Rehabilitation Program Research Articles

Early Surgical Treatment of Posttraumatic Myositis Ossificans of the Vastus Intermedius Muscle.

This case study demonstrates the effectiveness of early surgical excision of the traumatic myositis ossificans of the vastus intermedius muscle in an elite football player and return to sports activity within 3months from the initial injury. A 27-year-old male professional football player presented with progressive pain and loss of range of motion after sustaining a severe, right quadriceps contusion 4weeks earlier. After unsuccessful conservative therapy, the differential diagnosis of myositis ossificans was suspected and confirmed on radiographic examination. MRI revealed significant edema encompassing a substantial portion of the vastus intermedius muscle. Surgical treatment was considered for the right thigh mass, being symptomatic 1month after the onset and refractory to conservative treatment and rehabilitation program. At 2months postsurgery, the patient was asymptomatic and had completed a rehabilitation program. Early surgical treatment followed-up with a rehabilitation program results with a complete recovery of muscle strength and range of motion. At 3months postinitial injury, the patient was considered fully recovered and had returned to the match without reporting pain or other symptoms.

Optimization of a comprehensive rehabilitation program for patients with motor dysfunction following a stroke

This study aims to optimize rehabilitation strategies for stroke patients with motor dysfunction by integrating traditional therapies with emerging technologies. A mixed-methods approach will be used to evaluate the effectiveness of a personalized rehabilitation program that combines physical therapy, occupational therapy, robotic-assisted therapy, virtual reality (VR), and neurostimulation. Participants will include stroke patients with motor impairments, and outcomes will be measured in terms of motor recovery, functional independence, and quality of life. Data will be analyzed through both quantitative (e.g., Fugl-Meyer Assessment, Stroke Impact Scale) and qualitative methods (e.g., interviews, thematic analysis). The study emphasizes the importance of patient-centered care and evidence-based practices, with the goal of providing more effective and individualized rehabilitation for stroke survivors.

The Development of a Vocational Rehabilitation Program to Assist Individuals With MDRTB and TB in Returning to Work.

Background: Individuals diagnosed with tuberculosis (TB) and multidrug-resistant (MDR) TB may struggle to return to work after they have completed a rehabilitation program. Multidrug-resistant tuberculosis (MDRTB) has been seen as a condition that is resistant to treatment, hence causing individuals to be economically in-active for considerable periods of time. Objective: The aim of the current study was to explore the views of individuals living with MDRTB, individuals with TB, and health professionals treating individuals with TB and MDRTB about the development of a vocational rehabilitation program. Method: The researchers used an exploratory descriptive research design, and semistructured interviews were conducted with five key informants and four participants who were diagnosed with pulmonary tuberculosis (PTB) and MDRTB. Thematic analysis was used in order to analyse the study findings. The current study is the second of two articles. The first article focused on barriers and facilitators linked to returning to work for individuals living with TB and MDRTB. The current article focuses on the development of a vocational rehabilitation program. Results: The findings of the original study revealed five themes; however, for the purpose of this article, only two themes will be presented, namely, Theme 1: promoting a holistic model and Theme 2: the use of resources for activity engagement. The latter theme contributed to the participant's view of the development of a vocational rehabilitation program. Conclusion: The study provided a description of the components of a vocational rehabilitation program that has been adapted from the Model of Occupational Self-Efficacy (MOOSE). The above program has been designed for individuals diagnosed with PTB/MDRTB and has the potential to assist them in returning to work. It is suggested that vocational rehabilitation programs be incorporated into general medical programs that focus on improving the functioning of individuals diagnosed with PTB/MDRTB.

Evidence synthesis of health policy and systems research in rehabilitation: a protocol for Cochrane overviews of systematic reviews on delivery, governance, financial arrangements, and implementation strategies.

Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Program are collaborating to produce four Cochrane overviews of systematic reviews that synthesize the current evidence from health policy and systems research (HPSR) in rehabilitation. They will focus on the four pillars of HPSR identified by the Cochrane Effective Practice and Organization of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. The protocol describes why HPSR is currently needed in rehabilitation, provides detailed information on the four EPOC pillars in interaction with rehabilitation and reports the Cochrane methods that will be followed to produce the overviews. 1. Del Furia MJ, Minozzi S, Arienti C, Battel I, Capodaglio P, Côté P, Décary S, De Groote W, Duttine A, Frontera WR, Gimigliano F, Kiekens C, Mudau Q, Ryan R, Sabariego C, Negrini S. Delivery arrangements for rehabilitation services in health systems: an overview of systematic reviews. 2. Gimigliano F, Arienti C, Butzback OK, Capodaglio P, Côté P, Décary S, Del Furia MJ, De Groote W, Duttine A, Frontera WR, Iolascon G, Kiekens C, Liguori S, Minozzi S, Mudau Q, Negrini S, Paoletta M, Ryan R, Sabariego C, Moretti A. Financial arrangements for rehabilitation services in health systems: an overview of systematic reviews. 3. Atkinson-Graham M, Mior S, Bakaa N, Konstantinidis T, Wong J, Arienti C, Capodaglio P, Décary S, De Groote W, Del Furia MJ, Duttine A, Frontera WR, Kiekens C, Minozzi S, Gimigliano F, Mudau Q, Negrini S, Ryan R, Sabariego C, Côté P. Governance arrangements for rehabilitation services in health systems: an overview of systematic reviews. 4. Touhami D, Ryan R, Engeda EH, Arienti C, Capodaglio P, Côté P, Décary S, Del Furia MJ, De Groote W, Duttine A, Frontera WR, Gimigliano F, Kiekens C, Minozzi S, Mudau Q, Negrini S, Sabariego C. Implementation strategies for rehabilitation services in health systems: an overview of systematic reviews. The protocol is largely common to all four overviews. The individual parts of each overview can be identified by the sub-titles delivery arrangements, financial arrangements, governance arrangements, and implementation strategies for overviews 1 to 4.

Evaluation of the impact of a comprehensive rehabilitation program on improving nutritional status, psychoemotional signs and adverse events in patients with melanoma after surgical treatment

Observations were conducted on 148 patients diagnosed with melanoma of various localizations, who were divided into two groups by simple randomization: study (n=77) and control (n=71). The study group received surgical treatment in combination with rehabilitation programs (psychotherapy, nutritional support, general magnetic therapy), while the control group received only standard surgical treatment. In the study group, there is a significant improvement in the quality of life, as well as an improvement in the general condition against the background of the addition of comprehensive rehabilitation programs. According to the results of the analysis, it was noted that adverse events in the study group against the background of the use of comprehensive rehabilitation programs were less common in 41 (53%) patients than in patients in the study group in 54 (76%), where only surgical treatment was performed. After treatment, in the study group, there was a reliably significant decrease in the risk of nutritional deficiency in 16 patients (none), compared with the control group in 12 patients, respectively, (p<0.05). In the study group, a significant decrease in complaints was recorded for the indicators "Emotional functioning" (by 13.4%, in the control group a decrease of 4.9%, p<0.05), "Role functioning" (by 15.1%, in the control group by 3.4%, p<0.05), "Cognitive functioning" (by 13.7%, in the control group by 5.6%, p<0.05) and "Social functioning" (by 14.2%, in the control group by 4.0%, p<0.05). The use of a multidisciplinary rehabilitation approach, including nutritional support, magnetic therapy and psychological assistance, demonstrates a significant improvement in symptom management and quality of life in patients with melanoma after surgical treatment.

Investigation of the Effects of Counseling in Elderly Individuals Attending Vestibular Rehabilitation Program

Subjects: The effects of counseling service given together with vestibular rehabilitation in elderly individuals with a history of age-related-imbalance were examined. Material and Methods: 21 volunteer elderly individuals presbyastasis were included in the study. Sensory Organization Test, Mini-BESTest, Tinetti Balance-Gait Test, daily living activities with in Vestibular Disorders, and quality of life was evaluated. Results: Before the vestibular rehabilitation protocol, counseling was given to the elderly individuals for an average of 45 minutes. Vestibular rehabilitation training was applied in Computerized Dynamic Posturography twice a week for 8 weeks. After the training, balance and walking, activities of daily living, and quality of life improved (P &lt; .05). Conclusions: According to these results, it was concluded that the inclusion of vestibular rehabilitation, which is provided with counseling service, in the rehabilitation program of elderly individuals may be beneficial in improving balance, activities of daily living and quality of life.

Is longer really better? Results of a retrospective real-life cohort study evaluating the benefit of adding a weekly educational session to a traditional 8-week home-based pulmonary rehabilitation programme in people with COPD

ObjectivesTo evaluate the short-term and long-term benefits of adding a weekly educational session to a traditional 8-week home-based pulmonary rehabilitation (PR) programme in people with chronic obstructive pulmonary disease (COPD)....

Best Evidence Summary for the Improvement and Management of Disorders of Consciousness in Patients With Severe Brain Injury.

The treatment effect of consciousness after brain injury is currently uncertain. Thus, this study aimed to retrieve the evidence from neurologists around the world on the management of consciousness disorders in patients with severe brain injury and evaluate and summarize the evidence, providing the guidance on the related management for clinicians. Following the evidence summary report standard of Fudan University Center for Evidence-Based Nursing, clinical guidelines, expert consensuses, systematic reviews, and evidence summaries were systematically retrieved from UpToDate; BMJ Best Practice; Guidelines International Network; the Cochrane Library; Embase; PubMed; Sinomed; Web of Science; CNKI; WanFang database; American Academy of Neurology (AAN); American Congress of Rehabilitation Medicine (ACRM); European Academy of Neurology; and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The publishing timeline for articles was limited from January 2017 to January 2024. Fourteen articles were finally identified. The 26 best pieces of evidence were recommended by inducting and integrating the evidence from these articles, covering the following seven aspects: consciousness assessment, multidisciplinary team, intervention in facilitating arousal, sensory stimulation programs, drug administration, rehabilitation program, and prevention of complications. This study summarized the evidence of consciousness management in patients with brain injury, providing guidance for clinicians to develop and apply those interventions to improve the patient's clinical outcomes and quality of life. In addition, relevant factors such as the clinical environment and cooperation with the patient's family members should be evaluated and adjusted before applying such evidence. Future studies should focus on more targeted randomized clinical trials.

Classification of the Homeless as one of Asnaf Zakat: A Case Study of the Federal Territory of Kuala Lumpur

This study aims to analyze the categorization of the homeless and the factors contributing to homelessness. To achieve this objective, this study employs a research design based on a quantitative approach through interview surveys using questionnaires conducted on a group of homeless individuals in Kuala Lumpur. A total of 100 respondents were selected using purposive sampling techniques. The methodology employed for data analysis is the descriptive approach and binomial logistic regression. The findings indicate that homeless individuals should be categorized as asnaf fakir (poor) and miskin (needy), as their circumstances closely align with issues of poverty, followed by the categories of al-riqab (the slave or bondage) and ibnu sabil (wayfarer). Additionally, the study identifies economy factors, stigma and discrimination, as well as health and mental problems factors, as significant contributors to homelessness. Based on the research findings, this study recommends that all parties, including the government, zakat institutions, non-governmental organizations (NGOs), civil society, and others, collaborate in developing holistic and integrated solutions encompassing economic empowerment programs, accessible health and mental care services, a comprehensive assistance framework, rehabilitation programs, and anti-stigma campaigns to effectively support the asnaf group among the homeless.

High-intensive physical rehabilitation approach in children and adolescents with acquired brain injury during subacute phase (REHABILITY): a feasibility study protocol

IntroductionWhile principles of neuroplasticity and motor learning emphasise the potential of high dosage of physical rehabilitation in children and adolescents with acquired brain injury (ABI) during the subacute phase, we...

Doctors’ Satisfaction with the Rehabilitation System for Anti-Terrorist Operation Participants: A Factor Analysis

A war has a catastrophic effect on veterans' health. However, there is a knowledge gap about the veterans' rehabilitation system, requirements, and the satisfaction of doctor-organizers. The present study aims to assess the level of satisfaction of the doctor-organizers of health care with the existing rehabilitation system for anti-terrorist operation (ATO) veterans in Ukraine. A cross-sectional design was conducted during the ATO in March-April 2020. A total of 25 organizing doctors from healthcare institutions filled out the form. The questionnaire consisted of three blocks: 1) Main characteristics of the existing system of rehabilitation of ATO veterans (14 items); 2) Strengths of the existing system of rehabilitation of ATO veterans (11 items); and 3) Weaknesses of the existing system of rehabilitation of ATO veterans (8 items). Evaluation of the rehabilitation system was carried out using factor analysis. The main features of the system were accessibility, financing of rehabilitation programs, and commitment to the rehabilitation of ATO veterans. The advantages of the system included 1) doctors and organizers identifying the regulatory and legal provision of medical and social protection for the rehabilitation of veterans, 2) access to experienced personnel to carry it out, 3) respectful attitude towards veterans, and 4) comprehensive rehabilitation. In addition, disadvantages inherent in the system included: 1) violation of the integral principle, 2) insufficient material, technical support, and financial resources for rehabilitation programs, and 3) legislative and regulatory gaps necessary to provide rehabilitation to ATO veterans. The findings provided healthcare organizers with information on the main features, advantages, and disadvantages of the rehabilitation of ATO veterans. These insights can aid in optimizing the current rehabilitation system in Ukraine.

Training as a technology for correcting emotional and cognitive impairments of HIV-infected patients. Evaluation of effectiveness

The subject of the study is the emotional sphere and cognitive functions (memory, attention, thinking) of patients with HIV infection. The object of the study is the patients themselves. The author provides a detailed analysis of the cognitive impairments in this group of patients, which significantly affect treatment adherence, emotional stability, and overall quality of life. The focus is on the experience of conducting group training, the effectiveness of which is demonstrated by improvements of participants' emotional state and cognitive functions. The study emphasizes the importance of a personalized approach to assessing and correcting cognitive functions and emotional disorders, considering factors such as disease stage, comorbidities, psychoemotional state, and individual patient characteristics. Based on these findings, the author developed a training program tailored to meet the needs of this group. In the work we used an information questionnaire, Schulte tables, “10 words memorization test”, “Munsterberg test”, methods “Essential attributes”, “Exclusion of superfluous” (non-verbal version), method “Complex analogies”, “Psychopathological symptomatology severity questionnaire”, method of diagnostics of irrational attitudes A. Ellis and method “Life satisfaction index”. Psychodiagnostic examination was conducted before the training and after every eight sessions. The main conclusions of the study are the proven effectiveness of the training in improving memory (of 39% of participants), attention (of 83%), logical thinking (of 36%) and emotional state, including a significant reduction in somatization, obsessive-compulsive manifestations, depression and anxiety (of 47-63%). Questionnaire survey of participants showed high satisfaction with the training and improvement of cognitive functions and emotional state, which confirms the relevance of the approach. Correlation analysis showed a significant relationship between emotional tension and irrational attitudes, which is important to consider in rehabilitation programs. The training program was adapted to the peculiarities of the participants, which allowed to achieve improvements in cognitive and emotional spheres.

Computerized cognitive rehabilitation in patients with multiple sclerosis (MS): A systematic review and meta-analysis.

Cognitive impairment (CI) is one of the main features of multiple sclerosis (MS). Cognitive rehabilitation (CR) programs are crucial for improving cognition and computer-assisted cognitive rehabilitation is considered as an effective method for cognition rehabilitation. To assess the effects of computer-based cognitive rehabilitation program on cognition in patients with multiple sclerosis (MS). We performed a comprehensive search in PubMed, Scopus, Web of Science, EMBASE, and Google Scholar databases along with gray literature up to September 2021. Randomized clinical trials, articles had been published in the English language. We evaluated the risk of potential bias via the Cochrane Collaboration's tool for assessing the risk of bias. Standardized mean difference (SMD) was calculated. The preliminary search retrieved 2302 articles by literature search, after deleting duplicates 2248 remained. Eight articles remained for meta-analysis. Totally, 235 patients in intervention group and 192 in control group were evaluated. Mean age ranged from 43.5-52 years. The SMD of PASAT (Paced Auditory Serial Addition Test) (Case-control) test was 0.35 (95%CI:0.1-0.66) (I2:24.4%, P=0.2). The SMD of SDMT (Case-control) test was 0.07 (95%CI:-0.18-0.33). The SMD of PASAT before and after intervention in case group was 0.68 (95%CI:0.45-0.91) (I2:40%, P=0.15). The SMD of SDMT before and after intervention in case group was 0.44 (95%CI:0.21-0.66) (I2:40%, P=0.15). The results of this systematic and meta-analysis showed that computerized cognitive rehabilitation program is effective in improving PASAT score.

Young Adults Rehabilitation experiences and Needs following Stroke (YARNS): A scoping review of the rehabilitation care experiences and outcomes of young adults post-stroke.

Stroke is one of the leading disabling conditions in the United Kingdom. While an increasing focus on the rehabilitation care for stroke survivors has been noted, practice guidelines, targets and services tend to be tailored for the elderly population rather than young adults. This scoping review aimed to map the existing literature on the rehabilitation care experiences and outcomes of young adults post-stroke aged between 18 and 45 years within acute and social care settings. A scoping review was conducted to identify existing practice and published academic and evidence-based literature related to the topic. Arksey and O'Malley's framework guided the review and reporting followed the PRISMA-ScR checklist. Electronic databases and grey literature were searched to capture the potentially recent and relevant literature available in English from year 2000-2022. The databases included CINAHL, MEDLINE, EMBASE, PsycINFO, ASSIA, AMED, PEDro, Cochrane Library and Web of Science. Grey literature was searched from the following sources: Google Scholar, websites of networks, organisations and charities related to stroke. Hand searches were performed on the reference lists of the included articles and grey literature to find relevant references. Data were extracted on young adults' experiences of stroke and rehabilitation care and their outcomes and experiences of a particular stroke rehabilitation programme in acute and social care settings. Eighty-five articles were included in this review. In most instances, stroke was reported to negatively impact young adults, although positive consequences were also documented. The focus and the outcomes of stroke rehabilitation were predominantly physical especially in the areas of movement, communication and memory. Young adults experienced a lack of age-adapted stroke rehabilitation in acute and social care settings. Our results highlight the unmet needs of young adults in their stroke recovery journey. Effective rehabilitation programmes and interventions should be developed to support young adults following stroke and meet their age-specific needs.

Anxiety, Depression, and Expanded Disability Status Scale Independently Predict the Perception of Disability in Persons With Multiple Sclerosis: A Cross-Sectional Study.

Multiple sclerosis (MS) is the most common cause of disability in young adults due to several motor, sensory, and cognitive symptoms. However, little is still known about the impact of psychological, cognitive, and social-support variables on subjective disability. This study is aimed at exploring the role of clinical, psychological, cognitive, and social-support variables in predicting disability levels as perceived by persons with multiple sclerosis (pwMS). The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the Expanded Disability Status Scale (EDSS) were used as subjective and objective measures of disability, respectively. State-Trait Anxiety Inventory and Beck Depression Inventory-II assessed symptoms of anxiety and depression; 19-item Medical Outcome Study-Social Support Survey assessed social support; and Rao's Brief Repeatable Battery assessed cognitive functioning. A multivariable regression analysis was applied using the WHODAS 2.0 as an outcome. One hundred and fifty-one pwMS (93 females, mean age 51.6, standard deviation (SD) 5.8) were enrolled. EDSS (β = 7.190; p < 0.001), state anxiety (β = 0.265; p = 0.009), and symptoms of depression (β = 0.835; p < 0.001) explained a large amount of the variance of subjective disability (Adj.R 2 = 0.705; p < 0.001) measured through the WHODAS 2.0. Contrarily, cognitive functioning and perceived social support are not independently associated with the WHODAS 2.0 score. Psychosocial interventions in rehabilitation settings, aimed at reducing the overall perceived disability of pwMS, should be implemented in rehabilitation programs.

Loaded Open Kinetic Chain Exercises Caused More Anterior Tibial Translation and Anteromedial Graft Elongation Than Closed Kinetic Chain Following Double-Bundle Anterior Cruciate Ligament Reconstruction.

To further improve rehabilitation programs while preventing overstretching the anterior cruciate ligament (ACL), a thorough understanding of the knee kinematics and ACL length change during closed kinetic chain and open kinetic chain (OKC) exercises is essential. The measurement of ACL graft length relates to the changes in strain experienced by the ACL graft during different types of exercises rather than simple physical length. This study aimed to determine the effects of closed kinetic chain and OKC exercises on tibiofemoral kinematics and ACL graft length changes following double-bundle ACL reconstruction. Cohort study (diagnosis); level of evidence, 3. Laboratory. Fifteen patients who underwent double-bundle ACL reconstruction were asked to perform 10-kg loaded seated knee extension (OKC-10) and single-leg lunge. During the seated knee extension, patients were instructed to extend and flex the knee within a range of 0° to 90° of flexion, with a 10-kg load applied to the ankle. For the lunge, patients began in a natural standing position and were instructed to flex the ACL-reconstructed knee to approximately 90°. The 3-dimensional tibiofemoral kinematics under different weight-bearing conditions were determined using a dual-fluoroscopic imaging system. The tibiofemoral kinematics in 6degrees-of-freedom were measured. And 3-dimensional ligament simulation technique was used to quantify length changes of the anteromedial bundle and posterolateral bundle. The tibia exhibited significantly more external rotation during the OKC-10 motion than during the single-leg lunge from 35° to 70° of knee flexion (P ≤ .028). Beyond 30° of knee flexion, the tibia exhibited significantly more varus during the OKC-10 motion than during the single-leg lunge (P ≤ .028). And a significantly more anterior tibial translation was observed during the OKC-10 motion than during the lunge from 0° to 15° of flexion (P ≤ .018). The anteromedial bundle length was significantly longer during the OKC-10 motion than during the lunge between 0° and 25° of knee flexion (P ≤ .028). The effects of OKC exercises with loads on knee rotational stability should be considered in making rehabilitation programs for patients after ACL reconstruction. Since some degree of anterior tibial translation is physiological, it is important to note that increased translation alone does not necessarily indicate danger or instability.

Inter- and intraspecific blood-related biomarkers and chemical exposure in confined and free-living sea turtles.

The relevance of recovery centers and head-starting programs for rescue, rehabilitation, rearing, and conservation of sea turtles is recognized worldwide. In addition, these centers contribute to generating biochemical and physiological data needed to identify health markers and provide baseline values. Because of the marine ecosystems' deterioration, biomarker identification is a global priority for sea turtle conservation; nevertheless, information on specific endpoints, such as neurotoxicity and mutagenesis, is still limited in sea turtles. This study aimed to contrast a set of non-invasive blood biomarkers with ecotoxicological and clinical applications in confined green sea turtles (Chelonia mydas) compared with free-living ones from the Mexican Caribbean. Additionally, interspecific (green, hawksbill (Eretmochelys imbricata), loggerhead (Caretta caretta) turtles) differences were also evaluated. Plasmatic organochlorine pesticides (OCs) and polychlorinated biphenyl (PCBs) were also determined. The concentration ranges of uric acid, total proteins, lipids (cholesterol and triglycerides), and thyroxine of both confined and free-living green turtles fell outside the reference intervals for the species. Additionally, confined green turtles had the highest number of erythrocytic nuclear abnormalities (ENA) and elevated levels of hemoglobin, lipid peroxidation, and activity of glutathione S-transferase, glutathione peroxidase, and carboxylesterase (CE). Contrasts among confined species identified hawksbill turtles with the lowest glutathione reductase activity, green turtles with the lowest ENA frequency and CE activity, and loggerhead turtles with the highest plasmatic concentrations of PCBs and OCs. The information here provided can be used as information in health monitoring programs and for conservation and management policies at regional, national, and international level.

Perceptions of Patients With Stroke Regarding an Immersive Virtual Reality-Based Exercise System for Upper Limb Rehabilitation: Questionnaire and Interview Study.

With substantial resources allocated to develop virtual reality (VR)-based rehabilitation exercise programs for poststroke motor rehabilitation, it is important to understand how patients with stroke perceive these technology-driven approaches, as their perceptions can determine acceptance and adherence. This study aimed to examine the perceptions of patients with stroke regarding an immersive VR-based exercise system developed to deliver shoulder, elbow, forearm, wrist, and reaching exercises. A questionnaire was used to assess the perceptions of 21 inpatients who had experienced stroke (mean time from stroke onset: 37.2, SD 25.9 days; Brunnstrom stage of stroke recovery for the arm: 3-5) regarding the perceived usefulness of, ease of use of, attitude toward, intrinsic motivation for, and intention to use the exercise system. The measurement items were rated on a 7-point Likert scale ranging from 1 (very strongly disagree) to 7 (very strongly agree), with higher values indicating more positive perceptions. Descriptive statistics were used to summarize the responses. Moreover, we conducted semistructured interviews that were audio recorded, transcribed, and subjected to content analysis to identify thematic patterns. The questionnaire results revealed that the patients' perceptions of the exercise system were positive (mean ratings >6). The content analysis revealed 6 positive themes from 73 statements about the exercise system: ease of use, usefulness, enjoyment, motivation, accessibility, and game design. Conversely, 15 statements reflected negative perceptions, which were clustered into 3 themes: difficulty in handling VR devices, uncomfortable experiences when using VR devices, and monotony. Integrating VR technology into poststroke functional exercises holds significant promise based on patient interests. However, patient preferences and adaptability must be considered to promote the technology's success. VR-guided exercises should be user-friendly, health-promoting, engaging, and well-designed. Furthermore, addressing challenges, such as bulkiness, motion sickness, discomfort, and exercise monotony, is crucial for the widespread adoption and diffusion of this technology.

Psychosocial Rehabilitation of Military Personnel with Post-Traumatic Stress Disorder: The Example of Ukraine

Introduction: Given the current events of the Russian-Ukrainian war, post-traumatic stress disorder (PTSD) is one of the most common psychological problems among military personnel, which requires the introduction and use of new techniques of psychological rehabilitation.Objectives: The study aims to develop and test a comprehensive programme for psychological rehabilitation of military personnel and determine its effectiveness.Methods: The study was conducted among 30 military respondents diagnosed with PTSD. The experiment used pre-test and post-test data from participants at three different time points: pre-intervention, two weeks post-intervention, and four months post-intervention—main instruments: Military PTSD Checklist and Patient Health Questionnaire (PHQ-9). For mental health assessment, 3 scientifically validated indicators were used for data analysis: PCL-M, PHQ-9, and GAD-7.Results: The results demonstrate the need to implement a comprehensive psychological rehabilitation programme for military personnel. If, at the beginning of the test, they were diagnosed with PTSD, acute depression and anxiety, then after two weeks of implementing the comprehensive programme, the indicators decreased significantly. After 4 months, the scores rose slightly but not significantly. This demonstrates the relevance and importance of using various activities to support the psychological state of military personnel who have experienced difficult and traumatic periods. Conclusions: The conclusions summarise that recovery from PTSD requires a comprehensive approach that should consider the internal and external characteristics of each patient

Improving access to pulmonary rehabilitation for patients with COPD treated for substance misuse in the London Borough of Islington

Chronic obstructive pulmonary disease (COPD) is a collection of conditions that cause permanent damage to the lungs. Among a range of treatment options, patients can benefit from pulmonary rehabilitation (PR)...