scholarly journals The Impact of Physiotherapy in the Water Assisted by Dolphins for Motor Skills of Patient after Haemorrhagic Stroke (Case Analysis)

2019 ◽  
Vol 1 (20) ◽  
Author(s):  
Evelina Rimkutė ◽  
Eglė Radzevičienė ◽  
Brigita Kreivinienė
Keyword(s):  
Muscle Strength ◽  
Motor Skills ◽  
Haemorrhagic Stroke ◽  
The Status ◽  
Animal Interaction ◽  
Therapeutic Activities ◽  
The Impact

Background. Stroke is one of the leading causes of morbidity, mortality and long-term disability worldwide. In terms of innovative technologies which help to recover from stroke one of the newest and least researched methods is physiotherapy in the water assisted by dolphins. Such an innovative case study was conducted in Lithuania. A great variety of scientifc literature on animal assisted therapies and interventions can be found worldwide, however, concerning research on human-animal interaction mechanisms a scientifc gap is still existing as presented in various journals of different felds (Beetz et al., 2012). The aim of the study was to determine the effectiveness of healing exercises in the water assisted by dolphins for motor skills of patients with haemorrhagic stroke. Methods. The study was carried out at the Dolphin Therapy Centre of the Lithuanian Sea Museum. The study lasted two weeks. The sample was a man diagnosed with a haemorrhagic stroke. The research data was collected on motor skills in the water, leg muscle strength, coordination, balance and gait. The patient participated in ten therapeutic activities in the water, assisted by dolphins (length of one activity – 30 minutes). The physiotherapist working with the patient applied balance and coordination exercises in the water. The status of the patient was evaluated four times: before activities with dolphins, after fve activities with dolphins, after ten activities with dolphins, and follow up in three weeks after ending the activities with dolphins. Results. The muscle strength of legs increased signifcantly in the foot group and slightly in the lower limb muscle group. The greatest result in balance was registered after ten therapeutic activities with dolphins in the water. The greatest improvement in coordination and walking occurred later. Assessing motor skills in the water, a signifcant positive change in equilibrium was observed. Conclusions. The results of the study showed that physiotherapy exercises in the water assisted by dolphins might help to achieve improvements in motor skills.Keywords: haemorrhagic stroke, motor skills in the water, balance, gait, therapeutic activities for assisting dolphins, physiotherapy in water.

scholarly journals Restoration of hand function with long-term paired associative stimulation after chronic incomplete tetraplegia: a case study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
A. Rodionov ◽  
S. Savolainen ◽  
E. Kirveskari ◽  
J. P. Mäkelä ◽  
A. Shulga
Keyword(s):  
Spinal Cord ◽  
Muscle Strength ◽  
Motor Evoked Potentials ◽  
Hand Function ◽  
Left Hand ◽  
Hand Muscles ◽  
Cord Injury

Abstract Introduction This case study explores the gains in hand function in an individual with a chronic spinal cord injury (SCI). The intervention was long-term paired associative simulation (PAS). We aimed to provide PAS until full recovery of hand muscle strength occurred, or until improvements ceased. Case presentation A 46-year-old man with traumatic C7 AIS B tetraplegia was administered PAS three times per week. After 24 weeks, PAS was combined with concomitant motor training of the remaining weak hand muscles. Outcome measures included the manual muscle test (MMT), motor-evoked potentials (MEPs), F-responses, hand functional tests, and the spinal cord independence measure (SCIM). Discussion After 47 weeks of PAS the subject had improved self-care and indoor mobility and was able to perform complex motor tasks (SCIM score improved from 40 to 56). His left hand regained maximum MMT score (total 75; increase of score from baseline condition 19); the effect remained stable in the 32-week follow up. In the right-hand muscles, MMT scores of 4–5 were observed in follow up (total 71; increase from baseline 48). Improved values were also observed in other outcomes. This is the first demonstration of long-term PAS restoring muscle strength corresponding to MMT scores of 4–5 in an individual with chronic SCI. The effect persisted for several months, indicating that PAS induces stable plastic changes in the corticospinal pathway.

Camel usage and impacts at a permanent spring in central Australia: a case study

2010 ◽  
Vol 32 (1) ◽  
pp. 55 ◽  
Author(s):  
Jayne Brim-Box ◽  
Tracey Guest ◽  
Peter Barker ◽  
Mirjana Jambrecina ◽  
Sean Moran ◽  
...  
Keyword(s):  
Ground Cover ◽  
Land Trust ◽  
Aquatic Fauna ◽  
Drainage Patterns ◽  
Microbial Analysis ◽  
The Impact ◽  
Ground Cover Vegetation

The impact of camel usage at a small rockhole (‘X’) on the Petermann Aboriginal Land Trust was evaluated from May 2007 through to July 2008. Camel usage and impacts were determined through multiple methods including ground cover, vegetation and macroinvertebrate surveys and through the use of surveillance cameras and depth loggers. Camels appear to use X most heavily in periods when rainfall is scant and more at night than during the day. However, in long periods with little or no rainfall, it appears that camels use X heavily during the day and night and there is little chance for X to re-fill. The low number of macroinvertebrates present during the study period suggests that the aquatic fauna is negatively impacted by the presence of camels, as was the vegetation surrounding X. Shrubs near X showed signs of heavy browsing and the ground cover became denuded of vegetation due to camel browsing and trampling during dry periods. This could lead to long-term alterations in drainage patterns and erosion of the site. Follow-up vegetation and ground cover surveys are needed to better assess these impacts. X was and is a traditional source of drinking water for people travelling through the country. Preliminary microbial analysis indicated that at certain periods X is not suitable for drinking, even if the water itself looks ‘clean’ or clear. The faecal contamination evident was most probably due to camel use of the waterhole. These results have been discussed with traditional owners, but further microbial analyses may be needed for longer-term assessments.

scholarly journals Nutrient retention behind a tropical mega-dam: a case study of the Sardar Sarovar Dam, India

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Harish Gupta ◽  
S. Kiran Kumar Reddy ◽  
Mounika Chiluka ◽  
Vamshikrishna Gandla
Keyword(s):  
Arabian Sea ◽  
Inorganic Nitrogen ◽  
Nutrient Retention ◽  
Significant Loss ◽  
N Removal ◽  
Narmada River ◽  
Sardar Sarovar ◽  
The Impact

AbstractIn this study, we demonstrate the impact of the construction of a mega-dam on the nutrient export regime of a large tropical river into the Arabian Sea. Long-term (11 years) fortnight nutrient parameters, upstream and downstream to Sardar Sarovar (SS) Dam, were examined to determine the periodical change in nutrient fluxes from the Narmada River, India. During this 11-year period, the average discharge of the Narmada River upstream to Rajghat (35.3 km3 year−1) was higher than that of downstream at Garudeshwar (33.9 km3 year−1). However, during the same period, the suspended sediment load was reduced by 21 million tons (MT) from 37.9 MT at Rajghat to 16.7 MT at Garudeshwar. Similarly, mean concentrations of dissolved silica (DSi) reduced from 470 (upstream) to 214 µM (downstream), dissolved inorganic phosphate (DIP) from 0.84 to 0.38 µM, and dissolved inorganic nitrogen (DIN) from 43 to 1.5 µM. It means that about 54%, 55%, and 96% flux of DSi, DIP, and DIN retained behind the dam, respectively. The estimated denitrification rate (80,000 kg N km−2 year−1) for the reservoir is significantly higher than N removal by lentic systems, globally. We hypothesize that processes such as biological uptake and denitrification under anoxic conditions could be a key reason for the significant loss of nutrients, particularly of DIN. Finally, we anticipated that a decline in DIN fluxes (by 1.13 × 109 mol year−1) from the Narmada River to the Arabian Sea might reduce the atmospheric CO2 fixation by 7.46 × 109 mol year−1.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

scholarly journals Evaluation of the Impact of Timber Truck Configuration and Tare Weight on Payload Efficiency: An Australian Case Study

Forests ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 855
Author(s):  
Mark W. Brown
Keyword(s):  
Load Management ◽  
Vehicle Design ◽  
Forest Industry ◽  
Post Operation ◽  
Gross Vehicle Weight ◽  
Australian Case ◽  
Trends Over Time ◽  
The Impact

The forest industry tends to plan, and model transportation costs based on the potential payload benefits of increased legal gross vehicle weight (GVW) by deploying different configurations, while payload benefits of a configuration can be significantly influenced by the vehicle design tare weight. Through this research the relative benefit of increased legal GVW of different configurations is compared across Australia over a 13-year period from 2006 to 2019, by examining data collected post operation across multiple operations. This approach is intended to offer realistic insight to real operations not influenced by observation and thus reflect long-term operating behaviour. The inclusion of the three most common configuration classes in Australian forestry over a 13-year period has also allowed the exploration of load management between configurations and potential trends over time. When considering the legal GVW and the tare weight impacts across the fleets, the semi-trailer has an 8 t payload disadvantage compared to B-Doubles and 19.6 t disadvantage compared to road trains.

scholarly journals Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Performance ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
P Values ◽  
Student’S T ◽  
The Impact ◽  
Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

scholarly journals P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Rehabilitation Programme ◽  
Spinal Mobility ◽  
The Impact

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

scholarly journals Follow-up services for delirium after COVID-19—where now?

2021 ◽  
Author(s):  
Shibley Rahman ◽  
Kit Byatt
Keyword(s):  
Service Utilisation ◽  
Sustainable Business ◽  
Community Based ◽  
Care And Support ◽  
Early Supported Discharge ◽  
Business Cases ◽  
Older Inpatients ◽  
The Impact

Abstract Delirium is a common presentation in older inpatients with coronavirus disease 2019 (COVID-19), and a risk factor for cognitive decline at discharge. The glaring gaps in the service provision in delirium care, regardless of aetiology, after a hospital admission pre-existed the pandemic, but the pandemic arguably offers an opportunity now to address them. Whilst a delirium episode in itself is not a long-term condition, the context of it may well be, and therefore patients might benefit from personalised care and support planning. There is no reason to believe that the delirium following COVID-19 is fundamentally different from any other delirium. We propose that the needs of older patients who have experienced delirium including from COVID-19 could be addressed through a new model of post-acute delirium care that combines early supported discharge, including discharge-to-assess, with community-based follow-up to assess for persistent delirium and early new long-term cognitive impairment. Such a drive could be structurally integrated with existing memory clinic services. To succeed, such an ambition has to be flexible, adaptable and person-centred. To understand the impact on resource and service utilisation, techniques of quality improvement should be implemented, and appropriate metrics reflecting both process and outcome will be essential to underpin robust and sustainable business cases to support implementation of delirium care as a long-term solution.

scholarly journals Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Wojtasik-Bakalarz ◽  
Zoltan Ruzsa ◽  
Tomasz Rakowski ◽  
Andreas Nyerges ◽  
Krzysztof Bartuś ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Of Death ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Artery Disease ◽  
The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

scholarly journals Storm Driven Migration of the Napatree Barrier, Rhode Island, USA

Geosciences ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 330
Author(s):  
Bryan A. Oakley
Keyword(s):  
Rhode Island ◽  
Shoreline Change ◽  
Aerial Photographs ◽  
Tropical Storms ◽  
Lower Intensity ◽  
Storm Activity ◽  
The Impact ◽  
Washover Fan

Napatree Point, an isolated barrier in southern Rhode Island, provides a case study of barrier spit migration via storm driven overwash and washover fan migration. Documented shoreline changes using historical surveys and vertical aerial photographs show that the barrier had little in the way of net change in position between 1883 and 1939, including the impact of the 1938 hurricane. The barrier retreated rapidly between 1945 and 1975, driven by both tropical and extra-tropical storms. The shoreline position has been largely static since 1975. The removal of the foredune during the 1938 hurricane facilitated landward shoreline migration in subsequent lower intensity storms. Dune recovery following the 1962 Ash Wednesday storm has been allowed due to limited overwash and barrier migration over the last several decades. Shoreline change rates during the period from 1945–1975 were more than double the rate of shoreline change between 1939 and 2014 and triple the rate between 1883 and 2014, exceeding the positional uncertainty of these shoreline pairs. The long-term shoreline change rates used to calculate coastal setbacks in Rhode Island likely underestimate the potential for rapid shoreline retreat over shorter time periods, particularly in a cluster of storm activity. While sea-level rise has increased since 1975, the barrier has not migrated, highlighting the importance of storms in barrier migration.

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