10 case studies selected by experts to outline how best practices in occupational therapy and physiotherapy, related to the three pillars of sustainability and the UN's Sustainable Development Goals (SDGs), can contribute to increasing PH. The bibliometric analysis revealed four major research strands: 1) enhancing patient care and quality of life; 2) integrating sustainability in health care and rehabilitation; 3) professional development and clinical competence; and 4) evidence-based practice and quality improvement. Moreover, further temporal analysis revealed how the topic evolved, from advancing evidence-based practice and clinical effectiveness, exploring the strengthening of health care and person-centred practices, to connecting the topic to aspects also predicted by the SDGs, such as integrating environmental and climate concerns in therapy and addressing psychological and self-care impacts on health. The case studies confirmed this trend, and a framework of PH in occupational therapy and physiotherapy through the lens of the SDGs was developed to support future research and practitioners in advancing this research field. Occupational therapists and physiotherapists are essential players in public health and can integrate sustainability at every level of practice, from using resources during therapy sessions to advocating for more sustainable lifestyles.

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study.

Monitoring of gait patterns by insoles is popular to study behavior and activity in the daily life of people and throughout the rehabilitation process of patients. Live data analyses may improve personalized prevention and treatment regimens, as well as rehabilitation. The M-shaped plantar pressure curve during the stance phase is mainly defined by the loading and unloading slope, 2 maxima, 1 minimum, as well as the force during defined periods. When monitoring gait continuously, walking uphill or downhill could affect this curve in characteristic ways. For walking on a slope, typical changes in the stance phase curve measured by insoles were hypothesized. In total, 40 healthy participants of both sexes were fitted with individually calibrated insoles with 16 pressure sensors each and a recording frequency of 100 Hz. Participants walked on a treadmill at 4 km/h for 1 minute in each of the following slopes: -20%, -15%, -10%, -5%, 0%, 5%, 10%, 15%, and 20%. Raw data were exported for analyses. A custom-developed data platform was used for data processing and parameter calculation, including step detection, data transformation, and normalization for time by natural cubic spline interpolation and force (proportion of body weight). To identify the time-axis positions of the desired maxima and minimum among the available extremum candidates in each step, a Gaussian filter was applied (σ=3, kernel size 7). Inconclusive extremum candidates were further processed by screening for time plausibility, maximum or minimum pool filtering, and monotony. Several parameters that describe the curve trajectory were computed for each step. The normal distribution of data was tested by the Kolmogorov-Smirnov and Shapiro-Wilk tests. Data were normally distributed. An analysis of variance with the gait parameters as dependent and slope as independent variables revealed significant changes related to the slope for the following parameters of the stance phase curve: the mean force during loading and unloading, the 2 maxima and the minimum, as well as the loading and unloading slope (all P<.001). A simultaneous increase in the loading slope, the first maximum and the mean loading force combined with a decrease in the mean unloading force, the second maximum, and the unloading slope is characteristic for downhill walking. The opposite represents uphill walking. The minimum had its peak at horizontal walking and values dropped when walking uphill and downhill alike. It is therefore not a suitable parameter to distinguish between uphill and downhill walking. While patient-related factors, such as anthropometrics, injury, or disease shape the stance phase curve on a longer-term scale, walking on slopes leads to temporary and characteristic short-term changes in the curve trajectory.

The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke

PurposeTo explore the mediating effect of hope in the relationships between social support and self-esteem with psychological resilience among patients with stroke survivors in early rehabilitation.MethodsA cross-sectional study design was adopted. Data from a cross-sectional survey of 210 patients undergoing early stroke rehabilitation were analyzed using structural equation modeling. The variables of interest were measured using the Connor Davidson Resilience Scale, the Social Support Rating Scale, the Herth Hope Index, and the Self-Esteem Scale. This article reports according to the STROBE checklist.ResultsA positive relationship was found between social support and psychological resilience (β1 = 0.548), which was mediated by hope (β2 = 0.114), and social support had significant direct effect on resilience (β3 = 0.434). A positive relationship was also found between self-esteem and psychological resilience (β4 = 0.380), which was mediated by hope (β5 = 0.200), and self-esteem had significant direct effect on resilience (β6 = 0.179).ConclusionAccording to the results of this study, some strategies can be incorporated into the rehabilitation process to enhance psychological resilience, such as cultivating individual personality characteristics and improving patients’ social relationships. In the future, we need to explore methods for improving psychological resilience among patients with stroke in combination with their risk factors to improve their quality of life and reduce the incidence of post-stroke depression.

Therapeutic Recreation Support Practice: Children Saving Dormitory Camps

Therapeutic recreation is a process that enables individuals with physical, cognitive, emotional, and social limitations to increase their skills, knowledge, and behaviors through participation in recreational activities to support their development. This process offers opportunities to participate in recreational activities and is seen as an area that makes the lives of children exposed to difficulties and limitations meaningful. In this direction, it aims to examine the institutional structure of the Children’s Saving Dormitory Camps (CSDC), which is an exemplary application related to the inclusion of children living on the streets in life in the historical process, and to reveal the content of therapeutic recreation practices in organized nature camps. In this study, the document analysis technique, a qualitative research data collection method, was used. The data in this study were obtained through text-based documents, such as state archives, newspapers, and a comprehensive literature review. Within the framework of the findings, the CSDC, which was established in 1933, aimed to help children living on the streets adapt to social life and socialize by implementing an education system that would help them become useful individuals for society. In this context, vocational and academic training, physical activities, and nature camps were organized for the children. The camps organized within the framework of CSDC included therapeutic recreation practices consisting of various physical activities such as swimming, hiking, and camping to support the rehabilitation process of children living on the streets. As a result, the physical, cognitive, emotional, and social development of children living on the streets is supported through camps, physical activities, and therapeutic recreation practices consisting of various games.

Presence of Self-Reported Sleep Alterations After Stroke and Their Relationship With Disability: A Longitudinal Study.

Sleep disorders have a prevalence of 30% to 70% in post-stroke individuals. The presence of sleep disorders and poor sleep quality after stroke can affect important functions and lead to worse outcomes. However, most studies are restricted to the acute post-stroke stage only. To investigate the frequency of self-reported sleep alterations in a sample of chronic stroke individuals and to identify which self-reported sleep alterations were associated with disability. Prospective exploratory study. Self-reported sleep alterations were measured by the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and STOP-Bang Questionnaire. The dependent variable was measured 3 years after the first contact by the Modified Rankin Scale (mRS). Step-wise multiple linear regression analysis was employed to identify which sleep alterations were associated with disability. Sixty-five individuals with stroke participated. About 67.7% of participants had poor sleep quality, 52.4% reported insomnia symptoms, 33.9% reported excessive daytime sleepiness, and 80.0% were classified as intermediate or high risk for obstructive sleep apnea. Only risk for obstructive sleep apnea was significantly associated with disability and explained 5% of the variance in the mRS scores. Self-reported sleep alterations had a considerable frequency in a sample of chronic stroke individuals. The risk of obstructive sleep apnea was associated with disability in the chronic stage of stroke. Sleep alterations must be considered and evaluated in the rehabilitation process even after a long period since the stroke onset.

К ВОПРОСУ О РОЛИ ПСИХОЛОГИЧЕСКОЙ КОМПОНЕНТЫ В ЛЕЧЕБНО-РЕАБИЛИТАЦИОННОМ ПРОЦЕССЕ

Rehabilitation in medicine is one of the essential elements of rehabilitation. In modern practical medicine, rehabilitation is referred to as the third stage of providing medical care to the population, which in turn belittles its effectiveness and significantly postpones the use of rehabilitation measures at a later time. In fact, the rehabilitation potential is already beginning to form at the first contact with the patient (at the stage of diagnosis and active treatment). Rehabilitation measures can be specific depending on the type of nosology and general, suitable for a wide range of diseases. It is at the initial stages and throughout the rehabilitation process that its psychological component is most important for all types of diseases. Mental and social rehabilitation is especially important for people with socially dangerous diseases (pathological dependence, infectious, venereal diseases, etc.). The delayed application of rehabilitation measures, as well as insufficient attention to its psychological component, requires a deeper study of this problem. The purpose of this work was to study and analyze modern literature on various aspects of rehabilitation and find ways to optimize it.

Fostering proactive work behavior: Where to start?

This study underscores the significance of assessing the capabilities of rehabilitation officers in navigating challenges, devising innovative work methods, and successfully executing the rehabilitation process. This is particularly crucial amid the dual challenges of overcapacity and the repercussions of the Covid-19 pandemic, making it an essential area for research. To be specific, it aims to obtain empirical evidence about the influence of proactive personality and supportive supervision on proactive work behavior, as well as the mediating role of Role Breadth Self-efficacy and Change Orientation. This research was conducted on all rehabilitation officers at the Narcotics Penitentiary in Sumatra, totaling 272 respondents. This study employs a quantitative method via a questionnaire using a purposive sampling technique. The data was subsequently examined using the Lisrel 8.70 software and Structural Equation Modeling (SEM). It can be concluded from the results that the rehabilitation officers for narcotics addicts at the Narcotics Penitentiary can create and improve proactive work behavior properly through the influence of proactive personality, supportive supervision, role breadth self-efficacy, and change orientation. The study may suggest new ways of working and generate new ideas to increase initiative, encourage feedback, and voice employee concerns. Furthermore, this research has the potential to pinpoint deficiencies in proactive work behavior, serving as a foundation for designing interventions or training programs. These initiatives aim to enhance the innovative and creative contributions of rehabilitation officers in the rehabilitation process.

‘Successful Ageing’ Needs a Future: Older Incarcerated Adults’ Views on Ageing in Prison

Demographic changes have led to an increase in older people in prisons. Whereas the rehabilitative process of younger offenders is geared towards their reintegration into the labour market, successful ageing should be a policy aim for older prisoners. This study explores how older incarcerated persons view their ageing. A qualitative study using a written survey with only the single question What does ageing in prison mean to you? was conducted in Bavaria, Germany. A total of 64 prisoners (61 male, 3 female) supplied answers varying in length from a few words to several pages. The thematic analysis revealed that together with health concerns, social relations and everyday activities, the uncertainty of the future was a central focus point for the older adults in prison. The authors propose that a positive vision of the future needs to be included in any model of successful ageing. If successful ageing is used as an aim for older prisoners, more attention needs to be paid to support interventions during and after the release process.

Cultural Narratives of Charles V and Spanish Imaginaries in West Germany during the Franco Dictatorship

ABSTRACT: This article aims to contribute to research on the international relations between the Federal Republic of Germany and Spain after World War II, when the Franco dictatorship experienced a process of rehabilitation. In order to gain a better understanding of this phenomenon, we need to complement existing studies on the history of diplomatic relations with approaches to the sphere of cultural imaginaries. This article, intended as a particular case study, analyzes the resignification of Francoism in the Federal Republic of Germany (FRG) via the heritage and tourist narratives associated with one historical figure shared by both nations: Charles V.

Assessment of kinesiophobia levels in patients with musculoskeletal pathologies: A demographic, physical, and clinical perspective

IntroductionKinesiophobia is a crucial factor influencing the rehabilitation process for individuals with musculoskeletal pathologies. Assessing kinesiophobia levels is crucial for personalized interventions. AimThe aim of this study is to investigate the level of kinesiophobia in individuals with musculoskeletal pathology based on the pathology areas, demographic, physical, and clinical characteristics. MethodsA total of 210 participants with musculoskeletal pathologies were included in the study. All participants were assessed using a sociodemographic information form for demographic and physical characteristics, the Tampa Kinesiophobia Scale for kinesiophobia level, and the McGill-Melzack Pain Questionnaire for pain location and intensity. ResultsThere was no statistically significant difference observed in kinesiophobia level between patients in terms of pathology location and sex. However, a significant difference in kinesiophobia levels was found among patients based on the acute and chronic duration of the disease (p = 0.00), previous treatment history (p = 0.04), and exercise engagement (p = 0.00). When kinesiophobia levels were examined according to educational status, a significant difference was found between the primary education group and the undergraduate and above group (p = 0.00). ConclusionsAccording to the results of this study, kinesiophobia levels appear to be independent of pathology location and sex, but vary based on educational level, exercise habits, pain duration and history of previous treatment. Considering these findings, it is essential to take into account these factors in treatment programs in clinical practice and to provide support in exercise and physical activity training to individuals who have previously received treatment and individuals with low education levels.