Standard Rehabilitation Treatment Research Articles

Guideline for rehabilitation assessment and treatment of adolescent idiopathic scoliosis (2024 edition)

Scoliosis is a complex three-dimensional deformity of the spine that affects the growth of the spine in adolescent, leading to a heavy burden on families and society. According to the guidelines for the treatment of scoliosis, most adolescent idiopathic scoliosis (AIS) requires rehabilitative intervention. So far there has been a lack of scientific, evidence-based, and standardized rehabilitation assessment and treatment for AIS in China. Therefore, in order to promote the standardization of rehabilitation assessment and treatment for AIS, Chinese Society of Physical Medicine and Rehabilitation organized the domestic experts in multiple disciplines such as rehabilitation medicine, orthopedics, pediatric surgery, radiology, evidence-based medicine, etc., who has conformed to the principles of scientificity, safety, efficacy and advancement to propose the 19 recommendations of 8 categories using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Reporting Items for Practice Guidelines in Healthcare (RIGHT). Through the steps of literature search, evaluation, and establishment of direction and intensity of recommendation opinions, 19 recommendations were formed, involving AIS screening, assessment and treatment.

Might patients with cerebellar ataxia benefit from the Computer Assisted Rehabilitation ENvironment (CAREN)? A pilot study focusing on gait and balance.

Introduction: Ataxia is a neurological symptom that causes decreased balance, loss of coordination, and gait alterations. Innovative rehabilitation devices like virtual reality (VR) systems can provide task-oriented, repetitive and intensive training with multisensorial feedback, thus promoting neuroplastic processes. Among these VR technologies, the Computer Assisted Rehabilitation ENvironment (CAREN) associates a split belt treadmill on a 6-degrees of freedom platform with a 180° VR screen and a Vicon motion capture system to monitor patients' movements during training sessions. Methods: Eight patients affected by cerebellar ataxia were enrolled and received 20 sessions of CAREN training in addition to standard rehabilitation treatment. Each patient was evaluated at the beginning and at the end of the study with 3D gait analysis and clinical scales to assess balance, gait function and risk of falls. Results: We found improvements in kinematic, kinetic, and electromyographic parameters (as per pre-post- CAREN training), as well as in clinical outcomes, such as balance and risk of falls in ataxic patients. In addition, we found that trunk rotation improved, after CAREN intervention, approximating to the normative values. Discussion: Our results suggested that CAREN might be useful to improve specific biomechanical parameters of gait in ataxic patients.

Enhancing emotional abilities in anorexia nervosa treatment: A rolling-group cognitive remediation and emotional skills training protocol.

Anorexia nervosa (AN) is characterised by limited remission rates and emotional dimensions are often neglected. Cognitive remediation and emotional skills training (CREST) protocol aims to address cognitive and emotional factors. This study evaluates the feasibility and effectiveness of a modified rolling-group CREST protocol in an inpatient setting. Quasi-experimental design evaluated CREST protocol in a rehabilitation programme. A total of 116 females diagnosed with AN were included, of whom 63 were included in the CREST protocol and 53 in the standard rehabilitation treatment. Various standardized measures were employed to assess psychopathology. Data collection occurred longitudinally, before and after CREST implementation. No significant differences emerged between groups regarding changes in specific eating psychopathology. CREST group exhibited significant improvements in emotion regulation (p=0.002) and social skills (p=0.014), besides a reduction in alexithymia (p<0.001) and cognitive rigidity (p=0.013). Empathic features remained stable. Participants reported positive perceptions of the CREST intervention. The study highlights the potential benefits of integrating emotional training within multidisciplinary intensive treatment for AN. Results emphasise the importance of treatment protocol with more affective and hot-cognition-related interventions, beyond weight-related psychopathology. Implementing a rolling-group CREST protocol in an inpatient setting showed promise in enhancing the emotional abilities of AN patients.

Osteopathic correction in complex rehabilitation of children who have undergone cochlear implantation

Introduction. Currently, the only way to rehabilitate patients with deafness is cochlear implantation (CI). CI includes not only surgery, but also rehabilitation carried out by a whole group of specialists. This is a multi- stage, labor-intensive, complex, long-term process of developing and maintaining speech function, so there is a constant search for new approaches and methods that could increase the effectiveness of ongoing rehabilitation measures. Previous studies have demonstrated that osteopathic correction in preschool children reduces the severity of speech disorders, contributes to the regression of speech therapy disorders, and helps in the correction of certain forms of dysarthria. Of particular interest is the work in which the authors demonstrated the existence of relationships between certain somatic disfunctions and the presence of disturbances in peripheral sound conduction and/or central sound conduction in children with sensorineural hearing loss. The question of the possibility of using osteopathic correction in the rehabilitation of children with pathologies of hearing and speech function (since, in addition to the consequences of highly invasive surgical intervention, children who have undergone CI, as a rule, have delayed speech development), seems promising for study.The aim was to study the results of the use of osteopathic correction in the rehabilitation of children who have undergone CI.Materials and methods. A randomized controlled prospective study was conducted from March 2022 to December 2022 on the basis of the Federal State Budgetary Institution RNTSCAiS FMBA of Russia, FSBI NMCIO FMBA of Russia. 36 children aged from 17 to 37 months were under observation. Depending on the treatment used, all observed patients were divided into 2 groups using a simple randomization method: main (20 people) and control (16 people). Patients in both the main and control groups received standard rehabilitation treatment. Each patient of the main group additionally underwent a single session of osteopathic correction lasting from 45 to 60 minutes. All patients were assessed for osteopathic status, time of connection and adjustment of the cochlear implant, and quality of life.Results. In children after CI, global neurodynamic disorders and regional biomechanical disorders in the regions of the head, neck, and dura mater were most often detected. After treatment, only patients in the main group showed a statistically significant (p&lt;0,05) decrease in the frequency of detection of both global neurodynamic and the above-mentioned regional biomechanical disorders. A single session of osteopathic correction contributes to a significant reduction in the time of connection and adjustment of the cochlear implant, which can be considered as a favorable factor for subsequent rehabilitation measures. Against the background of the ongoing rehabilitation, a statistically significant increase in the level of quality of life was obtained in both groups, however, in the main group this indicator was statistically significantly higher.Conclusion. For children who underwent CI, the most characteristic was the presence of a global neurodynamic disorder, as well as regional biomechanical disorders at the level of the head, neck and dura mater. A single session of osteopathic correction can significantly reduce the time of initial connection and adjustment of a cochlear implant, as well as improve the quality of life of this category of patients. This allows us to recommend the inclusion of osteopathic correction in comprehensive rehabilitation programs for children who have undergone cochlear implantation.

The use of postural balance restoration tools in the complex treatment of children with cerebral palsy

Physical rehabilitation of children with cerebral palsy (CP) requires long-term, systematic, individual and step-by-step use of a complex of tools to restore lost motor functions.&#x0D; All forms of cerebral palsy cause a violation of the body's balance control system, which is manifested by unsteady walking, unexpected falls, swaying, and impaired coordination of movements.&#x0D; The purpose of the study is to increase the effectiveness of comprehensive rehabilitation of patients with cerebral palsy in the late residual stage by using means of restoring postural balance.&#x0D; Research methods: analysis of special scientific and methodical literature; analysis of medical histories; assessment of the level of motor disorders (gross motor function classification system (GMFCS); assessment of the degree of change in muscle tone (modified Ashworth scale); assessment of balance function (Berg balance scale); methods of mathematical statistics.&#x0D; To achieve the goal, an examination of 20 children with cerebral palsy from 6 to 12 years of age with mainly spastic forms of cerebral palsy was carried out. Patients of the main group received standard rehabilitation treatment and classes on the balance beam and in the rehabilitation system "Spider" in combination with therapeutic gymnastics. The control group of patients received the standard rehabilitation treatment used in this rehabilitation facility. The standard rehabilitation program included therapeutic gymnastics, segmental-reflex massage, mechanotherapy.&#x0D; The impact of means of postural balance restoration in combination with existing methods of physical rehabilitation in children with cerebral palsy on coordination and movement disorders was studied.&#x0D; It has been established that complex therapy with the use of means for restoring postural balance can improve the rehabilitation of children with cerebral palsy, both in the older and younger age groups. According to all the conducted tests, positive dynamics were obtained.

REHABILITATION OF PATIENTS WITH CERVICAL AND LUMBAR SPINE INSTABILITY USING TYMO ROBOTIC STABILOMETRICAL PLATFORM.

Introduction. The musculoskeletal system plays a vital role in maintaining posture and facilitating human movement, with the muscles often subjected to significant stress. Stabilometry can be used for evaluating postural balance and aiding in rehabilitation. This study aimed to assess the efficacy of the TYMO robotic stabilometric platform for the rehabilitation of patients with cervical and lumbar spine instability.Participants and methods. The study was conducted on the stable platform TYMO (Tyromotion). The study included 30 healthy students (group 1), 28 patients with instability of the cervical vertebra, who underwent standard rehabilitation treatment (group 2), 28 patients with instability of the cervical vertebra, who additionally used with a stabiloplatform (group 3), 29 patients with with instability of the lumbar spine, who received standard rehabilitation treatment (group 4), 29 patients with instability of the lumbar spine, who were additionally treated with a stabiloplatform (group 5). Groups 3 and 5, alongside with standard rehabilitation treatment, received a 10-day course involving stabiloplatform training. The parameters of the Center of Force (COF) section and load distribution were analyzed. Results and Discussion. When analyzing the respective indices across all groups in various functional positions prior to the treatment, the values were significantly increased. The use of the stabiloplatform proved to be effective in the treatment of patients, leading to the normalization of these indices. Notably, its application yielded a lasting therapeutic effect, whereas conventional physiotherapeutic methods fell short in achieving a lasting impact. Conclusions: Patients with cervical or lumbar spine instability demonstrate impaired balance test indicators. Following a 10-day treatment regimen with traditional rehabilitation methods, improvements are observed across all indicators, but they do not fully restore to the control levels in all functional positions. Furthermore, after one month, indicators deteriorate in nearly all functional positions. Training using a stabiloplatform is an effective approach in the treatment of patients with cervical or lumbar spine instability, and its use demonstrates a sustained therapeutic benefit.

Wearable Integrated Volitional Control Electrical Stimulation Device as Treatment for Paresis of the Upper Extremity in Early Subacute Stroke Patients: A Randomized Controlled Non-inferiority Trial

ObjectiveTo investigate the effect of a wearable integrated volitional control electrical stimulation (WIVES) device that has been developed as more compact and simpler to use in daily life compared with conventional integrated volitional control electrical stimulation (IVES) devices. DesignRandomized controlled non-inferiority trial. SettingConvalescent rehabilitation ward. ParticipantsPatients with paresis of the upper extremity (UE) after early subacute stroke (N=20). InterventionsEligible patients were randomized to receive IVES treatment or WIVES treatment for 8 hours per day for 28 days in daily living, in addition to standard rehabilitation treatment. In both groups, the extensor digitorum communis on the affected side was the target muscle for stimulation. Main Outcome MeasurePrimary outcomes were assessed with Fugl–Meyer Assessment of the UE (FMA-UE) before and after treatment. Non-inferiority was determined with a specified margin of non-inferiority. ResultsTwenty patients completed the trial (IVES group: n=10, WIVES group: n=10). FMA-UE improved in both groups. The mean change in FMA-UE was 4.7 for the IVES group and 6.0 for the WIVES group (P>.05, 95% confidence interval: −6.73 to 4.13). The mean difference between the groups was 1.3, and the upper 95% confidence interval did not exceed the non-inferiority margin. ConclusionThe effectiveness of WIVES treatment is non-inferior to that of IVES treatment. As a portable device, IVES may facilitate the use of affected upper extremities in daily living and may help improve paresis of the UE.

Evaluation of osteopathic treatment of patients with distal tibia fractures in the late postoperative period

Background. The postoperative period is often accompanied by pain and limited mobility in the ankle joint. There is a need to evaluate the effectiveness of additional rehabilitation methods in the late postoperative period.&#x0D; Aim. Evaluation of the effectiveness of complex (standard + osteopathic) treatment compared with standard restorative treatment in patients with distal tibia fractures in the late postoperative period.&#x0D; Material and methods. In the course of a randomized study, patients in the late postoperative period (68 weeks after surgery; n=40) were divided into two groups: the main group (n=20) received a standard rehabilitation treatment regimen and osteopathic treatment (correction of identified somatic dysfunctions); the comparison group (n=20) only the standard rehabilitation treatment regimen. The amplitude of motion of the affected ankle joint was assessed using a goniometer, the level of pain in the affected ankle joint was assessed using a visual analogue scale, and the level of quality of life was assessed using the SF-36 questionnaire. Data are presented as arithmetic mean and standard deviation M (SD). When analyzing intergroup differences, the nonparametric MannWhitney test (U-test) was used; when analyzing intragroup differences, the nonparametric Wilcoxon test (W-test) was used. The critical level of statistical significance was taken as 5% (p=0.05).&#x0D; Results. The addition of osteopathic treatment to the standard scheme led to a significant decrease in the level of pain (0.3 points in the main group, 1.5 points in the comparison group; p=0.0026), an increase in the amplitude of active movements in the ankle joint (64.7 in the main group, 51.8 in the comparison group; p=0.000217), improvement in the quality of life physical functioning (an increase in the indicator in the main group by 39 points, in the comparison group by 26 points), general health (an increase in the indicator in the main group by 47 points, in the comparison group by 28 points).&#x0D; Conclusion. Combined treatment (standard plus osteopathic) improves the results of restorative treatment compared with standard therapy alone in patients with fractures of the distal tibia in the late postoperative period.

Feasibility and effects of cognitive–motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients: a randomized controlled pilot study

BackgroundPeople with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive–motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD.MethodsForty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1–4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effectsResultsAdherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time–group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2.DiscussionExergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted.Trial registration: The study has been registered at ClinicalTrials.gov (ID: NCT04872153).

Biofeedback method influence on motor function restoration in early rehabilitation period of noncardioembolic ischemic stroke patients

Study of motor function restoration in patients with non-cardioembolic ischemic stroke during early rehabilitation period is presented. The first group (n = 92) consisted of patients who received standard rehabilitation treatment with biofeedback trainings of electromyographic modality. The second group (n = 100) of patients received standard rehabilitation treatment. There were no significant differences between the compared groups by gender, age, stroke risk factors and severity of the condition at the rehabilitation treatment start. Biofeedback trainings significantly improved kynesiophobia and increased the proportion of patients with a mild degree of addiction in daily living.

Physiotherapists' experiences of internet-based neck-specific exercises for patients with chronic whiplash-associated disorders.

Neck-specific exercises for individuals with chronic whiplash-associated disorders (WAD) have shown promising results, but there is also a need for more efficient and flexible ways of rehabilitation, such as use of digital health tools. Understanding physiotherapists' experiences of an internet-based tool may help to improve digital tools within physiotherapy. The purpose of this study was to describe how physiotherapists' experience an internet-based neck-specific exercise program for patients with chronic WAD. This study has a qualitative design. Focus group discussions were held with physiotherapists who have been treating patients with chronic WAD, using an internet-based neck-specific exercises program in a randomized controlled multi-center trial in south and central Sweden. Three focus groups were held with three participants in each group. Phenomenography was applied as a research approach for data analysis. One main category was identified as "internet-based program as a complement to regular rehabilitation," with five descriptive sub-categories: (a) support in patient work; (b) usefulness based on a patient's prerequisites and preferences; (c) physiotherapist and patient interaction; (d) increasing efficiency in rehabilitation; and (e) enabling patient participation, autonomy and self-management. From a physiotherapy perspective, an internet-based program could work as a method of complementary support to the standard rehabilitation treatment for patients with chronic WAD, as long as it is interactive and adjustable to the individual. The internet-based program could lead to increased autonomy and self-efficacy, and save resources and time for physiotherapists and patients. Further, more research is needed to strengthen these digital tools within the healthcare system.

The effects of motor imagery on trapeziometacarpal osteoarthritis in women during the post-surgical immobilisation period: A protocol for a randomised clinical trial

Background: Trapeziometacarpal osteoarthritis is the second most frequent degenerative hand disease and is the most functionally debilitating. The condition presents in 66% of women over 55. Motor imagery (MI) training post-surgery could help reduce rehabilitation times. Method: It is an experimental, prospective, longitudinal, parallel arm randomised clinical trial. Participants were women over 50 years old on the surgical waiting list. The experimental group will undergo MI training during the 3-week post-surgical immobilisation period. The control group will receive standard rehabilitation treatment. Outcomes will be assessed four times throughout the study using the Disabilities of the Arm, Shoulder and Hand questionnaire, the Cochin Hand Function Scale questionnaire, the Visual Analogue Scale, goniometry, baseline pinch gauge, circumferential measurement (cm), the Modified Kapandji Index and the Kinaesthetic and Visual Imagery questionnaire. Discussion: Early MI could improve hand function leading to improvements in recovery times. Trial registration: Clinical Trials registration: NCT03815734. Ethics Committee approval: 17155. Project funded in 2021.

Structured Graded Lung Rehabilitation for Children with Mechanical Ventilation

Lung rehabilitation is safe and feasible, and it has positive benefits in weaning the machine as soon as possible, shortening the time of hospitalization and improving the prognosis of children with mechanical ventilation. However, at present, the traditional medical concept is deep-rooted, and doctors' understanding of early rehabilitation is inadequate. It is necessary to make in-depth exploration in the relevant guidelines and expert consensus to formulate standardized early rehabilitation diagnosis and treatment procedures and standards for mechanically ventilated children. In the paper, a structured graded lung rehabilitation program is constructed for children with mechanical ventilation to improve their respiratory function, shorten the time of mechanical ventilation and pediatric intensive care unit (PICU) hospitalization, and reduce their anxiety, based on the principal component analysis of functional pneumonia data. Scientific evaluation and dynamic monitoring ensure the safety of the implementation of the program and promote the prognosis and prognosis of the disease. The proposed lung rehabilitation program provides a reference basis for the formulation of lung rehabilitation guidelines for children with mechanical ventilation. And It has important reference significance for clinical pulmonary rehabilitation to alleviate the concerns of clinicians and lay the foundation for the large-scale promotion of early lung rehabilitation.

Objective assessment of the functional status of stroke patients: Can comprehensive rehabilitation treatment improve their functional efficiency?

Abstract Study aim: To check if the short rehabilitation treatment (3 weeks) complemented by complex rehabilitation on advanced equipment improves the functional status of chronic stroke patients; and which clinical and objective parameters can be used to assess the efficacy of such treatment. Material and methods: 28 patients 3 to 6 months after the stroke. They participated in 3 weeks rehabilitation program in Rehabilitation Hospital. This program was supplemented by rehabilitation on: Zebris treadmill, ALFA and GAMMA platform, Biodex Balance System SD, the Balance Tutor treadmill. Their functional status was assessed by: Scandinavian Stroke Scale (SSS), Timed-Up-And-Go test (TUG), balance tests on Zebris, instrumented gait analysis on BTS system. Results: The positive changes of the patients’ functional status were found in time of TUG test, in case of balance test for 95% of the ellipsoid area, lengths of major and minor axes of the ellipsoid, average sway speed, sway path length, total ground reaction force for left and right leg, and Gillette Gait Index in case of the gait analysis. Conclusions: The improvement of the functional status of chronic stroke patients after relatively short rehabilitation treatment was achieved, due to the addition to the standard rehabilitation treatment the program on the advanced technologically equipment.

Efficacy of Standardized Rehabilitation in the Treatment of Diastasis Rectus Abdominis in Postpartum Women.

PurposeThe incidence of diastasis rectus abdominis (DRA) in parturients is continuously increasing, which may cause uncomfortable and affect the quality of life. The present study aims to retrospectively summarize the experience and efficacy in the treatment of DRA via standardized rehabilitation procedures in Eastern China.MethodsThis retrospective study included the parturients with DRA admitted to the Xishan People’s Hospital of Wuxi between January 2017 and May 2021. Patients were separated into standardized rehabilitation group (SR) and non-standardized rehabilitation group (non-SR). The outcomes were the change in rectus abdominis separation and Physical Functioning Scale (PFS). Measurement data were compared between the two groups, and multivariate linear regression was used to analyze the factors associated with the standardized rehabilitation process. P values < 0.05 were considered statistically significant.ResultsAmong a total of 294 patients with DRA who were included in the study, 171 patients were treated with SR (SR), and the other 123 patients were treated without SR process (non-SR). Compared with non-SR, the separation of the rectus abdominis was significantly reduced in SR after standardized rehabilitation treatment (p value < 0.0001). The multiple linear regression model analysis results suggested that standardized rehabilitation was an independent factor influencing the prognosis of DRA in parturients (p < 0.0001). In addition, the quality of life of the study group was significantly improved (p < 0.0001).ConclusionStandardized rehabilitation method revealed high efficiency in treating DRA in postpartum women and could improve the quality of life of parturients.

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study.

Objective: The aim of this pilot randomized clinical trial was to test the feasibility and efficacy of an exergame-based cognitive-motor training program in geriatric inpatients.Methods: The study participants were randomly allocated to either the exergame intervention group or the control group. The control group received the standard rehabilitation treatment offered in the clinic. In addition to the standard rehabilitation program, the intervention group conducted supervised exergame training on 5 days per week using the Dividat Senso, an exergame system specifically designed for older adults. The primary outcome was feasibility, as measured by e.g., adherence rate, attrition rate, occurrence of adverse events, System Usability Scale (SUS) and NASA-TLX score. Secondary outcomes included measures of physical and cognitive functioning such as comfortable walking speed, maximal walking speed, dual task walking speed, Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), Color-Word Interference test (D-KEFS), Trail Making test A and B (TMT), Go/No-Go test and Step Reaction Time test (SRTT). All secondary outcome measures were assessed pre- and post-intervention.Results: Thirty-nine persons were included in the study. Average adherence rate was 99%, there were no intervention-related dropouts and no adverse events. The mean System Usability Scale (SUS) score was 83.6 and the mean NASA-TLX score 45.5. Significant time-group interaction effects were found for the dual task walking speed, the Go/No-Go test and Step Reaction Time test (SRTT).Conclusion: Exergaming is a feasible, safe and effective cognitive-motor training approach in inpatient rehabilitation of geriatric patients. Incorporating exergaming in the rehabilitation program of geriatric patients offers potential to reduce fall risk factors and to increase patients’ exercise motivation and rehabilitation success.

Impact of yoga and physical exercise on psychological wellbeing among substance abusers: a randomized controlled trial.

Substance use disorder is a pattern of recurrent use of illicit substances that leads to severe psychosocial imbalance and recurrent relapse. The study was to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing psychological wellbeing, compared with physical exercise among substance abusers. In this randomized controlled study, 96 male participants with substance use disorder from a residential rehabilitation treatment center, Kathmandu, Nepal, were randomly allocated into two groups namely the yoga group (n=48, mean age±SD=25.18±6.43) and the physical exercise group (n=48, mean age±SD=25.02±5.02). The participants in the yoga group attended the 90min yoga sessions for 12weeks (sixdays per week) whereas the physical exercise group attended exercise sessions for the same duration. Above mentioned interventions were in addition to standard rehabilitation treatment. The study measured the Self-Control, Anxiety, Depression, Sleep parameters, and Mindfulness at the baseline and after 12weeks of intervention. A significant enhancement in self-control was observed in both the yoga (p<0.033, d=0.33) and the exercise group (p<0.038, d=0.32). Yoga group showed significant improvement in mindfulness score (p<0.017, d=0.37), whereas exercise group did not show any significant changes in mindfulness (p<0.169, d=0.21). The depression and anxiety scores reduced significantly in both yoga (p<0.044, d=0.31; p<0.025, d=0.35 resp.) and exercise (p<0.032, d=0.34. p<0.039, d=0.32. resp.) group. Furthermore, significant reduction was seen in sleep disturbance after yoga (p<0.001, d=0.52) and exercise (p<0.001, d=0.78) intervention. The sleep- somnolence score reduced significantly only in yoga group (p<0.020, d=0.36). The magnitude of improvement was higher in the yoga group than physical exercise group on self-control, mindfulness, depression, anxiety and some sleep parameters, however the between group differences could not reach to the level of significance. The 12week yoga intervention did not appear to be significantly more effective than the 12week physical exercise program on psychological wellbeing in male participants with substance use disorder. However, greater improvement in psychological wellbeing was observed within the yoga group. In future, a multi-centric study with robust design, larger sample size and longer follow-up is required to conform the present results and to find out the difference between the impacts of yoga and physical exercise on psychological wellbeing in substance abusers.

A novel model of home-based, patient-tailored and mobile application-guided cardiac telerehabilitation in patients with atrial fibrillation: A randomised controlled trial

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group (n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P < 0.01) and the control group (n = 48) (baseline vs 12 weeks: 18.7 ± 4.9 vs 22.9 ± 6.3 ml/(min kg), P < 0.01). The results of the between-group analysis of aerobic capacity were significantly in favour of the intervention group. During the 12-week program, patients in the intervention group exhibited better adherence than those in the control group. Moreover, self-reported physical activity improved more in the intervention group than in the control group, as did the beliefs related to cardiovascular disease and exercise self-efficacy (all P < 0.01). Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation.

Сравнительная оценка показателя микрокристаллизации ротовой жидкости у пациентов с фурункулом челюстно-лицевой области и шеи при различных подходах к послеопрационному лечению

The purpose of the study is to study the index of microcrystallization of oral fluid in patients with boils of the maxillofacial region, to carry out a comparative assessment of the effectiveness of postoperative treatment of this disease using a standard rehabilitation treatment and the same treatment combined with electroacupuncture (EAT). Materials and methods. We observed 40 patients with boils of the maxillofacial region aged 18-58 years old who were divided into two groups of 20 people in each group after primary surgical treatment (PST) of the infectious and inflammatory focus. Group 1 received a standard anti-inflammatory therapy in the postoperative period. In group 2, the standard treatment was combined with electroacupuncture. The study involved 20 practically healthy people (a control group). The microcrystallization index (MCI) was determined by the method of I.O. Pohodenko-Chudakova, Yu.M. Kazakova, N.D. Pokhodenko (2011). In the control group, the microcrystallization index was determined once, in groups 1 and 2 – twice (at the patient's admission to the hospital and on the 10th day after the primary surgical treatment). The obtained data was processed statistically using the package of application tables "Statistica 10.0" Results and discussion. In the control group, type I of microcrystallization was determined in 72 (40.0%) quadrants, type II – in 98 (54.4%) quadrants, and type III – in 10 (5.6%) quadrants. In group 1 patients in the 1st study, type I of microcrystallization was in 17 (9.4%) quadrants, type II – in 53 (29.5%) quadrants, and type III – in 110 (61.1%) quadrants. In group 2, type I of microcrystallization was detected in 11 (6.1%) quadrants, type II – in 49 (27.2%) quadrants, and type III – in 120 (66.7%) quadrants. On the 10th day of the follow-up period in patients of group 1, type I of crystal formation was determined in 66 (36.7%) quadrants, type II – in 75 (41.7%) quadrants, type III – in 39 (21.6%) quadrants. During the same follow-up period, type I was found in 66 (36.7%) quadrants, type II – in 93 (51.7%), and type III ‒ in 21 (11.6%) quadrants. The microcrystallization index value of group 1 decreased during standard treatment, but it didn’t have directed signs (χ2=7.0; p=0.316). The microcrystallization index in the 2nd study was significantly different from the control (U=0.0; p &lt;0.001) and therefore did not reach the normal values. According to the data of group 2, the revealed positive dynamics had directed signs (χ2=20.0; p &lt;0.001). The microcrystallization index at the end of treatment had no significant differences with the control (U=99.5; p=0.007). Conclusion. The study proves the advantage of the results of treatment of a group of patients who were treated with electroacupuncture as well as the possibility of using the microcrystallization index of oral fluid both for diagnosing the severity of the general condition of a patient with a boil of the maxillofacial region and predicting the course of the disease

Hand rehabilitation with sonification techniques in the subacute stage of stroke

After a stroke event, most survivors suffer from arm paresis, poor motor control and other disabilities that make activities of daily living difficult, severely affecting quality of life and personal independence. This randomized controlled trial aimed at evaluating the efficacy of a music-based sonification approach on upper limbs motor functions, quality of life and pain perceived during rehabilitation. The study involved 65 subacute stroke individuals during inpatient rehabilitation allocated into 2 groups which underwent usual care dayweek) respectively of standard upper extremity motor rehabilitation or upper extremity treatment with sonification techniques. The Fugl-Meyer Upper Extremity Scale, Box and Block Test and the Modified Ashworth Scale were used to perform motor assessment and the McGill Quality of Life-it and the Numerical Pain Rating Scale to assess quality of life and pain. The assessment was performed at baseline, after 2 weeks, at the end of treatment and at follow-up (1 month after the end of treatment). Total scores of the Fugl-Meyer Upper Extremity Scale (primary outcome measure) and hand and wrist sub scores, manual dexterity scores of the affected and unaffected limb in the Box and Block Test, pain scores of the Numerical Pain Rating Scale (secondary outcomes measures) significantly improved in the sonification group compared to the standard of care group (time*group interaction < 0.05). Our findings suggest that music-based sonification sessions can be considered an effective standardized intervention for the upper limb in subacute stroke rehabilitation.