Rehabilitation Therapy In Patients Research Articles

The Efficiency of Rehabilitation Therapy in Patients Diagnosed with Neurogenic Bladder: A Systematic Review

The Efficiency of Rehabilitation Therapy in Patients Diagnosed with Neurogenic Bladder: A Systematic Review

#2014 Exercise safety and efficacy as a rehabilitation therapy for patients on hemodiafiltration: a 6-month controlled study

Abstract Background and Aims Individuals with chronic kidney disease (CKD) stage 5D face challenges due to the accumulation of uremic toxins. Hemodiafiltration (HDF) stands out for its efficacy in removing solutes of various molecular weights, offering mortality benefits. Although exercise rehabilitation is established as a beneficial adjunct therapy for patients on maintenance hemodialysis, its impact on maintenance HDF programs remains understudied. The primary aim was to evaluate the safety and efficacy of exercise as rehabilitation in patients undergoing HDF. The secondary aim was to compare the outcomes between intra- and inter-HDF exercise sessions. Method This study enrolled CKD 5D patients at Fenix Nephrology Group from 2021 to 2023. The assessment occurred at the initiation of the exercise program and after six months of exercise rehabilitation. Physical tests included the step-test, handgrip, and one-repetition maximum (1RM), and the Kidney Disease Quality of Life Short Form (KDQOL-SF), a patient-reported outcome measure. The urea reduction ratio (URR) reflected HDF adequacy. Patients engaged in twice-weekly aerobic exercises achieving 70% of maximum heart rate and resistance exercises (60% 1RM). Results Data from 234 patients were obtained, and 81 were not on the exercise program. From the remaining 153 patients, we excluded 64. Twelve patients were excluded because underwent kidney transplantation during their participation, 41 had incomplete data, and 11 patients carried out less than 80% of the scheduled exercise sessions. We included in our final analysis data from 89 patients (55 ± 15 years; 58.4% male). The mean dialysis vintage was 9 ± 7 years, including high-flux hemodialysis and HDF. Specifically, for HDF, the mean dialysis vintage was 5 ± 4 years. Mean exercise session adherence was 94 ± 4%, and the mean number of sessions was 39 ± 4. Concerning the performance outcomes, we observed significant improvements in the step-test (80 ± 22 to 93 ± 25 steps; p < 0.001) and handgrip measurement (28 ± 7 to 30 ± 7 kgf; p < 0.001), alongside an approximate 4% increase in lean body mass (13 ± 2 to 14 ± 2 kg; p < 0.001) during the 6 months. The KDQOL-SF improved in physical functioning (64 ± 22 to 72 ± 23; p < 0.001), general health (55 ± 23 to 61 ± 2; p = 0.01), social function (73 ± 26 to 80 ± 21; p = 0.004), physical (43 ± 9 to 47 ± 8; p < 0.001) and mental composite scores (46 ± 10 to 48 ± 9; p = 0.04), along with a reduction in fatigue (57 ± 17 to 60 ± 17; p = 0.03). A similar favorable trend was observed for the URR (68 ± 10% vs. 71 ± 8%; p < 0.05). We also analyzed the exercise rehabilitation program in two different groups. Thirty-five patients carried out intradialytic exercise (i.e., during the dialysis session). In this group, the mean dialysis vintage was 10 ± 7 years and specifically 5 ± 3 years on HDF. The other group included 54 patients performing interdialytic exercise (i.e., pre- or post-session). In this group, the mean dialysis vintage was 8 ± 6 years and specifically 4 ± 2 years on HDF. We did not observe complications during the exercise program, and no sessions were interrupted due to adverse events. Demographic and anthropometric data (age, sex, weight, and body mass index) were comparable between the groups. Furthermore, exercise performance was equivalent in both groups. Conclusion Our findings suggest that a supervised exercise program for maintenance dialysis patients performing HDF is safe and efficacious, yielding substantial improvements in patient-reported and performance outcomes. Notably, the positive effects of exercise persisted whether conducted during intradialytic or interdialytic periods.

Changes in Structural Neural Networks in the Recovery Process of Motor Paralysis after Stroke.

In recent years, neurorehabilitation has been actively used to treat motor paralysis after stroke. However, the impacts of rehabilitation on neural networks in the brain remain largely unknown. Therefore, we investigated changes in structural neural networks after rehabilitation therapy in patients who received a combination of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) and intensive occupational therapy (intensive-OT) as neurorehabilitation. Fugl-Meyer assessment (FMA) for upper extremity (FMA-UE) and Action Research Arm Test (ARAT), both of which reflected upper limb motor function, were conducted before and after rehabilitation therapy. At the same time, diffusion tensor imaging (DTI) and three-dimensional T1-weighted imaging (3D T1WI) were performed. After analyzing the structural connectome based on DTI data, measures related to connectivity in neural networks were calculated using graph theory. Rehabilitation therapy prompted a significant increase in connectivity with the isthmus of the cingulate gyrus in the ipsilesional hemisphere (p < 0.05) in patients with left-sided paralysis, as well as a significant decrease in connectivity with the ipsilesional postcentral gyrus (p < 0.05). These results indicate that LF-rTMS combined with intensive-OT may facilitate motor function recovery by enhancing the functional roles of networks in motor-related areas of the ipsilesional cerebral hemisphere.

Diaphragmatic breathing combined with abdominal drawing-in maneuver for walking function in post-stroke patients: a randomized controlled study protocol

BackgroundPatients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training.MethodsThis single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test.DiscussionThe primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation.Trial registrationChinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.

The general essential objectives of medical rehabilitation in the management of chronic dyspnea – a systematic review

Dyspnea is defined by an increased laboured breathing, due to interactions of motor, sensory and metabolic nerve impulses, with increased airway resistance, caused by hypox-emia or hypercapnia. Chronic dyspnea presents various causes, respiratory disease, car-diovascular disease, skeletal disease, anaemia, obesity or even physical deconditioning, a condition that persists for more than 4–8 weeks. As for the rehabilitation program, it in-volves the patient’s re-education, the actual physical recovery, change in risk factors and psychological counselling, all leading to the definite improvement of the physical and mental condition, with positive consequences on the quality of life. The rehabilitation pro-gramme applied to increase exercise tolerance in patients with chronic dyspnea can be performed safely; it will also result in an increase in the quality of life of patients. There is a need to develop a strategy for a long-term approach to patients with chronic dyspnea, involving a multidisciplinary team for the constant follow-up of these patients using easily reproducible, feasible and low-cost methods. Rehabilitation therapy in patients with chronic dyspnea uses a set of therapeutic measures, with the aim of restoring greater physical and mental capacity than before the programme

Rehabilitation for non-motor symptoms for patients with Parkinson's disease from an α-synuclein perspective: a narrative review.

Parkinson's disease (PD) is a common neurodegenerative disorder affecting aged population around the world. PD is characterized by neuronal Lewy bodies present in the substantia nigra of the midbrain and the loss of dopaminergic neurons with various motor and non-motor symptoms associated with the disease. The protein α-synuclein has been extensively studied for its contribution to PD pathology, as α-synuclein aggregates form the major component of Lewy bodies, a hallmark of PD. In this narrative review, the authors first focus on a brief explanation of α-synuclein aggregation and circumstances under which aggregation can occur, then present a hypothesis for PD pathogenesis in the peripheral nervous system (PNS) and how PD can spread to the central nervous system from the PNS via the transport of α-synuclein aggregates. This article presents arguments both for and against this hypothesis. It also presents various non-pharmacological rehabilitation approaches and management techniques for both motor and non-motor symptoms of PD and the related pathology. This review seeks to examine a possible hypothesis of PD pathogenesis and points to a new research direction focus on rehabilitation therapy for patients with PD. As various non-motor symptoms of PD appear to occur earlier than motor symptoms, more focus on the treatment of non-motor symptoms as well as a better understanding of the biochemical mechanisms behind those non-motor symptoms may lead to better long-term outcomes for patients with PD.

Efficacy and safety of acupuncture combined with rehabilitation training for poststroke cognitive impairment: A systematic review and meta-analysis

BackgroundAccumulated evidence has proven that both acupuncture and rehabilitation therapy are beneficial for stroke sequelae. However, there is no systematic review to identify the efficacy and safety of acupuncture combined with rehabilitation training for poststroke cognitive impairment (PSCI). Therefore, the aim of this study was to assess the efficacy and safety of acupuncture combined with rehabilitation therapy for patients with PSCI. MethodsWe searched nine databases, including PubMed, Embase, Scopus, Web of Science, EBSCO, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wan Fang, from their inception to September 2022. Randomized controlled trials (RCTs) examining the effect of acupuncture combined with rehabilitation on PSCI were included. The primary outcomes were the Mini-Mental State Examination (MMSE) score, Montreal Cognitive Assessment (MoCA) score, Modified Barthel Index (MBI) score, and Fugl-Meyer Assessment (FMA) score. The quality of the methodology was evaluated by Cochrane's risk of bias tool. Meta-analyses were performed by Revman 5.3 software. ResultsA total of 18 RCTs involving 1654 patients were included. The overall methodological quality of the included studies was low. Pooled results demonstrated that acupuncture combined with rehabilitation could significantly improve the clinical efficacy of PSCI (OR=3.23, 95% CI: 2.13 to 4.89), MMSE score (MD= 2.85, 95% CI: 2.56 to 3.15), MoCA score (MD= 2.18, 95% CI: 1.38 to 2.97), MBI score (MD= 9.23, 95% CI: 5.62 to 12.84), and FMA score (MD=5.72, 95% CI: 3.48 to 7.96). ConclusionsAcupuncture combined with rehabilitation may produce better outcomes than rehabilitation alone in the treatment of PSCI. However, the safety of combined interventions is still unclear. Therefore, research with more rigorous study designs and RCTs with larger sample sizes is still needed.

3D Virtual Reality Rehabilitation Therapy for Patients with Vertigo Due to Peripheral Vestibular Dysfunction.

This study aimed to evaluate 3D virtual reality rehabilitation therapy in patients with vertigo due to peripheral vestibular dysfunction. The subjects were 20 patients with peripheral vestibular dysfunction confirmed by Videonystagmography, Divided into 2 groups: Group 1 (study group) underwent vestibular rehabilitation therapy using 3D virtual reality in a customised VR lab with specific headset (Oculus rift and htc vive) with software application, which allows vestibular rehabilitation treatment using high quality immersive virtual reality console in which environment appears real and in 3D. The exercises are designed for gaze stability, increase postural stability, improve vertigo and daily activities, through sensory stimuli and in addition to conventional Cawthorne-Choksey exercises. Group 2 (control group) are treated by conventional Cawthorne-Choksey exercises alone. A VSS-SF (Vertigo Symptom Scale-short form) questionnaire and VAS (Visual Analog Scale) were used to assess the levels of patient satisfaction compared before and after each treatment session in both groups. A significant higher level of subjective satisfaction was observed in patients who underwent 3D virtual reality rehabilitation therapy with conventional therapy (group 1) compared to patients who underwent conventional cawthorne-Choksey exercises alone (group 2). The study gave a substantial subjective satisfaction in patients using 3D virtual reality rehabilitation therapy with conventional therapy (group1) than conventional Cawthorne-Choksey exercises alone (group 2). Future of VR rehabilitation therapy brings a revolutionary novelty in field of rehabilitation therapy were it involves real time stimulation and interaction between sensory, motor and cognitive channels.

Force/moment tracking performance during constant-pose, force-varying, bilaterally symmetric, hand-wrist tasks.

Bilateral movement is widely used for calibration of myoelectric prosthesis controllers, and is also relevant as rehabilitation therapy for patients with motor impairment and for athletic training. Target tracking and/or force matching tasks can be used to elicit such bilateral movement. Limited descriptive accuracy data exist in able-bodied subjects for bilateral target tracking or dominant vs non-dominant dynamic force matching tasks requiring more than one degree of freedom (DoF). We examined dynamic trajectory (0.75Hz band-limited, white, uniform random) constant-posture, hand open-close, wrist pronation-supination target tracking and matching tasks. Tasks were normalized to maximum voluntary contraction (MVC), spanning a±30% MVC force range, in four 1-DoF and 2-DoF tasks: (1, 2) unilateral dominant limb tracking with/without visual feedback, and (3, 4) bilateral dominant/non-dominant limb tracking with mirror visual feedback. In 12 able-bodied subjects, unilateral tracking error with visual feedback averaged 10-15%MVC, but up to 30%MVC without visual feedback. Bilateral matching error averaged∼10%MVC and was affected little by visual feedback type, so long as feedback was provided. In 1-DoF bilateral tracking, the dominant side had statistically lower error than the non-dominant side. In 2-DoF bilateral tracking, the side providing mirror visual feedback exhibited lower error than the opposite side. In 2-DoF tasks (assumed to be more challenging than their constituent 1-DoF tracking tasks), hand grip force errors grew disproportionately larger than those of each wrist DoF. In unilateral 1-DoF tasks, both hand vs target and wrist vs target latency averaged 250-350ms. In unilateral 2-DoF tasks, wrist vs target latency also averaged 250-350ms, while hand vs target latency averaged>500ms. These results provide guidance on bilateral 2-DoF hand-wrist performance in target tracking, and dominant vs non-dominant force matching tasks.

Effects of external diaphragm pacing combined with conventional rehabilitation therapies in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

Numerous randomized controlled trials (RCTs) have reported the benefits of external diaphragm pacing combined with conventional rehabilitation therapies (EDP-CRTs) on pulmonary function and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, evidence-based regarding its effects remains unclear. This systematic review and meta-analysis aimed to evaluate the effects of EDP-CRTs versus CRTs on patients with COPD. Systematic review and meta-analysis. We performed a systematic review and meta-analysis, searching PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, China Biology Medicine Disc, Chinese National Knowledge Infrastructure, Wan-Fang Database, and Chinese Scientific Journal Database from inception to 10 September 2023. RCTs investigating the effects of EDP-CRTs versus CRTs on COPD patients were included. The primary outcome was pulmonary function, including forced expiratory volume in 1 s (FEV1), the percentage of predicted values of FEV1 (FEV1%pred), and FEV1/forced vital capacity (FVC)%. Secondary outcomes included arterial blood gas analysis [the partial pressure of arterial oxygen (PaO2) and the partial pressure of arterial carbon dioxide (PaCO2)]; dyspnea [modified Medical Research Council Dyspnea Scale (mMRC)]; exercise capacity [6-min walking distance (6MWD)]; and quality of life [COPD assessment test (CAT)]. RevMan 5.3 software was used for meta-analysis. The quality of the included studies was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0). The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system. In total, 13 studies/981 participants were included. The pooled results revealed significant benefits of EDP-CRTs versus CRTs on the FEV1 [standardized mean difference (SMD) = 1.07, 95% confidence interval (CI) = 0.58-1.56], FEV1%pred [weighted mean difference (WMD) = 6.67, 95% CI = 5.69-7.64], the FEV1/FVC% (SMD = 1.24, 95% CI = 0.48-2.00), PaO2 (SMD = 1.29, 95% CI = 0.74-1.84), PaCO2 (SMD = -1.88, 95% CI = -2.71 to -1.04), mMRC (WMD = -0.55, 95% CI = -0.65 to -0.45), 6MWD (SMD = 1.63, 95% CI = 0.85-2.42), and CAT (WMD = -1.75, 95% CI = -3.16 to -0.35), respectively. Planned subgroup analysis suggested that EDP-CRTs had a better effect on FEV1, FEV1/FVC%, 6MWD, and CAT in the duration of 2-4 weeks. EDP-CRTs have better effects on pulmonary function, PaCO2, dyspnea, exercise capacity, and quality of life in COPD patients than CRTs, and the duration to achieve the most effective treatment is 2-4 weeks. This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No. CRD42022355964).

Long-term data of interval hypoxic therapy in patient rehabilitation after COVID-19

Long-term data of interval hypoxic therapy in patient rehabilitation after COVID-19

Quantitative Upper Limb Assessment With Natural User Interface in Children With Hemiparesis

Quantitative, efficient, and accurate measurement of upper limb motor performance is relevant for monitoring upper limb progress in daily activities of people with cerebral palsy, which is helpful to define an appropriate rehabilitation procedure. Currently, motion capture sensors using a Natural User Interface (NUI) are the most feasible solutions due to the low-cost implementation, portability, and effectiveness for upper limb motion analysis. A quantitatively assessment study of the upper limb motor performance for children with spastic hemiparesis using the NUI Kinect v2 sensor is described in this paper. The study participants were eighteen children with an average age of 8.28 ± 2.32 years having a Manual Ability Classification System level I and II. The assessment was done for each participant before and after the application of a Modified Constrained-Induced Movement Therapy (mCIMT) applied five days a week along twelve weeks. According to obtained results significant differences (p<0.05) in the Fugl-Meyer Assessment (FMA) score for motor performance in abduction movement of upper limb between the first and last sessions were quantitatively detected. The described NUI assessment method helped to quantitatively show that the applied therapy sessions were effective to improve upper extremity motor performance. Additionally, the upper limb movements motorically limited after the rehabilitation therapy were also identified. The main contribution of the described NUI assessment method is its potential use as a quantitative measurement tool, which might be used by specialists to objectively diagnose and consequently define an appropriate rehabilitation therapy for patients with hemiparesis.

The efficacy of neuro-optometric visual rehabilitation therapy in patients with visual snow syndrome.

This study intends to evaluate the feasibility of Neuro-Optometric Rehabilitation Therapy (NORT) to treat Visual Snow Syndrome (VSS). This pilot study utilized the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) to assess quality of life (QOL) before and after treatment. Twenty-one participants were recruited as successive intake patients diagnosed with VSS at the clinics of Dr. Terry Tsang Optometry, Inc and Neuro-Vision Associates of North Texas. Participants completed the NEI Visual Function Questionnaire 25-2000 edition and performed NORT, conducted by a neuro-optometrist or a qualified vision therapist. The NEI-VFQ-25 was administered before, at 6 weeks, and at 12 weeks of NORT to evaluate the effects of treatment on patient QOL. The participants demonstrated an improvement in QOL composite and subscale scores after 6 and 12 weeks of NORT treatment. The NEI-VFQ-25 composite scores from the pre-test (M = 68, SD = 18) and at 6 weeks of treatment (M = 75, SD = 17) indicate an improvement in QOL [t (20) = 4.0, p = 0.0007]. The NEI-VFQ-25 composite scores from pretest to 12 weeks of treatment showed further improvements. This trend of improvement on NEI-VFQ-25 composite scores continued into the 12th week (M = 77, SD = 17) of treatment [t (20) = 4.5, p = 0.0002]. The subscales of general vision, distance activities, near activities, social functioning, mental health, role difficulties and dependency also showed improvement. Our results suggest that patients with VSS experience improvement in QOL in as little as 6 weeks, with further improvement by 12 weeks of NORT. This suggests NORT is an effective treatment option for managing the condition and improving QOL in patients with VSS, although a reduction in specific symptoms has yet to be demonstrated. This study provides justification that NORT warrants further investigation on VSS symptom reduction.

The effectiveness of the inclusion of ozone therapy in comprehensive rehabilitation programs for post-COVID syndrome

BACKGROUND: The global scale of the pandemic of a new coronavirus infection is determined by the involvement of the entire world population in the problem. Recently, the scientific and medical community has been paying increased attention to the consequences of COVID-19, including aspects of the rehabilitation of patients who have had this infection.&#x0D; AIM: to evaluate the effectiveness and safety of including ozone therapy in the rehabilitation of patients with long COVID.&#x0D; MATERIALS AND METHODS: This randomized controlled clinical trial included 51 patients aged 29 to 78 years with a confirmed diagnosis of pneumonia associated with SARS-CoV-2 (J12.8). Patients were divided into three statistically comparable groups depending on the complex of rehabilitation treatment, which they received. In the first (control) group (n=17), a 10-day course included daily breathing exercises and physiotherapy for the lungs. In the second (main) group (n=18), in addition to the complex of basic measures, daily intravenous infusions of ozonized saline with an ozone concentration of 2.0 mg/l were performed daily. Patients in the third group (comparison, n=16) received ozone therapy every other day. In order to determine the effectiveness and safety of the inclusion of systemic ozone therapy in a comprehensive program for the rehabilitation of patients after COVID-19, an analysis of blood oxygen saturation in air, laboratory parameters (D-dimer and C-reactive protein), changes in peripheral blood flow, a decrease in patients' oxygen demand to and after a 10-day course of rehabilitation treatment. The dynamics of patients' complaints and changes in the patient's quality of life during rehabilitation were assessed using the EQ5D questionnaire.&#x0D; RESULTS: All patients during rehabilitation had positive dynamics in all parameters, there were no adverse reactions during the course and 2 months after rehabilitation. An analysis of various indicators revealed a greater effectiveness in prescribing systemic ozone therapy for rehabilitation. When comparing different methods, it turned out that daily ozone therapy had a better effect on laboratory parameters than daily ozone therapy.&#x0D; CONCLUSIONS: The use of ozone therapy in the complex rehabilitation of patients after COVID-19 is safe and effective. Further study in more patients is needed to determine indications and criteria for use.

Effectiveness of vestibular rehabilitation therapy in patients with idiopathic Cerebellar Ataxia with Bilateral Vestibulopathy (iCABV).

To evaluate the benefit of vestibular rehabilitation therapy (VRT) in the management of patients with idiopathic cerebellar ataxia with bilateral vestibulopathy (iCABV). iCABV is a hindbrain degenerative disorder with impairment of both central and peripheral vestibular pathways. There is combined failure of four compensatory eye movement systems including the vestibulo-ocular reflex (VOR), optokinetic reflex, smooth pursuit and the visually enhanced vestibulo-ocular reflex (VVOR). Phenotypic presentation includes postural and gait instability, oscillopsia and dizziness with active head movement. The benefit of VRT in iCABV patients has not been established. A retrospective review was performed on a cohort of twelve patients diagnosed with iCABV in a multidisciplinary neuro-otology clinic. All participated in VRT and completed their suggested course of VRT. The following clinical measures were assessed before starting and after finishing VRT: 1) Dizziness Handicap Inventory (DHI), 2) Activities-Specific Balance Confidence (ABC) Scale, 3) Catastrophization scale, 4) Positive Affective Negative Affective Score (PANAS), 5) Dynamic Gait Index (DGI) and 6) Modified Clinical Test of Sensory Interaction in Balance (mCTSIB). The number of falls historically was recorded in addition to gait speed (ft./sec). Following VRT, patients were found to have improved balance on mCTSIB (condition 4 : 7 vs 18 seconds, P = 0.04) and a better postural stability with a reduced number of falls (p = 0.01). No statistically significant improvement was seen in the DHI, ABC, Catastrophization scale, DGI, PANAS and gait speed (p > 0.05). iCABV patients who underwent VRT were found to have a better postural stability and reduced risk of falls. VRT was not found to significantly improve patients' overall subjective perception of their symptoms or their psychological status.

EVALUATION OF FUNCTIONALITY, DEPRESSION AND QUALITY OF LIFE IN HEMIPLEGIC PATIENTS DURING COVID-19 PANDEMIC

OBJECTIVE: The aim of this study was to investigate the changes of the functionality, mood and life quality of patients diagnosed with hemiplegia due to an ischemic or hemorrhagic stroke during the COVID-19 pandemic. MATERIAL AND METHODS: A total of 83 patients (mean age, 62.0±6.43 years) diagnosed with hemiplegia due to stroke, who received 30 sessions of rehabilitation therapy, before the COVID-19 pandemic, were included in this study. Data regarding the participants’ age, gender, body mass index (BMI), duration of stroke, stroke type, affected side, and education level were recorded. All the assessments were undertaken before the COVID-19 pandemic and repeated at the first year after the beginning of the pandemic. The functional status of the patients was evaluated with the Functional Independence Measure (FIM). The depression levels of the participants were evaluated using the Beck Depression Inventory (BDI). The life quality of the participants was evaluated using the Stroke-Specific Quality of Life Scale (SS-QOL). RESULTS: There were significant differences in the FIM total scores of the patients evaluated before and during COVID-19 (91.32±15.94 and 87.15±15.60, respectively, p&amp;lt;0.001).When the FIM domain scores were evaluated before COVID-19 and at the first-year control during COVID-19, the FIM self-care scores were 27.45±6.62 and 25.27±7.08, respectively, the FIM sphincter control scores were 10.10±2.56 and 9.39±2.87, respectively, the FIM transfers scores were 14.67±3.36 and 13.61±3.54, respectively, the FIM social cognition scores were 18.40±1.86 and 17.67±1.93 respectively (p&amp;lt;0.001). The BDI score was 10.06±3.18 before the pandemic and 13.66±3.04 at the first year of the pandemic, the SS-QOL scores was 136.48±29.63 before the pandemic and 133.63±29.63 at the first year evaluation (p&amp;lt;0.001). CONCLUSIONS: The COVID-19 pandemic has caused delays in both follow-up and rehabilitation therapy in patients with chronic hemiplegia. The functionality, life quality and mood of the patients have been affected due to the lack of therapy and social isolation.

Relationship of Neuropeptide S (NPS) with Neurocognitive, Clinical, and Electrophysiological Parameters of Patients during Structured Rehabilitation Therapy for Schizophrenia.

Introduction: Neuropeptide S is a biomarker related to various neuropsychiatric and neurocognitive functions. Since the need to improve cognitive functions in schizophrenia is unquestionable, it was valuable to investigate the possible relationships of plasma levels of NPS with neurocognitive, psychopathological and EEG parameters in patients with schizophrenia. Aim: Relationships between the serum NPS level and neurocognitive, clinical, and electrophysiological parameters were investigated in patients diagnosed with schizophrenia who underwent structured rehabilitation therapy. Methods: Thirty-three men diagnosed with schizophrenia were randomized into two groups. The REH group (N16) consisted of patients who underwent structured rehabilitation therapy, the CON group (N17) continued its previous treatment. Additionally, the reference NPS serum results were checked in a group of healthy people (N15). In the study several tests assessing various neurocognitive functions were used: d2 Sustained-Attention Test (d2), Color Trails Test (CTT), Beck Cognitive Insight Scale (BCIS), Acceptance of Illness Scale (AIS), and General Self-Efficacy Scale (GSES). The clinical parameters were measured with Positive and Negative Syndrome Scale (PANSS) and electrophysiological parameters were analyzed with auditory evoked potentials (AEPs) and quantitative electroencephalography (QEEG). The NPS, neurocognitive, clinical, and electrophysiological results of REH and CON groups were recorded at the beginning (T1) and after a period of 3 months (T2). Results: A decreased level of NPS was associated with the improvement in specific complex indices of d2 and BCIS neurocognitive tests, as well as the improvement in the clinical state (PANSS). No correlation was observed between the level of NPS and the results of AEPs and QEEG measurements. Conclusions: A decreased level of NPS is possibly related to the improvement in metacognition and social cognition domains, as well as to clinical improvement during the rehabilitation therapy of patients with schizophrenia.

Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability.

To compare the morphological anatomy and abnormalities of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in unilateral chronic ankle instability (CAI). 22 patients (men: women, 13:9; mean age, 28.95 ± 8.127 years) with unilateral CAI and 18 healthy volunteers (men: women, 9:9, mean age, 28.33 ± 3.678 years) were recruited. MRI scans were divided into Group 1 (22 injured ankles), Group 2 (22 contralateral uninjured ankles), and Group 3 (36 healthy volunteer ankles). The morphologic variables, MRI signal intensity (SI) values were evaluated. The ATFL proximal, intermediate, and distal sites and the CFL proximal and distal sites in Group 3 were narrower than those in Group 1 (P ＜0.05). Both ATFL and CFL in Group 1 were thicker than those in Group 3 (P ＜0.01). The proximal and intermediate sites of the ATFL and the proximal site of the CFL in Group 3 were narrower than those in Group 2 (P ＜0.01). The intermediate site of the ATFL and the proximal and distal sites of the CFL in Group 2 were thicker than those in Group 3 (P ＜0.01). The mean SI values of the ATFL in Group 1 were higher than those in Groups 2 and 3 (P ＜0.01). The ATFL and CFL SI values were higher in Group 2 than those in Group 3 (P ＜0.05). Both the injured and contralateral uninjured ankles had wider ATFL and CFL, more thickness, and higher SI values compared with those of healthy volunteer ankles. High-resolution three-dimensional MRI provides a potential tool assisting clinical decision on the treatment and rehabilitation therapy of patients with unilateral CAI.

Can CRP and ESR values may be influenced by rehabilitation therapy in patients with psoriatic arthritis?

Objective. Psoriatic arthritis (PsA) is a type of chronic inflammatory arthritis that is linked to psoriasis and affects 20 to 30 percent of those who have it. Clinical symptoms vary and can change over time as one articular pattern evolves into another. This condition has a significant financial and psychological cost attached to it, not to mention the mental state of the patient in relation to the disease. Inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are frequently used in primary care to diagnose and monitor inflammatory illnesses such as infections, autoimmune diseases, and malignancies. Our main goal was to see whether or not there was a difference between inflammatory markers in patients with psoriatic arthritis who benefited balneotherapy and kinesiotherapy, compared to those who remained only on the fund treatment. Material and methods. We performed a comparative retrospective study regarding the evolution of 110 patients diagnosed with psoriatic arthritis who underwent or not a rehabilitation program that was performed in Rehabilitation Hospital Baile Felix. Outcomes. One of the results we wanted to demonstrate was whether this type of treatment influences the values of CRP and ESR, thus proving the benefits or disadvantages of this treatment. Conclusion. To answer the major question, rehabilitation therapy DOES influence the values of CRP and ESR values in patients with psoriatic arthritis in the sense of decreasing their values. The 2 week-long rehabilitation therapy was capable of reducing the inflammatory process, a conclusion indicated by the decreasing of CRP and ESR values (mean value difference p &lt;0.001).

Relationship of Neuropeptide S with Clinical and Metabolic Parameters of Patients during Rehabilitation Therapy for Schizophrenia.

Neuropeptide S (NPS) is a factor associated with the central regulation of body weight, stress, anxiety, learning, memory consolidation, wakefulness–sleep cycle, and anti-inflammatory and neuroplastic effects. Its stress-reducing, anti-anxiety, arousal without anxiety, and pro-cognitive effects represent an interesting option for the treatment of neuropsychiatric disorders. The purpose of the study was to examine the potential associations of NPS levels in the blood with clinical and metabolic parameters during the rehabilitation therapy of patients with schizophrenia. Thirty-three male subjects diagnosed with schizophrenia were randomly divided into two groups. The rehabilitation group (REH, N16) consisted of patients who were subjected to structured, 3-month intensive rehabilitation therapy, and the control group (CON, N17) consisted of patients who were subjected to a standard support mechanism. Both groups continued their pharmacological treatment as usual. The NPS concentration, as well as clinical and metabolic parameters, were compared in both groups. Additionally, a group of healthy (H) males (N15) was tested for NPS reference scores. To look for the specificity and selectivity of the NPS relationship with clinical results, various factor models of the positive and negative syndrome scale (PANSS) were analyzed, including the original PANSS 2/3 model, its modified four-factor version, the male-specific four-factor model, and two five-factorial models validated in large groups in clinical and multi-ethnic studies. Results and conclusions: (1) Structured rehabilitation therapy, compared to unstructured supportive therapy, significantly reduced the level of schizophrenia disorders defined by various factor models derived from PANSS. (2) The clinical improvement within the 3-month rehabilitation therapy course was correlated with a significant decrease in neuropeptide S (NPS) serum level. (3) The excitement/Hostility (E/H) factor, which included schizophrenic symptoms of the psychotic disorganization, was specific and selective for the reduction in serum NPS, which was stable across all analyzed factor models. (4) The long-term relationship between serum NPS and clinical factors was not accompanied by basic metabolic parameters.