Rehabilitation Activities Research Articles

Resumption of Employment after Cervical Cancer Surgery: a 3-Year Follow-Up Study of Long-term Outcomes

INTRODUCTION. Despite advancements in cervical cancer (CC) diagnosis and treatment, surgical intervention remains the cornerstone of radical treatment. However, surgical procedures can result in complications such as lymphedema, sexual dysfunction, and other physical and psychosocial disorders, significantly affecting patients' quality of life (QoL) and ability to return to work. This emphasizes the need for effective strategies to support patients in resuming their occupational activities post-treatment. AIM. To investigate the relationship between different rehabilitation programmes following cervical cancer surgery and return to work MATERIALS AND METHODS. The study included patients aged 18 and older with stage 1A–1B cervical cancer. Patients were randomized into two groups: those receiving an active comprehensive rehabilitation program (СС-1, 51 patients) and those receiving passive rehabilitation (СС-2, 52 patients). The active rehabilitation program included a personalized, year-long regimen encompassing physical therapy, psychotherapeutic support, and lifestyle modifications, among other interventions. In contrast, the passive rehabilitation group received standard post-operative care information and general recommendations based on local clinical guidelines. The primary outcome was the proportion of patients who returned to work at various time points up to 36 months post-surgery. RESULTS. Patients in the СС-1 group demonstrated significantly higher rates of return to work compared to the CC-2 group from the third month post-surgery onwards. At 36 months, all patients in the CC-1 group had returned to work, whereas only 66.7 % of patients in the CC-2 group had resumed their professional activities. In the CC-1 group the chance of returning to work within 3 years after surgery was 2.14 times higher compared to those in the CC-2 group (OR = 0.467, 95 % CI 0.309–0.706, p 0.001). CONCLUSION. The study highlights the significant impact of personalized comprehensive active rehabilitation programs on improving the likelihood of return to work following surgical treatment for early-stage cervical cancer. These findings suggest that such rehabilitation approaches may be crucial in enhancing the long-term recovery and social reintegration of cervical cancer patients, ultimately contributing to better overall outcomes. Further research is needed to identify the most effective components of these rehabilitation programs and optimize their implementation.

Mechanism evaluation of a digitally enabled rehabilitation intervention for people in aged care and neurological rehabilitation: mediation analysis of the AMOUNT trial

Purpose To investigate potential mechanisms of a digital rehabilitation intervention associated with improved mobility among adults undertaking rehabilitation. Materials and methods Causal mediation analysis of the AMOUNT trial (ACTRN12614000936628). Participants were randomised to digitally-enabled rehabilitation (virtual reality video games, activity monitors, and handheld computer devices prescribed by a physiotherapist) and usual care or usual care alone. Outcomes were mobility (Short Physical Performance Battery; continuous version; range 0–3), physical activity (average steps per day), and quality of life (EQ-5D-5L; utility score; range 0–1) measured at 6-months post-randomisation. Hypothesised mediators included mobility, physical activity, cognition, balance confidence, pain, activity and participation, and computer self-efficacy, assessed at 3-weeks post-randomisation. Results 216 participants with complete data were included. Three-week sit-to-stand ability mediated 6-month mobility (indirect effect 0.09 points, 95%CI 0.03–0.16), explaining 48% of the intervention’s effect. Dynamic single-leg-stance balance mediated physical activity (indirect effect 345 steps per day, 95%CI 63–678) and composite mobility mediated quality of life (indirect effect 0.03 points, 95%CI 0.00–0.05). Conclusion Digital rehabilitation outcomes appear to be mediated through sit-to-stand ability, dynamic single-leg-stance balance, and overall mobility. While future research is required to better understand these mediators, our findings recommend sit-to-stand training as a core element of digital rehabilitation interventions targeting mobility.

Developing Robust Rehabilitation Scenario Profiles for Life Cycle Cost Analysis

Life Cycle Cost Analysis (LCCA) is an economic procedure often used to compare competing pavement designs. For the LCCA to be meaningful and reliable, the analysis must reflect the most likely activities for each alternative being evaluated. Currently, most state highway agencies (SHA) apply a standard, policy-set, rehabilitation schedule to all pavements based on “historical” performance, which may or may not be representative of the given design. The fact is that there are many different rehabilitation scenarios that could be performed when the pavement requires rehabilitation and which one is selected will impact the results. This paper shows how SHAs can use the American Association of Highway and Transportation Officials’ (AASHTO) Mechanistic Empirical Pavement Design Guide to determine when rehabilitation activities are required, and Decision Tree Analysis to examine multiple scenarios of which rehabilitation activities are to be done. By using these two processes, it is possible to develop multiple rehabilitation schedules that are specific to a given pavement design, which makes the LCCA more robust and reliable. Finally, a case study is shown to demonstrate the extent to which these processes could affect the outcome of an LCCA.

Home-Based Intervention Tool for Cardiac Telerehabilitation: Protocol for a Controlled Trial.

Among cardiovascular diseases, adult patients with congenital heart disease represent a population that has been continuously increasing, which is mainly due to improvement of the pathophysiological framing, including the development of surgical and reanimation techniques. However, approximately 20% of these patients will require surgery in adulthood and 40% of these cases will necessitate reintervention for residual defects or sequelae of childhood surgery. In this field, cardiac rehabilitation (CR) in the postsurgical phase has an important impact on the patient by improving psychophysical and clinical recovery in reducing fatigue and dyspnea to ultimately increase survival. In this context, compliance with the rehabilitation program is a key element for the therapeutic benefits of the program. The increase of mobile health care devices and software has greatly extended self-care capabilities across the spectrum of health care activities. Moreover, the possibility of telemonitoring the progress of this self-care provides elements of empowerment and awareness of one's state of health. As a branch of telehealth, CR can be optimized and facilitated using remote telemedicine devices. The principal goal of the Innovation in Postoperative Rehabilitation Training and Monitoring (IPOTERI) study is to design, realize, and test a composite and integrated system for postsurgical rehabilitation therapies at home specialized for cardiac surgery. The secondary aims are to implement the system in a "real-life" context of postcardiac surgical rehabilitation, and to create a data set and a data collection methodology to prototype data analytics algorithms and artificial intelligence techniques for customizing the rehabilitation pathway. The IPOTERI method consists of a telemonitoring platform that guarantees continuity of postoperative care, an intelligent home station based on an Android app for the patient with a user-friendly interface to record vital signals (electrocardiogram, blood pressure, oxygen saturation, and body weight) and access the planning of rehabilitation activities, and a decision support system that communicates with hospital medical records to transmit alerts and specific support information for the formulation and updating of the treatment and care plan. The pilot test started in June 2023 (protocol number 20406/2021) including 50 patients who will be monitored for 12-14 weeks using the developed platform, as described in the Procedures subsection of the Methods section. The IPOTERI approach, based on the processing of data recorded during the monitoring of telemedicine devices used at home during the postsurgical rehabilitation of a cardiac patient, together with clinical data from the perioperative and postoperative periods could have positive effects on adherence to the rehabilitation program and clinical improvement as well as result in overall improvement of quality of life. DERR1-10.2196/47951.

Application research on mechanical assessment and training based on intelligent physical training system in the rehabilitation of athletes’ ankle injuries

As the only hinge connection between human body and the ground, ankle joint plays an important role in sports. Based on the theory of rehabilitation medicine, this paper puts forward an intelligent physical training system integrating mechanical evaluation and training functions, and applies it to the rehabilitation of athletes’ ankle injuries. The system adopts virtual reality (VR) technology, realizes active ankle rehabilitation training through high-precision sensors and advanced computer simulation technology, and provides accurate evaluation, monitoring and personalized training scheme for ankle rehabilitation. The system creates an immersive training environment for athletes by simulating real sports scenes and processes. The experimental results show that the system is excellent in training convergence speed and performance, and the error is small. Compared with the traditional algorithm, the accuracy is improved by 19.27%. The main contribution of this paper is that the intelligent physical training system integrating mechanical evaluation and training is applied to the rehabilitation of athletes’ ankle injuries, and good rehabilitation results have been achieved.

The Role of the Church in Reintegration of Street Children into Their Families in Lusaka District

The purpose of the study was to analyze the role of the church in the reintegration process and to come up with new strategies for increasing the effectiveness of these rehabilitation activities. The study objectives were to establish the type of support churches provide to the families with children on the street in Lusaka district and to assess the church-led initiatives that foster positive parent-child relationships after integration of street children in Lusaka district. A total sample of five families, 15 family members and four counsellors totaling to 19 participants made the total sample of the study. Interviews were conducted with parents and their children while a focus group discussion was conducted in this study at the sampled church grounds. Data was analyzed thematically by sorting similar responses and created themes under which the findings were presented. The study found that that under family talk on child care, it was the responsibility of the family to initiate family integration was initiated by the willingness of the family and the child at the same time. With regards to child safety and future consequences, the church had a responsibility to ensure that the family provided safety guarantees for the child before the child could be talked to by the church counsellors. On food provision to broken families, the church provided start up packs for families which were struggling to keep their children at home. the financial provision for family sustainability was available to the parents whose children were integrated into the family and the parents were helped financially with capital for business and employment as maids or guards to help them earn a living. It can be concluded that the church and parents played a crucial role in ensuring that there was effective and peaceful integration of children into the main family. The study recommended that Churches should come to the aid of the parents and homes where children have left for the streets so that family integration is supported. This will enable members of the church to feel safe to belong to the church since there will be enough help

Framework for Design and Construction of Long-Life Concrete Pavements

In the past, concrete pavements were routinely designed and constructed to provide low-maintenance service life of 20 to 25 years. In fact, the majority of the U.S. interstate and the primary system were designed on the basis of the 20 to 25 year initial service life. Experience has shown that pavements in high volume traffic corridors need to be designed and constructed to provide longer service life because of the difficulties in performing effective repair and rehabilitation activities along these high volume highway corridors. In addition, the public is no longer tolerant of frequent extended lane closures to perform repair activities. It is becoming an established practice in the U.S. to require that concrete pavements provide low-maintenance service life of 40 plus years. PCC pavements can meet this specific requirement if proper considerations are incorporated in the design and good construction practices, including use of sound concrete making materials, are followed. This paper provides an overview of current U.S. practices and efforts at optimizing pavement design features and construction practices to minimize early age failures and provide long-term low-maintenance service in excess of 40 plus years. The paper also provides a framework for ensuring that the critical design and construction features that impact long-term service are recognized and accounted for. The design and construction features discussed include features that improve slab cracking and deflection responses, features that minimize maintenance operations, and construction features that assure long-life pavement.

Efficacy of preoperative pulmonary rehabilitation in lung cancer patients: a systematic review and meta-analysis of randomized controlled trials

Although previous studies have shown that preoperative pulmonary rehabilitation training may improve postoperative prognosis in patients with lung cancer, the literature included in the existing meta-analysis is highly heterogeneous and lacks effective subgroup analysis. Therefore, an updated meta-analysis is needed to integrate the latest published randomized controlled clinical trials (RCT). This updated analysis was performed to identify the clinical effects of preoperative pulmonary rehabilitation on physical rehabilitation (lung function, activity endurance, and dyspnea), psychological rehabilitation, quality of life, length of hospital stay, and postoperative pulmonary complications in patients with lung cancer. The PubMed, Embase, Cochrane Library, and Web of Science database were searched since inception up to March 2024. A random-effects model was used to pool data, and sensitivity and subgroup analyses were performed to explore the stability of outcomes and potential sources of heterogeneity. All analyses were conducted via Review Manager 5.4.1 and STATA 15.0. The final analysis included 11 RCTs with 1250 patients. The results of meta-analysis suggest that preoperative pulmonary rehabilitation can significantly improve the quality of life of patients with lung cancer after surgery (SMD: 0.16; 95% CI: 0.01, 0.32; P = 0.04) and significantly reduce the risk of postoperative pulmonary complications (PPCs) (RR: 0.39; 95% CI: 0.25, 0.60; P < 0.0001). The results of subgroup analysis suggested that the effect of combined preoperative and postoperative rehabilitation was significantly better than that of preoperative rehabilitation alone, and the effect of short-term preoperative pulmonary rehabilitation (≤ 3 weeks) was significantly better than that of long-term rehabilitation. Preoperative pulmonary rehabilitation for patients with lung cancer can significantly improve their postoperative quality of life and reduce postoperative complications, but factors such as intervention time and intervention method may affect the rehabilitation effect.

A Concussion Management Policy Change Promoted Earlier Initiation of Rehabilitation Services and Improved Clinical Recovery Outcomes in Concussion.

In line with emerging research, an interprofessional specialty concussion clinic instituted a policy change permitting earlier physiotherapy-based treatment entry. Our objective was to determine the effect of this policy change on concussion recovery outcomes. Secondary analysis of prospectively collected clinical data. 600 youth with concussion were included. Active rehabilitation was initiated ≥4 weeks (prepolicy) or ≥2 weeks (postpolicy) postconcussion based on institutional policy. Cox proportional hazard models, linear mixed models, and chi-square analyses were conducted. The postpolicy group (median = 22 d [interquartile range: 17-27]) started treatment earlier than the prepolicy group (median = 26d [interquartile range: 24-30], P < .001). Length of episode of care (χ2(1) = 11.55, P < .001, odds ratios = 1.49; 95% confidence interval, 1.19-1.88); rehabilitation (χ2(1) = 9.47, P = .002, odds ratios = 1.73, 95% confidence interval, 1.22-2.45]); and total recovery (χ2(1) = 11.53, P < .001, odds ratios = 1.49; 95% confidence interval, 1.18-1.88) were reduced in patients postpolicy change. A significant interaction effect was found for total postinjury symptom (F2,320 = 3.59, P = .03) and symptom change scores (F2,315 = 5.17, P = .006), with the postpolicy group having faster symptom resolution over time. No group differences were observed for persisting symptoms. Earlier rehabilitation initiation occurred as intended following an institutional policy change, which had small, but significant, effects on recovery outcomes in youth with concussion. Health care providers should adopt policies to encourage early active rehabilitation services after concussion.

Resources for enhancing parental competence in the rehabilitation of a child with disabilities

Introduction. In light of the apparent contradiction between the necessity for parental involvement in the rehabilitation of children with disabilities and the limited competence of many parents, which hinders such participation, it is essential to study the nature of parental competence. This includes examining its levels, factors, and components that contribute to successful rehabilitation outcomes. Aim. The aim of this study is to analyse the resources associated with parental competence, within the context of social capital theory, that enable parents to attain successful outcomes in the rehabilitation process of a child with disabilities. Methodology and research methods. The sample population for this study comprised 500 respondents. The research was conducted between 2022 and 2024 at the Sverdlovsk Regional Disability Rehabilitation Centre in Ekaterinburg. A questionnaire survey was administered to the parents of children with disabilities. In addition to quantitative methods, qualitative techniques were employed to gather empirical data, utilising evaluative and projective approaches to assess various dimensions of family capital, including trust, support, attention, and the closeness of the parent-child relationship. The study also aimed to identify the types of parental positions adopted in relation to the child, which included partnership, mentoring, dominance, and rejection. Furthermore, the focus of parental engagement during rehabilitation activities within the specialised institution was examined, along with an evaluation of the effectiveness of the child’s rehabilitation process. Results and scientific novelty. Based on factor analysis, it has been established that the level of social capital possessed by parents, encompassing both family and non-family resources, directly influences the level of parental competence. Furthermore, the level of income is directly correlated with the type of parental role assumed in relation to the child, while the effectiveness of rehabilitation is significantly dependent on the degree of parental involvement in rehabilitation activities. A majority of parents exhibit a dominant and rejecting stance, which is associated with a low level of social capital and a corresponding low level of competence. In contrast, parents who assume a partner or, to a certain extent, a mentoring role, exhibit a high level of resources, while the resources accessible to other parents are classified as medium-level resources. Practical significance. The research findings can be utilised to formulate strategies aimed at improving the resource allocation for parents, with a particular emphasis on educational resources. This can be achieved by broadening the range of services available to them and establishing an eco-rehabilitation environment.

Post-operative rehabilitation in a hospital setting for people with scoliosis: a narrative review

Introduction: Idiopathic scoliosis, known as a three-dimensional alteration in the shape and position of the spine, is highly prevalent in children and adolescents. It causes major motor, respiratory, social and psychological limitations. After determining the degree and location of the scoliosis, corrective surgery may be indicated in the most advanced situations.Objective: Identify rehabilitation programs to be implemented for people undergoing corrective surgery for scoliosis, in the post-operative period, in a hospital setting.Methods: A narrative review was carried out using a bibliographic search on EBSCOhost, with the words: scoliosis, hospitalization, postoperative period, rehabilitation, nursing, functionality, exercises, physical, postural and pulmonary, over the last 5 years.Results: The 9 studies included were mostly primary, focused on knowledge and instruction for people with scoliosis, the importance of respiratory and motor rehabilitation, body balance and self-care in activities of daily living. Several authors suggest building rehabilitation protocols for people with scoliosis, from pre- to post-surgery, due to the gains in functionality and quality of life that can be achieved.Conclusions: The core areas of rehabilitation intervention for people undergoing corrective surgery for scoliosis in the post-operative period are functional respiratory re-education, functional motor re-education and re-education of body balance and self-care.

Информационная система поддержки ранней медицинской реабилитации.

Medical rehabilitation is an integral part of the process of restoring health and improving the quality of life for patients who have undergone severe illnesses. The success of rehabilitation activities largely depends on a comprehensive, multidisciplinary approach, careful risk assessment, precise goal setting, the implementation of individualized plans, and regular monitoring of patients’ conditions. The specifics of the subject area necessitate specialized methodologies and tools for informational support, which differ from the traditional implementation of clinical medical and diagnostic processes. This work discusses the development of research in the field of medical rehabilitation conducted collaboratively by the PSI RAS, INTERIN group of companies, and the Early rehabilitation clinic «Three sisters» as part of the project to implement the medical information system Interin PROMIS Alpha PG (INTERIN group of companies).

ANALISIS KARAKTERISTIK MASYARAKAT YANG TERLIBAT DALAM KEGIATAN REHABILITASI DAS DAN BIAYA PEMBUATAN TAHUN PERTAMA (P0), PEMELIHARAAN TAHUN PERTAMA (P1) DAN PEMELIHARAAN TAHUN KEDUA (P2) REHABILITASI DAS SWARANGAN

Implementation of watershed rehabilitation activities requires technical design, namely short-term detailed planning which becomes a reference for implementation in the field, both physical and non-physical activities carried out during the creation of the first year (P0), maintenance of the first year (P1) and maintenance of the second year ( P2). This research was carried out at PT. Pro Sarana Cipta Tambang Kandangan which was carried out in Swarangan Village Pelaihari Wildlife Reserve which is managed by the South Kalimantan Natural Resources Conservation Center, Jorong District, Tanah Laut Regency, South Kalimantan Province for three months from October 2023 to January 2024. The method used in this research is purposive sampling, calculated from the results of the questionnaire, recommended from the results of interviews in the field. The results of the research are the total cost requirements carried out by PT. Pro Sarana Cipta during planting activities (P0) amounted to Rp. 1,411,753,200, during first year plant maintenance (P1) amounted to Rp. 691,792,200,- and second year plant maintenance costs (P2) amounted to Rp. 559,822,000,- so The total total costs reached IDR 2,663,367,400.-.

A Personalised Pacing and Active Rest Rehabilitation Programme for Post-Exertional Symptom Exacerbation and Health Status in Long COVID (PACELOC): A Prospective Cohort Study.

Background: Post-COVID-19 Syndrome or long COVID (LC) is a novel public health crisis and, when persistent (>2 years), is a long-term condition. Post-exertional symptom exacerbation (PESE) is a characteristic symptom of LC and can be improved in a structured pacing rehabilitation programme. Aims: To evaluate the effect of an 8-week structured World Health Organisation (WHO) Borg CR-10 pacing protocol on PESE episodes, LC symptoms, and quality of life in a cohort of individuals with long-term LC. Methods: Participants received weekly telephone calls with a clinician to discuss their activity phase, considering their PESE symptoms that week. They completed the Leeds PESE questionnaire (LPQ), C19-YRS (Yorkshire Rehabilitation Scale), and EQ-5D-5L at the beginning of the programme (0 weeks), the end of programme (8 weeks), and at final follow-up (12 weeks). Results: Thirty-one participants (duration of LC symptoms: 29 months) completed the programme. The PESE episodes decreased in number each week (15% fewer each week, 95% CI: 11% to 20%, p < 0.001) and were of shorter duration and milder severity each week. The changes in C19YRS symptom severity and functional disability (0-12 weeks) were statistically significant but not clinically significant. The EQ5D-5L index score change was not statistically significant. Conclusions: A structured pacing protocol effectively reduced PESE episode frequency, duration, and severity but did not produce clinically significant changes in LC symptoms, reflecting the long-term nature of the condition in this cohort.

Structural behavior of hospitals during the Kahramanmaraş earthquake of February 6, 2023

On February 6, 2023, two earthquakes (Mw 7.8 and 7.5) occurred in Turkey. The earthquakes impacted 10 provinces in Turkey and others in Syria, resulting in significant casualties due to the total and partial collapse of many buildings. This article evaluates the impact of damage on the performance of healthcare services based on the investigation of seven hospitals. The observed damages in structural and non-structural elements identified during a post-earthquake inspection are presented and discussed in detail. When possible, interviews with hospital managers and staff members were conducted to understand the key decisions and possible rehabilitation activities after the earthquake. The study aims to improve knowledge of the seismic performance of hospitals and identifies aspects to improve the structural performance of healthcare infrastructure under severe seismic demands.

Effects of Prone Posture Maneuver to Ameliorate Pusher Behavior in Acute Stroke: A Retrospective Study.

Background: Pusher behavior after stroke is an important sequela that interferes with rehabilitation and independence in activities of daily living. As represented by visual or vestibular feedback, conventional methods require substantial assistance and time commitments, but have limited effectiveness. A recent case series suggests that prone posture may alleviate pusher behavior in patients with acute stroke. This study was conducted to retrospectively investigate the effects of prone posture maneuvers. Methods: This retrospective cross-sectional observational study was conducted in a stroke care unit at a university hospital. In total, 37 acute stroke cases presenting with pusher behavior were included from 787 eligible patients. Individuals with pusher behavior were conditioned with prone posturing for 10 min for 2 consecutive days, in addition to regular daily rehabilitation training. The Scale for Contraversive Pushing (SCP) values, Stroke Impairment Assessment Set (SIAS), and functional activities were assessed before, immediately after, and three days after the intervention. Results: The SCP value and the ability to roll over and sit balanced significantly improved compared with the baseline (p < 0.05) and persisted for 3 days after the intervention. Multiple regression analysis identified the SIAS motor score as a determinant of SCP changes. Conclusions: The prone posture maneuver promptly and consistently suppressed pusher behavior, particularly in patients with mild paresis, as indicated by SCP values in acute stroke cases. The uncontrolled, single-site, and retrospective features of the current study require further investigation.

Development of an Active Orthosis and Internet of Things (IoT) Application for Lower Extremity

The IoT (Internet of Things) technology has begun to draw attention in the field of sports sciences, as it has in numerous other domains. In athlete rehabilitation, this technology offers significant advantages over its older versions and demonstrates superior capabilities. This study is structured into three phases aimed at developing a new-generation active lower extremity rehabilitation system based on IoT. In the first phase, an active controlled orthosis design will be developed for the lower extremity. The controller for the active orthosis will employ the admittance control method. In this method, admittance A will be manipulated with small or zero, low deviations to control the rapid rise (lifting) effect, achieving the desired force response during treatment. This study holds intrinsic value in filling a gap within the existing literature. The second and third phases will focus on developing an adaptable active orthosis design capable of transferring data to mobile applications for athletes and sports physicians. This system distinguishes itself from others with these features. The developed system can be personalized for athletes, enabling the physician to easily monitor the recovery process of multiple athletes via a mobile device and provide real-time feedback on device usage to the athlete. The system instantaneously records the pressure applied by the patient to the sensor, and when the pressure surpasses the threshold set by the doctor, notifications and vibrations are sent to the athlete. Consequently, the athlete's monitoring and treatment processes can proceed without intervention.

MAIN APPROACHES AND TYPES OF REHABILITATION OF MILITARY PERSONNEL WHO PARTICIPATING IN HOSTILITIES

In today's conditions, when the war with the Russian Federation continues, the problem of socio-psychological rehabilitation of military personnel who have been in military conflicts, which includes assessing the likelihood of preserving their health and working capacity after exposure to extreme factors, is becoming especially relevant today. The purpose of the article is to systematize and generalize the main approaches and types of rehabilitation of military personnel participating in hostilities. In the scientific survey, the authors highlighted the problem of rehabilitation of military personnel who participated in hostilities. Various scientific approaches to determining the components (types) of rehabilitation of military personnel participating in hostilities have been systematized and analyzed. It has been established that the rehabilitation of military personnel participating in hostilities involves the presence of four main components (types) - psychological, social, pedagogical, and medical A scheme of types of rehabilitation of military personnel as part of comprehensive rehabilitation has been developed. The essence of each type of rehabilitation is characterized. The emphasis is on the fact that all types of rehabilitation activities with military personnel participating in hostilities are quite important, but only all of them in combination can ensure the effectiveness of the rehabilitation system as a whole. Therefore, in this regard, there was a need to develop a proposal for the formation of a state policy for the rehabilitation of military personnel who participated in hostilities, both on the basis of medical and rehabilitation institutions and outside them, applying positive factors of the functioning of civil society, such as the involvement of social workers, practical psychologists, heads of public organizations and volunteers who work in military units and hospitals for war veterans.

Post-discharge care interventions to support patient recovery after elective degenerative spine surgery: a systematic review.

To characterize the type, content, and results of care interventions that support spine surgery patients in their early post-discharge recovery. This systematic review was conducted according to PRISMA guidelines. The literature search was conducted in March 2022 (updated in May 2023) in MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ebsco), PsycINFO (Ovid), and Scopus. Given the heterogeneity of the interventions, outcome parameters, and controls, data for pooling for meta-analysis was not possible. We performed a thematic analysis to categorize the characteristics of the type, content, and results of care interventions. A total of 14 articles met the eligibility criteria. The included studies were published between 2008 and 2022 and included 1,399 unique patients with mean reported ages of 42.3 to 62.3years. The reported interventions were divided into two categories: "Early active rehabilitation" and "Telemonitoring". As for pain, function, quality of life, and activity the majority of the early active rehabilitation interventions showed no differences compared to usual care. In contrast, the telemonitoring interventions seemed mainly to be in favor of the interventions versus usual care in all of the aforementioned aspects. The included studies demonstrated diverse interventions across settings, populations, interventions, controls, follow-up times, and outcome measures. This variability suggests unclear patient needs and preferences for post-discharge care. Given the heterogeneity and overall study quality, further high-quality research is essential. Future studies should prioritize identifying these needs before intervention design.

Implementation of an advanced practice role for oxygen prescription by physiotherapists in pulmonary rehabilitation: an explanatory sequential mixed-method quality evaluation

BackgroundPhysiotherapists play a key role in the administration of supplemental oxygen during physical activity in pulmonary rehabilitation. However, supplemental oxygen requires a medical prescription making processes cumbersome for physiotherapists. This study aimed to implement and evaluate an advanced practice role for physiotherapists (APO2) allowing them to prescribe oxygen during physical activity.MethodsTraining and certification process for respiratory physiotherapists employed in an inpatient rehabilitation clinic was implemented. A mixed-method approach for retrospective evaluation was used. Quantitative analysis included routine clinical data from oxygen prescriptions, titrations, and exercise capacity. Additionally, healthcare professionals’ experiences and perceptions of the new APO2 role was explored using a survey. Qualitative data included interprofessional interviews, survey comments, and data from the critical incidence reporting system.ResultsIn 15% of patients during the evaluation period, certified APO2 were involved in oxygen prescription. These patients had more frequent titrations (median 8 [interquartile 6, 10] vs. 5 [4, 8]), prescription adjustments (3 [2, 4] vs. 1 [1, 2]), and narrower oxygen dosage ranges prescribed (2 [1, 3] vs. 4 [3, 4]). No significant difference in exercise capacity was observed and no adverse events reported. Survey data from 19 healthcare professionals and interviews indicated that the specialised expertise of APO2 positively impacts interprofessional collaboration and workflow efficiency.ConclusionsPhysiotherapy-led oxygen prescription during physical activity in pulmonary rehabilitation is feasible, safe, and perceived as beneficial for the workflow and interprofessional collaboration across healthcare professions.Trial registrationAccording to Swiss law (Human Research Act, Art. 2), ethics approval for the study and informed consent were not required and were waived off. All methods were in accordance with the regulations and guidelines of the Swiss Human Research Act and Swiss ethics law.