Successful Rehabilitation Research Articles

Anatomical and functional outcome of surgical correction of optic disc pit maculopathy using autologous scleral patch graft: a long-term retrospective analysis

BackgroundOptic disc pit (ODP) is a rare congenital anomaly of optic nerve head and is associated with maculopathy. Scleral patch graft (SPG) as a therapeutic option is recently advocated.MethodsThis is a retrospective analysis of 54 patients with ODP maculopathy who were followed up for 12 months post-operatively. The parameters assessed included best corrected visual acuity (BCVA) in LogMAR chart and central macular thickness (CMT) at baseline and at 1-, 3- and 12-months post-surgery.ResultsThe mean age of presentation was 36.36 ± 15.69 years [Median 36, Interquartile range (IQR) 14.75]. 51.85% were female. 53.7% were operated in left eye. The average period of follow-up was 15.37 ± 2.34 months after surgery. The mean presenting BCVA in LogMAR chart was 0.66 ± 0.37 (Median 0.6, IQR 0.4) and average CMT was 677.46 ± 251.57µ (Median 674, IQR 276). On follow up over 1, 3 and 12 months, average BCVA were 0.74, 0.58 and 0.49 LogMAR respectively. The improvement in final BCVA was statistically significant (p = 0.016). The CMT at the corresponding follow-up periods were 461.26 ± 238.3µ (Median 435, IQR 220.5), 362.68 ± 125µ (Median 367, IQR 141) and 287.36 ± 121.9µ (Median 266, IQR 139.5). Decrease in CMT was significant at all follow up visits (p < 0.001). On assessing OCT Biomarkers, Subretinal fluid (57.4%), Intraretinal Fluid (57.4%), macular schitic cavity (79.63%), Outer Lamellar Macular hole (31.48%), Pachychoroid vessels (35.19%), Outer Retinal Layer Disruptions (24.07%) were present in various proportions on presentation. After surgery over the follow-up, retinal fluid and schitic cavities were observed to get regressed over time. Outer Lamellar Macular holes showed excellent regression after surgery over a period of time. On final visit after 1 year of surgery, complete anatomical success in terms of OCT interpretation was achieved in 16 cases (29.63%). Partial anatomical success was achieved in further 24 cases (44.44%). At least some anatomical improvement was seen in 49 patients while in 3 patients it remained almost unaltered and 2 cases worsened. Successful visual rehabilitation was achieved in 45 patients (83.33%)ConclusionsDetailed OCT based and functional analysis in this study with long-term follow-up helps to entitle the importance of scleral patch graft based surgical procedure in managing this challenging surgical condition. This article caters the largest case series with meticulous analyses of the ODP Maculopathy surgically managed using autologous scleral plug.

Plasma chemistry and hematology of Eastern Mediterranean Sea green turtles undergoing rehabilitation

Plasma chemistry and hematology of Eastern Mediterranean Sea green turtles undergoing rehabilitation

Treatment Quality or Hotel Quality - What Determines more Rehab Satisfaction and Subjective Treatment Success in Psychosomatic Rehabilitation?

Rehab satisfaction and treatment success are firmly anchored in the German Pension Insurance's quality assurance program as quality criteria for medical rehab. In the field of psychosomatic rehab, there are hardly any studies in which the relative importance of treatment- and hotel-related characteristics for the prediction of these criteria has been investigated. In a secondary analysis, anonymous survey data from 25 psychosomatic rehab clinics/specialist departments were analyzed. The sample comprises around 50,000 inpatient rehabilitants from 2018-2022. The surveys were conducted using a largely standardized questionnaire for the purpose of internal quality assurance. The extent to which the two outcome criteria can be predicted from 14 predictors (assessments of partial performance areas) and from a heuristic model with three blocks of variables (KV=control variables, RB=rehabilitation treatment, HL=hotel services) was examined using regression analysis. All 14 predictors correlate significantly with both criteria and can explain a total of around 67% (rehab satisfaction) resp. 40% (treatment success). In stepwise regressions, the predictors "psychotherapeutic care" and "preparing for the time after rehab" contribute most to the prediction of the criteria. Hierarchical regressions show that the incremental share of the RB block in the prediction of both criteria, i. e. the share that can be attributed with certainty to the rehab treatment variables, is many times greater than that of the hotel services. The hierarchical regression analyses support earlier findings that characteristics of the actual rehab care (e. g. good psychotherapeutic support) play a much greater role for the rehabilitants with regard to both outcome criteria than hotel -related features. There is much to suggest that these findings are also valid for inpatient psychosomatic acute care.

The effect of non-significant internal carotid artery stenoses on the results of cognitive training and electroencephalographic indicators in cardiac surgery patients

The effect of atherosclerotic lesions of the carotid arteries (CA) on the success of the cognitive function recovery procedures in cardiac patients has not been sufficiently studied. This study aims to evaluate the effects of cognitive rehabilitation depending on the presence of CA stenosis in patients after coronary artery bypass grafting (CABG) using neurophysiological indicators.Material and methods. The cohort prospective study involved 85 patients (16 of them women), aged 45 to 75 years, admitted for elective CABG. All patients underwent standard clinical and instrumental, neurological, extended neuropsychological and neurophysiological examination.Results. After multi-task training, the patients with CA stenosis had higher levels of high-frequency beta power (13-30 Hz), while the spectral power of the alpha1 rhythm (8-10 Hz) in this group was lower compared to patients without stenosis. In the case of successful cognitive rehabilitation (absence of POCD) at 11–12 days after CABG, compared with the group with POCD, patients without stenoses had higher total power of alpha 1 power and lower — beta power than patients with stenoses CA.Conclusion. The absence of CA stenosis in the patients with successful completion of multi-tasking training contributed to the optimization of brain activity with an increase of alpha power. Whereas the patients with CA stenosis were characterized by an increase in high-frequency brain activity, both in the case of successful multi-tasking training and in its absence, in the early postoperative period of CABG. This study may serve as a basis for the development of special cognitive rehabilitation programs for patients with atherosclerotic lesions of the carotid system.

Rapid posterior capsular opacification in two patients treated for negative dysphotopsias

BackgroundNegative dysphotopsias (ND) are visual aberrations associated with in-the-bag optic intraocular lens (IOL) placement, causing arc-shaped or linear shadows. Reverse optic capture (ROC) is employed to prevent ND, yet it poses the risk of posterior capsular opacification (PCO) which usually develops within 2–5 years post-surgery due to the lens epithelial cells (LECs) proliferation and migration onto the posterior capsule. This can lead to a cloudy or hazy appearance in the visual field. Early identification of posterior capsular opacities is crucial to ensure timely intervention and minimize visual impairment.Cases presentationsWe detail the management of two cases of acute and rapidly progressive PCO two weeks post-cataract extraction (CE) and IOL placement in patients with a prior history of ND at the Bascom Palmer Eye Institute. To prevent the development of ND in the subsequent eye, both patients underwent the ROC technique, in which a 3-piece intraocular lens with silicone aspheric neutral optics (SofPort LI61AOR2300 Bausch & Lomb Inc.) was inserted. At two-weeks post-operation, both patients reported a significant progressive decrease in vision in the treated eye, and severe posterior capsular opacities were observed. A diagnosis of PCO was confirmed, and successful visual rehabilitation was achieved through the performance of a neodymium-doped yttrium aluminum garnet (ND: YAG) laser capsulotomy without complications. This case series represents the first reported instances of patients developing PCO within two weeks of CE and IOL placement using the ROC technique.ConclusionsThis case series sheds light on the occurrence of posterior capsular opacities shortly after CE and IOL placement using the ROC technique. It highlights the importance of preoperative patient education, postoperative monitoring, and prompt management of potential complications in cataract surgery.

Strategi Komunikasi Lingkungan Ekowisata Taman Mangrove Jung Koneng Bangkalan untuk Rehabilitasi

Examining the environmental communication strategy implemented by the Payung Kuning Tourism Awareness Group as the manager of the Jung Koneng Mangrove Park in Labuhan Village, Ten District, Bangkalan. Starting from damage to the coastal environment due to the behavior of people who do not care about the sustainability of the mangrove ecosystem, as well as uncontrolled piles of rubbish, resulting in a significant decline in environmental quality. Using descriptive qualitative methods, researchers identified strategic steps in environmental communication which were grouped into four main stages, namely situation analysis, planning, media production, and action and reflection. At the situation analysis stage, Pokdarwis identified the environmental problems faced and the actors involved in mangrove rehabilitation. The planning stage involves developing a communication strategy based on local conditions, collaboration with external parties, and the use of traditional and digital media. In the media production stage, various communication channels such as social media, face-to-face discussions, and visual learning media are used to convey educational messages. The final stage, action and reflection, focuses on implementing rehabilitation activities and evaluating the impact of the communication strategies that have been implemented. Community participation not only contributes to the successful rehabilitation of the mangrove ecosystem, but also increases the community's social and economic awareness regarding ecotourism potential. Keywords: environmental communication strategy, mangrove, ecotourism, education, Jung Koneng Mangrove Park

Vocational rehabilitation services and career readiness for individuals with intellectual disability in Saudi Arabia

Successful vocational rehabilitation (VR) programs facilitate a smooth transition to work. However, finding and maintaining a job is still a challenge for individuals with disabilities for various reasons, including job readiness. Given that teachers are involved in delivering VR services to adolescents with disabilities, the purpose of this study was to examine teachers’ perspectives on VR services provided to individuals with intellectual disabilities (ID) in their educational institutions in Al-Kharj city to prepare them to transition to employment. Teachers’ perspectives on VR programs for students with ID are vital in identifying the current state of the services provided and directing future efforts in the field of secondary transition. A descriptive approach was employed to achieve the study’s purpose, and a survey was designed and used, reaching 89 respondents. The findings revealed that teachers believe that services provided in VR programs prepare individuals with ID to transition to work. The study also showed statistically significant differences between teachers’ responses concerning services provided according to years of experience and institution type. Implications for future research and practices are discussed.

Return to Play After Shoulder Stabilization –What If This Isn't Going Well?

Traumatic shoulder instability is prevalent among athletes, often leading to surgical intervention and challenging rehabilitation outcomes. This chapter explores the complexities surrounding return to play (RTP) following shoulder stabilization procedures, highlighting the significant variance in RTP rates and the common lag in returning to pre-injury performance levels, particularly in throwing athletes. Factors influencing successful outcomes include the nature of the instability, surgical approach, and individual athlete characteristics. A consensus on RTP criteria remains elusive, with a predominant reliance on time-based recovery, yet evidence suggests that other physical and psychological variables must be considered. Emphasizing a shared decision-making process and ongoing assessment of range of motion, strength, and proprioception, this chapter aims to identify key deficits and interventions that can enhance rehabilitation success for athletes struggling to return to play. Effective communication among the sports medicine team and the athlete is essential to optimize adherence to rehabilitation protocols and improve overall outcomes.

Eye Mapping: Innovative Technique for Precise Iris Positioning in Prosthetic Eye.

The aim of this technique is to institute "Augmented Reality Tool" in the field of maxillofacial prosthesis for an accurate and precise iris positioning in a prosthetic eye. A congenital defect, irreversible damage, a painful blind eye, sympathetic ophthalmia, or the requirement for histological confirmation of a suspected illness can all result in the absence or loss of an eye. In such circumstances, meticulous preoperative, surgical, and prosthetic planning using a multidisciplinary approach is imperative for successful rehabilitation. Augmented reality filter was used to provide precise mapping of facial landmarks and to aid in iris positioning. Smartphone device (S22) was used and artificial intelligence (AI)-generated Instagram application was unfurled and augmented reality (AR) filter was instituted. The filter available in the application made it possible to see and confirm the iris shell's location in three dimensions from various angles. The dimensions thus provided, aided in the correct positioning of the iris in the prosthetic eye. Iris positioning stands as one of the crucial steps in fabricating a patient-specific ocular prosthesis. In the present case report, iris positioning was done using AI has provided an excellent esthetics results and patient compliance was met with satisfaction. Accurate positioning of iris can be done using AR tool which is popular, easily accessible, less technique sensitive, and can be performed with slightest efforts in small clinical set-ups. Relating to patient, it is comfortable, economic, and trouble-free procedure. How to cite this article: Zilpilwar NR, Nimonkar SV, Chitlange P, et al. Eye Mapping: Innovative Technique for Precise Iris Positioning in Prosthetic Eye. J Contemp Dent Pract 2024;25(7):711-714.

EFFECTIVE REHABILITATION STRATEGIES FOR MUSCLE INJURIES IN FOOTBALL PLAYERS

The rehabilitation of muscle injuries in football players is a pivotal area of sports physiotherapy, addressing the intense physical demands and high injury rates associated with the sport. Muscle injuries often arise from factors such as overload, muscle imbalances, and improper techniques, impacting athletes' performance and career longevity. To optimize recovery, evidence-based methodologies are crucial, allowing physiotherapists to create personalized rehabilitation programs tailored to the specifics of each injury. Central to effective rehabilitation is a thorough functional assessment, which identifies specific deficits in players. Techniques such as electrotherapy and therapeutic ultrasound are effective in accelerating healing and reducing pain, while functional taping provides support without restricting movement. Neuromuscular rehabilitation is equally vital, incorporating proprioceptive exercises to enhance stability and prevent future injuries. The multidisciplinary approach, involving collaboration between physiotherapists, medical professionals, nutritionists, and coaches, ensures comprehensive care for athletes. Psychological support also plays a key role in addressing anxiety and fostering a positive mindset during recovery. Recent studies underscore the importance of accurate diagnosis and individualized treatment plans, utilizing frameworks like the PRICE principle and specific rehabilitation protocols that facilitate faster and safer returns to play. The literature indicates a gap in understanding among team managers regarding the role of sports physiotherapy, highlighting the pressure players face to return prematurely, which increases the risk of re-injury. In summary, successful rehabilitation of muscle injuries in football necessitates a comprehensive, personalized approach that integrates physical, nutritional, and psychological elements. As research continues to evolve, these strategies will enhance the effectiveness of rehabilitation programs, ensuring football players can recover fully and maintain optimal performance levels.

Employment, work ability and sick leave in melanoma patients within the first year of diagnosis.

Malignant melanoma affects younger working individuals. This study investigated work ability and sick leave within one year after diagnosis, as well as the impact of rehabilitation and psycho-oncological measures on employment outcomes. In this monocentric, prospective, observational cohort study, 221 patients (62.4% females), aged 19-65, participated. 78.5% had tumor stageIB or lower at baseline. Routine clinical documentation, occupational history, work ability, subjective prognosis of employment, need for and satisfaction with rehabilitation measures were repeatedly assessed. 181 patients (82%) were employed at first visit, 172 (78%) at last visit. Approximately 75% of patients initially rated work ability as "moderate", with up to 9 sick leave days. In the following year, sick days increased significantly in patients with stageIB and IIA (p=0.044) and highly significantly in patients with stageII B and above (p<0.001). Psycho-oncologic consultation (24%) and rehabilitation (18%) did not change the significantly worse self-rated work ability of these patients. Melanoma affects work ability, even in tumor stages without lymph node involvement or distant metastasis. Controlled clinical trials would be useful to evaluate the success of rehabilitation and psycho-oncological interventions for patients with melanoma.

New titanium mesh design method in customized bone regeneration of the jaws: preliminary study on a sample of 11 patients

The aim of this study is 1) to present a new method of virtually-designed custom made scaffolds to be employed in customized bone regeneration (CBR) for segmental jaw atrophies and 2) to evaluate long-term clinical results in terms of bone regeneration success and implant rehabilitation success. A total of 11 patients with edentulousness and bone atrophy in a localized area of the mandible or the maxilla were recruited for the study. To fulfill the research inquiries, CT images of the pre-regeneration mandibular or maxillary arch of each patient were collected. A dedicated Mevislab 2.4 software was employed to virtually design custom bone regeneration meshes designed to fit the atrophic sector of each patient's mandible or maxilla. Subsequently, a second Meshmixer software was used to refine the margins of each of the designed meshes. All patients underwent oral surgery, during which a mixture of autologous and heterologous bone in a 1:1 proportion was grafted into the atrophic site, a custom-made mesh was placed, and a resorbable membrane was inserted. The mesh was removed after this procedure, and implant rehabilitation was performed. All patients underwent the bone regeneration procedure, with eight undergoing titanium mesh removal. A total of seven patients completed implant rehabilitation. Average horizontal bone augmentation was 3.525 ± 1.36 mm; average vertical bone augmentation was 4.45 ± 2.22 mm. Implant survival was 92.85%. During the healing phase, complications occurred in 9.09% of patients. The use of dedicated software, Mevislab 2.4 and Meshmixer, for titanium mesh design is an accurate, predictable, effective, and quick-to-use method. The learning curve for design is uncomplicated and rapid. Mesh exposure does not necessarily lead to bone graft failure; this complication can be treated by chlorhexidine aids.

Relationship between locus of control and health-related quality of life in chronic stroke patients: a cross-sectional study

IntroductionStroke is a major cause of disability in adults and the elderly worldwide. Post-stroke rehabilitation success largely depends on consistent participation in treatment sessions and adherence to prescribed physical exercises; however, factors such as individual belief about their health status often affect motivation, slowing recovery. Addressing these influences is essential for improving health-related quality of life and optimizing recovery outcomes.MethodsThis study employed a cross-sectional and correlational design with convenience sampling. The aim was to explore the relationship between recovery locus of control (RLOC) and health-related quality of life (HRQoL) among chronic stroke survivors. The Recovery Locus of Control scale and the EuroQol 5D-5L scale were utilized for assessment.ResultsA total of 69 participants were included in this survey. The mean RLOC score was 34.91, with internal RLOC at 21.16 and external RLOC at 13.77 and the total EQ5D index was 0.659. Age was a significant grouping factor, with the 30–39 age group showing a significant positive relationship (r = 1.000, p = 0.002), pain and anxiety/depression (p = .045), mobility and anxiety/depression (p = .009), anxiety/depression and self-care (p = .047), IRLOC and ERLOC (p = .013).ConclusionThe study found that while respondents exhibited high RLOC scores, there was no significant relationship between RLOC scores and the EQ5D-5L index score, suggesting that other factors may play a more critical role in influencing HRQoL among chronic stroke survivors.

Integrating lifestyle modifications with physiotherapy: Evaluating the role of nutrition and psychological interventions in recovery

Physiotherapy is widely recognized for its role in rehabilitating musculoskeletal and chronic conditions through physical interventions. However, emerging evidence highlights the importance of lifestyle modifications, particularly dietary changes and psychological support, in enhancing treatment outcomes. This review evaluates the influence of such modifications on the effectiveness of physiotherapy interventions. By synthesizing literature on the integration of nutritional strategies, such as increased intake of anti-inflammatory nutrients, and psychological interventions like cognitive-behavioral therapy (CBT) and mindfulness, the study examines their impact on recovery rates, pain levels, and overall treatment success. Results indicate that dietary changes, including omega-3 fatty acids and antioxidants, promote tissue repair and reduce inflammation, while psychological support improves pain management, patient adherence, and functional recovery. The findings suggest that a holistic approach, incorporating both dietary and psychological elements into physiotherapy, can optimize patient outcomes. Future research should focus on standardized protocols to integrate these lifestyle factors with physiotherapy for sustained rehabilitation success.

Assessment of Cochlear Implant Rehabilitation Success by Speech-Language Therapists Using International Classification of Functioning, Disability and Health Criteria.

This study aims to introduce an assessment questionnaire based on the International Classification of Functioning, Disability and Health (ICF) to enable quantifiable clinical documentation. The questionnaire assists speech-language therapists (SLTs) in evaluating both non-audiological and audiological rehabilitation outcomes of patients with cochlear implants (CIs). Six SLTs were recruited to evaluate the effectiveness of CI care using ICF criteria. We carefully selected 20 pertinent ICF criteria, and SLTs received thorough training in how to apply them uniformly. A cohort of 48 patients was evaluated at three distinct time points: presurgery, postsurgery, and 6 months post-initial CI fitting. Patients underwent dedicated speech-language therapy sessions throughout the treatment course. A total of 144 complete datasets were scrutinized using a two-factor analysis of variance for ranks. Following CI care, patients exhibited substantial improvements in auditory perception, characterized by enhanced sound recognition and speech discrimination. Additionally, patients demonstrated improved attentional focus, proficiency in daily tasks and increased conversational engagement over time. Environmental factors, particularly sound perception, improved markedly, correlating with reported reductions in stress levels. Minimal changes were noted in stress management and communication techniques. Articulatory function, speech functions, and pain perception exhibited the least alteration. The data extracted from the ICF-based assessments underscore the vital significance of incorporating speech therapy-based metrics to evaluate both non-audiological and audiological factors in assessing the success of CI care within the SLTs domain. This approach proves to be highly relevant both in terms of demonstration and clinical applicability.

Ocular Lesions in Birds of Prey in Portugal: A Retrospective Study

In wildlife rehabilitation centers, thousands of animals are treated annually, with a substantial proportion being birds of prey. Since vision is essential for the survival of these species, this study focused on investigating the causes of ocular injuries in raptors admitted to four rehabilitation centers across mainland Portugal from 2017 to 2021. Of the 2207 birds admitted during this period, 156 (7%) presented ocular injuries. Hyphema (28.2%) and corneal ulcers (20.5%) were the most prevalent injuries, often occurring together or alongside lens luxation. Nocturnal raptors showed a higher prevalence of these injuries (76.9%) compared to diurnal raptors (23.1%). A significant association was found between ocular injuries and causes of admission, particularly with ocular hemorrhages and multiple injuries in the eye. Despite the severity of the ocular injuries, the release rate remained relatively high at 51%, underscoring the critical role of comprehensive ocular examinations and vision assessments in guiding treatment decisions and discharge decisions. This study highlights the need for further research with larger samples to better understand the impact of ocular injuries on the rehabilitation success of wild birds in Portugal.

ALVEOLOPLASTIA, CIRURGIA PRÉ-PROTÉTICA PARA REGULARIZAÇÃO DE REBORDO ALVEOLAR MANDIBULAR: RELATO DE CASO

Surgical interventions may be necessary for the adequate adaptation of prosthetic devices, for example, in cases of irregular alveolar ridges, which generally appear after tooth extractions. Such changes make it difficult or even prevent satisfactory oral rehabilitation. In this sense, the present work aims to carry out a literature review as well as describe a clinical case report on pre-prosthetic surgery, aiming to regularize the mandibular alveolar ridge, through alveoloplasty. In short, pre-prosthetic surgeries allow for good seating of the prostheses, providing comfort and harmony with the other orofacial components. Therefore, alveoloplasty is safe and effective, whose ridge leveling allows significant success in oral rehabilitation, as it provides a well-adapted, stable and retentive prosthesis, consequently restoring aesthetics, chewing function, phonetic readjustment, well-being and quality of life to patients.

Postoperative Otoplasty Care With ChatGPT-4: A Study on Artificial Intelligence (AI)-Assisted Patient Concern and Education.

Otoplasty is a cosmetic surgery that is performed to alter the size, shape, or position of the ear by using permanent stitches. Its main purpose is to correct protruding ears, a condition known as prominauris. After the surgery, it is crucial to provide proper care to ensure successful recovery. However, obtaining timely medical advice can be difficult, especially in remote areas or places with limited resources. To address this issue, incorporating advanced artificial intelligence (AI) tools like Chat Generative Pre-trained Transformer (ChatGPT)-4 into postsurgical care could help fill the gap in patient education and support. This study aims to assess whether ChatGPT4 can be a reliable, accurate, and effective method for answering the most common patient questions and concerns post-otoplasty. The main objective was to assess the AI chatbot's capacity to deliver precise, concise, and pertinent information, especially in situations where health care professionals are limited in availability. In this study, over 50 patients were engaged, and ChatGPT4 was employed to present the same 5 common postoperative questions post-otoplasty surgery care. The AI chatbot's responses were analyzed for accuracy, response time, clarity, and relevance. The chatbot could potentially provide timely assistance, answer questions, and address concerns related to postsurgical care in otoplasty. The responses exhibited a perfect accuracy rate of 100%, closely corresponding to existing medical guidelines. This study explores the potential of AI-driven solutions to enhance patient education and support, especially in areas where access to health care professionals may be limited. However, professional medical advice is crucial in postoperative care and cannot be replaced by ChatGPT-4. By leveraging AI tools like chatbots, individuals in remote or resource-limited settings can potentially receive valuable information and guidance, contributing to successful rehabilitation and overall health care outcomes. Ethical considerations around the use of AI in health care must also be carefully addressed to ensure patient privacy, data security, and appropriate clinical oversight.

An Interactive Vision-Based 3D Augmented Reality System for In-Home Physical Rehabilitation: A Qualitative Inquiry to Inform System Development.

Postoperative physical rehabilitation is crucial after total joint replacement (TJR). However, completing the recommended levels of postoperative physical exercise is challenging for many older adults with TJR. Lack of adequate postoperative physical exercise has negative consequences on rehabilitation outcomes. Innovative rehabilitation tools for postoperative physical exercises are needed to ensure successful rehabilitation outcomes among older adults with TJR. The aim of this study is to explore key knowledge users' perspectives about how to design an interactive vision-based three-dimensional augmented reality system (3D ARS) to support in-home postoperative physical rehabilitation for older adults with TJR. We conducted a qualitative descriptive study involving 11 semi-structured interviews and six focus groups with 42 older adults with TJR and four unrelated family caregivers. Data were analysed using thematic analysis. Participant insights were grouped into two main themes: (1) dreaming up possibilities and (2) being pragmatic. The first theme captured participants' reflections on the potential utility of a 3D ARS for postoperative physical rehabilitation and features that could be embedded in the 3D ARS to support successful postoperative physical rehabilitation. The second theme captured participants' reflections on practical issues and considerations that could impact access and usage of the 3D ARS. These findings provide researchers, rehabilitation providers and system developers with the foundations for designing, implementing and evaluating innovative augmented reality tools that support effective in-home physical rehabilitation among older adults with TJR. Research users (i.e., individuals and organisations invested in and using the research findings) were actively engaged throughout this work. Specifically, a meeting was held between the research team and representatives of an Expert by Experience team (individuals with lived experience), which was established to support the National Research Council's (organisation) Aging in Place programme. During this meeting, the idea to develop and evaluate an ARS for postoperative physical rehabilitation of older adults with TJR was supported. Research users had the opportunity to review the current study protocol and provide feedback on the study design, offering direction to maximize the relevance and usefulness of our findings to the National Research Council Canada's Aging in Place programme. Research users contributed to participant recruitment efforts and the development of the interview guide. Two Experts by Experience also agreed to be on the Advisory Panel for this multi-phased study, supporting active engagement and centring the voice of research users in knowledge creation and implementation. These experts reviewed a brief report of the current study findings, and continue to guide how the study findings are used to inform the next phase of this multi-phased research.

Thiamine responsive megaloblastic Anemia and deafness: A rare case of Roger's syndrome with successful hearing rehabilitation by cochlear implantation

Thiamine responsive megaloblastic anemia (TRMA), also known as Roger's syndrome, is an exceptionally rare autosomal recessive disorder stemming from mutations in the SLC19A2 gene responsible for encoding a thiamine carrier protein.This syndrome manifests as the classic triad of megaloblastic anemia, sensorineural hearing loss, and diabetes mellitus. Here, we present the case of a one-and-a-half-year-old male infant born to non-consanguineous parents in India, a region where TRMA cases are seldom reported. At five months of age, the child exhibited the characteristic symptoms, prompting immediate treatment involving thiamine therapy, insulin administration, and blood transfusions. Notably, the child exhibited significant improvement in all aspects except for hearing loss, which conventional hearing aids failed to alleviate. However, following a cochlear implant procedure conducted within a few months, the child regained hearing abilities. This case underscores the importance of early recognition and intervention in the form of cochlear implant, demonstrating the potential to reverse TRMA symptoms and provide affected individuals with a substantially improved quality of life.