Rehabilitation Program Research Articles

Abstract 4147608: Trends in Mortality and 30-Day Readmission Rates Among Heart Failure Patients Undergoing Cardiac Rehabilitation: A Nationwide Analysis from 2017 to 2020

Background: Heart failure (HF) is a significant public health concern, affecting approximately 6.2 million adults in the United States, with high mortality and readmission rates. Cardiac rehabilitation (CR) programs have been widely recognized as a crucial component of HF management, aiming to improve physical function, reduce symptoms, and enhance quality of life. Despite the established benefits of CR, there is a need to understand the trends in mortality and readmission rates among HF patients participating in these programs. We aim to analyze mortality and 30-day readmission rate trends among heart failure patients undergoing cardiac rehabilitation from 2017 to 2020 using NRD data. Hypothesis: We hypothesize a significant downward trend in mortality rates and significant yearly variation in 30-day readmission rates among heart failure patients undergoing cardiac rehabilitation. Methods: We analyzed NRD data from 2017 to 2020, including patients with ICD-10 codes I50 (heart failure) and Z5189 (cardiac rehabilitation). Trend analyses were performed using Ordinary Least Squares (OLS) regression for mortality rates and the Cochrane-Armitage test for binary data. Multivariate regression adjusted for age, sex, and comorbidities. Statistical analyses were conducted using STATA version 18. Results: From 2017 to 2020, annual mortality rates were 6.9% (95% CI: 0.95% to 12.85%), 5.5% (95% CI: 0.47% to 10.52%), 4.6% (95% CI: -0.51% to 9.68%), and 1.9% (95% CI: -1.90% to 5.74%), respectively. The mean age was 78 years, with 54% were female. OLS regression showed a significant downward trend in mortality (p = 0.025), while the Cochrane-Armitage test did not (p = 0.998). Multivariate regression also indicated a downward trend, though individual predictors were insignificant (p=0.576). For 30-day readmission rates from 2017 to 2020, annual margins were 21.5% (2017), 21.7% (2018), 18.0% (2019), and 34.3% (2020), showing significant yearly variation. Conclusion: Despite the varying range of 30-day readmission within the years of interest, there seems to be a significant downward trend in mortality for heart failure patients who underwent cardiac rehabilitation. Further studies are required to corroborate these findings as understanding CR program outcomes can help identify improvement areas, guide resource allocation, and inform healthcare policy decisions.

The Effects of a Stepped-Care Mental Health Program on Trauma Recidivism at a Level 1 Trauma Center.

This study aimed to analyze the effects of a stepped-care mental health program (TRRP) on trauma recidivism at a single institution. Designs: Retrospective review. single Level 1 trauma center. Trauma activation patients presenting at a single Level 1 trauma center between 2017-2021 were selected. Data on demographics, mechanism of injury, readmissions, and TRRP participation were recorded. Main outcomes included recidivism rates, risk factors for re-presentation, and determining if a change in readmission risk existed after participation in TRRP. 4,484 patients were included, with a mean age of 44.8 years. 65.9% were males and 34.1% were female. 14.2% (637/4,484) patients presented to the same institution having experienced an unrelated traumatic incident after their index injury. 75.6% patients identified by TRRP participated in at least one TRRP service. Patients who did not participate in TRRP were statistically significantly more likely to be recidivists (15.6%) compared to those who did (10.9%, p<0.001). Multivariable binary logistic regression analysis demonstrated statistically significant associations between increased trauma recidivism and being unmarried, Black/African American race, no use of seatbelts, alcohol intoxication at index injury, history of depression, alcohol use disorder, smoking, and government insurance (p≤0.024). The multivariable regression model predicted a decrease in trauma recidivism by 33% in privately insured patients (p=0.002), by 33% after participation in TRRP (p<0.001), and by 18% after participation in each additional step of the TRRP program (p<0.001). Results demonstrate reduced rates of trauma recidivism with involvement of the Trauma Resilience and Recovery Program. While programs focused solely on psychosocial interventions may be sufficient to reduce the risk of subsequent traumatic events, further development of trauma rehabilitation programs should address both the psychosocial consequences of traumatic injuries as well as re-injury and readmission prevention. III.

Impact of Fluoroquinolones on Tendon Health: A Comprehensive Overview for the General Population and Athletes

Introduction: Fluoroquinolones are a class of broad-spectrum antibiotics widely used to treat various bacterial infections. Despite their effectiveness, increasing evidence links fluoroquinolones to tendinopathy and tendon rupture, with cases occurring shortly after initiation or even months post-therapy. This review provides a comprehensive overview of the impact of fluoroquinolones on tendon health - highlighting the underlying pathomechanisms, clinical manifestations, and epidemiology of fluoroquinolone-associated tendinopathy. Purpose of the work: The purpose of this study is to review the effects of fluoroquinolones on tendon health in the general population. Special attention is given to the athletes, who are particularly vulnerable to tendon injuries. Materials and methods: A comprehensive analysis of research articles available on PubMed, Google Scholar, Web of Science, Embase, and Scopus was conducted using search terms related to: "fluoroquinolones," "tendinopathy," "tendon rupture," "athletes" and "connective tissue damage." Results: Fluoroquinolones are linked to an increased risk of tendinopathy and tendon rupture, particularly among those with certain risk factors, including athletes. Understanding the mechanisms by which fluoroquinolones affect tendon tissue and recognizing early signs of tendon damage can help mitigate these risks. Prevention strategies, including cautious prescribing fluoroquinolones and targeted rehabilitation programmes, may reduce the adverse effects of fluoroquinolone usage, particularly in high-risk groups like athletes.

Impact of an Asian Community-Based Cancer Rehabilitation Program on Health-Related Quality of Life

Background/Objectives: Inpatient exercise-based rehabilitation has been shown to improve health-related quality of life (HRQOL) in cancer survivors. However, there is a lack of studies on the impact of community-based cancer rehabilitation programs on health-related quality of life, especially in Asian countries. Methods: This was a retrospective cohort study involving patients with cancer at an outpatient community-based rehabilitation center. There were 197 patients who were recruited and enrolled in a physician-led rehabilitation program which included physiotherapists, occupational therapists, nutritionists and exercise physiologists. Results: Most of the patients had a diagnosis of breast cancer (61.4%), while 76 (38.6%) had a diagnosis of other cancers. On initial assessment, we found a mean Distress Thermometer (DT) level of 3.37 (SD = 2.41) and a mean Functional Assessment of Cancer Therapy-General-7 Item Version (FACT-G7) score of 11.83 (SD = 4.01). On follow-up assessment after 3–6 months of rehabilitation, there was a significant reduction in mean DT level to 2.42 (SD = 2.25) and an improvement in mean FACT-G7 score to 13.09 (SD = 4.77). Multivariate regression analysis revealed that significant factors for improvement in FACT-G7 scores were age (p = 0.046) and number of exercise therapy sessions (p &lt; 0.001). Conclusions: This study demonstrates the positive impact of a community-based cancer rehabilitation program on HRQOL among cancer patients.

Paralabral cyst in cricketers – A case series

Objectives: Paralabral cysts of the shoulder are rare, and it is usually associated with labral tears. Repetitive stress on the labrum due to increased training history in cricketers can cause micro-tear of the labrum. These tears commonly occur during the early cocking phase in cricketers. These longstanding micro-tears usually form paralabral cysts where the tear operates as a one-way valve. It is fairly common in cricketers who had a longer duration of training and playing history. These cysts are commonly seen in posterior-superior labral tears and SLAP tears. Materials and Methods: Data were obtained from a total of 12 cricketers between the period of March 2022 and July 2023. All these athletes mostly came with complaints of chronic shoulder pain, and the diagnosis was confirmed with magnetic resonance imaging. All these patients were treated by arthroscopic cyst decompression with labral repair. A rehabilitation regimen was administered postoperatively to improve the functional ability of the shoulder and help the athlete to return-to-play. QuickDASH score was performed 12 months postoperatively to assess the effectiveness of the surgical outcome. Results: All the patients reported remission of pain and showed improvement in their QuickDASH scores compared to the pre-operative period. A properly supervised rehabilitation regimen helped the athlete to return to sport. Conclusion: Early diagnosis of paralabral cysts helps in preventing neurological compromise and quicker return-to-play in cricketers. Arthroscopic cyst decompression with labral repair, along with a criteria-based rehabilitation program helps in improving the functional outcome of the athlete.

A comprehensive nurse-led aftercare programme addressing post-burn sexual well-being of adult burn survivors: a randomised controlled trial.

Sexual well-being is a key part of being human yet often remains shrouded in secrecy and poorly addressed in the clinical setting. The impact of burns and its long-term sequelae often lead to concerns regarding body image disturbance, self-esteem issues, and interpersonal challenges which can impact on an individual's sexual well-being. However, existing post-burn rehabilitation programmes usually lack components addressing concerns regarding sexual well-being. As a part of a larger project, we developed a nurse-led aftercare programme, and this study sought to examine the effects of the programme in addressing the post-burn sexual well-being of adult burn survivors. A randomised controlled trial approach was used. Sixty burn survivors aged ≥ 18 years with burn size ≥ 10% total burn surface area were assigned to intervention and control groups. Participants in the intervention group underwent the nurse-led aftercare programme which involved pre-discharge support and proactive follow-up support over 8 weeks. The sexuality subscale of the Burn Specific Health Scale-Brief was used to evaluate the outcome of interest. Data were collected at three timepoints: baseline (T0), post-intervention (T1), and follow-up (T2). Using a corrected p value of 0.017, the study observed only statistically significant time effect at both T1 and T2. Both group and interaction effects were statistically insignificant for this outcome. Issues regarding sexual well-being are often considered sacred and may be challenging to discuss. Thus, a longer duration of the intervention may be considered with ongoing training of practitioners to identify and resolve emerging challenges. Despite the non-significant interaction and group effects, including sexual well-being support in post-burns rehabilitation programmes will facilitate access to and utilisation of the service among burn survivors who may need it. Prospectively registered on 14th August 2020. govNCT04517721.

The impact of stroke support groups on stroke patients and their caregivers

Background: Stroke survivors often face multifaceted challenges encompassing physical, psychological and social aspects of health during their recovery journey.Aim: To explore the impact of stroke support groups on stroke patients and their caregivers in Kenya.Setting: The study was conducted in eight Kenyan county referral facilities.Methods: The study applied a qualitative interpretive paradigm and collected data from semi-structured face-to-face interviews with eight stroke survivors and their caregivers. Thematic content analysis was employed to extract and analyse data.Results: The analysis of data revealed four key themes: (1) mental functioning, (2) environmental impact, (3) personal impact and (4) social participation. These themes were organised and related to the World Health Organization’s (WHO’s) International Classification of Functioning, Disability, and Health (ICF).Conclusion: Peer stroke support groups significantly enhanced the ICF component of mental functioning, environmental and personal, through emotional support, social connection, coping, learning, mobility, communication and domestic life of stroke survivors and caregivers. Participation promoted affirmation and acceptance, and reduced loneliness, which led to increased involvement in a range of activities. Moreover, stroke support groups played a vital role in empowerment, education and advocating for systemic change.Contribution: This study provides new information that improves understanding of the positive impact of stroke support groups in Kenya. It highlights the importance of integrating peer support into post-stroke rehabilitation programmes.

Clinical features and rehabilitation outcome after surgical treatment of spinal meningioma.

Retrospective analysis of clinical routine data. Spinal meningioma is a common type of benign spinal tumor. Surgical removal is the standard therapeutic approach. While surgery is generally associated with excellent outcomes, little is known about the rehabilitation outcome of patients with postoperative deficits. Therefore, we aim to describe the clinical features and rehabilitation outcomes of patients after surgical removal of spinal meningioma. Region of Swabia, Bavaria, Germany. We conducted a retrospective analysis of patients with spinal meningioma who underwent a rehabilitation program for patients with non-traumatic spinal cord injury at our department over the past five years. In addition to routine data, we focussed on analysing the Barthel Index, SCIM III score, and ASIA impairment scale before and after rehabilitation. 15 patients were included in the analysis. While most of them only had a few restrictions relevant to activities of daily living, some had severely limited walking ability. The predominant clinical feature was incomplete paraplegia with or without neurogenic bladder and bowel affection. The Barthel Index and SCIM III score demonstrated positive changes in the majority of cases, while alterations in the ASIA impairment scale were observed in a minority. Considering the results of outcome parameters, rehabilitation treatment appears effective for these patients. Nonetheless, further studies with larger patient cohorts are necessary to confirm these findings.

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.

QOL-26. GLIOMA PATIENTS’ COGNITION AND THEIR CAREGIVERS: THE GOOD, THE BAD, AND THE BURDEN

Abstract BACKGROUND Cognitive decline, common in patients with gliomas, can contribute to reduced independence in daily functioning. Patients with gliomas often rely on informal caregivers for functional support, evidenced to cause distress in other caregiver populations (e.g., Alzheimer’s, terminal cancer, dementia). Few studies have investigated this relationship in neuro-oncology; thus, we explored whether patients’ neurocognitive function was associated with aspects of caregiver burden. METHODS Patients with glioma underwent neurocognitive testing including Auditory Verbal Learning Test-Delayed Recall (AVLT), Trail Making Test-Part B (TMT-B), Stroop Color-Word Interference (CWI), Controlled Oral Word Association Test (COWA), and the Grooved Pegboard (GPB). Caregiver burden was assessed using the schedule burden and self-esteem subscales of the Caregiver Reaction Assessment (CRA). Hierarchical regressions and independent samples t-tests evaluated whether neurocognitive performance predicted caregiver burden and differences in caregiver burden between patients with intact versus impaired (AVLT; ≥ -1.5 SD) memory. RESULTS Seventy-eight dyads were included for analyses (Patient: Mage=53.4, 65.4% male, 97.4% Non-Hispanic/White; Caregiver: Mage =52.5, 71.8% female, 96.2% Non-Hispanic/White). AVLT performance was significantly related to both caregiver schedule burden (β = -.63, p =.003) and self-esteem (β =.26, p =.046). Performance on TMT-B, COWA, GPB, and CWI and patient age were not related to caregiver burden in any model (ps&amp;gt;.05). There was a significant difference in caregiver schedule burden between those with (M=15.17, SD=5.84) and without memory impairment (M=18.50, SD=5.60) [t(72)=-2.44, p=.017] but not for self-esteem (p&amp;gt;.05). CONCLUSIONS Patient performance on verbal memory was sensitive to the changes that may contribute to increased caregiver burden. An amnestic profile may be the most salient cognitive predictor of strain on neuro-oncology caregivers. Our findings speak to the interdependence of patient outcomes and caregiver quality of life. Supporting patients’ neurocognitive capabilities, such as implementing individualized cognitive rehabilitation programs, may improve caregiver burden.

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.

Factors Influencing the Attrition Rate of a 10-Week Multimodal Rehabilitation Program in Patients After Lung Transplant: A Neural Network Analysis

Background/Objectives: Despite the effectiveness of exercise and nutritional interventions to improve aerobic capacity and quality of life in lung transplant (LT) recipients, their compliance is low. Strategies to reduce the high attrition rate (participants lost over time) is a major challenge. Artificial neural networks (ANN) may assist in the early identification of patients with high risk of attrition. The main objective of this study is to evaluate the usefulness of ANNs to identify prognostic factors for high attrition rate of a 10-week rehabilitation program after a LT. Methods: This prospective observational study included first-time LT recipients over 18 years of age. The main outcome for each patient was the attrition rate, which was estimated by the amount of missing data accumulated during the study. Clinical variables including malnutrition, sarcopenia, and their individual components were assessed at baseline. An ANN and regression analysis were used to identify the factors determining a high attrition rate. Results: Of the 41 participants, 17 (41.4%) had a high rate of attrition in the rehabilitation program. Only 23 baseline variables had no missing data and were included in the analysis, from which a low age-dependent body mass index (BMI) was the most important conditioning factor for a high attrition rate (p = 7.08 × 10−5), followed by end-stage respiratory disease requiring PT (p = 0.000111), low health-related quality-of-life (HRQoL) (p = 0.0009078), and low handgrip strength (p = 0.023). Conclusions: The prevalence of high attrition rate in LT recipients is high. The profile of patients with a high probability of attrition includes those with chronic obstructive pulmonary disease, low BMI and handgrip strength, and reduced HRQoL.

Machine Learning Model for Predicting Walking Ability in Lower Limb Amputees

Background/Objectives: The number of individuals with lower limb loss (LLL) is rising. Therefore, identifying the walking potential in individuals with LLL and prescribing adequate prosthetic systems are crucial. Various factors can influence participants’ walking ability, to different extents. The aim of the present study was to apply machine learning methods to develop a predictive mode. This model can assist rehabilitation and limb loss care teams in making informed decisions regarding prosthesis prescription and predicting walking ability in individuals with LLL. Methods: The present study was designed as a prospective cross-sectional study encompassing 104 consecutively recruited participants with LLL (average age 62.1 ± 10.9 years, 80 (76.9%) men) at the Medical Rehabilitation Clinic. Demographic, physical, psychological, and social status data of patients were collected at the beginning of the rehabilitation program. At the end of the treatment, K-level estimation of functional ability, a Timed Up and Go Test (TUG), and a Two-Minute Walking Test (TMWT) were performed. Support vector machines (SVM) were used to develop the prediction model. Results: Three decision trees were created, one for each output, as follows: K-level, TUG, and TMWT. For all three outputs, there were eight significant predictors (balance, body mass index, age, Beck depression inventory, amputation level, muscle strength of the residual extremity hip extensors, intact extremity (IE) plantar flexors, and IE hip extensors). For the K-level, the ninth predictor was The Multidimensional Scale of Perceived Social Support (MSPSS). Conclusions: Using the SVM model, we can predict the K-level, TUG, and TMWT with high accuracy. These clinical assessments could be incorporated into routine clinical practice to guide clinicians and inform patients of their potential level of ambulation.

Self-Assessment of Impulsivity in Patients with Paranoid Schizophrenia in Exacerbation and Remission

Background: impaired impulse control is thought to be an important hallmark of schizophrenia, which is closely related to the dysfunction of many of the neurophysiological systems of the central nervous system characteristic of the disease. The presence of increased impulsivity requires special attention in view of the risks associated with it, both for the patients themselves and for society. Aim of the study: to assess the presence of signs of a significant level of impulsivity in self-reporting on the Barratt scale in patients with paranoid schizophrenia in a state of exacerbation and remission. Patients and Methods: the study included two groups of patients suffering from paranoid schizophrenia both in a state of sustained remission with residual psychotic symptoms and patients in a state of exacerbation. Control group: consisted of healthy subjects. To assess impulsivity, the Barratt scale, adapted to the Russian population, was used. Results: it turned out that in both groups of patients, increased impulsivity was detected in half of the cases (54% and 46%, respectively). In the control group, only 22% had such cases. There were no differences between the groups of patients. When analyzing the ratio of indicators on different subscales of the Barratt scale, no differences were found both between the groups and in comparison, with the control group. Conclusion: the results of the study suggest that impulsivity as an element of the clinical picture, which is found in the patient’s self-report, may be an informative sign that should be taken into account when forming a psychopharmacological treatment regimen and rehabilitation programs. The Barratt scale can be used in patients with schizophrenia in everyday practice.

Metabolic syndrome is associated with poorer outcomes in people with osteoarthritis participating in a rehabilitation program: an observational study

Purpose To determine the prevalence of metabolic syndrome and explore its association with clinical outcomes (pain, quality of life, and physical function) in adults participating in an education and exercise program (GLA:D®). Methods An observational study of adults with hip and/or knee osteoarthritis who participated in GLA:D® between 2019 and 2022. Metabolic syndrome status was determined through self-report. Differences in clinical outcomes among people with, at risk of (1–2 risk factors), or without metabolic syndrome were compared at baseline, 3-, and 12-months using linear mixed models (age, sex, and baseline outcomes as covariates). Results Of 6846 participants (aged 65(SD 9) years), 20% (n = 1337) had, and 68% (n = 4632) were at risk of metabolic syndrome. Adults with metabolic syndrome reported higher pain (0–100 VAS: 7.3, 95% CI 5.4–9.1), lower health-related quality of life (EQ5D 0–100, VAS: −8.6, 95% CI −10.2 to −7.0), and slower gait speed (−0.26 m/s, 95%CI -0.3 to −0.23) at baseline compared to those with no metabolic risk factors. Differences remained at 3- and 12-months for pain and quality of life. Conclusions Metabolic syndrome risk factors were common in adults with osteoarthritis. Clinical outcomes remain impaired in people with metabolic syndrome compared to those without after education and exercise, suggesting further intervention may be required.

Evaluating the Quality-of-Life and Happiness Indices of Hydropower Project-Affected People in Pakistan: Towards a Sustainable Future

Worldwide, the development of massive hydropower projects is becoming more common, especially when it comes to attempts to mitigate environmental degradation and increase a nation’s energy capacity. People affected by projects (PAPs) are forced to relocate in order to support large-scale development initiatives, which puts their lives and livelihoods at jeopardy. In comparison to the value of infrastructure development, which is mostly reaped by distant stakeholders, it comes at a high cost. In relation to CSR/resettlement and rehabilitation programs carried out by construction corporations in Pakistan’s hydropower development, this study on the quality-of-life (QoL) and happiness indicators of PAPs is being conducted. The analysis of factors affecting happiness and other aspects of quality-of-life indicators, including job and livelihood opportunities, housing, health, infrastructure, social interactions, environmental sustainability, inclusion, equity, and diversity, is the goal of this study. Using a questionnaire survey approach, data were directly gathered from PAPs, and about 424 replies were obtained to help with the model’s development. Structural equation modelling has been applied in conjunction with multivariate statistical analysis to analyse data. The outcome demonstrates the essential connections between the concepts that were taught in light of human, social, environmental, physical, and economic problems. The results also show that project supporters’ relocation and rehabilitation efforts fell short of what was needed to improve the quality of people’s lives. As a result, a conceptual framework specifically tailored to the hydropower construction region has been created and verified to provide PAPs with a high-quality living environment.

Goal-Directed Rehabilitation Versus Standard Care for Individuals with Hereditary Cerebellar Ataxia: A Multicenter, Single-Blind, Randomized Controlled Superiority Trial.

Rehabilitation is thought to reduce ataxia severity in individuals with hereditary cerebellar ataxia (HCA). This multicenter, randomized controlled superiority trial aimed to examine the efficacy of a 30-week goal-directed rehabilitation program compared with 30 weeks of standard care on function, ataxia, health-related quality of life, and balance in individuals with an HCA. Individuals with an autosomal dominant or recessive ataxia (aged ≥15 years) were enrolled at 5 sites in Australia. Participants were randomized (1:1) to receive rehabilitation (6 weeks of outpatient physiotherapy followed by a 24-week home exercise program) (n = 39) or continued their usual activity (n = 37). The primary outcome measure was the motor domain of the Functional Independence Measure (mFIM) at 7 weeks. Secondary outcomes included the Scale for the Assessment and Rating of Ataxia (SARA) and the SF-36v2, assessed at 7, 18, and 30 weeks. Outcome assessors were blinded to treatment allocation. Seventy-one participants (rehabilitation, 37; standard-care, 34) were included in the intention-to-treat analysis. At 7 weeks, mFIM (mean difference 2.26, 95% confidence interval [CI]: 0.26 to 4.26, p = 0.028) and SARA (-1.21, 95% CI: -2.32 to -0.11, p = 0.032) scores improved after rehabilitation compared with standard care. Compared with standard care, rehabilitation improved SARA scores at 30 weeks (mean difference -1.51, 95% CI: -2.76 to -0.27, p = 0.017), but not mFIM scores (1.74, 95% CI: -0.32 to 3.81, p = 0.098). Frequent adverse events in both groups were fatigue, pain, and falls. Goal-directed rehabilitation improved function at 7 weeks, with improvement in ataxia and health-related quality of life maintained at 30 weeks in individuals with HCA, beyond that of standard care. ANN NEUROL 2024.

Surgically managed traumatic spinal cord injury in Singapore: a descriptive study across two level one trauma centres

Study designCase SeriesObjectivesTo provide an updated understanding of the incidence of surgically managed Traumatic Spinal Cord Injury (TSCI) in Singapore and to identify factors affecting discharge disposition.SettingPatients were identified from two level one trauma centres in Singapore.MethodsAll patients who underwent surgical management for acute TSCI between January 2020 to December 2021 were included. Demographics, injury details, peri-operative condition, hospital length of stay (LOS) and discharge disposition were evaluated. The overall characteristics of TSCI were summarised using descriptive statistics. The difference between discharge destinations was compared using chi-square test or t test. Variables with p values < 0.3 were selected for multivariable analysis.ResultsForty-four patients were included. Median age was 65. The most common SCI aetiology was fall from standing height or less (54.6%). Accidents involving personal mobility devices, bicycles and motor vehicles made up the next largest group (20.5%). Thirty-nine cases (88.6%) involved the cervical region. There were two cases of inpatient mortality. Twenty-one patients (50%) were discharged home, 21 (50%) were discharged to a community hospital (CH) or nursing home (NH). The median LOS in an acute hospital was 41 days. Multivariable logistic regression analysis revealed that functional independence measure (FIM) score on discharge was an independent factor that influenced discharge disposition (p = 0.037).ConclusionA public health focus on falls prevention, the development of geriatric spinal rehabilitation programs, and the consideration of a national registry are recommended for the comprehensive management of TSCI in Singapore.

Focusing on Sedentary Behavior in Comprehensive Cardiac Rehabilitation.

In recent years, the adverse effects of prolonged sedentary behavior in daily life, so-called 'sitting too much', on health have been pointed out. Sedentary behavior is defined as 'all waking behavior in which the energy expenditure in a sitting, semi-recumbent, or recumbent position is 1.5 metabolic equivalents or less'. Even if a person engages in the level of physical activity recommended in the guidelines, sitting for too long at other times may increase the risk of developing various diseases and death. For patients with cardiovascular disease, a comprehensive cardiac rehabilitation program that systematically includes not only medical treatment but also exercise therapy, patient education, and disease management is extremely important. Also, differences in sedentary behavior during the acute and recovery phases are known to affect physical function and activities of daily living at the time of hospital discharge. Here, we discuss cardiac rehabilitation that addresses sedentary behavior and review the previous related research.

The effect of home exercises with kinesiotaping on pain, functionality, and work performance in bus drivers with non-specific neck pain.

Clinical research on the management and rehabilitation of work-related upper spinal pain in bus drivers is sparse, indicating a gap in knowledge and treatment strategies. This highlights the growing need for innovative approaches to rehabilitation programs in this area. To examine the effects of kinesio taping (KT) on pain, functionality, and work performance in bus drivers experiencing neck pain. The study involved 44 participants who were randomised into two different groups: the exercise group (n= 22) and the kinesio tape group (n= 22), with participants in both groups undertaking exercise interventions. Evaluations were made before and after 6 weeks of treatment. At the end of the 6-week, the participants' ROM, pain evaluations and functional scales were evaluated with disability, and work functionality. Neck pain severity decreased in both groups (p< 0.001 for each value), but there was no difference between the groups (p: 0.071). When disability scores were evaluated, improvement was noted in both groups (p: 0.001 for each value), but no statistically significant difference was found (p: 0.754). When the improvements in ROM values before and after the treatment were examined, the difference between the groups was recorded only in the neck extension ROM value (p: 0.011). Significant improvement was noted in all sub-steps of job performance in both groups (p< 0.05). KT added to ergonomic training and home exercise programmes is effective in controlling work-related musculoskeletal pain in drivers with neck pain. However, the addition of KT to exercise therapy was found to be no more effective than exercise therapy alone in improving pain control, functionality and work performance.