Rehabilitation Treatment Program Research Articles

The comparative experimental study of rehabilitation program decision for spinal cord injury based on electronic medical records

ObjectiveElectronic medical records (EMRs) contain patients' medical and health information. The Utilization of EMRs for assisted diagnosis is of significant importance for the rehabilitation of spinal cord injury (SCI) patients. Therefore, this study proposes a decision-making model for rehabilitation programs of SCI patients based on EMRs. MethodsFirst, an Electronic Medical Records (EMR) dataset comprising 1252 Spinal Cord Injury (SCI) patients was constructed, and data preprocessing was completed. Second, the Random Forest (RF) feature extraction algorithm was utilized to select case features with high contribution levels. Then, to address the imbalance issue in EMRs, a multi-label learning framework based on the improved MLSMOTE was adopted. Finally, seven multi-label classification models were employed to predict patients' physical therapy (PT) prescriptions. ResultsThe proposed improved MLSMOTE multi-label learning framework can solve the problem of class imbalance. Compared with the other six models, the CC model has improved significantly in many metrics. Its hamming loss and ranking loss were 0.1388 and 0.2467, and precision, recall, and F1-score were 83.33 %, 81.20 %, and 79.82 % respectively. ConclusionsThe improved MLSMOTE multi-label learning framework proposed in this study can make full use of the information in EMRs and effectively improve the decision-making accuracy of rehabilitation treatment programs.

Application of virtual reality technologies in the rehabilitation of patients with left and right hemisphere lesions in the acute period of ischemic stroke

BACKGROUND: Currently, neurocognitive rehabilitation with the integration of innovative virtual reality (VR) technologies is the standard component of early rehabilitation treatment programs for patients with acute focal brain damage. AIM: Based on the statistical methodology, this study aimed to evaluate the efficiency of neurocognitive rehabilitation with the application VR technologies in patients with left and right hemisphere lesions in the acute period of ischemic stroke. MATERIALS AND METHODS: The study examined 160 patients diagnosed with ischemic stroke exhibiting cognitive impairments. Patients were divided into two groups based on stroke localization: group 1 (n=80) had left hemisphere lesions, whereas group 2 (n=80) had left hemisphere lesions. Since day 5 of hospitalization, in addition to basic therapy, rehabilitation was performed using a hardware–software multimedia complex based on VR for remote-controlled rehabilitation «Devirta-Delphi». Rehabilitation efficiency (RE) was assessed by testing objectively quantitative measures of accuracy and coordination of movement performance before and after treatment using a Kinect Delphi system. Cognitive and psychoemotional measures were assessed by neuropsychological tests on days 2–4 of hospitalization and at the end of the VR therapy. Mathematical statistics were calculated using Python programming language and its libraries Pandas and SciPy. RESULTS: Higher RE values were obtained in patients with right-sided stroke. Irrespective of lesion lateralization, significant improvement was noted with respect to mnestic, executive function, and ideomotor praxis, regression of anxiety, depression, and general aggression. Group 1 also showed an improvement in speech function and a decrease in general asthenia, whereas group 2 showed an increase in attention and emotion recognition ability. Factors that negatively affected RE were identified, namely, apathy, anxiety, prestroke cognitive decline, semantic aphasia, and decreased attention in group 1 and semantic and visual–spatial impairments, prestroke decline, and recurrent stroke in group 2. CONCLUSION: The application of an immersive environment in the early rehabilitation of patients with cognitive impairment improves the performance of verbal and visual tests reflecting mnestic, regulatory, and neurodynamic executive functions in lesions with different lateralization.

Comparing effectiveness of residential versus intensive virtual treatment for veterans with posttraumatic stress disorder.

During the COVID-19 pandemic, restrictions imposed on residential treatment programs necessitated rapid implementation of virtual treatment delivery. Posttraumatic stress disorder (PTSD) Residential Rehabilitation Treatment Programs (P-RRTP) are a key mental health treatment for Veterans with PTSD who require more intensive interventions than outpatient care. During the pandemic, the W. G. (Bill) Hefner VA Healthcare System developed and implemented a Virtual Intensive Outpatient Program for PTSD (VIOPP) to meet the needs of the Veteran population. The purpose of this analysis was to compare the effectiveness of VIOPP to P-RRTP. Analyses included N = 370 Veterans, n = 193 who completed P-RRTP between January 2018 to April 2020 and n = 177 who completed VIOPP between June 2020 and November 2022 and provided pre- and posttreatment scores. Pre- and posttreatment scores of the PTSD Checklist for DSM-5 (PCL-5) were available for all patients. Pre- and posttreatment depressive symptom scores from the Nine-item Patient Health Questionnaire (PHQ-9) were available for n = 254 Veterans. Paired and independent samples t tests evaluated differences in change scores overall and by treatment modality (residential vs. virtual). Results indicated a significant decrease in PCL-5 scores regardless of treatment modality, p < .001. Despite beginning VIOPP with significantly higher PCL-5 scores than P-RRTP, there were no significant differences in PCL-5 change scores between virtual (M = -16.94) and residential treatment (M = -17.10), p = .910. PHQ-9 scores also decreased significantly for both treatment groups. These analyses suggest that intensive virtual treatment has similar effectiveness to residential treatment for PTSD. This supports the development of intensive virtual interventions as viable alternatives to residential treatments and a valuable component within the continuum of PTSD care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Role and Potential Mechanisms of Rehabilitation Exercise Improving Cardiac Remodeling.

Rehabilitation exercise is a crucial non-pharmacological intervention for the secondary prevention and treatment of cardiovascular diseases, effectively ameliorating cardiac remodeling in patients. Exercise training can mitigate cardiomyocyte apoptosis, reduce extracellular matrix deposition and fibrosis, promote angiogenesis, and regulate inflammatory response to improve cardiac remodeling. This article presents a comprehensive review of recent research progress, summarizing the pivotal role and underlying mechanism of rehabilitation exercise in improving cardiac remodeling and providing valuable insights for devising effective rehabilitation treatment programs. Graphical Abstract.

REHABILITATION PROGRAM DURATION AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A COMPARATIVE STUDY BETWEEN PROFESSIONAL AND RECREATIONAL ATHLETES

Introduction: Anterior cruciate ligament injury is an injury that occurs in both sexes and in the population of all ages. The anterior cruciate ligament (ACL) is a very strong internal ligament of the knee, whose injuries occur frequently in athletes (professional and recreational) and after which the recovery is very long and complicated. The aim of this study is to determine the effectiveness of a standardized rehabilitation program after anterior cruciate ligament reconstruction based on the time required for rehabilitation in athletes and recreational athletes. Methods: Research is designed as prospective study. The research was conducted in Polyclinic FM Sarajevo over a period of 10 months, starting in June 2018 and ending in March 2019. The collection of data required for the study was carried out using a form prepared for the analysis of patients included in the study. Results: Thirty-six people participated in the study, divided into two groups. In the first group, 52.8% belonged to recreational athletes, while in the second group, 47.2% belonged to athletes. At the end of the study, the flexion value in both studied groups was 120º. At the end of the study, the percentage of subjects with correct extension of the injured limb was 94.7% of recreational athletes and 64.7% of athletes. Of the total number of respondents included in this study, 33% were soccer players, 14% were basketball players, and 53% were recreational athletes. Conclusion: Based on the research results, it was confirmed that early rehabilitation after the established rehabilitation treatment program is shorter in recreational athletes than in professional athletes.

"I wish people could come together like we have," patient and provider perspectives on VA residential PTSD treatment.

Although most posttraumatic stress disorder (PTSD) care in the Veterans health administration (VHA) is provided on an outpatient basis, the VHA has 40 residential rehabilitation treatment programs (RRTPs) designed to treat Veterans who require more intensive and closely monitored care. Unfortunately, the clinical outcomes of these programs are modest, and previous attempts to identify key drivers of outcomes have uncovered few modifiable factors. The present study, informed by the model of resources, life events and changes in psychological state, was designed to identify factors associated with treatment response among RRTP patients and providers. Semistructured interviews were conducted with 24 patients and 12 providers at three regional RRTPs, using interview guides based on the theoretical model. Data were analyzed using rapid analysis. Results showed that patients and providers agreed on several factors critical to RRTP success. These factors included the provision of evidence-based psychotherapy (EBP), support and understanding from fellow patients, and skill and support from providers. Patients and providers also noted the importance of psychological flexibility, openness, and willingness to change. Patients who experienced less symptom improvement over the course of treatment were more likely to report poor therapeutic alliance. These findings underscore the importance of continued emphasis on EBP delivery but also suggest that RRTPs might find additional ways to capitalize on the residential milieu to encourage engagement in treatment and a focus on therapeutic change. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Clinical outcomes of veterans affairs residential PTSD treatment for PTSD and depressive symptoms: 1-year follow-up outcomes and gender differences.

The long-term effectiveness of Department of Veterans Affairs (VA) residential treatment for posttraumatic stress disorder (PTSD), and how it may vary for men and women veterans, is unknown. This is the first national investigation of symptom change from admission, discharge, 4 months, and 1-year postdischarge from VA PTSD residential rehabilitation treatment programs (RRTPs). Participants included all veterans discharged from 40 VA PTSD RRTPs October 1, 2017-September 30, 2020 (n = 2,937; 14.3% women). Linear mixed models examined PTSD and depressive symptoms across time points; it was hypothesized that women veterans would experience greater symptom reduction during and after treatment. Overall, veterans reported large-sized reductions of PTSD symptoms at all time points (Cohen's d: discharge = 1.23, 4-month follow-up d = 0.97, 1-year follow-up d = 1.51). Treatment effects for depressive symptoms were large-sized at all time points (Cohen's d; discharge = 1.03, 4-month follow-up d = 0.94, 1-year follow-up d = 1.05). Women veterans showed greater improvement in PTSD and depressive symptom severity (p < .001) than men at discharge, but not at 4-month or 1-year follow-ups. Veterans reported significant reductions in PTSD and depressive symptoms, and treatment gains were maintained one year postdischarge. Women experienced greater benefit during, but not after, treatment. Results not only provide support for the effectiveness of VA residential treatment for PTSD but also highlight the continued need for strategies to maximize and maintain treatment gains. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Tai Chi as a Complementary Therapy for Depression and Anxiety Among U.S. Veterans in a Mental Health Inpatient Setting.

Depression and anxiety are two of the top five mental illnesses veterans report. Treatment for depression and anxiety includes medications and psychiatric treatment in inpatient, outpatient, and residential treatment programs; the use of complementary and alternative medicine (CAM) can have beneficial results by decreasing symptoms, recognize patients' preference for CAM, and be cost-effective. This study aimed to evaluate the effects of Tai Chi on depression and anxiety symptoms on inpatient psychosocial or substance use disorder (SUD) rehabilitation treatment program residents since little evidence exists regarding the effectiveness of Tai Chi on participants in residential mental health treatment programs. METHOD: A mixed-method, cohort design with 88 participants (41 usual treatment without Tai Chi, 47 intervention) used a demographic survey, Hamilton Anxiety Scale, Quick Inventory of Depressive Symptomatology, self-report, and the Patient Health Questionnaire-9 at Weeks 1 and 4 of the treatment program. After Week 4, the intervention group responded to six open-ended questions about Tai Chi's effects on their overall depression and anxiety. The anxiety level of the intervention group was significantly decreased, as evidenced by the Hamilton Anxiety Scale scores (p = .02). However, the measures of depression did not differ between the groups. Two themes, mindfulness and satisfaction, were identified from the written responses regarding the Tai Chi intervention. Tai Chi effectively reduced symptoms of anxiety that varied by age and ethnicity. This study increased the insight regarding the benefit of including Tai Chi as a complementary therapy for those participating in residential treatment programs.

Sleep disorders and suicide attempts following discharge from residential treatment

IntroductionSuicide is a significant public health concern and its prevention remains a top clinical priority of the Veterans Health Administration. Periods of transition in care (e.g., moving from inpatient to outpatient care) represent a period of increased risk. Sleep disorders are prevalent amongst Veterans and are modifiable risk factor for suicide. The present study examined the relationship of sleep disorders to time to suicide attempt amongst Veterans known to have attempted suicide in the 180 days following discharge from a Mental Health Residential Rehabilitation Treatment Program.MethodThe present sample was comprised of all Veterans enrolled in services with the Veterans Health Administration known to have attempted suicide following discharge from a Mental Health Residential Rehabilitation Treatment Program during Fiscal Years 13 and 14 (N = 1,489). To create this sample, electronic medical record data were extracted from two VHA data sources: the Corporate Data Warehouse and the Suicide Prevention Application Network.ResultsCox regression models revealed that Veterans with a sleep disturbance (N = 1,211) had a shorter time to suicide attempt than those without a sleep disturbance [Hazard Ratio (HR) = 1.16, CI (1.02–1.32)]. A subsequent Cox regression model including age, insomnia, nightmare disorder, and alcohol dependence revealed that sleep-related breathing disorders [HR = 1.19, CI (1.01–1.38)], alcohol dependence [HR = 1.16, CI (1.02–1.33)], and age group were associated with increased risk.ConclusionFindings indicate that sleep disturbance, primarily driven by sleep-related breathing disorders, was associated with time to suicide attempt in this sample of high-risk Veterans known to have attempted suicide in the 180 days following their discharge from a Mental Health Residential Rehabilitation Treatment Program. These findings reveal an opportunity to reduce risk through the screening and treatment of sleep disorders in high-risk populations.

Chin-tuck assistant system (CAS)-A novel method using auditory feedback for postural maintenance in a chin-tuck maneuver: A randomized trial.

Chin-tuck are effective in patients with dysphagia, where aspiration can occur due to pharyngeal swallowing delays. This study aims to verify whether Chin-tuck Assistant System Maneuver (CAS-M) supplemented with Chin-Tuck Maneuver (CTM) is effective for learning and maintaining correct chin-tuck postures. In addition, we investigated the possibility of using CAS-M as a customized rehabilitation treatment program for patients with poor cognitive ability, attention issues, and general swallowing disorders. To demonstrate the effectiveness of CAS, we recruited 52 healthy adults and assigned them to 2 groups. The CTM group was trained to maintain the correct chin-tuck posture using the general Chin-Tuck Maneuver, while the CAS-M group was trained using CAS. Four evaluations were conducted using CAS to investigate the degree of postural maintenance of chin-tuck before and after intervention. The CAS-M group showed a statistically significant difference in TIME, BEEP, and change (P < .05), but the CTM group showed no statistically significant differences (P < .05). YZ evaluation showed no statistically significant differences in both groups. After examining the effects of CAS-M using CAS on healthy adults, we confirmed this to be a more effective method for correct chin-tuck posture than conventional CTM.

Comparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment.

Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) are first-line treatments for posttraumatic stress disorder (PTSD). There have been few direct comparisons of CPT and PE intended to determine their comparative effectiveness, none of which have examined outcomes among military veterans receiving these treatments in a residential setting such as the Department of Veterans Affairs (VA) residential rehabilitation treatment programs (RRTPs). Such work is essential given that these veterans are among the most complex and severely symptomatic patients with PTSD treated in VA. In this study we compared changes in PTSD and depressive symptoms across admission, discharge, four months and 12 months following discharge among veterans who received CPT or PE within VA RRTPs. Using linear mixed models conducted on program evaluation data derived from the electronic medical record and follow-up surveys, we compared self-reported PTSD and depressive symptom outcomes among 1130 veterans with PTSD who were treated with individual CPT (n = 832, 73.5%) or PE (n = 297, 26.5%) in VA PTSD RRTPs in fiscal years 2018-2020. PTSD and depressive symptom severity did not significantly differ at any time points. The CPT and PE groups both showed large-sized reductions in PTSD (CPT d = 1.41, PE d = 1.51) and depression (CPT d = 1.01, PE d = 1.09) from baseline to 12-month follow-up. Outcomes for PE and CPT do not differ among a highly complex population of veterans with severe PTSD and several comorbid conditions that can make it difficult to engage in treatment.

The Effect of a Rehabilitative Treatment Program on The Efficiency of The Knee Joint After Reconstructing the Cartilaginous Ligament by Prolotherapy

The Effect of a Rehabilitative Treatment Program on The Efficiency of The Knee Joint After Reconstructing the Cartilaginous Ligament by Prolotherapy

Association between Participation in a Rehabilitation Program and 1-Year Survival in Patients Requiring Prolonged Mechanical Ventilation.

The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p&lt;0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden's index). Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

Therapeutic physical factors in chronic inflammatory diseases of the pelvic organs. (A wounded home-controlled study)

In case of chronic inflammatory diseases of the pelvic organs (CID) in women, it is advisable to use therapeutic physical factors that have a sanogenetic effect in rehabilitation treatment programs. To study the effectiveness of complex restorative treatment of patients with chronic salpingoophoritis with the consistent use of therapeutic physical factors. The study included 96 patients with chronic salpingoophoritis at the age of 18 to 49 years. Two groups were formed by a simple sampling method: in the main group (MG/n=44), against the background of standardized treatment in inpatient conditions, patients received intravaginal ultrasound therapy, in non-hospital settings - interference therapy; in the control group (CG/n=41) - women received only standardized therapy. The criteria for the effectiveness of treatment were: determination of markers of pain and inflammation; ultrasound examination of the ovarian arteries with their Doppler measurements; assessment of quality of life criteria. Comprehensive restorative treatment of patients with chronic salpingoophoritis with sequential use of curative physical factors (CPF), according to direct and long-term observations, provides a significant reduction in pain intensity (p<0.01), inflammation (p<0.01), peripheral blood flow (p<0.01), physical and mental health (p<0.01). The implementation of a new developed method of restorative treatment of patients with chronic salpingoophoritis with sequential use of CPF provided a significant increase of 10-12% in the effectiveness of therapeutic measures in comparison with standardized therapy (p<0.05-<0.01).

Psychiatric rehabilitation and cognitive deficit for treatment-resistant depression.

Patients with TRD often experience persistent impairment of affective, psychosocial, and cognitive function, which impedes their recovery. The continuation of pharmacotherapy for patients with TRD remains the cornerstone of functional recovery. Cognitive dysfunction is prevalent in patients with MDD and may make patients' depressive symptoms and psychosocial functioning worse, even in the remitted stage of illness. Deficits can manifest not only in specific cognitive domains but also in global cognitive function, which may reflect underlying persistent pathophysiological changes. Compared with nontreatment-resistant patients with MDD, patients with TRD exhibit greater subjective and objective cognitive impairment, which possibly contributes to a greater adverse impact on daily functioning. Cognitive and psychosocial remission should be a goal in treating MDD. How to appropriately and individualized perform pharmacological intervention, psychotherapy, neuromodulation, cognitive remediation or other rehabilitation treatment programs is a critical step to achieve our goal. Integrating multiple interventions that engage multiple physiological systems with a multidisciplinary team warrants increased attention, and personalized therapeutic programs may facilitate the complete restoration of patients' everyday functioning.

Measurement-based care in Veterans Health Administration mental health residential treatment.

In 2016, the Veterans Health Administration (VHA) launched the Measurement-Based Care (MBC) in Mental Health Initiative to support the use of patient-reported outcome measures (PROMs) across mental health services to increase veteran engagement and promote collaborative treatment planning. The present study reported on the administrations of PROMs across all residential stays within the VHA's Mental Health Residential Rehabilitation Treatment Programs between October 1, 2018, and September 30, 2019 (N = 29,111). We subsequently explored a subsample of veterans attending substance use residential treatment during the same period who completed the Brief Addiction Monitor-Revised (BAM-R; Cacciola et al., 2013) at admission and discharge (n = 2,886) to determine the feasibility of using MBC data for program evaluation. The rate of residential stays with at least one PROM was 84.49%. We also identified moderate to large treatment effects on the BAM-R from admission to discharge (Robust Cohen's d = .76-1.60). There is frequent use of PROMs in VHA mental health residential treatment programs with exploratory analyses demonstrating significant improvements for veterans in substance use disorder residential treatment. Considerations for the appropriate use of PROMs in the context of MBC are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Rehabilitation of patients after a new coronavirus infection COVID-19 at the second and third stage

BACKGROUND: Patients who have undergone a COVID-19 infection are in need of comprehensive rehabilitation, taking the polysyndromic manifestations of the post- COVID syndrome and comorbidities into account.&#x0D; AIM: The purpose of this article is the need to evaluate the effectiveness of medical rehabilitation programs for patients who underwent a COVID-19 infection at the second and third stages of medical rehabilitation from the standpoint of evidence-based medicine.&#x0D; MATERIALS AND METHODS: 330 medical rehabilitation programs for patients who had a COVID-19 infection were examined. All patients underwent functional tests: control of blood oxygen saturation (SpO2), spirometry, Stange and Gench tests, testing on the Borg exercise tolerance scale and the MRC dyspnea scale; the EQ-5D quality of life questionnaire was completed. Patients were divided into 2 representative groups (160 and 170 people). The average duration of treatment was 14 days. The methods of physical and rehabilitation medicine: therapeutic exercises, breathing exercises, inhalation therapy were applied to the patients in the observation group. Patients in the observation group underwent rehabilitation treatment programs depending on comorbidities and severity of symptoms in organs and systems. The survey was conducted on at 2 control points: 1 day (first), 14 day (second).&#x0D; RESULTS: The observation group showed significantly better recovery results (p 0.05). The average values of the Stange and Gench samples showed a positive trend. There was an improvement in the subjective assessment of the tolerability of the 6-minute walk test on the Borg scale, a decrease in the severity of dyspnea on the MRC dyspnea scale, and an improvement in the quality of life on the EQ-5D scale.&#x0D; CONCLUSION: The structure of the rehabilitation programs used in the clinic of medical rehabilitation and recovery treatment was analysed, showing positive results that have indicated the effectiveness of the methods of physical and rehabilitation medicine in patients with various manifestations of post-COVID syndrome.

PREDICTING RECIDIVISM RISK: COPING STYLES IN OFFENDERS WITH INTERNAL AND EXTERNAL LOCUS OF CONTROL

Conventionally, intervention programs and risk assessment tools have emphasized the shortfalls that criminal offenders hold. Most prevailing programs emphasize treating specific challenges relating to external and internal acts/behaviours, like aggression or substance abuse. Therefore, increasing support for rehabilitation, reformation, and reintegration treatment programs in correctional settings to evaluate and foster the strengths and virtues of individuals has been observed lately. Locus of Control is an individual’s expectation of specific reinforcement, in a certain situation, which depends greatly on their attitude toward the situation relatively than the situation itself. Attitude towards law was understood to be influenced by the locus of control with the internally located having a better attitude and awareness towards the law when compared to the externally located individuals. Coping with life hardship and maladaptive coping behaviour were considered to be related to offending and re-offending. Implications are noteworthy presuming that our consideration of coping can upsurge the ability of correctional staff to reduce later recidivism in the community. Recidivism is measured by various social and psychological variables and factors that could influence the offender to engross into reoffending. This study focused on exploring the coping skills as possible predictors of recidivism risk amongst prisoners with respect to their orientation of locus of control. 30 female and 50 male convicted inmates older than 18 years, serving their sentences for cognizable offenses at Telangana Central Prisons were involved as the participants. The correlations between Locus of control and coping skills were drawn and further analyzed for prediction of recidivism risk. Results indicated that the external locus of control in offenders is inversely related to their coping and the avoidant coping style in them was observed to be a significant predictor of Recidivism risk. Further, rehabilitation, reformation, and reintegration treatment programs were proposed for correctional settings based on the results.

Comprehensive rehabilitation for injuries to the medial collateral ligament of the knee in skiers and snowkiters

BACKGROUND: The main function of the medial collateral ligament is static stabilization when the tibia is deviated outward. Medial collateral ligament damage may result from the application of a sharp force to the tibia and knee joint in a valgus position, often leading to knee instability, recurrent synovitis and posttraumatic osteoarthritis. This often results in the development of functional disorders that sharply limit the motor abilities of patients, thereby affecting the performance (support ability) of the injured limb.&#x0D; AIM: The study aimed to conduct a comparative analysis of the efficiency of various current rehabilitation techniques providing a more patient-oriented approach in the conservative treatment of various degrees of medial collateral ligament injuries based on the assessment of the capabilities of magnetic resonance imaging in 38 patients.&#x0D; MATERIALS AND METHODS: Thirty-eight patients (27 men and 11 women, 71.05% and 28.95%, respectively) with partial medial collateral ligament injuries were followed up. The mean age was 28.5 years (1938 years). All subjects were involved in skiing and snowkiting in the alpine skiing discipline. The diagnosis was made based on clinical examination, patients complaints, and magnetic resonance imaging (MRI) of the knee joint. The examination was performed on a Vestra-2 magnetic resonance tomograph with a superconducting magnet and a magnetic field induction of 0.5 Tesla. Optimal for knee joint examination was a quadrature Surf-76 receiving and transmitting coil, which allowed the selection of a small field of view without artifacts or spatial distortion and increased the signal/noise ratio. The knee joints were examined twice: on the day of admission (maximum 1.5 days after injury) and at the end of the week 6 of conservative treatment.&#x0D; RESULTS: Using the rehabilitation treatment program proposed by the authors in patients with medial collateral ligament injuries, a decrease in the severity of clinical symptoms and an improvement of functional characteristics were observed. Inclusion of the kinesiotaping technique led to a reduction of the treatment recovery period.&#x0D; CONCLUSIONS: Current noninvasive diagnostic techniques (in particular, MRI) for bone tissues, articular cartilages, and periarticular soft tissues allow to determine the degree of damage to anatomical structures, choose the optimal conservative treatment method , and set the duration and extent of artificial immobilization and the terms of the onset of rehabilitation procedures for patients with partial injuries of the medial collateral ligaments. The results of the proposed rehabilitation treatment program for injuries of the medial knee ligament include a reduction of pain, synovitis and limping, and an improvement of muscle strength and elasticity and knee stability.

Feasibility and Acceptability of Group-Facilitated Prolonged Exposure Therapy for PTSD in VA Residential Rehabilitation Treatment Programs

Prolonged Exposure therapy (PE) is a first-line treatment for posttraumatic stress disorder (PTSD); however, few VA patients receive this treatment. One of the barriers to PE receipt is that it is only available in an individual (one-on-one) format, whereas many VA mental health clinics provide the majority of their psychotherapy services in group format. In particular, PTSD residential rehabilitation treatment programs (RRTPs) offer most programming in group format. Consequently, strategies are needed to improve the scalability of PE by adapting it to fit the delivery setting. The current study was designed to pilot test a group-facilitated format of PE in RRTPs. Thirty-nine Veterans who were engaged in care in the PTSD RRTP at a Midwestern VA were recruited to participate in a Group-facilitated PE protocol. Participants engaged in twelve 90-minute sessions of Group PE over the course of 6 weeks, plus six 60-minute individual sessions for imaginal exposure. Group treatment followed the PE model and consisted of psychoeducation, treatment rationale, and in vivo exposure to reduce trauma-related avoidance and thereby improve PTSD symptoms. PTSD symptoms were measured via the PTSD Checklist for DSM-5 (PCL-5) and depression symptoms were measured via the Patient Health Questionnaire (PHQ-9) at baseline, endpoint (6 weeks), and at 2-month follow-up. Thirty-nine individuals initiated Group-facilitated PE and 34 completed treatment. The average number of group sessions attended was 11 out of 12. Acceptability ratings were high. Mean change (improvement) in the intent-to-treat sample at 2-month follow-up was 20.0 points on the PCL-5 (CI 18.1, 21.9; Cohen’s d = 1.1) and 4.8 points on the PHQ-9 (CI 4.1, 5.5, d = .8). These results suggest that adapted evidence-based interventions for PTSD can improve treatment access and efficiency for the RRTP setting. A group-based approach has the potential to improve the scalability of PTSD treatment by reducing required resources. A fully powered trial is now needed to test the effectiveness of Group-facilitated PE in the RRTP setting.