scholarly journals Strategy of Psycho-Correctional Work in Medical Rehabilitation of Patients with Movement Disorders

2020 ◽  
Vol 9 (4) ◽  
pp. 151-168
Author(s):  
A.V. Kotel'nikova ◽  
A.А. Kukshina ◽  
T.S. Buzina ◽  
A.S. Tihonova
Keyword(s):  
Movement Disorders ◽  
Medical Problem ◽  
Medical Rehabilitation ◽  
Expert Assessment ◽  
Rehabilitation Process ◽  
Depressive Feelings ◽  
Compliance Level ◽  
High Level ◽  
Attending Physician ◽  
Preventive Diagnostics

The purpose of present work is to study the dynamic characteristics of the personality (current psycho-emotional state, adherence to treatment) of patients with movement disorders in order to identify the main targets of psycho-correctional work. 363 patients were examined: 195 after stroke and 168 with degenerative-dystrophic diseases of large joints and spine. The following tools were used: SCL-90-R, Tampa Scale, Compliance Level Questionnaire, expert assessment of compliance by the attending physician and physical therapy instructor on a five-point scale. High level of somatization of anxiety and depressive feelings and psychological component of kinesiophobia (fear of movement), manifested in convincing patients that their illness is an insoluble medical problem were marked as targets of psycho-correctional works during the study. The contribution of personal compliance, understood as the implicit willingness of the patient to be committed to treatment and to the achievement of satisfactory compliance, registered in the rehabilitation process, is studied. The expediency of drawing up individual programs of psychological rehabilitation on the basis of preventive diagnostics of compliance is shown, while the average level of the mentioned indicator is determined as optimal for the effectiveness of rehabilitation.

scholarly journals Аpplication of rehabilitation technologies to improve cognitive functions in patients with ischemic stroke

2021 ◽  
Vol 20 (2) ◽  
pp. 155-160
Author(s):  
Anna A. Mikhailova ◽  
Natalya B. Korchazhkina ◽  
Elizaveta S. Koneva ◽  
Konstantin V. Kotenko
Keyword(s):  
Ischemic Stroke ◽  
Drug Therapy ◽  
Movement Disorders ◽  
Cognitive Functions ◽  
Muscle Tone ◽  
Depression Scale ◽  
Medical Problem ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Standard Drug

BACKGROUND: Currently, the development and implementation of new effective comprehensive programs for medical rehabilitation of patients who have undergone acute cerebrovascular accident is an important and urgent medical problem. AIMS: To study the effect of combined methods of medical rehabilitation in patients with post-stroke spasticity on cognitive functions and psychoemotional status. MATERIAL AND METHODS: The study involved 60 patients who underwent ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the form of spasticity in the long-term period. Patients of the control group (30 people) underwent standard drug therapy and medical rehabilitation, patients of the main group (30 people), against the background of standard drug therapy and medical rehabilitation, used combined physiotherapy methods from the Alpha LED Oxy Light Spa apparatus. Subjective indicators of cognitive impairment (Montreal Cognitive Assessment Scale) and psychoemotional defects (Hospital Anxiety and Depression Scale) were assessed. RESULTS: Immediately after treatment on day 14, cognitive functions significantly improved and the degree of psychoemotional defect decreased, which was confirmed by the MOCA and HADS scales. CONCLUSION: The inclusion of combined physiotherapy methods in the standard complex of medical rehabilitation and treatment of patients after ischemic stroke with movement disorders in the form of hemiparesis contributes to a significant improvement in cognitive functions and a decrease in the degree of psychoemotional impairment.

Barriers of physical activity (kinesiophobia) in patients subjected to cardiac rehabilitation

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Janusz Kocjan ◽  
Andrzej Knapik
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Short Form ◽  
Social Activity ◽  
Self Assessment ◽  
Rehabilitation Process ◽  
Sf 36 ◽  
Polish Version ◽  
High Level ◽  
The Relationship

AbstractBackground: Comprehensive cardiac rehabilitation (CR) is a process designed to restore full physical, psychological and social activity and to reduce cardiovascular risk factors. Fear of movement may contribute to the occurrence and intensification of hypokinesia, and consequently affect the effectiveness of therapy. The aim of the study was to determine the level of barriers of physical activity in patients undergoing cardiac rehabilitation. The relationship between selected determinants (age and health selfassessment) and the kinesiophobia level were also examined.Material/Methods: 115 people aged 40-84 years were examined: 50 females (x = 63.46; SD = 11.19) and 65 males (x = 64.65; SD = 10.59) - patients undergoing cardiac rehabilitation at the Upper-Silesian Medical Centre in Katowice. In the present study, the Polish version of questionnaires: Kinesiophobia Causes Scale (KCS) and Short Form Health Survey (SF-36) were used. Questionnaires were supplemented by authors’ short survey.Results: The patients presented an elevated level of kinesiophobia, both in general as well as in individual components. In women, the kinesiophobia level was higher than in men. The psychological domain was a greater barrier of physical activity than the biological one. Strong, negative correlations of psychological and biological domains of kinesiophobia to physical functioning (SF-36) were noted in women. In the case of men, correlations were weaker, but also statistically significant.Conclusions: 1. Sex differentiates patients in their kinesiophobia level 2. Poor self-assessment of health is associated with a greater intensification of kinesiophobia 3. A high level of kinesiophobia may negatively affect cardiac rehabilitation process

scholarly journals POS1118 THE RELEVANCE OF OSTEOPOROSIS DIAGNOSIS AND TREATMENT FOR DOCTORS WORKING IN THE FIELD OF PHYSICAL AND REHABILITATION MEDICINE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 838.2-838
Author(s):  
L. Marchenkova ◽  
V. Vasileva
Keyword(s):  
Diagnostic Procedures ◽  
Rehabilitation Medicine ◽  
Medical Problem ◽  
Medical Rehabilitation ◽  
Mineral Density ◽  
Medical Specialties ◽  
Treatment And Prevention ◽  
Medical Institutions ◽  
Physical And Rehabilitation Medicine ◽  
High Prevalence

Background:There is a high prevalence of osteoporosis (OP) among patients of the older age undergoing rehabilitation. Therefore, it is obvious that physicians working in the field of physical and rehabilitative medicine should be well oriented in this medical problem.Objectives:to study the relevance of the problem of osteoporosis (OP) for physicians working in the field of physical and rehabilitation medicine, their awareness of the main methods of diagnosis, treatment and prevention of this disease, as well as the frequency of their use in daily clinical activities.Methods:A cross-type study was carried out using a questionnaire survey. The study included 157 doctors (M-34, F-123) of 8 medical specialties working in 27 specialized medical institutions on the profile of “medical rehabilitation. The questionnaire for doctors consisted of 21 items of special questions.Results:90.45% of the surveyed doctors believed that the problem of OP is relevant for their clinical activities, 100% of the respondents indicated that the presence of OP significantly affects the rehabilitation prognosis and 95.54% - on the degree of effectiveness of medical rehabilitation. According to the respondents, patients with OP make up on average 30.0% [20.0; 50.0] (0-90) of the total flow of patients. 92.36% (145/157) of doctors indicated that they know the risk factors for OP, 98.73% (155/157) - methods for diagnosing OP, 68.79% (108/157) - methods for treating OP, 80.25 % (126/157) - methods of preventing OP, 47.13% (74/157) - what is FRAX. However, 35.01% (55/157) of the respondents considered their level of awareness of the problem sufficient for managing patients with OP. Diagnostic procedures for OP are recommended by all endocrinologists (100%) and the majority of traumatologists (72.73%), gynecologists (66.67) and cardiologists (64.28%), as well as on average half (50%) neurologists and therapists. Endocrinologists (100%), gynecologists (66.67%) and therapists (60%) are mainly involved in the treatment of OP. 32.48% (51/157) of physicians have ever referred their patients to a bone mineral density assessment.Conclusion:Conclusion. The problem of OP is relevant for the clinical activities of specialists in physical and rehabilitation medicine, and there is the need for advanced training on the problem of OP among these specialists.Disclosure of Interests:None declared.

Rehabilitation in Tehri Dam: An evaluation

Social Change ◽  
2001 ◽  
Vol 31 (1-2) ◽  
pp. 110-143 ◽  
Author(s):  
B. K. Sinha ◽  
H. C. Pokhriyal
Keyword(s):  
Common Property ◽  
Rehabilitation Process ◽  
Common Property Resources ◽  
Urban Households ◽  
Positive Externalities ◽  
Rural And Urban ◽  
Tehri Dam ◽  
High Level ◽  
Available Information ◽  
Ownership Rights

In the whole debate of ecological suitability of Tehri Dam, the rehabilitation aspect has been found ignored. Keeping in view of the significance of complete rehabilitation and resettlement of the oustees, the overall rehabilitation process including rural and urban population is analysed in the present paper. In total, 125 villages will be fully or partially submerged affecting more than one lakh population. More than twenty thousand urban populations will also be rehabilitated. It is expected that around 6000 cores of rupees (at 1993 price level) will be spent. Out of which 13% will be spent on the rehabilitation of the oustees. On the basis of the available information, it is found that only 33% of the rural families and 66% of the urban households have actually received the compensation or taken the possession of the land in the new sites. Non availability of land to the rest of the oustee households has been identified as the peculiar dimension of the rehabilitation process. The resettled households in Dehradun and Haridwar districts are facing the problem of geographic continuity, land owner shiprights and absence of institutional mechanism like panchayati raj institutions in the new settlements. The absence of non-farm employment and non-accessibility to the common property resources are the critical problems, including the availability of drinking water, irrigation, primary health and education, which can be observed seen in the rehabilitation sites. The resettlers are unable to adjust with the new environment including a high level of dependency on the market forces for each and every requirement. The partially submerged population is also facing peculiar problems. They will only be given cash compensation without any other compensatory measures. The ‘upstream cost and down stream benefits syndrome’ is strikingly visible in the rehabilitation process. In the urban resettlement process various issues Iike-the validity of survey, classification of urban households and cut off dates are relevant to mention. The positive externalities of the old Tehri town were completely missing in the new urban rehabilitation site. As a whole it can be tentatively said that the process of rehabilitation has been loosely coordinated and badly implemented. The issues of upstream cost, accessibility to common property resources and customary rights are the neglected aspects in the process. The re-organisation of the institutional frame work and granting land ownership rights to the resettlers and quality of the basic amenities are the other inevitable requirements need proper assessment and implementation. The present process of rehabilitation is largely non-participatory and non transparent, which can only be solved through radical measures. These measures are unlikely to be initiated in the present set of Tehri dam administration.

scholarly journals Prospects for Blood Pressure Remote Monitoring in Hypertensive Patients in the Ryazan Region

2020 ◽  
Vol 15 (6) ◽  
pp. 795-801
Author(s):  
N. V. Aksenova ◽  
A. A. Nizov ◽  
O. N. Selyavina ◽  
E. I. Suchkova ◽  
E. V. Filippov
Keyword(s):  
Blood Pressure ◽  
Remote Monitoring ◽  
Medical Professional ◽  
Automatic Data ◽  
Hardware Complex ◽  
Software And Hardware ◽  
Monitoring Center ◽  
Clinically Significant ◽  
High Level ◽  
Attending Physician

Aim. To study the effectiveness and benefits of blood pressure (BP) remote monitoring in outpatients with hypertension.Material and methods. The study included 100 patients with a verified diagnosis of hypertension, who didn’t achieve target BP pressure levels. The patients measured their BP twice a day over 6 months with facilities with automatic data transmission over GSM-channel to a remote monitoring center. BP parameters were being transmitted online to the remote monitoring center, where they were being processed and transferred to the personal account planner (created by the Web interface based on the software and hardware complex) of the attending physician and operator of the remote monitoring center. It is important that doctor received information only on clinically significant measurement results, based on which he determined the urgency of contact with the patient and the further tactics of his management.Results. No malfunctions in the work of communication facilities, technical failures in the software and hardware complex were registered over the entire period of the study. After 6 months of the monitoring it was possible to achieve target BP levels less than 135/85 mm Hg in 70% of patients. The proportion of patients with a high level of normal BP increased from 10% to 19%, while the proportion of patients with grade 1 and 2 of hypertension decreased significantly (from 33% to 7% and from 54% to 3%, respectively). At the beginning of telemedicine monitoring 3% of patients had stage 3 of hypertension, at the end of the study – 1%.Conclusion. The technology of telemedicine monitoring has shown itself as a simple, affordable and reliable way of management of outpatients with hypertension in conditions of real clinical practice. It was possible to achieve BP levels less than 135/85 mm Hg in 70% of patients by the method of remote outpatient monitoring. BP remote monitoring changed fundamentally the decision-making strategy of the patients management: it was not the patient who independently determined the need for consultation with a medical professional, but the attending physician made a decision on the method and urgency of contact with the patient on the basis of the data of objective monitoring indicators.

scholarly journals Modern aspects of social protection of combatants depending on the severity of disability

2020 ◽  
pp. 35-40
Author(s):  
N. M. Bieliaieva ◽  
O. B. Yavorovenko ◽  
I. V. Kurylenko ◽  
L. V. Prysiazhniuk ◽  
O. V. Dziuniak ◽  
...  
Keyword(s):  
Medical Rehabilitation ◽  
Rehabilitation Services ◽  
Persons With Disabilities ◽  
Rehabilitation Process ◽  
Group Iii ◽  
Rehabilitation Programs ◽  
Social Rehabilitation ◽  
Group I ◽  
Severity Of Disability ◽  
Rehabilitation Measures

The urgency of the problem is due to the significant increase in recent years in the number of young and middle-aged people who have passed the war, the need to develop adequate measures of social assistance and protection. An important task in the organization of the rehabilitation process is to determine the structure of the needs of servicemen with disabilities in various types of medical and social care and the development of individual rehabilitation programs (IRP) based on them. The purpose of the study: to determine the structure of the needs of servicemen with disabilities in medical and social rehabilitation depending on the severity of disability. Statistical data from 25 administrative territories of Ukraine for 2018 are analyzed, the needs of participants of military service with disabilities in medical and social rehabilitation measures, their structure are calculated. The data of the information base of the centers and the bureau of medical and social examination of the regions were used. Processing of the primary material was performed using the universal statistical package "Excel". In 2018, medical and social expert commissions (MSEC) of Ukraine for the first time and re-certified and recognized persons with disabilities 7843 combatants. Of these, disability of group I (IA and IB) was established in 2.6 %, II – in 29.2 %, III – in 68.2 % of cases. All victims for MSEC were formed IRP. The dependence of the needs of combatants in medical and social rehabilitation measures on the severity of disability has been established. For persons with disabilities of groups II and III, priority is given to medical and professional rehabilitation, group I – social rehabilitation and technical means of rehabilitation with medical support. Of the medical rehabilitation services for persons with II and III groups of disability, sanatorium treatment is significant, and group I – rehabilitation therapy. Among vocational rehabilitation services, employment in production conditions is important – for persons with group III disabilities, in specially created conditions – for persons with group II disabilities, at home – for persons with group I disabilities. Vocational training was offered to a small number of people with disabilities of all groups. Among social rehabilitation services and technical means of rehabilitation, the services of social workers of territorial social service centers were significant for representatives of all disability groups, simpler means of transportation for persons of group III disability and more complex means for persons of group I. Determining the characteristics of the needs of servicemen with disabilities depending on its severity allows MSEC specialists to better form the IRP, develop targeted rehabilitation programs at the regional level, assess shortcomings in the organization of the rehabilitation process and build a rehabilitation system for combatants.

scholarly journals Tingkat Kepatuhan Minum Obat Antihipertensi Pada Pasien Hipertensi Tanpa Penyakit Penyerta Di Puskesmas Sumowono

2021 ◽  
Vol 2 (2) ◽  
pp. 78-84
Author(s):  
Yulistiawan Ardita Admin ◽  
Dian Oktianti ◽  
Niken Dyahariesti
Keyword(s):  
Public Health ◽  
Health Center ◽  
Antihypertensive Medication ◽  
Antihypertensive Drugs ◽  
Descriptive Analysis ◽  
Public Health Center ◽  
Compliance Level ◽  
High Prevalence ◽  
Therapy Compliance ◽  
High Level

Hypertension is a chronic disease that is often called the silent killer and has a fairly high prevalence. The level of compliance to take medication is a major factor to determine the success of therapy. Compliance and a good understanding in carrying out therapy can affect blood pressure and can prevent complications. To identify the level of compliance to take antihypertensive drugs in hypertensive patients without comorbidities at Sumowono Health Center in terms of the MMAS-8 scores. This research is a non-experimental research with a descriptive design. Sampling was done in total sampling , analyzed in a descriptive manner. Samples obtained were 22 respondents. The results of this study showed. 9 respondents had high compliance 40.9%, 7 respondents had moderate compliance 31.8%, 6 respondents had compliance 27.3%. Based on a descriptive analysis of the level of compliance with taking drugs at the Sumowono Public Health Center has a high level of taking medication (40.9 %). Hypertension patients without comorbidities in Sumowono Public Health Center are compliant in taking antihypertensive medication. Hypertension, No Accidental Disease , Compliance Level, MMAS-8. ABSTRAK Hipertensi adalah penyakit kronis yang sering disebut the silent killer dan memiliki prevalensi yang cukup tinggi. Tingkat kepatuhan minum obat merupakan faktor utama penentu keberhasilan terapi. Kepatuhan serta pemahaman yang baik dalam menjalankan terapi dapat mempengaruhi tekanan darah dan dapat mencegah terjadinya komplikasi. Mengidentifikasi tingkat kepatuhan minum obat antihipertensi pada pasien hipertensi tanpa penyakit penyerta di Puskesmas Sumowono ditinjau dari hasil nilai MMAS-8. Penelitian ini termasuk dalam penelitian jenis non eksperimental dengan rancangan deskriptif. Pengambilan sampel dilakukan secara total sampling yang dianalisis dengan cara deskriptif. Sampel yang diperoleh sebanyak 22 responden. Hasil penelitian ini menunjukkan. 9 responden memiliki kepatuhan tinggi 40,9%, 7 responden memiliki kepatuhan sedang 31,8%, 6 responden memiliki kepatuhan 27,3%. Berdasarkan analisis deskriptif tingkat kepatuhan minum obat di Puskesmas Sumowono memiliki kepatuhan minum obat yang tinggi (40,9%). Pasien hipertensi tanpa penyakit penyerta di Puskesmas Sumowono patuh dalam minum obat antihipertensi. Hipertensi, Tanpa Penyakit Penyerta, Tingkat Kepatuhan, MMAS-8.

Counseling for the Catastrophically Disabled: A Critical Need in the Medical Model

1989 ◽  
Vol 20 (4) ◽  
pp. 39-41
Author(s):  
Elaine Irons ◽  
Thomas R. Irons
Keyword(s):  
Sexual Functioning ◽  
Medical Model ◽  
Rehabilitation Program ◽  
Medical Rehabilitation ◽  
Rehabilitation Process ◽  
Areas Of Concern

The intent of this article is to create greater awareness of a continuing problem in the medical rehabilitation of the catastrophically disabled. That problem is a need for counseling throughout the rehabilitation program. It is noted that without this element in the medical model there are numerous problems related to later adjustment, such as socialization, and sexual functioning. The authors comment on these areas of concern, and discuss what might be implemented to facilitate the total rehabilitation process.

scholarly journals Ventilatory Care in Status Asthmaticus

1998 ◽  
Vol 5 (6) ◽  
pp. 485-490 ◽  
Author(s):  
Robert J Smyth
Keyword(s):  
Pressure Support ◽  
Status Asthmaticus ◽  
High Pressures ◽  
Work Of Breathing ◽  
Ventilatory Support ◽  
Medical Problem ◽  
Severe Exacerbation ◽  
Number Of Patients ◽  
Effective Ventilation ◽  
High Level

Asthma continues to pose a significant medical problem in terms of both morbidity and mortality. A number of patients with a severe exacerbation of asthma fail medical therapy and require urgent intubation and mechanical ventilation. New modalities of ventilatory support, including noninvasive ventilation, have been shown to provide effective ventilation even in the presence of severe bronchoconstriction. An intrinsically high level of auto positive end-expiratory pressure in these patients requires a precise balance between respiratory frequency, tidal volume and inspiratory flow rates. Pressure support ventilation reduces the risk of barotrauma and lowers the work of breathing in these patients. Adjuvant therapy with inhaled anesthetics and bronchoalveolar lavage may also be indicated in patients requiring high pressures to achieve adequate ventilation.

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