Subsequent Rehabilitation Research Articles

Clinical Observation of VR Virtual Reality Rehabilitation Training Combined with Acupuncture in the Treatment of Mild Cognitive Impairment.

Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia, and its symptoms include easy forgetting, distraction, and mental deterioration. This directly affects the patient's motor function, daily living ability, and social adaptability, and brings many difficulties to the patient's reintegration into society. Therefore, clinical research on MCI is very necessary. The purpose of this paper is to study the efficacy of acupuncture and moxibustion in the treatment of MCI based on VR virtual reality technology. This paper firstly expounds the application prospect of VR virtual reality rehabilitation training and virtual scene intervention in MCI patients. It then introduces the characteristics of acupuncture and the acupuncture points of scalp acupuncture and eye acupuncture. This paper then establishes the algorithm model of the VR virtual reality rehabilitation training system, which lays a solid foundation for the design of the subsequent rehabilitation training system. This paper then conducts clinical experiments and analysis on the treatment of mild cognitive impairment, which establishes a treatment group and a control group for comparative experiments. The experimental results showed that the combined effect size OR=2.74 of the meta-analysis, the combined effect size test statistic Z=3.38, WMD=2.42, and the 95% CI was (1.98, 3.06). It indicated that the treatment group had better efficacy. The MMSE score and MoCA score of the treatment group after treatment and training increased by 28.68% and 15.36%, respectively, and the scores were higher than those of the control group. Therefore, the use of VR virtual reality technology combined with acupuncture is of great significance for the rehabilitation and treatment of patients with mild cognitive impairment.

Dental Rehabilitation After Microvascular Reconstruction of Segmental Jaw Defects: A Ten-Year Follow-Up.

Background/Objectives: Defects in maxillary and mandibular continuity are common in maxillofacial practice. They can occur after trauma, osteonecrosis, congenital jaw deformities, or surgical resection of benign or malignant tumours. Reconstruction with microvascular bone flaps and subsequent prosthetic rehabilitation is considered the contemporary first line treatment. This study assessed the extent to which the underlying disease influences the treatment course of microvascular segmental jaw reconstruction. Methods: A retrospective review of prospectively collected data from all patients who underwent microvascular segmental jaw reconstruction from January 2011 to December 2020 was completed. The course of treatment as well as the process of dental rehabilitation was assessed. Results: Two hundred patients were included in the study. A total of 15.5% of patients were fitted with a conventional removable prosthesis, and implant-supported prosthetic restoration could be realized in 53.5% of patients. However, dental rehabilitation was not possible in 31.0% of patients. The outcomes of prosthetic restoration showed a statistically significant difference between the different underlying diseases (p < 0.0001). About 50% of patients with malignant diseases and osteonecrosis remained without dental rehabilitation. In contrast, more than 90% of patients with jaw continuity defects, due to benign diseases or malformations, were able to receive an implant-supported prosthesis. Among the diagnostic groups, there was a significant difference regarding the number of implants placed (p < 0.0001). There was a significant correlation between increased incidence of complications and the size of the bone flaps. Conclusions: The underlying disease influenced significantly the treatment course and the outcome of dental rehabilitation after microvascular jaw reconstruction.

Effectiveness of Perioperative Finger Sensory Rehabilitation in Patients Undergoing Fingertip Amputation and Reimplantation: A Retrospective Study.

Finger reimplantation is an effective method for the treatment of amputated fingertips. However, there are several shortcomings in traditional postoperative rehabilitation programs, which may affect a patient's functional recovery after surgery. Finger sensory rehabilitation is a comprehensive program that helps patients restore sensory and motor function to their fingers through the use of specific training methods and equipment. Thus, this study aimed to analyze the effect of finger sensory rehabilitation on a group of patients who had undergone fingertip amputation and reimplantation. The medical records of 106 patients having undergone fingertip amputation and reimplantation from January 2022 to January 2024 were retrospectively analyzed. The patients were classified into experimental group (n = 52, receiving conventional rehabilitation training + finger sensory rehabilitation training) and the control group (n = 54, receiving only conventional rehabilitation training). Patients in both groups participated in a 20-week rehabilitation training, and the Semmes-Weinstein monofilament test was used to evaluate the finger touch pressure sensation after completing the rehabilitation training in both groups, and the Visual Analogue Scale (VAS) score, Generic Quality of Life Inventory-74 (GQOLI-74) score to evaluate their pain sensation and quality of life on the 2nd postoperative day and at the end of rehabilitation training. After completing rehabilitation, a specialized method for assessing the patient's tactile sensory deficits was used, showing that the number of cases with light tactile hypoesthesia to single-fiber sensation in the reimplanted fingertips was higher in the experimental group than in the control group (p < 0.01), while there was no significant difference in the number of cases of protective hypoesthesia between the two groups (p > 0.05), the number of cases of protective sensory loss was significantly lower in the experimental group than in the control group (p < 0.01). There was no significant difference in the pain scores and comfort scores between the two groups before management (p > 0.05). However, the pain level of the two groups after management was significantly lower than that before management (p < 0.01), whereas the post-management comfort scores of both groups were significantly higher than that before management (p < 0.001). The experimental group's degree of improvement was significantly higher than that of the control group (p < 0.001). The pre-management GQOLI-74 scores were not significantly different between the groups (p > 0.05), whereas after management, the experimental group outperformed the control group in all dimensions of the scores, except in thinking ability (p < 0.01). Although not statistically significant (p > 0.05), the total perioperative complication rate of the experimental group was lower than that of the control group. The implementation of finger sensory rehabilitation training is effective for restoring tactile function, reducing pain levels, and improving quality of life among patients who had undergone fingertip amputation and reimplantation. This finding can inform the development and selection of subsequent rehabilitation programs.

Comprehensive management of complex resorptive lesions: Report of two cases

Abstract In the field of endodontics, the management of complex resorptive lesions demands innovative and precise interventions. This report delineates the comprehensive management of two distinct cases, each presenting unique challenges. The first case involved a 23-year-old male with hypothyroidism, presenting with pain and external cervical resorption with internal communication in his lower left front tooth. The case was diagnosed with pulp necrosis and asymptomatic apical periodontitis. The second case involved a 26-year-old female in good health, dissatisfied with the cosmetic appearance, and experiencing occasional pain from a previously treated upper front tooth with concurrent external apical and internal resorption. It was diagnosed as previously treated, with symptomatic apical periodontitis. These cases were notable for their complexity and the tailored approach to diagnosis and treatment, employing advanced techniques and materials, such as bioceramic materials, for optimal outcomes. The first case was approached through conventional endodontic disinfection, flap reflection, and the meticulous external management of the resorptive defect with bioceramic material, followed by restorative procedures. The second case required retreatment, including wide canal management, apex negotiation, and the establishment of an apical plug with bioceramic material, culminating in backfilling with thermoplasticized gutta-percha and subsequent prosthetic rehabilitation. Remarkably, both cases demonstrated successful healing and patient satisfaction at a 6-month follow-up, with radiographs and photographs evidencing the desired clinical outcomes. This report highlights the necessity of adaptability, precision, and the integration of innovative materials and techniques in endodontic practice to effectively address complex resorptive lesions. It underscores the significance of a comprehensive diagnostic and treatment framework that can guide clinical decision-making and enhance procedural outcomes in similar challenging scenarios. It contributes valuable insights and reinforces the imperative of detailed management in endodontic complexities.

EXPERIENCE OF TREATING OF SHOULDER JOINT ADHESIVE CAPSULITIS TREATMENT

This paper summarizes the experience of treating 59 patients with adhesive capsulitis of the shoulder joint. The observation period was 2 years. Rationale of choosing a method of treatment and a methodology of conservative treatment of adhesive capsulitis of the shoulder joint by intra-articular injection of corticosteroids in the projection of the anteriorupper arthroscopic access and subsequent exercise therapy and physical rehabilitation are described. As a result of the study, it was found that in 94% of patients treated for adhesive capsulitis there was a complete relief of adhesive capsulitis symptoms after 3 months from the start of the treatment, a full range of motion was achieved.

The Role of PDZ in Cerebral Ischemia

Cerebral ischemia is a widespread disease and a leading cause of death and disability worldwide. Its complex origins and the mysterious mechanisms behind its development make it a formidable adversary in the field of medicine. PDZ proteins are part of the human proteome with multiple functions and have been identified as key mediators of cell signaling and synaptic transmission. Their interactions with PDZ-binding proteins underlie their role in the pathogenesis of a variety of diseases. In this paper, PDZ domains have been extensively studied, exploring their structural properties and functional roles in cells. This review highlights the importance of these domains in signal transduction pathways, which are essential for the normal function of the nervous system. It also highlights emerging evidence linking PDZ proteins to the regulation of angiogenesis in cerebrovascular diseases, a key process in the development of ischemic disease. In addition, we further discuss the potential of PDZ proteins in neuronal regeneration, an area that is expected to play a role in stroke development and subsequent rehabilitation. This review also discusses the link between PDZ proteins and excitatory synaptic transmission, further exploring the mechanisms involved in excitatory toxicity. By analyzing the complex relationship between PDZ proteins and their binding partner, this paper aims to reveal the molecular basis of cerebral ischemia. This suggests that a deeper understanding of these interactions could pave the way for innovative therapeutic interventions for stroke management. The review concludes by advocating continued research into PDZ proteins, recognizing their potential as building blocks for the development of new treatment and prevention strategies for stroke and related disorders.

Legg-Calvé-Perthes Disease in Clinical Case Studies in Dogs

Abstract Legg-Calvé-Perthes disease (LCPD) is a degenerative disorder of the femoral head bone with a genetic basis which generally occurs in predisposed small dog breeds (up to 12 kg) at a young age (4–10 months). The aim of this study was to present an overview of this disease, the most common clinical symptoms and to describe methods of diagnosis and therapy of LCPD in dogs. This involved a follow-up of patients, dogs (n = 43; 20 males and 23 females) brought to the veterinary clinic in Hungary with suspicion of LCPD, where they were subjected to clinical, orthopaedic and radiographic examination and then to the most suitable conservative or surgical treatment. The most characteristic clinical symptom – lameness ‒ expressed by lameness grade (from 1 to 5), was monitored in all patients, especially those with grade 4 (n = 26). Additional clinical symptoms, such as response to manipulation (n = 42), pain on palpation (n = 33), weight-bearing (n = 2), muscle atrophy (n = 17) and crepitation (n = 24), were checked in the dogs. The prevalence of the unilateral form of LCPD in the pelvic limbs was observed in 38 patients (88.37 %) and the bilateral LCPD form appeared in 5 patients (11.63 %). Based on the Ljunggren’s score the degree of hip joint damage was observed in most LCPD patients with score 4 (n = 22; 51.10 %). Following the diagnosis, it was necessary to decide on the therapy, conservative or surgical (ostectomy), with elimination of painful symptoms and subsequent long-term postoperative rehabilitation as well as the improvement of the patient’s health status.

Comprehensive rehabilitation of patients after injuries of the facial region: interaction of dentists and surgeons

This work highlights in detail modern approaches to the comprehensive rehabilitation of patients who have suffered injuries to the maxillofacial region, which can significantly affect the quality of life, causing functional disorders such as problems with chewing, speech and breathing, as well as significant aesthetic defects. Injuries in this area require the participation of specialists from different fields, and in this context, special attention is paid to the interaction of dentists and maxillofacial surgeons. Comprehensive rehabilitation includes several key stages: surgical treatment, restoration of bone and soft tissue structures, orthopedic and orthodontic treatment, as well as aesthetic correction. The need for close cooperation between the surgeon and the dentist is emphasized at all stages of treatment, from the initial diagnosis of injuries and treatment planning to surgical interventions and subsequent dental rehabilitation. Modern methods of surgical correction, such as osteosynthesis, reconstruction of bone defects using bone grafts and implants, as well as the use of new biomaterials, are discussed. Dental rehabilitation includes occlusion restoration, dental prosthetics and bite correction, which requires careful planning and consideration of surgical aspects. The issues of functional rehabilitation of patients, such as restoration of chewing function, proper articulation and facial aesthetics, are also considered. Special attention is paid to new technologies and innovative approaches, such as 3D modeling, digital surgery planning and the use of dental implants, which allow achieving high results in restoring both functionality and appearance of the patient. The article focuses on the importance of coordinated work of an interdisciplinary team to achieve the best results in the rehabilitation of patients after maxillofacial injuries. The authors emphasize that an integrated approach, including the interaction of specialists of different profiles, provides a more effective restoration of functions and aesthetics, which significantly improves the quality of life of patients.

Abnormal gait recognition with millimetre‐wave radar based on perceptual loss and convolutional temporal autoencoder

AbstractWalking is fundamental to normal human life. However, many people suffer from walking impairments due to various diseases that may severely affect their daily activities. Early detection of an abnormal gait can aid subsequent treatment and rehabilitation. This paper proposes a novel abnormal gait recognition method based on a perceptual loss convolutional temporal autoencoder (PLCTAE) network. It comprises upstream and downstream tasks, both of which utilise radar micro‐Doppler spectrograms as inputs. The upstream task employs a convolutional autoencoder with the perceptual loss to encode and decode micro‐Doppler spectrograms, achieving unsupervised pretraining and obtaining the initial parameters for the convolutional part of the PLCTAE. The downstream task fine‐tunes the convolutional part of the PLCTAE through supervised training to extract spatial features from the micro‐Doppler spectrograms and incorporates a bidirectional long short‐term memory (BiLSTM) network to further extract temporal features, accomplishing the task of abnormal gait classification. The experimental results demonstrate that the proposed method achieves good classification performance on the self‐established dataset which is collected by Texas Instruments' IWR6843ISK millimetre‐wave radar and contains eight types of abnormal gaits. The generalisation performance is also validated on a public dataset from the University of Glasgow containing six types of human activities.

A case of a fifteen-year-old patient suffering from rare adenocystic lung carcinoma bronchoplastic surgery

Adenoid cystic carcinoma of the lung is a relatively rare malignant tumor, accounting for 0.04–0.2 % of all primary malignant tumors of the respiratory system. This carcinoma can occur at any age, but it is more common in the 40–60 age group and usually in women. The main treatment method for adenoid cystic carcinoma is surgical. Since tumors of this histological form are often centrally located, options for bronchoplastic operations are considered. In childhood, adenoid cystic carcinoma is extremely rare, and performing bronchoplastic lobectomies in children is associated with several difficulties, such as the smaller diameter of the bronchi compared to adult patients, complicating surgical intervention and subsequent rehabilitation. This clinical case demonstrates the experience of performing a bronchoplastic operation on a 15-year-old patient at the Department of Thoracic Oncology of the National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation. The patient was hospitalized complaining of prolonged cough, shortness of breath, and chest pain. Adenoid cystic carcinoma of the central type was identified during diagnostics, which included bronchoscopy, computed tomography, and biopsy. The surgical intervention involved performing a bronchoplastic lobectomy, during which the affected lobe of the lung was removed with resection and reconstruction of the bronchus. The operation was performed taking into account the anatomical features of the child's body, which required high precision and surgical skills. The postoperative period proceeded without significant complications, and the patient was under the supervision of a multidisciplinary team of specialists.This clinical case provides a detailed description of the results of preoperative diagnostic measures, the stages of the operation, and the postoperative follow-up results. Special attention was paid to the difficulties associated with the small diameter of the bronchi in children, which required the use of specialized instruments and techniques. The importance of using modern diagnostic and treatment methods, as well as close interdisciplinary interaction, is emphasized for a successful treatment outcome.The experience of performing such operations in childhood is extremely important for improving the quality and safety of surgical treatment of adenoid cystic carcinoma and other rare tumors in children. Further observations will be described in stages.

Cognitive recovery of post critical care patients with and without COVID-19: differences and similarities, an observational study

BackgroundCoronavirus disease (COVID-19) patients treated in an intensive care unit (ICU) are at high risk of developing cognitive impairments of a “post-intensive care syndrome” (PICS). We explored whether critically ill COVID-19 and non-COVID-19 survivors differ in their post-ICU recovery course in terms of severity and affected cognitive domains.MethodsAn observational prospective study was conducted in a German post-acute neurological early rehabilitation clinic. Critically ill patients with or without SARS-CoV-2 infection (at least mechanically ventilated for one week) underwent repeated standardized assessments during their subsequent inpatient rehabilitation stay. Cognitive functions (information processing speed, learning, recognition, short-term and working-memory, word fluency, flexibility) assigned to different domains (attention, memory, executive functions) were assessed as primary outcome. Secondary outcomes included mental (depression, anxiety) and physical (Barthel index, modified ranking scale) state.ResultsOut of 92 eligible patients (screened between June 2021 and August 2023), 34 were examined, and 30 were available for analysis (15 per group). Both groups were ventilated for a similar period (COVID-19 vs. Non-COVID-19: median: 48 vs. 53 days). Patients of COVID-19 group spend on average 10 days longer at ICU and developed slightly more complications, but subsequent inpatient rehabilitation was of comparable duration (median: 36.5 vs. 37 days). On the group-level both groups showed similar cognitive dysfunctions with striking impairments (normative T-scores < 41) in information processing speed, word fluency, flexibility, and recognition memory on admission. Significant gains until discharge were only revealed for information processing speed in both groups (main effect visit, mean difference [95%CI] − 7.5 [− 13.1, − 2.0]). Physical and mental state were also similarly affected in both groups on admission, but improved over time, indicating that overall recovery for higher-order cognitive functions is slowest. Interestingly, majority of patients stated correctly being still physically disabled, while a discrepancy was found between subjective and objective evaluation of cognitive health.ConclusionsResults suggest a substantial overlap of cognitive, mental and physical dysfunction in post-acute recovery of ICU survivors independent of SARS-CoV-2 infection which warrants further monitoring to reduce the risk of long-term burden and enable a return to previous functionality.Trial registrationRetrospectively registered at https://drks.de/search/de/trial/DRKS00025523, 21.06.2021.

Quality of Life After Microvascular Alveolar Ridge Reconstruction with Subsequent Dental Rehabilitation

Background/Objectives: Defects in maxillary and mandibular alveolar ridges are common in maxillofacial practice. Reconstruction with microvascular bone grafts and subsequent prosthetic rehabilitation is the gold standard treatment. This study investigated patients’ quality of life (QoL) after microvascular alveolar ridge reconstruction with subsequent dental rehabilitation. The effect of the underlying disease and success rates of the prosthetic treatment on QoL were analysed. Methods: OHIP-49 was used to evaluate oral health-related QoL (OHrQoL). The SF-36 was used to assess disease-nonspecific QoL. Results: Fifty-eight patients were enrolled and divided into four diagnostic (malignancy, osteoradionecrosis, benign disease, and cleft palate) and five prosthetic groups (no prosthetics, removable partial dentures, complete dentures, implant-supported removable dentures, and implant-supported fixed dentures). There was a significant difference between the diagnostic groups in the total score of their OHIP-49 (p = 0.008). Patients with malignant disease and osteoradionecrosis had worse QoL scores than those with benign diseases and cleft palate. Implant-supported prostheses had the best OHrQoL. Removable partial dentures and patients in whom dental rehabilitation was not possible had the worst OHrQoL (p = 0.042). The SF-36 subscale score showed no statistically significant differences between the diagnostic and prosthetic groups (p &gt; 0.05). Conclusions: OHrQoL after microvascular alveolar ridge reconstruction differs significantly based on underlying diagnoses and prosthetic restorations. Benign diseases and implant-supported dentures have the highest scores.

Tratamento endodôntico em dentes decíduos associado à reabilitação oral estética e funcional: relato de caso

Pediatric dentistry is an area within dentistry dedicated to oral health care for babies, children and even teenagers. The main focus of this specialty, as well as the focus of this work, is to promote awareness about the importance of creating healthy habits for children and maintaining the deciduous tooth in the alveolus until it is naturally replaced by permanent teeth. Endodontic treatment is usually proposed for two main causes: caries and dental trauma, which is very common in early childhood. The objective of this work was to carry out an endodontic treatment in deciduous teeth (51 and 61) and subsequent aesthetic rehabilitation of elements 51, 61, 52, 62 with composite resin. It can be concluded that the rehabilitation of the anterior deciduous teeth was extremely important from the aesthetic, functional and psychological point of view of the child. The use of maneuvers such as endodontics in deciduous teeth as well as the association of restorations with composite resins became a viable alternative in this clinical case, allowing the reestablishment of form, function and aesthetics.

Impact of prosthodontic rehabilitation on psychological status and quality of life in maxillectomy patients of coronavirus disease 2019-associated mucormycosis at a tertiary care center: A prospective clinical study

Aims: The study was aimed to evaluate the effect of prosthodontic rehabilitation on psychological status (PS) and quality of life (QoL) in maxillectomy patients of coronavirus disease 2019-associated mucormycosis (CAM). Settings and Design: The study was designed as a prospective and clinical study. Materials and Methods: Twenty-four CAM patients undergoing maxillectomy and subsequent prosthetic rehabilitation were included. The treatment involved surgical, intermediate, and definitive obturator delivery at various phases of healing. PS was assessed using the Hospital Anxiety and Depression Scale (HADS), QOL using the European Organization for Research and Treatment of Cancer QoL Questionnaire-Head and Neck Module (EORTC QLQ-HandN35), and the functioning of obturator was assessed utilising the Obturator Functioning Scale (OFS) at various time points: before maxillectomy (T1), 2 weeks after maxillectomy (T2), 2 weeks upon usage of intermediate obturator (T3), just before delivery of definitive obturator (T4), and 12 weeks after the usage of definitive obturator (T5). Statistical Analysis Used: Data were analyzed using a social science statistical analysis program (Stata 14.0; StataCorp LLC, Texas, USA). The significance level was chosen &lt;0.05. Shapiro–Wilk test was used to assess the normality of quantitative data. Student’s t-test was employed (α =0.05) to evaluate if the patient’s PS, QOL, and obturator function had changed over time. The Spearman correlation coefficient (α =0.05) was utilized to evaluate the correlation coefficient between PS, QOL, and obturator function seen at T3 and T5. Results: Out of 24 enrolled patients, nine were dropped out. HADS-anxiety score was the highest at T1 (18.6 ± 1.2) and HADS-depression score was the highest at T2 (18.8 ± 1.6). HADS scores decreased significantly (P = 0.001) after prosthetic rehabilitation. EORTC QLQ-HandN35 score was the highest at T2 (105.8 ± 29.5), with statistical significance (P = 0.001) after rehabilitation. OFS was the highest at T3 (51.9 ± 3.9) and lowest at T5 (25.4 ± 2.8). Conclusion: CAM and maxillectomy deliberately affects the PS and QOL. Prosthetic rehabilitation, psychological motivation, and education create greater improvement in PS and QOL. The progress in parameters showed an upward trend with good obturator quality over a period of time.

FOLLOW-UP OF PATIENTS WITH POST COVID-19 CONDITION AFTER A MULTIDISCIPLINARY TEAM ASSESSMENT: A PILOT STUDY.

To follow up patients with post-COVID-19 condition (PCC) 6 months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave. A prospective pilot study conducted in a clinical setting of patients (n = 22) with PCC referred from primary healthcare to a specialist clinic for a 2 day-multidisciplinary team assessment followed by a subsequent rehabilitation plan. Data were collected through questionnaires filled in prior to the team assessment and 6 months later. Fifteen of the initial 22 patients participated in the follow-up. No statistically significant improvements were seen in any of the questionnaires after 6 months. However, 76.9% of the participants perceived the intervention as being helpful. This differed between the genders, where all the women 100% (n = 8) perceived it as being helpful, compared with 40% (n = 2) of the men (p = 0.012). Based on these findings, the benefit of a multidisciplinary team assessment of PCC is not fully convincing. However, since the participants themselves perceived the intervention as being helpful, the team assessment seems to be of some value. Further studies with larger populations would be of interest.

A 10-point preoperative checklist: selecting patients for outpatient joint replacement surgery

BackgroundWith advancements in perioperative care, joint replacement (JR) surgery is undergoing a transition from opacified in-patient institutions to nimble out-patient Ambulatory Surgical Centers (ASC). The goal of JR in ASC setting is safe patient discharge with subsequent rehabilitation without readmission. Multi-modal preoperative rehabilitation (MMPR) is a novel field of perioperative care, encompassing comprehensive parameters to ensure smooth transition from fitness for surgery to JR in outpatient setting. At present, there are no open-access schemes for selecting patients qualified for JR in the ASC setting. In this article, we propose an evidence-based, 10-point systematic evaluation of patients with target endpoints for MMPR to qualify patients for JR as an outpatient procedure. This checklist is a non-proprietary scheme serving as an initial framework for surgeons exploring surgery in the ASC setting.BodyWe introduce factors for a prehabilitation scheme, called Checklist Outpatient-Joint Replacement (CO-JR) to qualify patients for outpatient JR surgery. These factors have been developed based on an extensive literature review and the significant experience of authors to incorporate variables that drive a successful outpatient JR procedure. The factors include patient education, psychiatric & cognitive ability, medical fitness, musculoskeletal capability, financial ability, transportation access, patient motivation, information technology (IT) capabilities, along with ability to recover independently at home postoperatively. The CO-JR scheme is under the process of validation at multiple institutions. We introduce this as a starting point for collaborative development of an open-access scheme for all surgeons to learn and adapt as needed for their respective global region.ConclusionWe established a non-proprietary 10-point CO-JR scheme, serving as a framework for surgeons to successfully select patients for JR surgery in the ASC setting. We encourage concomitant validation of this scheme globally. Our goal is to reach an international consensus on an open-access scheme, available for all surgeons to enrol patients for JR in the ASC setting, but modifiable to accommodate regional needs.

Immediate versus conventional loading in short and ultra-short implants: a protocol design.

After tooth extraction, inevitable resorption of the postextraction socket occurs. Placing an immediate implant does not fully preserve the bone integrity of the socket. Preservation techniques cannot avoid alveolar resorption. In residual atrophies, bone augmentation techniques are necessary for subsequent rehabilitation with implants. The aim of this study was to propose a protocol of immediate loading in short implants as an alternative to bone augmentation techniques, comparing the immediate versus conventional loading, evaluating peri-implant bone loss, the biological and prosthetic complications, the survival of the implant and prosthesis and the patient satisfaction after one year. This study consists of a randomized controlled clinical trial. For implant planning, periapical intraoral radiographs and Cone Beam Computed Tomography will be used. All patients will receive Straumann Group® (Basel, Switzerland) titanium-zirconia implants with a 4.1mm or 4.8mm diameter and a 4 mm or 6 mm length. The expected results show similar or even minor bone loss, biological and prosthetic complications, identical or even better survival of the short implants with immediate loading, and greater satisfaction. Short implants demonstrate similar survival to conventional length implants, with comparable or even minor biological and prosthetic complications and bone loss. Immediate loading gives satisfactory results similar to conventional loading, with similar biological and prosthetic complications, and generally depends on poor hygiene levels. Bone loss is even less, and the satisfaction increases.

Treatment and rehabilitation of subtalar dislocations: A case series and a review of the literature

IntroductionSubtalar dislocation is an uncommon orthopaedic pathology, representing 1 % of all traumatic injuries of the foot and 1–2 % of all dislocations, mostly affecting young male adults. While its urgent treatment consisting in reduction and immobilization of the dislocation has been well described, disagreement exists about post-operative management with specific regards to immobilization length and rehabilitation protocols. Materials and methodA case series of traumatic subtalar dislocations treated with urgent reduction, a mean of 4 weeks immobilization and subsequent rehabilitation is presented, with 1-year minimum clinical and subjective follow up. Also, a systematic review of the literature concerning the post-operative management following a subtalar dislocation, and subsequent results, has been performed. ResultsAt 1-year minimum follow up, none of the patients presented with complications such as recurrence of dislocation or talus osteonecrosis. Tibio-talar and subtalar range of motion (ROM) were superimposable to the contralateral joints, with a maximum difference of 5°. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score highlighted a good functionality and a full recovery in all patients but one. Pure subtalar dislocations led to better results than complicated ones. Review of current literature available on the topic demonstrated that an earlier mobilization resulted in better ROM, but the global outcome did not differ among 4 to 6 weeks of immobilization. DiscussionConflicting reports are present in the literature regarding the most appropriate post-reduction management of subtalar dislocations. In our case series, successful results have been obtained with a mean of 4 weeks of limb immobilization and an early rehabilitation protocol. ConclusionsAlthough some limitations are present, 4 weeks immobilization appears to be the best balance between a good overall outcome and a better recovery of ROM. Further studies are needed to deepen the subject.

The Long-Term Impact of Cardiac Rehabilitation on Cognitive Function in Older Patients With Myocardial Infarction: A Systematic Review.

Myocardial Infarction (MI) isan obstruction in the coronary arteries, resulting in restricted blood flow and oxygen supply to the heart, leading to damage to the heart's tissues. Beyond the cardiovascular system, the impact of MI extends to potentially affecting cognitive abilities, especially in elderly populations. To optimize patient recovery and long-term outcomes, timely cardiac interventions and subsequent rehabilitation programs are essential. This systematic review aims to assess the potential benefits of cardiac rehabilitation (CR) in enhancing cognitive function among elderly individuals who have experienced an MI. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and utilizes PubMed, PubMed Central, Cochrane, Google Scholar, and ScienceDirect databases. Studies included in the review encompass meta-analyses, controlled trials, systematic/narrative reviews, randomized/nonrandomized trials, observational studies, and research articles published within the past five years. Only accessible, full-text English-language studies meeting the inclusion criteria are selected, while books, documents over five years old, animal studies, and individuals under 65 are excluded. Following a predefined template, the initial search identifies 4,915 studies. From this pool, 27 free full-text articles are then selected for quality appraisal based on relevance. After performing a quality assessment on each survey, 12 high-quality studies are included in this systematic review. The research studies demonstrate notable cognitive improvements among elderly patients who have experienced an MI and participated in CR programs. Additional clinical trial studies are recommended to substantiate these findings further and advance our understanding.

Taking a Closer Look: "Evaluating Online Video Content for Rehabilitation after Distal Radius Fracture".

Background: Fractures of the distal radius are among the most common bone injuries, and their frequency is constantly increasing, leading to an elevated need for subsequent rehabilitation. This growing need has led to the emergence of online content aimed at providing guidance on rehabilitation. Nonetheless, unreviewed online content raises concerns about its reliability; therefore, the objective of this study was to evaluate the quality, reliability, and comprehensiveness of online videos concerning rehabilitation following a distal radius fracture. Methods: A total of 240 YouTube videos were screened, identifying 33 videos that met the inclusion criteria. These selected videos were evaluated by five independent experts from various professional groups, using the Global Quality Scale, the DISCERN reliability tool, and the JAMA Benchmark Score, as well as a structured set of questions to assess their comprehensiveness and coverage of pertinent aspects. Results: The observers' assessment of the Global Quality Scale exhibited a broad spectrum of viewpoints, indicating considerable variability in evaluations. In most cases, therapy aligned well with the diagnosed condition, and most raters deemed the indication and instruction in the videos acceptable. A proportion of 87% of the videos was deemed suitable for home training by at least three raters. However, a concerning trend emerged, as potential risks and pitfalls were scarcely addressed. Conclusions: The moderate overall quality of the videos and the divergence in expert opinions highlight the need for a regulatory authority to ensure adherence to guidelines and maintain high-quality content. Additionally, our results raise concerns about the applicability of established assessment tools in this context.