Undergoing Rehabilitation Treatment Research Articles

Biomechanical gait analysis and rehabilitation in a traumatic hallux deficit patient: a case report

BackgroundThe hallux plays a crucial role in maintaining standing balance and facilitating forward and backward movements during gait.Case presentationA 21-year-old Japanese patient, suffering from a traumatic hallux deficit with only a portion of the basal phalanx intact, underwent rehabilitation treatment. The thenar area exhibited instability, leading to impaired balance and walking difficulties. Biomechanical assessment revealed the need for a rehabilitation strategy for the foot, as well as the knee, hip, and trunk. A rehabilitation protocol was designed to enhance medial foot loading during walking and standing, including balance and trunk strength training. After a 12-week rehabilitation period, the patient’s gait showed significant improvement. Specifically, the load response and single-support phases of the gait cycle on the affected side increased from 46.9% to 49.3%, while the pre-swing phase decreased from 14.6% to 11.6%. The vertical component of the ground reaction force rose from 599.8 to 647.5 N. The enhanced stability from balance training and increased muscle strength contributed to the patient’s improved walking and balance.ConclusionA patient with a traumatic hallux deficit underwent conservative treatment through strategic rehabilitation according to biomechanical assessment. This case report underscores the value of biomechanical gait analysis in the conservative management of similar conditions.

Systemic Oxidative Stress in Subacute Stroke Patients Undergoing Rehabilitation Treatment.

The imbalance in oxidative stress in acute stroke has been extensively studied; on the contrary, its investigation in the subacute phase is limited. The aim of this study was to analyse the variation in the systemic oxidative status in subacute post-stroke patients before (T0) and after a six-week rehabilitation treatment (T1) and to investigate the relationship between systemic oxidative status and rehabilitation outcomes. We enrolled 109 subjects in two different centres, and we analysed their serum hydroperoxide levels (d-ROMs), biological antioxidant power (BAP), thiol antioxidant components (-SHp), and relative antioxidant capacity (OSI and SH-OSI indices). Activity of Daily Living (ADL), hand grip strength, and walking endurance were evaluated using the modified Barthel Index, the Hand Grip test, and the 6-min walk test, respectively. At T0, most of the patients showed very high levels of d-ROMs and suboptimal levels of the BAP, OSI, and SH-OSI indices. Comparing the T1 and T0 data, we observed an improvement in the rehabilitation outcomes and a significant decrease in d-ROMs (549 ± 126 vs. 523 ± 148, p = 0.023), as well as an improvement in the OSI and SH-OSI indices (4.3 ± 1.3 vs. 4.7 ± 1.5, p = 0.001; 11.0 ± 0.4 vs. 1.2 ± 0.4, p < 0.001). In addition, significant correlations were seen between the oxidative stress parameters and the rehabilitation outcomes. These results suggest monitoring the systemic oxidative stress status in post-stroke patients in order to plan a tailored intervention, considering its relationship with functional recovery.

Muscle quality improvement in subacute post-stroke patients after rehabilitation: Usefulness of segmental phase angle from bioelectrical impedance analysis

During stroke rehabilitation, the whole-body Phase Angle (PhA) from Bioelectrical Impedance Analysis (BIA) is measured to assess whole-body muscle quality, which reflects cellular integrity and function. The segmental BIA is a valuable method for assessing the body composition of specific body segments, such as the arms, legs, and hemisoma. After a stroke insult, patients frequently experience hemiparesis, and segmental PhA from segmental BIA appears to be an appropriate parameter for examining the muscle quality of affected and unaffected limbs separately. This study aims to investigate whether segmental PhA is more informative than whole-body PhA in (a) assessing the deterioration of muscle quality in post-stroke patients and (b) monitoring its recovery following rehabilitative treatment. This longitudinal study recruited subacute post-stroke patients who were admitted to our rehabilitation center. At admission, demographic, anamnestic, and clinical information, such as the presence of comorbidities, were recorded. BIA was used to evaluate the whole-body PhA and segmental PhA of the affected and unaffected hemisoma, arms, and legs at admission (T0) and after a six-week rehabilitation program (T1). The modified Barthel Index (mBI), Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), and Motricity Index of the Upper (MI-UE) and Lower (MI-LE) Extremities were evaluated at T0 and T1 to determine the patient's Activity of Daily Living (ADL) performance, upper limb motor performance, and upper and lower limb muscle strength, respectively. We evaluated segmental and whole-body BIA in 70 subacute post-stroke patients (women n=34, ischemic n=56, mean age 70±11) at T0 and T1. Whole-body PhA values of the patients were below the normal range. Considering segmental data, the affected hemisoma, arm, and leg had considerably lower PhA values as compared to the unaffected body segments. Furthermore, at T1, the PhA values of all affected body segments improved, while those of the unaffected ones and whole-body PhA did not. At both T0 and T1, the segmental PhA values of the affected body segments showed to be related with all clinical outcome measures, while whole-body PhA correlated only with mBI. This study emphasizes the significance of measuring segmental PhA in hemiparetic subacute stroke patients undergoing rehabilitation treatment. Segmental PhA is a more accurate parameter to evaluate rehabilitation treatment in patients with hemiparesis because it can distinguish affected from unaffected body segments, hence facilitating accurate monitoring of muscle quality improvements resulting from a rehabilitation program.

ASSESSING THE RECOVERY LEVELS OF DRUG ADDICTS IN REHABILITATION CENTERS USING DRUG ADDICTION RECOVERY INSTRUMENTS

Abstract: Drug addiction recovery is a fundamental factor in helping drug users restart normal life and get back into society. It is also a vital stage of drug treatment, as it can be an indication or evidence of whether the procedures used during treatment are suitable for helping addicts with drug problems. This study focuses on identifying the level of recovery of drug addicts undergoing rehabilitation treatment at CCRC Besut quantitatively based on the built DART instrument. The Drug Addiction Recovery Test (DART) consists of four main components: drug dependency, relapse, drug resiliency, and mental strength. Every component has 20 items, so the total number of items in DART is 80. A total of 123 treated addicts in the Cure and Care Rehabilitation Centre (CCRC) in Besut were chosen as survey respondents. Study data was analysed using descriptive analysis for each component. As for the level of recovery, the study showed that 52% of the respondents were fully discharged from the CCRC, 37% could be released as outpatients, 9% of respondents could not be released and needed to be monitored, and 2% could not be released and needed to be given intensive treatment. The study proves that the instrument can be used to measure the recovery level of addicts treated at the CCRC. Additionally, this instrument would be able to help government institutions, especially the CCRC, treat the drug addiction crisis effectively in the future. &#x0D; Keywords: Addiction Recovery; Drug Dependency; Drug Possible Relapse; Drug Resiliency; Client Mental Strength

Assessment of Musculoskeletal Pain in Medical Rehabilitation of POST-COVID-19 patients

Background: Remaining phenomena presented by people who endured COVID -19 at various times after the acute pha-se of the disease, remain the objectives of the medical and social approaches. Musculoskeletal pain is increasingly re-ported by patients as one of the persistent symptoms in post-COVID-19 syndrome. The purpose of the study was the qualitative and quantitative assessment of musculoskeletal pain post _COVID 19 in the process of in-hospital medical rehabilitation. Methods: A group of 124 people who suffered SARS-Cov-2 infection were analyzed and underwent rehabilitation treat-ment with physiotherapy, halotherapy and electrotherapy sessions in the specialized “Post COVID rehabilitation” ward during a period of 14 days. For the analysis of the pain phenomenon, 103 people who presented musculoskeletal pain, before and after treatment were assessed by the Nordic Musculoskeletal Questionnaire, pain intensity by VAS scale and intensity of fatigue syndrome. Results. Musculoskeletal pain was present in 84.3% of cases among persons admitted for rehabilitation treatment. Re-habilitation programs applied under inpatient conditions increased the rate of people with moderate and mild pain by 6.8% and decreased the rate of those with severe pain by 13.6% (p&lt; 0.05), assessed by the Nordic Musculoskeletal Ques-tionnaire. The proportion of patients with severe pain, assessed by the VAS scale, decreased by 13.8% at discharge from the hospital. Conclusion. In-hospital medical rehabilitation programs applied to people with musculoskeletal pain post -COVID 19 had a beneficial effect by decreasing the number of painful areas and pain intensity.

ASSESSMENT OF MUSCULOSKELETAL PAIN IN MEDICAL REHABILITATION OF POST-COVID-19 PATIENTS

ASSESSMENT OF MUSCULOSKELETAL PAIN IN MEDICAL REHABILITATION OF POST-COVID-19 PATIENTS

Evaluation of the effectiveness of therapy in degenerative-dystrophic disk diseases

&#x0D; &#x0D; &#x0D; the dominant role during the incidence of degenerative-dystrophic changes of the spinal col- umn in the lesion is pain syndrome of varying intensity. The purpose of this study: to evaluate the effec- tiveness of conservative methods of treatment of degenerative-dystrophic disk diseases. The retrospective dynamic study included 107 medical records of outpatients, the average age of patients with degenera- tive-dystrophic disk disease who underwent rehabilitation treatment at Evminov Center for Vertebral Health in the period 2021-2022 was 43.4 ± 4.2. Rehabilitation treatment included personalized kinesitherapy on Evminov Prophylactor (inclined board), Glisson’s Loop, taking non-steroidal anti-inflammatory drugs (NSAIDs) for up to two weeks (appointment depending on the intensity of the pain syndrome) against the background of compliance with the orthopedic regimen and follow-up by a rehabilitologist in dynamics. Depending on the therapy, the examined patients were divided into 3 groups: group I – patients with kine- sitherapy, II – kinesitherapy in combination with non-steroidal anti-inflammatory drugs, III – kinesitherapy with Acetaminophen (respectively: 44 (41.1%)); 33 (30.8%); 30 (28.1%) patients). The duration of taking NSAIDs is 1-2 weeks, and Acetaminophen is 5-7 days. The condition of patients was assessed at the time of the initial visit to Evminov Center and after the first course (3-6 weeks) of rehabilitation measures aimed at decompression of the intervertebral discs. A visual analogue scale was used to measure the intensity of the pain syndrome. According to the results of the study, after 3-6 weeks, there was a positive dynamics of the course in all patients with degenerative-dystrophic disk disease. After 1-2 weeks from the initial visit to the doctor, all patients observed a significant or complete disappearance of pain. Since it is necessary to per- form therapeutic exercises on Evminov Prophylactor only until pain appears, and NSAIDs and Acetamino- phen block the pain perception threshold, kinesitherapy in groups II and III was carried out in a gentle mode (low-amplitude movements), in contrast to group I. After the end of the course of drug therapy (NSAIDs – up to 2 weeks and Acetaminophen – up to 7 days), patients of both groups increased the range of motion on an inclined board, which is confirmed by measuring the intensity of the pain syndrome with a visual analogue scale at certain time intervals. According to the results of the study, patients who received kinesitherapy started strength exercises 1-2 weeks earlier than in groups II and III. Thus, in the rehabilitation treatment of degenerative-dystrophic disk disease with pain syndrome of varying intensity, it is necessary to include kinesitherapy on Evminov Prophylactor, which, 1-2 weeks earlier than when combined with non-steroidal anti-inflammatory drugs or Acetaminophen, allows to get a positive effect, first of all regarding pain.&#x0D; &#x0D; &#x0D;

Safety and Potential Usability of Immersive Virtual Reality for Brain Rehabilitation: A Pilot Study.

Objective: This study was conducted to demonstrate the safety and usability of an immersive virtual reality (VR) game as a rehabilitative training by assessing adverse events (AEs), adherence, and satisfaction in patients with brain injury who had free optional opportunities. Materials and Methods: The results were analyzed retrospectively. Seventy-eight patients with brain injury, undergoing rehabilitation treatment for motor impairment, were recruited. Among them, 51 were available for postintervention survey. The immersive type of VR training was programmed to facilitate use of the paralyzed upper extremity through a fishing simulation game. The Oculus Rift was used as head-mounted display device. Patients were observed for any AEs as defined in the Common Terminology Criteria for AEs during and after each VR training session. A postintervention telephone survey was done to investigate adherence-related factors and safety. Results: The results were analyzed after dividing the patients into nonadherence (patients participated <3 times) and high-adherence (≥3 times) groups. No serious AEs were reported during and after the VR training, and several patients reported other AEs, predominantly dizziness, with one case requiring cessation of VR training. Overall, the satisfaction rate was 54%. Compared with the nonadherence group, the high-adherence group expressed higher satisfaction with VR training, regarded it as effective for recovery from upper limb paralysis, accepted VR as comprehensible, and considered the level of difficulty to be appropriate (P < 0.05). Conclusion: Immersive VR training appeared to be safe for patients with brain injury.

Estimating the prevalence of alcohol-related disorders and treatment utilization in Bremen 2016/2017 through routine data linkage.

In Germany, most individuals with alcohol dependence are recognized by the health care system and about 16% per year receive addiction-specific care. This paper aimed to analyze the prevalence and treatment utilization rate of people with alcohol dependence by type of addiction-specific care in the federal state of Bremen using routine and survey data. The number of individuals with alcohol dependence was estimated using data from the 2018 Epidemiological Survey of Substance Abuse (ESA). Furthermore, linked routine data of two statutory health insurances (SHIs), the German pension insurance (GPI), and the communal hospital group Gesundheit Nord - Bremen Hospital Group (GeNo), from 2016/2017, were analyzed. Based on SHI data, the administrative prevalence of various alcohol-related diagnoses according to the International Classification of Diseases (ICD-10), in various treatment settings, was extrapolated to the total population of Bremen. Based on all routine data sources, treatment and care services for individuals with alcohol dependence were also extrapolated to Bremen's total population. Care services included outpatient addiction care visits and addiction-specific treatments, [i.e., qualified withdrawal treatment (QWT), outpatient pharmacotherapy as relapse prevention, and rehabilitation treatment]. Of the survey-estimated 15,792 individuals with alcohol dependence in Bremen, 72.4% (n = 11,427) had a diagnosis documented with an ICD-10 code for alcohol dependence (F10.2) or withdrawal state (F10.3-4). One in 10 individuals with alcohol dependence (n = 1,577) used one or more addiction-specific care services during the observation period. Specifically, 3.7% (n = 675) received outpatient addiction care, 3.9% (n = 736) initiated QWT, 0.8% (n = 133) received pharmacotherapy, and 2.6% (n = 405) underwent rehabilitation treatment. The share of seeking addiction-specific treatment after diagnosis was highest among younger and male patients. Although more than half of the individuals with alcohol dependence are documented in the health system, utilization rates of addiction-specific treatments are low. These low utilization rates suggest that there are existing barriers to transferring patients with alcohol dependence into addiction-specific care. Strengthening primary medical care provision in dealing with alcohol-related disorders and improving networking within the addiction support system appear to be particularly appropriate.

Отдаленные результаты исследования двигательных функций у больных эпилепсией с двигательными нарушениями, прошедших курс реабилитации

Introduction. Epilepsy has a different nature and is characterized by a variety of clinical manifestations. The combination of epilepsy and movement disorders raises one of the most serious questions in neurorehabilitology: is the rehabilitation effect itself possible in epilepsy? At present, this issue cannot be considered resolved due to ongoing discussions. Aim. To determine the long-term results of the rehabilitation of young children suffering from epilepsy accompanied by motor dysfunction. Design. Single-center retrospective study. Materials and methods. Тhe study group consisted of 38 patients (19 girls and the same number of boys) with epilepsy and movement disorders, who underwent rehabilitation treatment from 2005 to 2015 in the following volume: in the 1st group — medical massage, in the 2nd — Vojta-therapy and in the 3rd — a combination of these methods. The cycle consisted of three courses of treatment with an interval of 2 to 5 months. The course included 10–15 sessions for 25–30 minutes daily. A follow-up assessment of the state of motor functions was carried out in the period from 2020 to 2021, the average follow-up period was 121.89 ± 5.32 months, Me = 126.00 [96.00; 156.00], SD 32.84 after the end of medical rehabilitation during this period, patients continued to receive rehabilitation measures. Results. Upon completion of the cycle of rehabilitation measures, a positive result was achieved in all 3 groups. We compared the indicators obtained at the end of rehabilitation and according to follow-up data. The most pronounced was the positive difference between the indicators after the end of the course and those obtained in the follow-up in the 3rd group (χ2 Pearson = 6.533; p = 0.038). In the 2nd group, the difference was also statistically significant (χ2 = 27.137; p = 0.001), but less than in the 3rd group. In the 1st group, the differences were the smallest, but, nevertheless, statistically significant (χ2 = 39.000, p = 0.0001). Thus, in all groups, a progressive improvement on the GMFCS scale was demonstrated, while in the 3rd group the result was the best. Conclusion. Thus, the improvement on the GMFCS scale achieved during the rehabilitation of patients with epilepsy and impaired motor function can not only be maintained, but also improved. Keywords: epilepsy, movement disorders, medical rehabilitation, children, massage

Quality of life among adolescents with idiopathic scoliosis in Tunisia.

our study aimed to assess the quality of life (QOL) among adolescents with adolescent idiopathic scoliosis (AIS) receiving nonoperative treatment, and to identify the demographic and clinical factors associated with poor QOL. this is a cross-sectional study. We included adolescents followed in the Department of Physical Medicine and Rehabilitation at Taher Sfar Hospital (Mahdia - Tunisia). The Quality-of-Life Profile for Spine Deformities (QLPSD), the Scoliosis Research Society 22 questionnaire (SRS-22) and the visual analogue scale objectifying the QOL (EVA QOL) were used. Correlations between the QOL domains and selected characteristics were performed. a total of 48 adolescents with AIS were included, with a mean age of 14.2 ± 2.1 years and a sex ratio (M/F) of 0.77. Adolescents who underwent rehabilitation treatment only had significantly better quality of life (QOL) scores than those with braces, as measured by three scales. Among brace wearers, we found a correlation between QOL and the degree of correction achieved by the brace, as measured by the EVA-QOL. We observed significant relationships between psychosocial status and age, correction angle, and treatment duration among braced patients, as measured by the QLPSD. Additionally, we found that dorsal flexibility was correlated with the correction angle and the treatment duration. According to the SRS-22, the overall QOL score of braced adolescents was significantly correlated with the correction obtained by the brace. wearing a brace in adolescent with AIS leads to a significant decrease in QOL according to the three QOL assessment scales.

Preferences for cardiovascular and pulmonary rehabilitation care: A discrete choice experiment among patients in Lebanon

Objective Patient preferences are important in designing optimal rehabilitation care. The aim of this study is to assess preferences for rehabilitation care among two groups of respondents. Design An online discrete choice experiment survey was carried out. Setting We use data for Lebanon, a country where rehabilitation care is still underdeveloped. Participants Patients who have undergone or are currently undergoing rehabilitation treatment (users) and those who have not (yet) used rehabilitation care (non-users). Intervention Patients were asked to repeatedly choose between two hypothetical rehabilitation care packages with seven different attributes: attitude of the staff, travel time to clinic, out-of-pocket costs, medical equipment, rehabilitation plan, additional lifestyle education session, and support during rehabilitation care. Main measures Preference heterogeneity among patients with different characteristics was investigated using random effect binary logistic regression (software package Stata 15). Results In total, 126 respondents completed the survey. The most preferred attribute was an informal and friendly attitude of the staff followed by modern medical equipment, additional lifestyle education session via eHealth, and support during the rehabilitation program via phone call or SMS. Respondents were less in favor of going to the rehabilitation clinic and paying additional out-of-pocket costs for the rehabilitation treatment. This rank order was similar between users and non-users. Conclusion Preferences of patients regarding the type of program chosen (eHealth or at clinical-based) need to be included in future rehabilitation programs. Improving patient experience with rehabilitation programs by giving the best care based on a patient-centered approach is essential.

Reliability of pictorial Longshi Scale for informal caregivers to evaluate the functional independence and disability.

The pictorial Longshi Scale was designed to assess patients' functional ability in the Chinese context, which is gradually used by some informal caregivers. However, its reliability compared with healthcare professionals has not been examined. A multi-centre cross-sectional study conducted in 24 Chinese hospitals. We recruited patients undergoing rehabilitation treatment and informal caregiver dyads. Informal caregivers and healthcare professionals evaluated patients' functional ability using the Longshi Scale according to three levels (bedridden, domestic and community). The Kappa coefficient and McNemar-Bowker test were used to examine the consistency and accuracy between the two parallel assessments. This study involved 947 patients (mean age: 46.07 ± 11.72 years) and informal caregiver dyads (64.86 ± 12.94 years). Most patients were males (66.3%), while most caregivers were females (60.7%). Over 70% of patients and caregiver dyads had a secondary-school education and lower. Around 90% of caregivers were relatives (spouse, 42.8%; offspring, 20.7%; siblings: 13.3%; parent, 12.0%) of patients. The agreement in sub-levels of the Longshi Scale between caregivers and healthcare professionals ranges from 73%-89%, and the corresponding Kappa coefficients range from 0.504-0.786. Caregivers were more likely to assign fewer patients to the bedridden group and more to the domestic group than healthcare professionals. The subgroup analysis by education level indicated that the difference in assigning patients into three degrees of functional disability was only significant in those with primary-school education, while non-significant in those with secondary-school education and higher. The evaluation outcomes of functional ability using the Longshi Scale are similar between informal caregivers and healthcareprofessionals. However, informal caregivers' education level is a dominant factor in affecting the assessment accuracy compared with healthcare professionals. Informal caregivers with a secondary-school education and higher are supported to evaluate patients' functional ability independently.

Rehabilitation of patients after a new coronavirus infection COVID-19 at the second and third stage

BACKGROUND: Patients who have undergone a COVID-19 infection are in need of comprehensive rehabilitation, taking the polysyndromic manifestations of the post- COVID syndrome and comorbidities into account.&#x0D; AIM: The purpose of this article is the need to evaluate the effectiveness of medical rehabilitation programs for patients who underwent a COVID-19 infection at the second and third stages of medical rehabilitation from the standpoint of evidence-based medicine.&#x0D; MATERIALS AND METHODS: 330 medical rehabilitation programs for patients who had a COVID-19 infection were examined. All patients underwent functional tests: control of blood oxygen saturation (SpO2), spirometry, Stange and Gench tests, testing on the Borg exercise tolerance scale and the MRC dyspnea scale; the EQ-5D quality of life questionnaire was completed. Patients were divided into 2 representative groups (160 and 170 people). The average duration of treatment was 14 days. The methods of physical and rehabilitation medicine: therapeutic exercises, breathing exercises, inhalation therapy were applied to the patients in the observation group. Patients in the observation group underwent rehabilitation treatment programs depending on comorbidities and severity of symptoms in organs and systems. The survey was conducted on at 2 control points: 1 day (first), 14 day (second).&#x0D; RESULTS: The observation group showed significantly better recovery results (p 0.05). The average values of the Stange and Gench samples showed a positive trend. There was an improvement in the subjective assessment of the tolerability of the 6-minute walk test on the Borg scale, a decrease in the severity of dyspnea on the MRC dyspnea scale, and an improvement in the quality of life on the EQ-5D scale.&#x0D; CONCLUSION: The structure of the rehabilitation programs used in the clinic of medical rehabilitation and recovery treatment was analysed, showing positive results that have indicated the effectiveness of the methods of physical and rehabilitation medicine in patients with various manifestations of post-COVID syndrome.

Observation on the Effect of Rehabilitative Physical Training on Ice and Snow Sports Injury under Ultrasound Examination.

In order to solve the problem of rehabilitative physical training on ice and snow sports injuries, the author proposed an observation method using ultrasonography to be proposed. This method selects patients with anterior talofibular ligament injury treated in a hospital, forty-nine patients who did not undergo conventional rehabilitation under the surveillance of sports medicine ultrasound were set as the control group, a total of 49 patients with anterior talofibular ligament injury who underwent rehabilitation treatment under the monitoring of sports medicine ultrasound were selected as the experimental group, and the clinical efficacy of the two groups of patients was retrospectively analyzed, in order to discuss the application value of sports medicine ultrasound in the rehabilitation of anterior talofibular ligament injury. The results showed that comparing the rehabilitation effect, ankle function score, and daily living ability of the two groups of patients, the experimental group was better than the control group. Comparing the thickness of ligament and effusion between the two groups, the experimental group was also better than the control group, and the difference was statistically significant (P < 0.05). Ultrasound medical examination can help doctors to effectively judge the degree of injury and recovery of patients, and doctors can adjust the treatment plan in time according to the examination results and formulate an effective rehabilitation plan, which can greatly shorten the recovery time of patients, improve the treatment effect, promote the functional recovery of the ankle joint, and reduce the occurrence of complications.

Predictors of functional outcomes in adults with brain tumor undergoing rehabilitation treatment: a systematic review.

The number of diagnosed brain tumors (BT) has increased in recent years. The results of treatment of patients with surgery, chemotherapy and radiotherapy are also improving and their survival rate has increased significantly. Symptoms of the disease and side effects of oncological treatment may reduce the functional performance of patients. It is so important to conduct rehabilitation in this group of patients. The aim of this systematic review is to identify predictors of effective rehabilitation in aspects of physical functioning of BT patients. The study was registered with health and social care, welfare, public health, education, crime, justice and international development departments, where there is a health-related interest outcome PROSPERO. We have received registration number is: CRD42021269398. To find relevant publications, the algorithm of keywords ("brain tumor") AND (rehabilitation OR "physical activity" OR exercise OR "physical therapy") was used. The search was conducted in PubMed, Web of Science, PEDro, ClinicalTrials.gov and Cochrane Library. Information was extracted using the PICO format (i.e., participants, intervention, comparison, outcomes). the initial search identified a total of 1122 results, and 21 articles met the criteria and were selected for analysis. The results present that rehabilitation is an important and safe cancer encouraging therapy, brings functional benefits. The type of rehabilitation program, especially in BT patients, depends on many factors such as time and type of oncological treatment, general conditions which is strongly related to the general functioning of the patient. It still is a need for clinical research into the safety and effectiveness of rehabilitation interventions already during radio or chemotherapy in this group of cancer patients.

Thyrotropic effects of balneotherapy in Truskavets’ spa and their endocrine, vegetative and metabolic accompaniments

Background. Previous studies of the Truskavetsian Scientific School of Balneology have studied the effects of course use of bioactive water Naftussya - the main therapeutic factor of the spa - on plasma levels of thyroid hormones in males and females healthy rats and women with thyroid hyperplasia. In men with chronic cholecystitis, the immediate thyrotropic effects of a single use of Naftussya water have been studied. The aim of this study is thyrotropic effects of balneotherapy in Truskavets’ spa and their endocrine, vegetative and metabolic accompaniments in men and women with chronic cholecystitis and pyelonephritis. Materials and Methods. The object of clinical-physiological observation were 34 men (23-70 years) and 10 women (39-76 years), who underwent rehabilitation treatment of chronic cholecystitis and pyelonephritis in remission in the Truskavets’ spa. The examination was performed twice, before and after a 7-10-day course of balneotherapy. The main object of study was the plasma level of Triiodothyronine. We determined also content in plasma Cortisol, Aldosterone, Testosterone and Calcitonin as well as the parameters of the HRV and metabolism. Results. We find in 16 patients (12 men and 4 women) inhibitory thyrotropic effect, in 22 (16 men and 6 women) neutral, and in 6 men only – enhancing effect of balneotherapy. Each variant of the thyrotropic effect is accompanied by characteristic changes in testosteronemia, calcitoninemia, parathyroid activity, Heart Rate, Baevskiy’s Activity Regulatory Systems Index, HRV-markers of vagal tone, Calciemia as well as VLD and LD lipoproteins Cholesterol plasma. Conclusion. Our data confirmed and supplemented the provisions on the multivariate effects of balneotherapy in the spa of Truskavets’ on the endocrine and autonomic nervous systems and metabolism of patients.

Neuro-endocrine mechanism of specific balneoeffects of sulfate-chloride sodium-magnesium mineral waters

Background. Earlier we showed that the newly created sulfate-chloride sodium-magnesium drinking mineral waters “Myroslava” (5 g/L) and “Khrystyna” (10 g/L) have favorable effects on neuroendocrine-immune complex and metabolism of patients with their violations. At the same time, the influence of both waters on one constellation of parameters is similar, despite the twofold difference in mineralization, while on the other constellation it is different. The aim of this study was to elucidate the neuroendocrine mechanism of specific effects. Materials and Methods. The object of clinical-physiological observation were 22 men aged 23-70 years, who underwent rehabilitation treatment of chronic pyelonephritis and cholecystitis in remission in the Truskavets’ spa. The examination was performed twice, before and after a 7-10-day course of balneotherapy. All patients received bioactive water Naftussya, however, 11 men additionally drank water "Khrystyna", and the other 11 men - water "Myroslava". The subject of the study were the parameters of the neuroendocrine-immune complex and metabolism. Results. The method of canonical analysis shows that the changes in neuroendocrine factors (LF and VLF bands HRV; beta- and delta-rhythm-generating nerve structures, cortisol and aldosterone determine changes in the parameters of immunity, microbiota, metabolism and cholekinetics by 99,5-98,6%. Conclusion. The primary effects of mineral waters are the modulation of the activity of the structures of the central and autonomic nervous and endocrine systems, which, in turn, have a regulatory modulating effect on the immune system, microbiota, metabolism, cholekinetics and blood pressure.

General non-specific effects of balneofactors of Truskavets’ spa on parameters of neuroendocrine regulation, metabolism, immunity and microbiota in patients with chronic pyelonephritis and cholecystitis

Background. Earlier in experiments on rats, it was shown that drinking mineral water, regardless of their mineralization and chemical composition, have similar (nonspecific) course effects on a number of parameters of metabolism and neuroendocrine-immune complex. The aim of this study is to identify such parameters in patients of Truskavets’ spa who received complex drinking balneotherapy. Materials and Methods. The object of clinical-physiological observation were 34 men aged 23-70 years, who underwent rehabilitation treatment of chronic cholecystitis and pyelonephritis in remission. The examination was performed twice, before and after a 7-10-day course of balneotherapy. All patients received bioactive water Naftussya, therewith, 11 men additionally drank sulfate-chloride sodium-magnesium water "Khrystyna" (5 g/L), and the other 11 men - water "Myroslava" with a similar chemical composition, but twice the mineralization. The object of the study were the parameters of the electroencephalogram, heart rate variability (HRV), hormones, metabolism, immunity, microbiota and cholekinetics. Results. The complex balneotherapy by interval use of Naftussya water with sulfate-chloride sodium-magnesium mineral waters causes similar significant changes in the constellation of 10 EEGs, 10 metabolic, 10 microbiota and 4 immune parameters as well as total power and entropy of HRV, calcitonin and testosterone plasma levels and cholecystokinetics activity index. Conclusion. Balneofactors of Truskavets’ spa causes non-specific modulating effects on parameters of neuroendocrine regulation, metabolism, immunity, microbiota and cholekinetics in patients with chronic pyelonephritis and cholecystitis.

Peculiarities of modulating effects of “Myroslava” and “Khrystyna” mineral waters on neuroendocrine-immune complex and metabolism in patients of Truskavets’ spa

Background. Earlier we found effects on the neuroendocrine-immune complex and metabolism, which are common to the mineral waters "Myroslava" and "Khrystyna", instead different from the effects of Naftussya water. The purpose of this article is to find the specific effects of these waters. Materials and Methods. The object of clinical-physiological observation were 22 men aged 23-70 years, who underwent rehabilitation treatment of chronic cholecystitis and pyelonephritis in remission in the Truskavets’ spa. The examination was performed twice, before and after a 7-10-day course of balneotherapy. Half of the patients received bioactive water Naftussya and sulfate-chloride sodium-magnesium mineral water "Myroslava" (M 5 g/L), and the other half - Naftussya and "Khrystyna" (M 10 g/L). The subject of the study were the parameters of the neuroendocrine-immune complex, microbiota, cholekinetics and metabolism. Results. Screening revealed specific changes in 37 parameters grouped into 5 patterns. The first pattern combines 11 parameters that decrease under the influence of "Myroslava" water (Myr), while increase under the influence of "Khrystyna" water (Khr). For the other 7 parameters of the second pattern, Myr acts similarly, while Khr is ineffective. Both mineral waters have a stimulating effect on 8 parameters, while Myr is inferior to Khr. Myr has a upregulating effect on 9 parameters of the fourth pattern, while Khr has a downregulating effect. Finally, sodium excretion and leukocyturia are reduced under the influence of both waters, but to a greater extent under the influence of Khr. Conclusion. The newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets’ spa have both common and specific favorable modulating neuroendocrine, metabolic and immune effects on patients with chronic cholecystitis and pyelonephritis.