Undergoing Rehabilitation Treatment Research Articles

“Myroslava” and “Khrystyna” drinking mineral waters modulate the state of neuroendocrine-immune complex and metabolism in patients of Truskavets’ spa

Background. Earlier in an experiment on rats we showed that newly created sulfate-chloride sodium-magnesium drinking mineral waters "Myroslava" and "Khrystyna" of Truskavets’ spa has a significant modulating effects on the parameters of metabolism and the autonomic nervous, endocrine and immune systems. Adhering to the principle "Ex experimento ad clinic", we continued research in this direction with the participation of patients of the resort. We showed that these mineral waters have favorable effects on metabolic, HRVs, EEGs, endocrine and immune parameters. This article presents an integrated assessment of previously identified effects. 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 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 complex balneotherapy by interval use of sulfate-chloride sodium-magnesium mineral waters with Naftusya water causes significant changes in the constellation of EEGs, HRVs, endocrine, metabolic and immune parameters, which are different from the effects of Naftusya water monotherapy. Own effects of mineral waters are estimated by modeling. In general, the effects are physiologically favorable and have a normalizing nature. Conclusion. The newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets’ spa have favorable neuroendocrine, metabolic and immune effects on patients with chronic cholecystitis and pyelonephritis.

Comparative study of the effects on the EEG of drinking monotherapy with Naftussya water and therapy supplemented with “Myroslava” and “Khrystyna” mineral waters

Background. Earlier we showed that the newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets’ spa have favorable effects on metabolism and neuroendocrine-immune complex of patients with their dysfunction. This report analyzes the effect of balneotherapy on the parameters of the electroencephalogram of the same contingent of patients. 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 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 electroencephalogram. Results. The complex balneotherapy by interval use of sulfate-chloride sodium-magnesium mineral waters with Naftussya water causes significant changes in the constellation of EEG parameters, which are different from the effects of Naftussya water monotherapy. Own effects of mineral waters are estimated by modeling. Two patterns of neurotropic effects have been identified - activating and inhibitory. In general, the neuromodulating effects are physiologically favorable. Conclusion. The newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets’ spa have favorable neuromodulating effects on patients with chronic cholecystitis and pyelonephritis.

Comparative study of the effect on the neuroendocrine-immune complex and metabolism of drinking monotherapy with Naftussya water and therapy supplemented with “Myroslava” and “Khrystyna” mineral waters

Background. Earlier in an experiment on rats, we showed that the newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets’ spa have neuroendocrine and metabolic effects significantly different from daily water. Adhering to the principle "From experiment to clinic", we continued research in this direction with the participation of patients of the resort. 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 in the Truskavets resort. 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 complex balneotherapy by interval use of sulfate-chloride sodium-magnesium mineral waters with Naftusya water causes significant changes in the constellation of neuroendocrine, metabolic and immune parameters, which are different from the effects of Naftusya water monotherapy. Own effects of mineral waters are estimated by modeling. In general, the effects are physiologically favorable and have a normalizing nature. Conclusion. The newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets resort have favorable neuroendocrine, metabolic and immune effects on patients with chronic cholecystitis and pyelonephritis.

Epidemiological characterization of stroke cases under rehabilitation on the Brazilian Unified Health System in Mossoró, Rio Grande do Norte

Objectives: To identify the clinical and epidemiological characteristics of patients undergoing treatment for a stroke at the only public rehabilitation clinic in Mossoró/RN (Doctor Ozias Alves de Souza Rehabilitation Center). Methods: Quantitative, prospective, descriptive, cross-sectional, exploratory study, structured from responses to a clinical-epidemiological and sociodemographic questionnaire with 39 items, to assess aspects concerning the profile of patients affected by stroke and undergoing rehabilitation treatment. Results: Twenty-eight individuals with stroke sequelae undergoing treatment at the rehabilitation center were identified, whose clinical-epidemiological characteristics revealed equivalence concerning gender (50% male:female), the predominance of white and brown color/race (46.4% each), and overweight (35.7%). Most of the patients lived in a family environment with a spouse (64.3%), were retired (71.4%), with monthly income between one and two minimum wages (64.3%), with hemiplegic sequelae resulting from the stroke (85.7%) and difficulties in adapting to the current way of life (75%). Conclusion: The present study allows an initial scrutiny of stroke cases in Mossoró/RN and their rehabilitation process. Such data may contribute to a better understanding of issues concerning stroke by government sectors, aiming to improve care and multidisciplinary interventions to provide patients with reinsertion in both work practice and in everyday social relationships.

Review on Patient-Cooperative Control Strategies for Upper-Limb Rehabilitation Exoskeletons.

Technology-supported rehabilitation therapy for neurological patients has gained increasing interest since the last decades. The literature agrees that the goal of robots should be to induce motor plasticity in subjects undergoing rehabilitation treatment by providing the patients with repetitive, intensive, and task-oriented treatment. As a key element, robot controllers should adapt to patients’ status and recovery stage. Thus, the design of effective training modalities and their hardware implementation play a crucial role in robot-assisted rehabilitation and strongly influence the treatment outcome. The objective of this paper is to provide a multi-disciplinary vision of patient-cooperative control strategies for upper-limb rehabilitation exoskeletons to help researchers bridge the gap between human motor control aspects, desired rehabilitation training modalities, and their hardware implementations. To this aim, we propose a three-level classification based on 1) “high-level” training modalities, 2) “low-level” control strategies, and 3) “hardware-level” implementation. Then, we provide examples of literature upper-limb exoskeletons to show how the three levels of implementation have been combined to obtain a given high-level behavior, which is specifically designed to promote motor relearning during the rehabilitation treatment. Finally, we emphasize the need for the development of compliant control strategies, based on the collaboration between the exoskeleton and the wearer, we report the key findings to promote the desired physical human-robot interaction for neurorehabilitation, and we provide insights and suggestions for future works.

Relationships between changes in EEG and some metabolic parameters in patients of Truskavets’ spa

Background. Earlier, we found relationships between EEG/HRV parameters and plasma/ urine electrolytes concentration in Truskavets’ spa patients. The aim of this study is to analyze the relationships between changes in these parameters under the influence of balneotherapy. Materials and Methods. The object of observation were 22 men (23-70 years), who underwent rehabilitation treatment of chronic pyelonephritis and cholecystitis in remission. The examination was performed twice, before and after a 9-11-day course of balneotherapy. The object of the study were the parameters of the EEG and exchange of electrolytes and nitric metabolites. Results. Judging by the coefficient of determination, changes in the concentrations of electrolytes and nitric metabolites in the urine and plasma are mediated by changes in neurodynamics by 99,8 % and 99,4% respectively. Conclusion. Balneotherapy affects the exchange of electrolytes and nitrogen metabolites through the CNS.

Fratura Traumática da Apófise Coracoide e do Colo da Omoplata em Atleta de Rugby

Introduction : The fracture of the coracoid process associated with a fracture in another location of the scapula is rarely described in the literature. Case Report : The authors present a case report of a 22- year-old male patient that suffered a fracture of the coracoid process with concurrently neck scapular fracture, in the context of a high-energy trauma of the upper limb during a rugby match. He was submitted to a surgical procedure that consisted in open reduction and placement of osteosynthesis material. Subsequently, in the initial assessment of physical medicine and rehabilitation (PMR), he showed: muscle amyotrophy in the shoulder region; active range of movement (aROM) and passive range of movement (pROM) limitation, in all axes of movement; and pain associated with movement. The patient underwent rehabilitation treatment aimed at correcting the scapulothoracic rhythm, recovering muscle strength and functional recovery, with good results. Conclusion : The authors highlight the importance of early diagnosis and the role of rehabilitation in the athlete’s clinical and functional recovery.

Effect of acceptance and commitment therapy on rehabilitation patients with spinal cord injury

This study aimed to explore the differences between the effectiveness of using a combination of rehabilitation and acceptance commitment therapy (ACT), and rehabilitation therapy alone for the treatment of spinal cord injury (SCI). The newly admitted patients with spinal cord injury whose post-traumatic stress disorder (PTSD) score was higher than 38 points were randomly categorized into the treatment group and control group, with 30 patients in each group. One group underwent ACT and rehabilitation treatment, while the other underwent rehabilitation treatment only. PTSD and functional independence measure (FIM) scores were evaluated. Changes in scores were compared between the two groups before, one month, two months, and three months after treatment. The total PTSD score in SCI patients who were treated with ACT was significantly different before and after treatment (P < 0.05). Total FIM scores were also significantly different before and after treatment (P < 0.05). The FIM score in the treatment group was significantly higher than that in the control group after 2 and 3 months of treatment (P < 0.05). The combination of rehabilitation therapy and ACT could immediately reduce stress levels and significantly improve impaired function, lifelong self-care ability, and the impact of rehabilitation therapy.

Relationships between changes in the state of neuroendocrine regulation and immunity in patients of Truskavets’ spa

Background. Earlier we showed that the balneotherapeutic complex of Truskavets’ spa have significant modulating effects on parameters of EEG&amp;HRV and Immunity of patients with chronic pyelonephritis and cholecystitis in remission accompanied of neuroendocrine-immune complex dysfunction. Were detected the close relationships between EEG, HRV, endocrine and immune parameters as well as between changes in EEG&amp;HRV and immune parameters under the influence of balneotherapy. The aim of this study was to analyze the relationships between changes in the state of neuroendocrine regulation and immunity of the same patients. 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 9-11-day course of balneotherapy. The subject of the study were the parameters of the electroencephalogram, heart rate variability, hormones and immunity. Results. The method of canonical correlation analysis states that the changes in immunity caused by balneotherapy are determined by the constellation of alaptation hormones by 98,9%, the autonomic nervous system by 99,9%, the central nervous system by 99,7%. Conclusion. Immunomodulatory effect of balneotherapy is realized through the neuro-endocrine mechanism.

Rehabilitation of the working population after occupation injuries

Introduction. The urgency to maintain health and man’s working population’s performance capability is inextricably linked to occupation-related injuries. They remain one of the most relevant heads of losses for both the employee and the employer and the state in the form of insurance benefits, sickness certificates, disability benefits, rehabilitation programs, and compensation payments. High rate of posttraumatic complications, disability and demographic losses call for improving in the treatment delivery at all its stages. The purpose is to improve rehabilitation effectiveness in patients after job-related injuries in recognition of the international classification of functioning of post-traumatic disorders of the upper extremities. Material and methods. 3,201 patients with domestic and job-related injuries of the body’s locomotor apparatus underwent rehabilitation treatment within second and third rehabilitation stages under twenty-four-hour inpatient treatment and outpatient care. Upper extremities injuries were in 57% cases; lower extremities injuries - 38%. Combined injuries made up 5 %. Since 2020, there has been introduced the work of a multidisciplinary team (MDT), consisting of doctors of physical and rehabilitation medicine (PRM) as well as doctors of physical therapy, neurologists, internists, reflexologist, traumatologist, doctors in exercise therapy, trainers in exercise therapy, clinical psychologists, ergotherapists, and specialized doctors (cardiologist, dietitian, endocrinologist, osteoporosis specialist, etc.). Results. The clinical practice of using treatment methodology from the position of rehabilitation potential and diagnosis is shown. Possible ways for improving the effectiveness of recovering the population’s health after injuries are analyzed using international standards. The main steps, tasks, and medical and social rehabilitation opportunities are discussed using the international classification of functioning, disability, and health (ICF). Conclusion. Our experience with patients of a traumatic profile, including individuals after job-related injuries, shows the reasonableness of using ICF in rehabilitation as a unified international tool and should be further used.

New Tasks for Medical Robotics in Rehabilitation and Hospital Services in a Pandemic Time – New Solutions: a Concept Model of an Autonomous Multifunctional Robot «Helper»

The article is devoted to an overview of modern medical robots used in everyday rehabilitation practice and hospital services. At thesame time, the emerging problems and new challenges associated with the COVID-19 pandemic are analyzed. Logically structured medical and technical solutions using innovative robotics are proposed. The concept model of the multifunctional autonomous robot “Helper” which is presented in the article has 7 functions that are critical in the face of a pandemic: movement along the specified routes; disinfection of premises and robot self disinfection; biometric identification; delivery of medicines; interpersonally communication;possibilities of telepresence and telemedicine; interactive musical-acoustic and virtual psychotherapy. It is an attempt to find effective practical response to the most serious challenges of our time associated with the pandemic aimed at reducing the risks of nosocomial spread of infection, unloading medical staff, providing psychological and service assistance to patients with COVID-19 who are undergoing rehabilitation treatment. The conclusive idea of the article is that medical robotics plays an increasingly significant role in the process of modern rehabilitation treatment and hospital services, which become especially important during a pandemic control and liquidation of its consequences. The relevant robotization of Healthcare Service has strategic importance with high medical,social and economic potential.

BDNF rs6265 Polymorphism and Its Methylation in Patients with Stroke Undergoing Rehabilitation.

Brain-Derived Neurotrophic Factor (BDNF) and its rs6265 single nucleotide polymorphism (SNP) play an important role in post-stroke recovery. We investigated the correlation between BDNF rs6265 SNP and recovery outcome, measured by the modified Barthel index, in 49 patients with stroke hospitalized in our rehabilitation center at baseline (T0) and after 30 sessions of rehabilitation treatment (T1); moreover, we analyzed the methylation level of the CpG site created or abolished into BDNF rs6265 SNP. In total, 11 patients (22.4%) were heterozygous GA, and 32 (65.3%) and 6 (12.2%) patients were homozygous GG and AA, respectively. The univariate analysis showed a significant relationship between the BDNF rs6265 SNP and the modified Barthel index cut-off (χ2(1, N = 48) = 3.86, p = 0.049), considering patients divided for carrying (A+) or not carrying (A−) the A allele. A higher percentage of A− patients obtained a favorable outcome, as showed by the logistic regression model corrected by age and time since the stroke onset, compared with the A+ patients (OR: 5.59). At baseline (T0), the percentage of BDNF methylation was significantly different between GG (44.6 ± 1.1%), GA (39.5 ± 2.8%) and AA (28.5 ± 1.7%) alleles (p < 0.001). After rehabilitation (T1), only patients A− showed a significant increase in methylation percentages (mean change = 1.3, CI: 0.4–2.2, p = 0.007). This preliminary study deserves more investigation to confirm if BDNF rs6265 SNP and its methylation could be used as a biological marker of recovery in patients with stroke undergoing rehabilitation treatment.

Total Serum Calcium and Recovery after Rehabilitation in Patients with Stroke

Calcium deficiency is frequently observed in stroke survivors, but no data exist concerning the relationship between calcium and rehabilitation outcome in patients with stroke. Therefore, we examined in a group of subacute stroke patients if changes in the Barthel Index after a rehabilitation treatment were associated with blood parameters related to calcium status. We retrospectively explored serum calcium status (total calcium, ionized calcium), serum total protein status, and serum albumin percentage in 30 subacute stroke patients admitted to our rehabilitation center. Patients underwent a 6-week rehabilitation treatment (each session lasting 45 min, 2 sessions/day, 6 days/week). Overall, 26.7% of patients had total calcium levels below the reference range, whereas 100% of patients had ionized calcium in the reference range. Total protein and albumin were below the reference range in about 77% and 67% of patients, respectively. We found that only total calcium was correlated with the change from baseline of the Barthel Index (BI) (rho = 0.466, p = 0.009). A multiple linear regression model confirmed that in our sample the total calcium significantly predicted the change from baseline of the Barthel Index (F5, 24 = 4.074, p = 0.008, adj. R2 = 0.346). This study suggests a possible connection between serum calcium status and total protein status of stroke patients undergoing rehabilitation treatment and rehabilitation outcomes. Further investigations are necessary to confirm the importance of testing serum calcium status of patients at admission in a rehabilitation unit for an eventual supplementation or a dietary personalized program.

Vitamin D and Rehabilitation after Stroke: Status of Art

Stroke is the first cause of disability in the population and post-stroke patients admitted to rehabilitation units often present a malnutrition status which can influence nutritional indices and then vitamin levels. Vitamin D deficiency seems implicated beyond stroke severity and stroke risk, and also affects post-stroke recovery. Some studies on vitamin D levels and outcome in stroke patients are available but very few data on vitamin D levels and outcome after rehabilitation treatment are reported. This literature review shows the possible relationship between vitamin D deficiency and recovery in post-stroke patients undergoing rehabilitation treatment. Moreover, because several studies have reported that single nucleotide polymorphisms and promoter methylation in genes are involved in vitamin D metabolism and might affect circulating vitamin D levels, these aspects are evaluated in the current paper. From the studies evaluated in this review, it emerges that vitamin D deficiency could not only have an important role in the recovery of patients undergoing rehabilitation after a stroke, but that genetic and epigenetic factors related to vitamin D levels could have a crucial role on the rehabilitation outcome of patients after stroke. Therefore, further studies are necessary on stroke patients undergoing rehabilitation treatment, including: (a) the measurement of the 25(OH) vitamin D serum concentrations at admission and post rehabilitation treatment; (b) the identification of the presence/absence of CYP2R1, CYP27B1, CYP24A1 and VDR polymorphisms, and (c) analysis of the methylation levels of these genes pre- and post-rehabilitation treatment.

POST STROKE REHABILITATION: CLINICAL EFFICACY OF BCI-DRIVEN HAND EXOSKELETON IN COMPARISON WITH "AMADEO" ROBOTIC MECHANOTHERAPY

Motor function deficit due to stroke is one of the leading causes for disability among working-age population. The most effective evidence-based treatment strategies are task oriented exercise approaches including constrained-induced movement therapy. Robot-assisted training provides high amount of repetitions and feedback to patient. Adjuvant therapies such as mirror therapy and motor imagery show their effectiveness if used in combination with basic neurorehabilitation methods and are treatment of choice for patients with severe motor impairment. Brain-computer interfaces allow to control motor imagery as a process by giving different type of feedback (e.g. kinesthetic via exoskeleton) during training sessions. It is poorly known if kinesthetic motor imagery is more effective comparing to robot-assisted training as a part of post-stroke rehabilitation. Materials and methods: 55 patients with arm paresis &gt;1 month after stroke were enrolled in the current study. Screening and randomization were performed. Participants underwent rehabilitation treatment where BCI controlled motor imagery training in main group and robot-assisted training in control group were included. Motor function of the paretic arm was assessed using Action Research Arm Test (ARAT) and Fugl-Meyer Assessment (FMA) before and after intervention. Results: Recovery of upper extremity motor function did not correlate with time since stroke and age of participants neither in main group, nor in control group. Correlations between change in motor scales scores and initial severity of motor deficit was shown in both groups (p

Avaliação da porcentagem de gordura corporal em um indivíduo com amputação transfemoral bilateral por diferentes métodos

A amputação predispõe a um risco de alterações na composição corporal, condição que interfere no equilíbrio no uso da prótese, aumenta o cansaço físico e tem como consequência menor rendimento nas terapias físicas. Nesse sentido, é fundamental eleger o método mais apropriado para avaliar a composição corporal. Objetivo: Avaliar a porcentagem de gordura corporal em um indivíduo com amputação transfemoral por diferentes métodos. Método: Trata-se de um estudo de caso de caráter clínico retrospectivo com um participante do sexo masculino, idade 67 anos com amputação transfemoral bilateral por insuficiência vascular, atendido pelo Serviço de Nutrição do Instituto de Medicina Física e Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - IMREA HCFMUSP. Utilizou-se o somatório das dobras cutâneas, absorciometria de raio-X de dupla energia (DXA) e análise de impedância bioelétrica (IB). Resultados: Os dados antropométricos apontaram porcentagem de gordura corporal de 34,3%, a IB 33% e o DXA revelou 37%. Conclusão: Para este caso, sugere-se que na inviabilidade de avaliar a porcentagem de gordura corporal em indivíduos com amputação com o DXA, o somatório das dobras é o método elegível. Estudos futuros são imprescindíveis a fim de estabelecer o método adequado para avaliação da composição corporal de pessoas com amputações bilaterais de membros inferiores, tendo em vista que este resultado contribui para o melhor desfecho clínico de pacientes em processo de reabilitação.

Disseminated actinomycosis causing incomplete paralysis

In May 2018, a 55-year-old man without underlying disease presented to emergency department with a 2-month history of aggravated cough, chest pain, fever and decreased muscle strength of limbs. The...

An Early Tailored Approach Is the Key to Effective Rehabilitation in the Intensive Care Unit

ObjectiveTo investigate the effectiveness, feasibility, and safety of an evidence-based rehabilitation care pathway in the intensive care unit (ICU) in different patient populations. DesignObservational prospective cohort study, with retrospective controls. SettingICUs of a university hospital. ParticipantsPatients admitted between April 1, 2015, and June 30, 2015, were compared to a retrospective cohort admitted to the same ICUs during the same 3-month period in 2014. The number of patients studied (N=285) included 152 in the prospective group and 133 in the retrospective group. InterventionsThe prospective cohort benefited of a rehabilitation care pathway based on (1) interdisciplinary teamwork; (2) early customized and goal-oriented rehabilitation; (3) daily functional monitoring and treatment revision; (4) agreed discharge policy; and (5) continuity of care. The retrospective cohort underwent usual care. Main Outcome MeasuresIncluded the following: (1) proportions of patients undergoing rehabilitation team evaluation; (2) latency between patient admission to ICUs and rehabilitation team assessment; (3) proportions of patients undergoing rehabilitation treatment during ICU stay; (4) latency between the patient admission to ICUs and rehabilitation start; (5) ICU stay and total acute hospital stay; and (5) proportion of ventilator-free days out of ICU stay. ResultsThe novel rehabilitation care pathway led to (1) an increased proportion of patients receiving rehabilitative assessment (P<.0001); (2) a decreased latency from ICU admission to both rehabilitation team assessment and rehabilitation start (P<.0001); (3) an increased proportion of patients undergoing rehabilitation (P<.0001); (4) a shorter length of stay in ICUs (P<.0001) and in hospital (P=.047); and (5) a shorter mechanical ventilation duration (P<.02). A direct relationship between rehabilitation start latency and ICU length of stay was observed. ConclusionsAn early, interdisciplinary team approach, providing a customized dynamic planning of physiotherapy programs, increases ventilator-free time and reduces total hospital stay, especially in patients admitted to the ICU after general surgery. This rehabilitation care pathway can be generalized to different geopolitical scenarios, being feasible, safe and cost effective.

Defining a prognostic criterion of orthopaedic complications development in patients with an injury of anterior cruciate ligament of knee joint

IntroductionPrognostic indices of orthopaedic implications development were investigated among patients with anterior cruciate ligament (ACL) injuries on the basis of stabilography research during the functional period of rehabilitation.MethodsThe study included 52 randomly selected individuals with a complete ACL tear qualified for surgical reconstruction. The patients’ age was 18–59 (average: 37.8 ± 2.0) years. All participants underwent rehabilitation treatment in the Institute of Traumatology and Orthopaedics, National Academy of Medical Sciences of Ukraine, and had surgeries in the Institute’s clinics. The crural part of the graft was fixed with the assistance of either the RigidFix system or the Cross-Pin system, and the Biointrafix or Biosure Sync system was applied for the tibial part.Results and conclusionsOn the basis of the performed analysis of indices that characterize the functional condition of the injured limb of patients with an injury of ACL of knee joint at the functional stage of rehabilitation treatment, it is possible to identify a high and medium level of loading asymmetry in the lower extremities, decrease of electrobiological activity and muscle resistance ability during bending, stretching, adduction, and abduction, as the main prognostic criterion of orthopaedic complications development.

Predictors of mobility domain of health-related quality of life after rehabilitation in Parkinson\u2019s disease: a pilot study

BackgroundParkinson’s disease impacts health-related quality of life (HRQoL), however no studies inquired on predictors of HRQoL changes after rehabilitation. This study assessed the relationship between mobility domain of HRQoL measured by Parkinson’s Disease Questionnaires-39 (PDQ-39) and clinical-demographic characteristics and developed a model predicting changes after rehabilitation.MethodsSubjects with Parkinson’s disease underwent rehabilitation treatment and completed the following predictors: 10-m walking test (10MWT), Timed Up and Go (TUG), Berg Balance scale (BBS), Activities-specific Balance Confidence scales (ABC), Freezing of Gait (FOGQ) and PDQ-39. Two general linear models were calculated to predict the relationship between HRQoL at baseline and to predict HRQoL changes after rehabilitation.ResultsForty-two subjects (age 74.9 ± 7.3 years, Hoehn&Yahr 2.8 ± 0.6) completed the baseline evaluation. The first model (multiple R2 = 0.59, F = 5.86, P < 0.001) showed that ABC (B = − 0.51, CI = − 0.86 to 0.15, R2 = 0.41, P = 0.005) and FOGQ (B = 2.38, CI = 1.03 to 3.73, R2 = 0.07, P = 0.001) were statistically significant predictors of mobility aspect of HRQoL at baseline. Thirty seven subjects completed the rehabilitation sessions, data were entered in the second model (multiple R2 = 0.40, F = 4.24, P < 0.004) showing that gender (B = − 5.12, CI = − 9.86 to − 0.39, R2 = 0.23, P = 0.034), Hoehn&Yahr (B = 10.93, CI = + 3.27 to + 18.61, R2 = 0.22, P = 0.006) and PDQ-39 mobility at baseline (B = − 0.38, CI = − 0.63 to − 0.14, R2 = 0.55, P = 0.002) were statistically significant predictors of changes of the mobility aspect of HRQoL.ConclusionsBalance confidence and Freezing of Gait are associated with the mobility aspect of HRQoL. Changes in mobility domain of HRQoL (as assessed by PDQ-39) are likely to be greater in males, in people at higher stages of the disease and in people with more severe limitation in mobility domain of HRQoL (as assessed by PDQ-39) before rehabilitation. Results might be different when considering different outcomes or different measures for the same outcome (performance mobility test instead of self-report questionnaires). Further investigations are needed to better understand other components of HRQoL in addition to mobility.Trial registrationNCT02713971 registered March 8, 2016.