Rehabilitation Program Research Articles

Technology Readiness Level and Self-Reported Health in Recipients of an Implantable Cardioverter Defibrillator: Cross-Sectional Study

Background Approximately 200,000 implantable cardioverter defibrillators (ICDs) are implanted annually worldwide, with around 20% of recipients experiencing significant psychological distress. Despite this, there are no ICD guidelines addressing mental health as part of rehabilitation programs, which primarily focus on educating patients about their condition and prognosis. There is a need to include elements such as emotional distress, social interactions, and the future use of technologies like apps and virtual communication in ICD rehabilitation, without increasing the burden on health care professionals. Objective This study aimed to demonstrate how data from the Readiness for Health Technology Index (READHY), combined with sociodemographic characteristics and exploratory interviews, can be used to construct profiles of recipients of an ICD, describing their ability to manage their condition, their need for support, and their digital health literacy. This aims to enhance health care professionals’ understanding of different patient archetypes, serving as guidance in delivering personalized services tailored to the needs, resources, and capabilities of individual recipients of ICDs. Methods Overall, 79 recipients of an ICD participated in a survey assessing technology readiness using the READHY. The survey also collected sociodemographic data such as age, sex, and educational level. Self-reported health was measured using a Likert scale. Cluster analysis categorized participants into profiles based on their READHY scores. Correlations between READHY scores and self-reported health were examined. In addition, qualitative interviews with representatives from different readiness profiles provided deeper insights. Results Four technology readiness profiles were found: (1) profile 1 (low digital health literacy, insufficient on 5 dimensions), (2) profile 2 (sufficient on all dimensions), (3) profile 3 (consistently sufficient readiness on all dimensions), and (4) profile 4 (insufficient readiness on 9 dimensions). Participants in profile 4, characterized by the lowest readiness levels, were significantly younger (P=.03) and had lower self-reported health (P<.001) than those in profile 3. A correlation analysis revealed that higher READHY scores were associated with better self-reported health across all dimensions. Qualitative interviews highlighted differences in self-management approaches and the experience of support between profiles, emphasizing the essential role of social support toward the rehabilitation journeys of recipients of an ICD. Two patient vignettes were created based on the characteristics from the highest and lowest profiles. Conclusions Using the READHY instrument to create patient profiles demonstrates how it can be used to make health care professionals aware of specific needs within the group of recipients of an ICD.

Manual Therapy for Fibrosis-Related Late Effect Dysphagia in Head and Neck Cancer Survivors: The MANTLE Nonrandomized Clinical Trial.

Late radiation-associated dysphagia (RAD) after head and neck cancer (HNC) treatment is challenging and commonly treatment refractory, with fibrosis stiffening connective tissues and compressing peripheral nerve tracts, contributing to diminished strength and possibly denervation of swallowing muscles. Manual therapy (MT), while common for cancer-related pain and other indications, remains largely unstudied for fibrosis-related late RAD. To determine the feasibility and safety of MT, estimate effect size and durability of MT for associated improvements in cervical range of motion (CROM), and examine functional outcomes after MT in survivors of HNC with fibrosis-related late RAD. This nonrandomized clinical trial, Manual Therapy for Fibrosis-Related Late Effect (MANTLE) Dysphagia in Head and Neck Cancer Survivors, is a prospective, single-institution, pilot, single-arm supportive care trial conducted at a National Comprehensive Cancer Network-designated academic comprehensive cancer center. Participants were adult survivors of HNC who were disease free at 2 or more years after curative-intent radiotherapy with grade 2 or higher fibrosis (per Common Terminology Criteria for Adverse Events version 4.0) and grade 2 or higher dysphagia (per video fluoroscopy Dynamic Imaging Grade of Swallowing Toxicity [DIGEST]). Data were collected June 2018 to July 2021 and analyzed November 2022 to November 2024. MANTLE included 10 hourly MT sessions by lymphedema-certified speech-language pathologists over 6 weeks with a home exercise program. During the subsequent 6-week washout period, participants implemented only the home exercise program, without clinician MT. Primary end points were feasibility (per therapy completion rate, with a 75% target) and safety. Secondary end points included functional outcomes per CROM, dysphagia severity (per DIGEST), maximum interincisal opening (MIO), and validated participant-reported outcomes (PROs). Among 24 survivors of HNC (20 male [83.3%]; median [range] age, 68 [53-80] years), there was a median (range) of 8.9 (2.4-30.2) years after curative-intent radiotherapy. A total of 22 participants (91.7%) completed the 10 prescribed therapy sessions, and 1 participant experienced a severe adverse event. Secondary end points improved among participants who completed the therapy: MIO (r = 0.76; 95% CI, 0.66 to 0.94) and all 6 planes of CROM (eg, cervical extension: r = 0.86; 95% CI, 0.83 to 0.93) improved, with large effect sizes from baseline to after MT. Large to moderate effect sizes were achieved in symptom measures per PROs (eg, lymphedema-fibrosis symptom severity after MT: r = 0.74; 95% CI, 0.63 to 0.99). However, effect sizes were small to moderate or null in uncompensated swallowing outcome measures (eg, MD Anderson Dysphagia Inventory composite score from baseline to after MT: r = 0.38; 95% CI, 0.07 to 0.73). This study found that MT was safe and feasible in long-term survivors of HNC with late RAD and was associated with several functional, physical, and psychosocial gains. This trial may offer insight into next directions to optimize swallowing outcomes by integrating MT into a comprehensive rehabilitation program. ClinicalTrials.gov Identifier: NCT03612531.

Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study

Background and Objectives: While shoulder injuries represent the musculoskeletal disorders (MSDs) most encountered in physical therapy, there is no consensus on their management. In attempts to provide standardized and personalized treatment, a robotic-assisted device combined with EMG biofeedback specifically dedicated to shoulder MSDs was developed. This study aimed to determine the efficacy of an 8-week rehabilitation program (3 sessions a week) using a robotic-assisted device combined with EMG biofeedback (RA-EMG group) in comparison with a conventional program (CONV group) in patients presenting with shoulder MSDs. Materials and Methods: This study is a retrospective cohort study including data from 2010 to 2013 on patients initially involved in a physical rehabilitation program in a private clinic in Chicoutimi (Canada) for shoulder MSDs. Shoulder flexion strength and range of motion were collected before and after the rehabilitation program. Forty-four patients participated in a conventional program using dumbbells (CONV group), while 73 completed a program on a robot-assisted device with EMG and visual biofeedback (RA-EMG group); both programs consisted of two sets of 20 repetitions at 60% of maximal capacity. Results: We showed that the RA-EMG had significantly greater benefits than the CONV group for shoulder flexion strength (4.45 [2.6;6.15] kg vs. 2.3 [0.90;4.775] kg, U = 761, p = 0.013) and for normalized strength (77.5 [51.3;119.1] % vs. 39.1 [16.6;89.2] %, U = 755, p = 0.016). In addition, the RA-EMG group showed a trend to greater absolute gain of ROM than the CONV group (10.0 [0;24.3] degrees vs. 5.5 [0;12.0] degrees, U = 1931, p = 0.067), and a greater benefit in normalized ROM was observed for the RA-EMG (7.4. [0;17.7] %) than the CONV group (4.6 [0;10.8], U = 1907, p = 0.046). Conclusions: The current retrospective cohort study showed that a specific and tailored 8-week rehabilitation program with constant effort by automatic adjustment of the level of resistance by EMG feedback induced greater benefits for shoulder flexion strength and a trend to improve range of motion compared to conventional rehabilitation in patients with shoulder MSDs. Future research should be pursued to determine the added potential of this approach for abduction and external rotation with a randomized controlled design.

Child Labour and Human Rights: A Socio-Legal Study of Policy Gaps and Challenges in India

Despite the legal setup, child labour is one of the serious socio-legal problems and a severe violation of human rights in India for millions of children. It shows that this significant problem exists here, although well-established laws prohibited child labour several decades ago. This research investigates the socio-economic factors, mainly poverty, education access denial, social norms, and labour laws' non-compliance in developing child labour among the vulnerable populace. It analyzes the existing mechanisms of law through critical examination in the light of the Child Labour (Prohibition and Regulation) Act, 1986, amended in 2016, the Right to Education Act, 2009, and other international conventions ratified by India. Through a case study from different states, this research exposes the loopholes in enforcement and policy implementation regarding sectors like agriculture, mining, garment industry, and domestic labour. Findings indicate that the weaknesses in law enforcement, corruption, bureaucracy, and lack of interagency coordination exacerbate this issue, thereby leaving many children open to exploitation. A multi-pronged approach strengthening legal enforcement, enhancing rehabilitation programs, integrating technology to monitor child labour, and increasing public awareness would serve as a necessary condition for sustainable eradication. This study emphasizes that because of the non-governmental organizations, the Indian government, and international agencies working together, child rights have to be taken seriously.

The crucial importance of preventive and cardiac rehabilitation programmes in patients with atrial fibrillation: AF-CARE units.

The crucial importance of preventive and cardiac rehabilitation programmes in patients with atrial fibrillation: AF-CARE units.

Advances in the application of human-machine collaboration in healthcare: insights from China

In the context of the technological revolution and the digital intelligence era, the contradiction between the rising incidence of diseases and the uneven distribution of quality medical resources is highlighted, and the diagnosis and prevention of diseases, and the prognosis and management of diseases are particularly important in the current society of aging population. “Human–machine collaboration” is based on an intelligent algorithmic system that utilizes the complementary strengths of humans and machines for data exchange, task allocation, decision making and collaborative work to provide more decision support. The traditional healthcare model is highly dependent on the unified management of hospitals, which further increases the burden on the healthcare system and often makes it difficult to formulate and implement personalized and precise rehabilitation programs for patients, which seriously affects their prognosis and quality of life, and increases the risk of re-admission to hospitals. In view of this, human-computer collaboration, an innovation-driven technology, is a groundbreaking solution to the outstanding healthcare issues of today. We use the subject words “Human–machine collaboration” OR “Human-Computer Interaction” OR “HCI” AND “chronic disease” OR “Health management” OR ”Precision medicine “were searched for CNKI, Wanfang Data, VIP, CBM, PubMed, Web of science, Embase, Cochrane Library and other Chinese and English databases to identify all relevant studies and compare their results, and finally include 68 relevant literature articles, we identified the broad application of HCI in five main areas: disease screening and treatment, health management, medical education, traditional medicine, and the integration and processing of medical data. The aim is to review the concept of human-computer collaboration, its application in global healthcare environments, and the challenges it faces, with a view to continually driving innovation in healthcare models, optimizing the allocation of healthcare resources, and providing new paradigms for the development and application of innovative technologies in healthcare.

Effect of a tailor-made hydrotherapy on physical functions in patients after unilateral unicompartmental knee arthroplasty—A feasibility study

IntroductionUnicompartmental knee arthroplasty (UKA) is one of the treatment options for patients whose osteoarthritis involves one out of the 3 compartments. Patients who underwent UKA benefited from shorter hospital stays, better range of motion, and lower risk of postoperative complications compared with patients who underwent total knee arthroplasty (TKA). Hydrotherapy is being introduced complementary to conventional postoperative rehabilitation programs. No report on the use of hydrotherapy evaluating physical functions on patients who underwent UKA leads us to carry out the present study. This is a feasibility study to investigate the effects of hydrotherapy on physical functions in patients after primary unilateral UKA.MethodsA retrospective cohort study recruited 68 patients who underwent primary unilateral UKA. Nineteen patients were allocated to the hydrotherapy group and 49 patients were in the convention group. Patients in the hydrotherapy group received hydrotherapy and conventional physiotherapy, and the convention group was given conventional physiotherapy only. The primary outcome was Knee Society Function Score (KFS) measured before surgery, six months, and one year after UKA. Self-reported walking tolerance, Timed Up and Go Test (TUGT), and 30-s Chair Stand Test (30CST) were conducted before and after the completion of rehabilitation. Pain and range of motion were also covered.ResultsHydrotherapy group showed significantly higher KFS at 6 months (P = 0.038) and one year (P = 0.030) after operation. Range of motion flexion and extension in the hydrotherapy group were significantly improved at postoperative 4 weeks and the last session of rehabilitation. Self-reported walking tolerance in the hydrotherapy group was significantly longer at the last session (P = 0.011). No significant difference was found in TUGT, 30CST, and pain between the two groups after rehabilitation. In both groups, all outcomes were significantly better as compared to preoperative findings.ConclusionPatients who underwent UKA after hydrotherapy complementary to conventional physiotherapy showed significant improvements in functions, range of motion, and time to tolerating walking before rest. Pain, mobility, balance, leg strength, and endurance were comparable between the two groups. Combination of hydrotherapy with conventional postoperative physiotherapy rehabilitation yielded even better outcomes than conventional physiotherapy alone. Further research with advanced study design, larger sample size and longer follow-up periods for patients who underwent UKA is recommended.Trial registrationNCT06459960, retrospectively registered on 13.06.2024 (ClinicalTrials.gov).

Analyzing Drug Consumption: Patterns, Causes, and Impacts using Looker Studio: A Data Visualization Paper

Drug consumption continues to be a significant global issue, affecting individuals' health and societal stability. This paper explores the various trends in drug use, examining the causes that drive individuals to substance abuse and the profound impacts it has on both mental and physical well-being. Through an analysis of demographic data, the study highlights several contributing factors, including peer pressure, stress, and socioeconomic challenges, which increase vulnerability to drug use. The findings underscore the importance of implementing focused intervention strategies to address these root causes and reduce the harmful effects of drug consumption. By understanding the intricate relationship between social and psychological factors and substance abuse, this research advocates comprehensive prevention and rehabilitation programs aimed at supporting affected individuals and strengthening communities.

Adaptive Judo and neuropathy: a mini review on motor skills, balance, and quality of life improvement

IntroductionPeripheral neuropathies are progressive conditions characterized by muscle weakness, impaired balance, and reduced quality of life. Rehabilitation programs and adaptive sports have shown promise in mitigating these effects. This paper explores the potential of adaptive Judo to improve motor skills, balance, and overall quality of life in patients with neuropathy.MethodsWe review existing literature, analyze the benefits of Judo’s physical and cognitive demands, and propose adaptive guidelines for its implementation.ResultsThis study highlights Judo’s potential as a cost-effective and scalable intervention to support neuropathic patients.ConclusionThis review emphasizes the evidence-based benefits of adapted Judo training has the potential to transform both the physical and emotional health of neuropathic individuals.

Sexual Well-Being as a Factor of Social and Psychological Rehabilitation of Persons with Disabilities

<p dir="ltr"><span>The article introduces the genetic connection between the synthetic multiple-factor activity-based personality-oriented neosocial model of rehabilitation of a person with disabilities by A. Shevtsov and the structural functional model of human sexuality by V. Hupalovska. In the multiple-factor model of rehabilitation, the socio-psychological component is important, which corresponds to the dispositional model of Allport and the provisions on the “fully functioning person” according to Rogers. An attempt to consider the self-actualisation of a person with a disability and his/her subjective well-being through the lens of sexual well-being as a factor in the social construction by the person with disability of his/her life at the internal level is made. The study investigates the role of sexual well-being as a factor contributing to the social and psychological rehabilitation of people with disabilities (PwD) who acquired lifelong severe somatic diseases. Based on a comparative empirical analysis involving 125 PwD and 121 conditionally healthy participants, it was found that sexual attitudes and subjective well-being in PwD are comparable to those of their healthy peers. Notably, PwD report higher levels of positive relationships and affect balance but encounter challenges in goal-setting due to their health limitations. Predictors of subjective well-being include the adoption of romantic, patriarchal, and traditional-parental sexual scenarios, while self-realisation, market-oriented, and passionate sexual scripts negatively influence subjective well-being. The study highlights that transcendental and hedonistic-communicative scripts enhance subjective satisfaction with life, while intimate and market scripts demonstrate an inverse relationship. These findings emphasise the importance of addressing sexual well-being in rehabilitation programs. Sexuality, functioning across physical, emotional, and spiritual dimensions, plays a crucial role in enabling PwD to construct meaningful lives and achieve subjective psychological balance. The research supports the integration of personal, social, and psychological factors into rehabilitation strategies, aligning with the neosocial model of rehabilitation.</span></p><div><span><br /></span></div>

Efficacy and safety of repetitive peripheral magnetic stimulation in patients with lumbosacral radiculopathy during early postoperative rehabilitation period following microdiscectomy

Background. The considerable number of surgical interventions for the treatment of discogenic lumbosacral radiculopathy(LSR) highlights the importance of optimizing complex post-surgical rehabilitation programs, particularly those incorporating innovative physiotherapeutic techniques. One of the modern and safe methods in physiotherapeutic rehabilitation is repetitive peripheral magnetic stimulation (rPMS).Objective: to evaluate the efficacy of a rehabilitation therapy that includes rPMS for patients with LSR during the early postoperative rehabilitation period following microdiscectomy.Material and methods. A prospective randomized comparative study involved 71 patients with LSR following microdiscectomy. On postoperative Day 7, the patients were randomly assigned to one of two groups. Group 1 (n=35) received a course of rPMS in addition to the standard rehabilitation therapy, while Group 2 (n=36) received only the standard treatment. Pain intensity was assessed using the visual analog scale, anxiety was evaluated using the state-trait anxiety inventory, and health-related quality of life was measured with the EuroQol-5D questionnaire.Results. On Day 21 of rehabilitation, a statistically significant difference (p=0.036) in pain intensity in the lower limb was observed between the two groups. In addition, a statistically significant difference (p=0.042) was revealed in the frequency distribution of trait anxiety severity. A statistically significant improvement in the frequency distribution of self-care level was observed in Group 1 between Days 7 and 21 (p<0.05).Conclusion. The clinical effects observed in terms of the regression of pain, improved sensory function, and psychological wellbeing were more pronounced in the group receiving rPMS. These findings suggest that rPMS incorporated into postoperative rehabilitation programs may serve as a valuable tool for enhancing patient recovery.

Comparative effects of Health Qigong and closed motor exercise on the physical and mental health of female drug rehabilitation participants: a randomized controlled trial.

Drug rehabilitation is a challenging process that impacts both the physical and mental health of individuals. Traditional martial arts, such as Health Qigong, and closed motor exercises, such as power cycling, have shown potential benefits in improving health outcomes. This study aims to compare the effects of Health Qigong, closed motor exercises, and their combination on the physical and mental health of female drug rehabilitation participants. In this randomized controlled trial, female participants from the Jilin Province Women's Compulsory Isolation Drug Rehabilitation Center were randomly assigned to three groups: Health Qigong (QigongG), Closed Motor Exercise (ClosedG), and Combined Health Qigong and Closed Motor Exercise (CombinedG). Measurements were taken at baseline, mid-intervention, and post-intervention and included resting heart rate, vital capacity, choice reaction time, sleep quality, and relapse tendency. At the study's conclusion, the ClosedG group showed significant improvements in relapse tendency, vital capacity, and sleep quality compared to baseline. The QigongG showed significant improvements in relapse tendency, sleep quality, and choice reaction compared to baseline. The CombinedG group demonstrated significant improvements in relapse tendency, vital capacity, sleep quality, and choice reaction time, outperforming the ClosedG groups in reaction time, and outperforming QigongG groups in vital capacity. The CombinedG group exhibited the most notable overall improvements. The combined intervention of Health Qigong and closed motor exercises is more effective in improving physical and mental health metrics among female drug rehabilitation participants than either intervention alone. These findings suggest that incorporating a combination of traditional martial arts and closed motor exercises could enhance rehabilitation programs for drug rehabilitation. ClinicalTrials.gov NCT06454565. The date of registration is 2024.07.11 (Retrospectively registered).

Quality matters: chronic kidney disease progression is associated to reduced muscle strength independently of changes in skeletal muscle mass: an observational study

Abstract Background and hypothesis Chronic kidney disease (CKD) is commonly associated with multifactorial neuromuscular impairments. Few studies have investigated CKD-induced changes in maximal voluntary force (MVF), and even fewer have longitudinal follow-up. The aim of this study is to investigate whether CKD progression modifies the relationship between skeletal muscle mass and force and the prevalence of sarcopenia and sarcopenic obesity. Methods The data used were prospectively collected during routine check-ups in a network of nutritional centres in Mexico and retrospectively analysed. From a dataset of 5430 patients, we selected 1098 patients with available anthropometric, kidney function, handgrip and bioimpedance data. The relationship between appendicular skeletal muscle mass (ASM) and MVF was investigated using mixed models and adjusted for age, sex, BMI, physical activity level and CKD aetiology. Sarcopenia prevalence were tested across period of follow-up using the Cochran-Mantel-Haenzen for repeated measures and across CKD stages using the Chi-2 test. Results After normalization with ASM, MVF was higher in CKD G1-G3 compared to G4 and G5 (p ≤ 0.001, Cohen's d = 0.270–0.576). Slopes between MVF and ASM were lower in CKD G3, G4 and G5 than in CKD G1-G2 (-2.268 [-3.927,-0.609], p = 0.008; -2.694 [-4.593,-0.794], p = 0.006; -3.675 [-5.326,-1.725], p < 0.001, respectively). The prevalence of sarcopenia and sarcopenic obesity did not differ across CKD stages, but recovery was most commonly observed in CKD G1-G2. Slope analysis showed an independent interaction between the slopes of kidney function and ASM on MVF evolution over time. Conclusions CKD negatively, progressively and independently affects the neuromuscular system, and force production is reduced for any given muscle mass as CKD progresses. While no association was found between CKD stage and prevalence of sarcopenia, recovery was more frequent in the early CKD stages. These results suggest the importance of early rehabilitation programs to improve musculoskeletal health, quality of life and survival in CKD patients.

Effect of a home-based physical rehabilitation program via virtual reality on the functional outcomes of frail older adults: a quasi-experimental study

Given the rapid aging of the population in Egypt, efforts to slow down or prevent frailty. Virtual reality technology constitutes a promising rehabilitation strategy, but its effect on frailty in older adults remains inconclusive. A non-equivalent control pre, post, and follow-up test design was used with a sample of 70 prefrail or frail older adults. In 3 urbans affiliated to Dakahlia governorate, tools of data collection; Mini-Cog, Structured Interview Schedule, Survey of Health, Aging and Retirement in Europe of the Frailty Indicator (FI), Short Physical Performance Battery, and Falls Efficacy Scale. For each group, a significant improvement in frailty, physical performance, and falls from each measurement period to immediately after (p < 0.001), and within the 30-days study period while those in the control group were relatively stable over time and sometime worsen. The baseline characteristics and assessment results were similar between groups. We observed significant improvements in the intervention group in terms of frailty criteria, standing balance, gait speed, chair stand, and fear of fall. No improvements were observed in the control group, we anticipate a decrease in frailty index, and increase in standing balance, reinforcing the proven benefits of the exercise in this vulnerable population.

Resources and Readmission for COPD Exacerbation in Pneumology Units in Spain: The COPD Observatory Project

Chronic obstructive pulmonary disease (COPD) represents one of the most frequent causes of hospital readmissions and in-hospital mortality. One in five patients requires readmission within 30 days of discharge following an admission for exacerbation. These ‘early readmissions’ increase morbidity and mortality, as patients often do not recover their baseline lung function. The identification of factors associated with increased risk has been a major focus of research in recent years. Studies describe patient-related predictors, although some studies also suggest that better-resourced centres provide superior care. Objective: To describe resources, performance, and care provided in pneumology units in Spain, assessing their association with 30-day readmission for COPD and in-hospital mortality. Methods: This survey was conducted in 116 hospitals responsible for the COPD pathway in pneumology units/departments from November 2022 to March 2023. Results: Of the 116 participating hospitals, 56% had a pneumology department while 25.9% had a pneumology section. The vast majority were public and university hospitals. The number of beds allocated to pneumology/100,000 inhabitants was 6.6 (3.1–9.2) and pulmonologist staffing was 3.3 (2.6–4.1) per 100,000 inhabitants. There was an intermediate respiratory care unit (IMCU) dependent on the pneumology department in 31.9% of units and a respiratory team for 24 h emergency care in 30% of units, while only 9.5% had interventional pneumology units for bronchoscopic procedures. COPD rehabilitation programmes were offered in 58.6% of pneumology units. The average rate of patients on ventilatory support in acute failure was 13.8 (9.2–25) per 100 discharges, with a 30-day COPD readmission rate of 14.9%, with significant differences according to the level of complexity (p = 0.041), with a mean length of stay of 8.72 (1.26) days. The overall in-hospital mortality in pneumology units was 4.10 (1.18) per 100 admissions. In the adjusted model, having a discharge support programme and interventions performed during admission (number of patients with ventilatory support) were predictors of a favourable outcome. Hospital stay was also maintained as a predictor of an unfavourable outcome. Conclusions: There is significant variability in resources and the organisation of care in pneumology units in Spain. The availability of a discharge support programme and greater use of ventilatory support at discharge are factors associated with a lower 30-day COPD readmission rate in the pneumology unit. This information is relevant to improve the care of patients with COPD and as a future line of research.

Universal intestinal suture in rehabilitation of patients with single-layer anastomoses after elective upper gastrointestinal tract surgery

To evaluate universal intestinal suture in rehabilitation of patients with single-row anastomoses after elective upper gastrointestinal tract surgery. A single-center study included 142 patients over 8-year period. There were 72 (50.7%) pancreaticoduodenectomies and 70 (49.3%) gastric resections and gastrectomies. The rehabilitation program included single-layer anastomoses using universal intestinal suture, intestinal drainage for decompression and enteral nutrition, therapeutic and diagnostic endoscopy to stimulate motor evacuation function, patency of anastomoses and assessment of anastomositis. Intestinal drainage for decompression and enteral nutrition was used for 6 (4; 7) days after surgery. Intraluminal endoscopy was performed after 9 (7; 11) days. In patients with anastomositis grade 0 (26.5%) and 1 (62.4%), we observed minimal inflammation along intestinal suture line (mean hospital-stay 16 (13; 20) days). In patients with anastomositis grade 2 (8.5%) and 3 (2.6%), we observed surface erosions and ulcers in the anastomosis zone (mean postoperative hospital-stay 20 (16; 27) days). Postoperative complications unrelated to anastomoses were diagnosed in 17.6% of cases; 12% of patients underwent redo surgery. Mortality rate was 2.8%. Universal intestinal suture in rehabilitation of patients with single-layer anastomoses contributed to uncomplicated healing of anastomoses in 88.9% of patients with anastomositis grade 0-1 and reduced the incidence of anastomositis grade 2-3 to 11.1%, as well as hospital-stay after elective upper gastrointestinal tract surgery.

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.

Screening for borderline personality symptoms amongst adult offenders attending rehabilitation programmes

There is a paucity of research into rates of borderline personality disorder in Australian forensic settings. This paper aimed to describe self-reported borderline personality symptoms within a South Australian offender cohort attending rehabilitation programmes in the prison or community. A retrospective audit of N = 576 offender records was undertaken between February 2021 and August 2023. Offenders routinely completed the McLean Screening Instrument for Borderline Personality Disorder on entry to rehabilitation programmes. Respondents who endorsed 7 or more items on this screener were categorised into a ‘high borderline symptom’ group and compared across key demographics. The sample was predominantly men (n = 546) with 33% categorised into the ‘high borderline symptoms’ group, compared to 20% of women assessed (n = 30). Findings suggest high rates of borderline personality symptoms amongst this cohort, which has implications for engagement in rehabilitation programmes, staff training and education, and opportunities for reducing recidivism.

Effectiveness of Physical Therapy with Kinesio Taping in the Treatment of Patients with Knee Ligament Injuries

Background. Kinesio taping is a therapeutic technique gaining popularity in knee injury treatment. The method is based on the use of a highly elastic adhesive material that allows free mobility of the treated body area. Objective. The aim of this study was to evaluate the effectiveness of kinesio taping in restoring joint functionality. Materials and Methods. A comparative analysis was conducted between two groups of patients: the control group (basic rehabilitation) and the experimental group (basic rehabilitation with kinesio taping). Results. At baseline, both groups had comparable clinical and functional indicators, including pain level, the Oswestry Disability Index, knee joint range of motion, and muscle strength. After the rehabilitation course, both groups demonstrated positive dynamics, with knee flexion amplitude improving by approximately 90% and extension by 70%. However, the kinesio taping group demonstrated statistically significant advantages: muscle strength increased by 36.46% (versus 14-17% in the control group), Lower Extremity Functional Scale scores improved by 44.55% (versus 5.33%), postural stability increased by 29.85% (versus 0.73%), and Hauser’s walking index improved by 30.51% (versus 3.33%). No statistically significant between-group differences were found in pain reduction (approximately 49% in both groups) and improvement in the Oswestry Disability Index (approximately 52%). Discussion. These results can be explained by the fact that kinesio taping provides additional proprioceptive stimulation and mechanical support during rehabilitation exercises, facilitating more effective recovery of muscle strength and postural control. Conclusions. The study confirms that incorporating kinesio taping into comprehensive rehabilitation program significantly enhances its effectiveness, particularly in restoring muscle strength, postural control and overall lower limb functionality, although showing no advantages in pain control or certain specific functional parameters compared to standard rehabilitation programs. These findings have important practical implications for optimizing rehabilitation protocols and rational use of kinesio taping in physical therapy for patients with knee ligament injuries.

Rehabilitation of a Patient with Knee Arthrofibrosis after Tibial Spine Fracture: a Case Report in Paediatrics

INTRODUCTION. Tibial spine fracture (TSF) is a rare injury, the incidence is higher among children. The common complication of treatment is arthrofibrosis. Early rehabilitation is important for its prevention. Guidelines haven’t been worked out. CASE REPORT. Patient A., 11 years old, was operated for TSF. When she had hospitalized in medical rehabilitation center after 4 months, knee arthrofibrosis was diagnosed. Examination: range of knee motion is 180–155°. Edema of periarticular tissues. The gait pattern is impaired. She couldn’t maintained balance in Trendelenburg test on affected leg. Psychological diagnostics: fear of knee flexion, decreased motivation. Rehabilitation aims: A. will begin to bend knee while walking after 10–14 procedures d450.3.2–d450.2.1, b7100.2–b7100.1. A. is not afraid to bend knee during exercises by the end of the rehabilitation d240.2.0–d240.1.0. Rehabilitation program: physical exercises, mechanotherapy (treadmill, ladder with ramp, continuous passive motion), electrical myostimulation, aquajet therapy, vibrotherapy, kinesiotaping, hardware massage, sessions with psychologist, magnetic laser. RESULTS AND DISCUSSION. Range of knee motion is 180–135°. Edema of tibia and hip has decreased. A. minimally bends knee when walking, hip flexion has appeared. A. can maintain balance in Trendelenburg test. The fear of bending knee has decreased according to self-assessment, but it is difficult for A. to cope with the situation of physical discomfort on her own. The aims have been partially achieved. Rehabilitation potential is low because of long period after surgery and personal characteristics. Life quality didn’t decrease, it made difficult setting rehabilitation aims. The team decided to focus on psychological work and improving motion. CONCLUSION. Teamwork and guidelines are important for rehabilitation due to variety and complexity the pathology.