Stages Of Rehabilitation Research Articles

Efficacy of the Simulation-Based Education Approach Enhanced by Music on Anxiety, Physical Activity, and Respiratory Outcomes in Patients under Open Heart Surgery: A Randomized Three-Group Clinical Study.

Many patients with advanced cardiovascular disease need Coronary Artery Bypass Graft (CABG) surgery, indicating the importance of cardiac rehabilitation. Our study explored the combined efficacy of simulation (using demonstration and return-demonstration approach) with music on post-Open Heart Surgery (OHS) outcomes. This randomized, controlled trial was conducted at Imam Reza Hospital, Mashhad, Iran, on 90 patients awaiting OHS. The participants were allocated to 3 groups: education via simulation, education via simulation enhanced by instrumental music, and conventional instruction. Evaluations were performed pre-education and 2-days post-surgery using the activity measure for post-acute care (AM-PAC) "6-Clicks" Questionnaire, 18-item Nursing Outcomes Classification (NOC) index, and State-Trait Anxiety Inventory (STAI). JASP software (JASP Team, 2023, Version 0.17.3) was employed for statistical analyses, using RM-ANOVA and ANCOVA test. The results revealed a significant effect in immediate post-intervention and 2-day follow-up periods across all outcome measures (all p < 0.05), except for activity. Post hoc tests demonstrated substantial variations in effect sizes between intervention and control groups. Both intervention groups had significantly greater impact than the control group, particularly the composite group, showing heightened effects in state and trait anxiety and respiratory scores (p < 0.05). The combined use of the simulation with rhythmic music in phase one cardiac rehabilitation notably improved post-surgical outcomes, outperforming the method without music. This approach shows promise as an effective instructional strategy in cardiac rehabilitation stages.

Temporal Dynamics and Physical Priori Multimodal Network for Rehabilitation Physical Training Evaluation.

Sensor-based rehabilitation physical training assessment methods have attracted significant attention in refined evaluation scenarios. A refined rehabilitation evaluation method combines the expertise of clinicians with advanced sensor-based technology to capture and analyze subtle movement variations often unobserved by traditional subjective methods. Current approaches center on either body postures or muscle strength, which lack more sophisticated analysis features of muscle activation and coordination, thereby hindering analysis efficacy in deep rehabilitation feature exploration. To address this issue, we present a multimodal network algorithm that integrates surface electromyography (sEMG) and stress distribution signals. The algorithm considers the physical knowledge a priori to interpret the current rehabilitation stage and efficiently handles temporal dynamics arising from diverse user profiles in an online setting. Besides, we verified the performance of this model using a learned-nonuse phenomenon assessment task in 24 subjects, achieving an accuracy of 94.7%. Our results surpass those of conventional feature-based, distance-based, and ensemble baseline models, highlighting the advantages of incorporating multimodal information rather than relying solely on unimodal data. Moreover, the proposed model presents a network design solution for rehabilitation physical training that requires deep bioinformatic features and can potentially assist real-time and home-based physical training work.

Application of sports rehabilitation training in mobile edge computing to treatment of patients with knee arthritis

According to the data of the National Bureau of Statistics, in 2019, the proportion of elderly people aged 65 and above in the total population reached 12.6%, and with the acceleration of the aging process, the incidence of knee osteoarthritis has increased significantly. According to the Chinese Journal of Orthopedics, the number of patients with knee osteoarthritis is growing at a rate of 6% every year, and there are more than 100 million patients with knee osteoarthritis in China, which significantly affects the quality of life of middle-aged and elderly people. This paper uses mobile edge computing technology and nanotubes to cooperate with reasonable sports to study the rehabilitation of patients with knee arthritis in the rehabilitation stage. The subjects of the study were 60 patients with knee arthritis, and the 60 patients were divided into 4 groups: group A used nanotubes and exercise rehabilitation training; group B used nanotubes but no exercise rehabilitation training; group C did not use nanotubes Tube, but sports rehabilitation training after the operation; D does not use nanotubes, and does not perform sports rehabilitation training after the operation. The 4 groups of patients performed routine exercises on the basis of rehabilitation exercise care. The study lasted for six months, with the 60 patients assessed monthly on their self-care ability, knee function and quality of life. Self-care ability was assessed by the Barthel Index (BI), knee function was assessed by the Knee Score Scale (KSS), and quality of life was assessed by the SF-36 Health questionnaire. The experimental results showed that all indexes of group A were higher than those of group B, KSS value was 2 higher than that of control group, ADL (activities of daily living) comprehensive value was 0.4 higher than that of control group, and SF-36 (The Short-From-36 Health Survey) value was 0.8 higher than that of control group. The self-care ability and health status of patients who performed balance exercises were significantly higher than those who did not perform balance exercises. The quality of life of patients who used nanotubes was significantly higher than that of those who did not. Therefore, the method of using nanotubes in combination with exercise rehabilitation training can restore the function of patients with knee arthritis and promote high quality of life.

The Application of Rehabilitation Sentences for Narcotics Addicts (Case Study of North Jakarta District Court Decision Number 115/Pid.Sus/2023/PN Jkt. Utr)

The crime of narcotics offenses is considered an extraordinary crime. Law Number 35 of 2009 concerning Narcotics, Article 1 point 13, states that a Narcotics Addict is a person who uses or abuses Narcotics and is in a state of dependency on Narcotics, both physically and psychologically. Narcotic rehabilitation is one of the efforts to save addicts from the shackles of narcotics and the dangers that accompany them. There are three stages of narcotic rehabilitation in Indonesia: medical rehabilitation, non-medical rehabilitation, and advanced rehabilitation. The problem formulation in this study is how the rehabilitation punishment for narcotics addicts is applied and how the analysis of the considerations of the Panel of Judges of the North Jakarta District Court in imposing rehabilitation sanctions in decision number 1151/Pid.Sus/2023/PN Jkt.Utr. The type of research in this legal research proposal is normative legal research, focusing on the applicable legal norms, namely positive legal norms in the form of legislation. The results of the study show that the provisions for rehabilitation for narcotics addicts are stipulated in Articles 54 and 127 of Law Number 35 of 2009 concerning Narcotics. Meanwhile, the classification of user groups is regulated in the Circular of the Supreme Court No. 4 of 2010 concerning the Placement of Abusers, Victims of Abuse, and Narcotics Addicts in Medical and Social Rehabilitation Institutions. The judge's basis for sentencing the Defendant to undergo treatment and/or care at a medical/social rehabilitation institution refers to the provisions of Article 103 jo Article 127 paragraph 2 jo Article 54 of the Republic of Indonesia Law No. 35 of 2009 concerning Narcotics jo Circular of the Supreme Court of the Republic of Indonesia No. 4 of 2010 dated April 7, 2010, concerning the Placement of Abusers, Victims of Abuse, and Narcotics Addicts into Medical and Social Rehabilitation Institutions, as well as other legal facts revealed in the trial.

Do we really need this robot? Technology requirements for vestibular rehabilitation: Input from patients and clinicians

BackgroundA main challenge in many types of physical rehabilitation is patient adherence to recommended exercises. Vestibular rehabilitation is the most effective treatment for the symptoms of dizziness, vertigo, imbalance, and nausea caused by vestibular disorders, but adherence levels are particularly low as the rehabilitation program calls for many short exercise sets during the day, which can worsen symptoms and impair balance in the short term. Technological tools have the potential to increase adherence, but to date, there has been no comprehensive analysis, in the context of vestibular rehabilitation, of the specific needs from technology, of its limitations, and of concerns regarding its use. ObjectiveThe aim of the study is to identify the main features required from technology for vestibular rehabilitation, as perceived by patients with vestibular disorders and by vestibular physical therapists, using a socially assistive robot as a test case. We seek here to provide practical information for the development of future vestibular rehabilitation technologies which are based on human-computer interaction (HCI) and human-robot interaction (HRI). MethodsWe conducted a qualitative study with six focus groups (N = 39). Three groups of patients with vestibular disorders (N = 18) and three groups of physical therapists (N = 21) participated in this study. The participants answered structured questions on technologies for vestibular rehabilitation, watched a presentation of two videos of a socially assistive robot (SAR), and completed an online survey. Thematic analysis with a mixed deductive and inductive approach was used to analyze the data. ResultsParticipants preferred phone applications or virtual/augmented reality platforms over an embodied robotic platform. They wanted technology to be adaptive to the different stages of rehabilitation, gamified, easy to use, safe, reliable, portable, and accessible remotely by the therapist. They reported that the technology should provide feedback on the quality and quantity of exercise performance and monitor these factors while considering the tolerability of the ensuing disruptive symptoms. Participants expected that using technology as part of the rehabilitation process would shorten exercise sessions and improve clinical outcomes compared to standard care. SARs for vestibular rehabilitation were perceived as useful mostly for children and patients with chronic vestibular disorders, and their potential use for rehabilitation raised concerns regarding safety, ethics, and technical complexity. ConclusionsAlthough SARs can potentially be used to increase exercise adherence, a phone application appears to be a more suitable medium for this purpose, raising fewer notable concerns from users. We provide a summary of perceived advantages and disadvantages of technology for vestibular rehabilitation, as well as a set of specific requirements from it, which may inform the future development of specific supportive technologies. In addition, the focus group methodology employed demonstrates the importance of participatory design in the development of rehabilitation-supportive technology as participants were able to identify the likely inappropriateness of SARs for the specific case of vestibular rehabilitation.

Modern technologies for medical rehabilitation of children with knee joint injuries

Pathology of the knee joint in children is a pressing problem in pediatric traumatology, orthopedics and pediatrics. The frequency of injuries to the knee joint is determined by the complexity of its structure, biomechanical features with a high probability of overload. At the same time, intra-articular injuries in children and adolescents, accounting for up to 7 % in the structure of inpatient pathology, are the cause of pronounced functional disorders of the lower limb and the risk of developing post-traumatic osteoarthritis Currently, physical factors are widely used at various stages of medical rehabilitation of children with damage to the capsular-ligamentous apparatus of the knee joint. The conducted studies have established the effectiveness of using local air cryotherapy in the early postoperative period, characterized by a pronounced anti-edematous, analgesic effect. Early regression of pain and elimination of microcirculatory disorders in the area of injury as a result of a course of pulsed low-frequency magnetic therapy at various stages of medical rehabilitation of children with damage to the capsular-ligamentous apparatus of the knee joint have been recorded. The beneficial effect of a pulsed low-frequency electrostatic field on indicators of orthopedic status, and thermography indicators in the area of injury in children with knee joint injuries has been established. Data were obtained on more pronounced regression of pain, earlier restoration of range of motion in the damaged joint and relief of signs of post-traumatic synovitis with the complex use of a pulsed low-frequency electrostatic field and robotic mechanotherapy in children with damage to the capsular ligamentous apparatus of the knee joint. The obtained clinical and functional results are of great importance for injuries of the knee joint with the risk of contractures in the postoperative period.

Driving assistant using generative AI pre-generated messages in simulator-based driving assessment: A step towards low-cost simulator-based driving assessment

This paper presents a novel approach for a low-cost simulator-based driving assessment system incorporating a speech-based assistant, using pre-generated messages from Generative AI to achieve real-time interaction during the assessment. Simulator-based assessment is a crucial apparatus in the research toolkit for various fields. Traditional assessment approaches, like on-road evaluation, though reliable, can be risky, costly, and inaccessible. Simulator-based assessment using stationary driving simulators offers a safer evaluation and can be tailored to specific needs. However, these simulators are often only available to research-focused institutions due to their cost. To address this issue, our study proposes a system with the aforementioned properties aiming to enhance drivers' situational awareness, and foster positive emotional states, i.e., high valence and medium arousal, while assessing participants to prevent subpar performers from proceeding to the next stages of assessment and/or rehabilitation. In addition, this study introduces the speech-based assistant which provides timely guidance adaptable to the ever-changing context of the driving environment and vehicle state. The study's preliminary outcomes reveal encouraging progress, highlighting improved driving performance and positive emotional states when participants are engaged with the assistant during the assessment.

Machine Learning-Based Stroke Patient Rehabilitation Stage Classification Using Kinect Data

Everyone aspires to live a healthy life, but many will inevitably experience some form of disease, illness, or accident that results in disability at some point. Rehabilitation plays a crucial role in helping individuals recover from these disabilities and return to their daily activities. Traditional rehabilitation methods are often expensive, are inefficient, and lead to slow progress for patients. However, in this era of technology, various sensor-based automatic rehabilitation is also possible. A Kinect sensor is a skeletal tracking device that captures human motions and gestures. It can provide feedback to the users, allowing them to better understand their progress and adjust their movements accordingly. In this study, stroke-based rehabilitation is presented along with the Toronto Rehab Stroke Pose Dataset (TRSP). Pre-processing of the raw dataset was performed using various features, and several state-of-the-art classifiers were applied to evaluate the data provided by the Kinect sensor. Among the various classifiers, eXtreme Gradient Boosing (XGB) attained the maximum accuracy of 92% for the TRSP dataset. Furthermore, hyperparameters of the XGB have been optimized using a metaheuristic gray wolf optimizer for better performance.

Expression of pro-inflammatory cytokines (IL-18, IL-33) at the level of the mucous membrane, the entry point of infection, in persons who have experienced COVID-19 disease

Introduction. The mucous membrane of the upper respiratory tract is the entrance gate for a large number of infections, including the SARS-CoV-2 virus. That is why the main task of the immune system of the mucous membranes of the entrance gate of infection is to maintain respiratory function. High production of proinflammatory cytokines, which play a key role in the development of severe COVID-19 infection, leads to detrimental consequences for all body systems. Their long-term influence can not only aggravate chronic pathologies, but also significantly increase the recovery period, leading to a decrease in the quality of life of patients. Therefore, the purpose of this work is to study the expression of IL-18 and IL-33 genes at the level of the mucous membranes of the upper respiratory tract in patients who have had COVID-19 disease. Materials and methods. The present study involved patients who had moderate or severe COVID-19. The control group consisted of relatively healthy individuals. The expression levels of IL-18 and IL-33 were detected using RT-PCR. Results. During the entire period of rehabilitation after suffering from COVID-19, patients showed a tendency to increase the level of IL-18 expression at the level of the mucous membranes of the nasopharynx and oropharynx. The level of IL-33 production was also increased, but varied depending on the location and period of sample collection. Conclusion. This increase in the level of IL-18 during the rehabilitation period of patients after COVID-19 may be explained by the fact that the virus, by activating glia through olfactory receptor neurons, triggers a powerful immune response and promotes the production of a large number of pro-inflammatory cytokines. On the contrary, overexpression of IL-33 in the late stages of rehabilitation is most likely associated with its ability to restore barrier tissues of the mucous membranes of the upper respiratory tract. Thus, we can conclude that the virus promotes excessive production of pro-inflammatory cytokines, the amount of which increases maximally at the 6th month of rehabilitation after suffering from COVID-19.

Change in Walking Parameters of Paralympic Athletes Diagnosed with Cerebral Palsy Using WALKBOT Training System at Recovery Stage of Rehabilitation

INTRODUCTION: The publication is devoted to studying the rehabilitative effect of the Walkbot innovative training system on restoring the walking function in Paralympic athletes diagnosed with cerebral palsy (CP). The novelty of the developed Walkbot robot-assisted training system (TS) and insufficient experience of its use in rehabilitation practice require investigations on contingents of patients with musculoskeletal disorders in CP to develop protocols and programs of the rehabilitation use of the Walkbot TS. AIM: Study of effectiveness of rehabilitation use of the Walkbot robotic TS to restore the walking function in Paralympic athletes with spastic cerebral palsy. MATERIALS AND METHODS: The study was conducted at the Medical Rehabilitation Center ‘Sergievskie Mineral Waters’ in 2023. Forty Paralympic athletes (all men) aged 30-35 years were examined. The experimental group (EG) and control group (CG) included 20 Paralympic athletes each with standardization of the groups by the main parameters. The classes were conducted for 60 minutes according to the rehabilitation program. In the experimental group, besides exercise therapy (ET), the participants also exercised on the robotic Walkbot TS to restore the walking function, namely, they used Go world game with the known tasks symbolizing counties of the world, Go palace game that permits to take a walk around the palace, when patients move to the right or left as they choose; Go undersea game occurring against the background of a fairy sea world where they must go through the route controlling the direction of movement. The Paralympians of the control group used the standard rehabilitation program including ET with no training and gaming technologies. RESULTS: The obtained results showed a pronounced improvement in the parameters of motor actions in Paralympians of the EG, while in the CG, positive rehabilitation changes were 2–3 times less expressed. At the initial and final rehabilitation stages, an increase of the tolerated duration of classes was recorded: by 5 times in the EG and 3 times in the CG, post-rehabilitation increase in the EG was 23.4% compared to that in CG. After training on the Walkbot TS, the volume of the performed load increased 5.9 times in the EG and 2.1 times in the CG. The increase in the EG made 64.5% compared to the CG, which indicated an increase in speed-strength qualities and endurance of para-athletes. At the end of rehabilitation, the amount of steps on the Walkbot TS in the EG increased 5.9 times (in the CG — 2.9 times), increase in the EG made 48.3% compared to the CG. CONCLUSION: The experiment established a complex multisided positive effect of training sessions on the Walkbot TS in the EG versus the effect of only exercise therapy in the CG. The obtained data suggest that training on the Walkbot TS confer a significant restorative and normalizing effect on the neurophysiological mechanisms of functioning of the central parts of the motor cortex.

Międzynarodowe uwarunkowania rozminowywania terytoriów w kontekście zrównoważonego rozwoju: perspektywa ekonomiczna

The problem of landmines is becoming increasingly prevalent, with a growing impact on all spheres of society and a consequent slowing down of sustainable development planning at the international, national and local levels. Since February 2022, the issue of mine clearance has become even more relevant for Ukraine, where active hostilities are still ongoing, which requires a thorough study of the economic, social and environmental aspects of this process. In order to mitigate the negative impact of the war and possibly speed up the clearance of mines and other explosive hazards, it is important to analyse the key results of international experience in this area, which has already been gained by a significant number of countries. In order to expand on the subject of this study the example of demining territories of the seven most heavily mined countries in the world were chosen: Albania, Afghanistan, Bosnia and Herzegovina, Cambodia, Croatia and Turkey. The authors concentrated on identifying problems and highlighting the potential for further research into the sustainable dimension of demining, which is considered in this study to be the initial stage of territorial rehabilitation. In this context, the authors focus on the key results of demining through the prism of sustainable development, with particular emphasis on the economic component, as it affects the possibility of rapid resumption of economic and other peaceful use of the territories affected by armed conflicts. This formed the basis of the conclusions, where the authors substantiated ways to implement international demining experience in Ukrainian practice that lies in the inclusion of sustainable development components in strategic and operational documents at the national level. This is to lay a solid foundation for restoring the economic, social and environmental potential of territories in the context of war and post-war recovery.

PRIMARY AND POST-OSSEOINTEGRATION STABILITY OF SHORT (ULTRA-SHORT) IMPLANTS ON EDENTULOUS ATROPHIED DISTAL SEGMENTS OF THE MANDIBLE - AN INDICATOR OF IMMEDIATE OR DELAYED LOAD

Introduction. The issue of determining the possibility of immediate or long-term load on the selected type of implants, which will ensure the predictable result of their long-term functionality, remains an ongoing discussion. The results of the resonance frequency analysis, which perfectly characterize the stability of short and ultrashort implants at all stages of their osseointegration and post-osseointegration periods, can serve as such an indicator basis. Aim. To analyze the primary and post-osseointegration stability of short (ultra-short) implants placed by the methods at the level of the cortical bone layer and subcortically in case of bone atrophy caused by acquired final dentition defects. Materials and methods. The primary and post-osseointegration stability of thirty-nine dental short (h = 6.5 mm X b = 4.0 mm – 20 pieces) and ultra-short (h = 5.5 mm X b = 4.0 mm – 19 pieces) implants placed on the edentulous distal segments of the human mandible was studied. According to the clinical assessment that met the aim and objectives of this study, all patients were divided into four study groups: the first group consisted of patients with a preserved dentition who did not require dental implantation; the second group – 25-45 years old, the third group – 46-60 years old, and the fourth group – ≥ 61 years old. Using the resonance frequency analysis (RFA) method by Penguin Instruments, the results were interpreted in declarative units of measurement – the implant stability quotient (ISQ). Results. The installed short (ultrashort) implants, according to the methodology by the level of the cortical layer of bone tissue, are characterized by their high primary stability by anti-rotational force: in the second group of the study (25-45 years old) with a mean number (M) of 87.0 and an error of the mean (± m) of ± 2.3 ISQ; in the third group (46-60 years old) – 76.4 ± 3.0 ISQ; in the fourth group (persons ≥ 61 years old) – 69.8 ± 4.8 ISQ. Low values of primary stability were obtained in implants installed by the subcortical implantation technique in the second age group of the study and amounted to 59.6 ± 2.7 ISQ with a slight increase to 66.0 ± 4.1 ISQ in the third group and 71.7 ± 4.2 ISQ in the fourth group of the study, which do not guarantee the prognosis of functional redistribution of the supra occlusion immediate load on the biological basis, with further preservation of the course of normal physiological processes in the bone tissue around the implanted implants. Conclusions. Rehabilitation of patients with bone atrophy caused by the loss of the masticatory group of teeth is possible using short (h = 6.5-6.0 mm) and ultra-short (h = 5.5 mm) implants, with clinical justification for the choice of methods of immediate or post-osseointegration load, with a detailed resonance frequency analysis as a priority and reliable method – an effective indicator of their stability, at all stages of clinical rehabilitation of patients.

Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms.

The role of nutrition in organ health including solid organ transplantation is broadly accepted, but robust data on nutritional regimens remains scarce calling for further investigation of specific dietary approaches at the different stages of organ transplantation. This review gives an update on the latest insights into nutritional interventions highlighting the potential of specific dietary regimens prior to transplantation aiming for organ protection and the interplay between dietary intake and gut microbiota. Nutrition holds the potential to optimize patients' health prior to and after surgery, it may enhance patients' ability to cope with the procedure-associated stress and it may accelerate their recovery from surgery. Nutrition helps to reduce morbidity and mortality in addition to preserve graft function. In the case of living organ donation, dietary preconditioning strategies promise novel approaches to limit ischemic organ damage during transplantation and to identify the underlying molecular mechanisms of diet-induced organ protection. Functioning gut microbiota are required to limit systemic inflammation and to generate protective metabolites such as short-chain fatty acids or hydrogen sulfide. Nutritional intervention is a promising therapeutic concept including the pre- and rehabilitation stage in order to improve the recipients' outcome after solid organ transplantation.

The use of biofeedback training in complex therapy of neurotic disorders and correction of negative psychological consequences of combat stress in combatants

The parameters and effectiveness of biofeedback training in the complex treatment of neurotic disorders at the hospital stage and psychological correction at the sanatorium stages of rehabilitation of military personnel were assessed. We examined 40 mentally healthy military personnel who participated in combat operations and 36 military personnel who participated in combat operations and suffered from stress-associated neurotic disorders and who were undergoing inpatient treatment in the S.M. Kirov Military Medical Academy clinics. In identifying possible negative psychological consequences of combat stress in a group of mentally healthy military personnel, a medical and psychological examination was performed using the military version of the Mississippi scale for assessing post-traumatic reactions, Neurotic Disorders-Symptomatic Questionnaire, and Quality of Life Questionnaire-12. The military personnel underwent stress testing according to a specially developed scenario using a biofeedback hardware software complex to assess individual changes in physiological parameters in response to emotionally significant stimuli. In the military personnel who participated in combat operations and suffered from neurotic disorders, a medical and psychological examination was performed using the Neurotic Disorders-Symptomatic Questionnaire and Quality of Life Questionnaire-12 upon admission to the hospital and on the eve of discharge, and stress testing was conducted upon admission to the hospital. The therapeutic effectiveness of biofeedback training in the treatment of neurotic disorders was evaluated by comparing the results of treatment between two groups of 18 individuals each. One group received only drug therapy, whereas the other group, in addition to drug therapy, underwent biofeedback training on the amplitude of the systolic wave. The level of stress-associated psychogenic damage was found to be correlated with the amplitude of the systolic wave according to the digital photoplethysmogram. Moreover, the physiological indicators of the circulatory and respiratory systems, used in foreign studies for psychophysiological training in the treatment of post-stress disorders, were not associated with the level of psychogenic damage, indicating their lack of involvement in pathogenesis and the ineffectiveness of their use. The addition of biofeedback training on the amplitude of the systolic wave to the complex therapy of neurotic disorders leveled astheno-neurotic symptoms and improved quality of life. Therefore, when treating astheno-neurotic disorders in military personnel participating in combat operations, it is critical to include biofeedback training on the amplitude of the systolic wave; this reduces severity of neurotic symptoms, improves quality of life, and forms preventive skill of conscious control of excessive physiological reactions of combat stress. Furthermore, the correlation between the magnitude of the decrease in the amplitude of the systolic wave and level of mental damage in combatants, revealed during stress testing, indicates the importance of biofeedback training on the amplitude of the systolic wave in sanatorium-resort organizations and military clinical hospitals of the Russian Ministry of Defense for the medical and psychological rehabilitation of military personnel exhibiting negative symptoms and those suffering from psychological consequences of combat stress.

Effect of aggressive surgical protocol based on ERAS model on perioperative period of multiple rib fractures

ObjectiveTo explore the effect of aggressive surgical protocol based on the enhanced recovery after surgery (ERAS) model on perioperative and postoperative rehabilitation of patients with multiple rib fractures. MethodsA total of 86 patients with multiple rib fractures were selected and divided into the ERAS group and a routine group, with 43 cases in each group, according to the random number table method. The conventional group implemented the conventional surgical protocol, and the ERAS group implemented the active surgical protocol based on the concept of ERAS based on the conventional group. Intraoperative blood loss, first postoperative exhaust time, thoracic tube removal time, postoperative hospital stays, and postoperative complications were compared between the two groups, and postoperative compliance was evaluated. ResultsAll patients were cured and discharged from the hospital. The amount of intraoperative blood loss, first postoperative exhaust time, postoperative thoracic tube removal time, and postoperative hospital stay in the ERAS group were significantly less than in the conventional group. There was no significant difference in the incidence of postoperative pulmonary infection and the other five complications between the two groups (P > 0.05). The postoperative compliance of the ERAS group was better than that of the conventional group, and the difference was statistically significant (P < 0.05). ConclusionThe active surgical program based on the ERAS model is beneficial to improve the clinical symptoms of patients with multiple rib fractures, reduce postoperative pain, promote postoperative recovery as soon as possible, shorten the length of hospital stay, and significantly improve the compliance of patients in the postoperative rehabilitation stage.

The role of the nurse at all stages of medical rehabilitation

The patient occupies a central place in the quality management system of the Federal Center for Traumatology, Orthopedics and Endoprosthetics in the city of Cheboksary, the goal of which is to constantly improve patient satisfaction with the quality of medical care, including at the rehabilitation stage. The article outlines the leading role of the nurse in medical rehabilitation at all stages of medical rehabilitation in the Federal State Budgetary Institution «FCTOE» of the Ministry of Healthcare of Russia (Cheboksary). A description of organizational technologies used in medical rehabilitation by nursing staff is provided.

The Impact of Gamified Auditory-Verbal Training for Hearing-Challenged Children at Intermediate and Advanced Rehabilitation Stages.

Background: Auditory-verbal training is essential for children with hearing challenges, and the gamification approach has become a promising direction for improving the rehabilitation experience and effect. However, the specific influence of the gamified training approach on participants at different rehabilitation stages has not been empirically studied, especially in the practical training effect caused by gamified interventions and the varying influence on children with different rehabilitation status. Objective: This article is thus intended to investigate the following research questions: (1) do the training performances of children at advanced rehabilitation stage differ before and after using the gamified training system? (2) Do the training performances of children at intermediate rehabilitation stage differ before and after using the gamified training system? (3) Do children enjoy the gamified training approach? Methods: For the purpose, a digital gamified auditory-verbal training system was originally developed, and a series of user experiments were organized. The training performance of 31 hearing-challenged children was assessed, and interviews with six professional therapists were conducted. Results: It can be found that generally the gamified training approach can effectively facilitate the training experience and help with the basic auditory memory and expression capabilities. Moreover, it is feasible to be applied in practical training due to the high customization of digital training contents, multimodal interactive training means, and highly enjoyable training experience. Conclusions: Regarding the specific influence, the gamified way can better improve the basic auditory-verbal performance of children at the intermediate stage since the focus is more on the ease of learning and adaption to the training system. While for children at the advanced rehabilitation stage, the precise training and professional training contents are more in demand, it is not easy to achieve quick improvements. These findings and conclusions can provide insights for further explorations and applications of the gamification approach in children's auditory-verbal rehabilitation. This study was approved by the Institutional Review Board (IRB) of Shanghai Jiao Tong University with the approval number H2022213P.

Application of haloinhalations at the sanatorium-resort stage of rehabilitation of patients after COVID-19.

After suffering from COVID-19, a large number of patients need respiratory rehabilitation. One of the methods of rehabilitation is inhalation with salt aerosols. Our work aimed to study the effectiveness of inhalations of a dry aerosol of salt precipitated from the mineral water of the "Teplitsa multidisciplinary sanatorium", Transcarpathian region of Ukraine. 30 male patients were examined after suffering from COVID-19. We formed two groups of patients, control and main, 15 people each. Patients in the control group received inhalation with a dry aerosol of table salt of the "Aero-M-sol". In contrast, patients in the main group received a course of inhalations with a dry aerosol of salt precipitated from the mineral water. Under the influence of the rehabilitation complex in both groups, there is a performance improvement but significant changes are observed only in patients of the main group. The indicator Forced Vital Сapacity1 increased to the greatest extent, which after rehabilitation is significantly higher than in the control group (p<0.05). As a result, the Tiffeneau index significantly increases in the main group compared to the control group, reaching normal values. The main effect is associated with a decrease in obstructive complications of the respiratory tract as a result of a decrease in inflammation. The use of iodine-bromine brines (as in our case) for inhalation in the treatment of respiratory diseases has been proven to be effective, with systemic effects in the form of decreased IgE and increased IgA in the blood serum having been noticed. The use of haloinhalations with MW salts in the rehabilitation of patients after suffering from COVID-19 disease significantly improves the clinical condition of convalescents.

Medical rehabilitation of patients after surgical treatment of prostate adenoma at the third outpatient stage of medical rehabilitation with inclusion of extracorporeal magnetic stimulation

BACKGROUND: For modern urology the problem of optimisation of approaches to medical rehabilitation of patients after surgical treatment of the prostate gland is relevant due to the high frequency of early and late surgical complications, such as secondary lower urinary tract infections, urodynamic disorders, erectile dysfunction and others. AIM: To study the effectiveness of medical rehabilitation of patients after surgical treatment of prostate adenoma at the third outpatient stage of medical rehabilitation with the inclusion of extracorporeal magnetic stimulation. MATERIALS AND METHODS: There have been observed 88 patients after surgical treatment of prostate adenoma. They were divided into 2 groups by simple randomization: in the comparison group (n=43) the patients had physical therapy, psychocorrection, alpha1-adroenblock Tamsulosin, transrectal magnetic therapy at the outpatient stage; in the main group 45 patients were additionally prescribed extracorporeal electromagnetic stimulation. The effectiveness of rehabilitation measures was monitored using ultrasound examination of pelvic organs, uroflowmetry, the assessment of the severity of urinary disorders and quality of life ― the International Prostate Symptom Score (IPSS). RESULTS: Performing stage-by-stage medical rehabilitation of the patients after surgical treatment of prostate adenoma using extracorporeal electromagnetic stimulation provides a significant leveling of urodynamic disorders (p 0.01), in the comparison group positive dynamics was expressed less (on average by 8–10%) in the absence of intergroup differences. The overall score and Quality of Life index according to IPSS significantly improved (p 0.01) immediately after rehabilitation in the main group, and 6 months later the positive dynamics of these indicators was significantly better compared to those in the comparison group (p 0.05). CONCLUSION: The implementation of the outpatient rehabilitation program after surgical treatment of prostate adenoma using extracorporeal electromagnetic stimulation provides a significant leveling of urodynamic disorders (p 0.01), restoration of quality of life (p 0.01).

Correction of immune disorders under the influence of pharmacotherapy and extracorporal magnetic stimulation in patients after surgical treatment of prostate adenoma

Abstract. The literature analysis shows that benign prostatic hyperplasia is associated with chronic prostatitis in 50–70 % of cases. Moreover, the course of benign prostatic hyperplasia is associated with immunological disorders at the systemic and local levels. The presence of a chronic, sluggish process is accompanied by endogenous intoxication, which leads to a gradual decrease in the body’s immune reactivity. Purpose of the study. To study the role of the complex effects of pharmacotherapy and extracorporeal magnetic stimulation (EMS) in the correction of immune disorders in patients after surgical treatment of prostate adenoma. Material and methods. Observations were carried out on 88 patients after surgical treatment of pancreatic adenoma, who underwent medical rehabilitation at stages II and III. At stage II, in the comparison group (CG), 43 patients received standardized drug therapy and individual physical therapy; in the main group (MG), 45 patients additionally received immunomodulatory therapy with Tamerit. At stage III in the GS, patients continued pharmacotherapy, exercise therapy and transrectal magnetic therapy; in the OG, 45 patients were additionally prescribed EMS. To study the content of interleukins (IL), the enzyme-linked immunosorbent assay method was used; To assess the quality of life, the IPSS-QOL (International Prostate Symptom Score — Quality-of-Life) questionnaire and SF-36 (The Short Form-36) were used.Significance level — p &lt; 0.05. Results. After the II inpatient stage of rehabilitation in patients with OH after surgical treatment of pancreatic adenoma, the level of proinflammatory ILs decreased on average by 47.5 % (p &lt; 0.01) with an increase in the level of anti-inflammatory IL-10 by 36.2 % (p &lt; 0.01). After the third outpatient stage of rehabilitation, the positive dynamics increased significantly and amounted to 63.2 % (p &lt; 0.01) and 51.9 % (p &lt; 0.01), reaching normative values in the population. It should be noted that the achieved results are maintained in the long term. In the GS, in all cases after stages II and III of rehabilitation, the positive dynamics were significantly lower (p &lt; 0.05 — p &lt; 0.01). With the same reliability, in the group there was a decrease in the severity of urinary disorders (p &lt; 0.01), restoration of quality of life (p &lt; 0.05) according to the IPSS-QOL and SF-36 questionnaires with significant intergroup values (p &lt; 0.05). Conclusion. The integrated use of pharmacotherapy and EMS in patients after surgical treatment of pancreatic adenoma provides significant correction of immune disorders and restoration of physical and mental health.