scholarly journals Post CO VID-19 Encephalopathy Treatment

2021 ◽  
Vol 20 (6) ◽  
pp. 40-47
Author(s):  
Jinna I. Lebedeva ◽  
Tatyana I. Kutergina ◽  
Elena F. Turovinina ◽  
Irina V. Elfimova ◽  
Alexandra S. Orlova

Aim. To evaluate the severity of encephalopathy and the efficacy of the second stage of rehabilitation in patients with post-infectious encephalopathy. Material and methods. The study included 92 patients with post-infectious encephalopathy, who underwent the second stage of rehabilitation after СOVID-19 infection. All patients were divided into 2 groups: those, who were referred to rehabilitation after the end of the treatment (n=54) and those, who refused to undergo rehabilitation (n=38). In all cases the severity of coronavirus infection, percentage of pulmonary involvement (based on chest CT-findings) and the presence of comorbid pathology were assessed. The severity of the prevailing syndromes was assessed using the International Classification of Functioning, Disability and Health (ICF). Patient status dynamics was assessed using Rehabilitation routing scale (RRS), Rivermead, Holden and Hauser scales. Results and discussion. Post-infectious encephalopathy was mainly accompanied by vestibular ataxia syndrome in 51 (55.4%) patients (in 51.9% and 60.5% patients in groups 1 and 2, respectively) and cerebro-asthenic syndrome in 73 (79.3%) patients (in 72.2% and 89.5% patients in groups 1 and 2, respectively). Comprehensive rehabilitation process is characterized by staging aimed at compensating for all components of pathogenesis that affected during the period of severe course of COVID-19 infection. Rehabilitation was an effective measure for the compensation of neurologic complications of COVID-19 infection. After 2 weeks, cerebro-asthenic syndrome was observed in 24.1% patients in group 1 and 71.0% in group 2 (p <0.05), vestibular ataxia syndrome – in 18.5% and 28.9% (p<0.05) of patients in groups 1 and 2, respectively. The current pandemic is highly likely to be accompanied by a significant increase in the prevalence of encephalopathy affecting the ability to return to daily functioning. Conclusion. The main manifestations of post-covid encephalopathy are cerebro-asthenic (79.3%) and vestibular ataxia (55.4%) syndromes. Therapeutic and rehabilitation measures carried out at the 2nd stage of rehabilitation is an effective measure to compensate for the severity of post-covid encephalopathy.

Author(s):  
V. V. Afanasyeva ◽  
A. A. Potapchuk ◽  
N. V. Chernysh

The objective was to determine the most significant categories of ICF that allow us to provide objective information about the biopsychosocial state of patients who have suffered a new coronavirus infection COVID-19 and to choose the most effective methods of rehabilitation based on the rehabilitation diagnosis of each group of patients.Methods and materials. On the basis of the clinic of the Pavlov University, a course of medical rehabilitation was conducted for 2 weeks for patients who had suffered a new coronavirus infection in severe and moderate degree of course. 2 groups were formed: EG1-25 people participating in the rehabilitation program with the use of physical exercises and EG2 — 39 people with the use of physical exercises and physiotherapy. A categorical rehabilitation profile of patients by ICF domains was compiled.Results. As a result of the application of the medical rehabilitation program, a statistically significant improvement in the indicators in EG 2 was revealed. The respiratory function (the Barbell test) improved by 14.6%, the functional state of the cardiovascular system according to the DBP indicator by 3.9%. The analysis of the results of the ICF category «activity and participation» revealed a statistically significant improvement in the motor test parameters (6MSHT) in both groups: by 11.9 % in EG2 and by 20.6 % in EG1.Conclusions. The results of the study indicate the positive impact of the proposed program of medical rehabilitation and confirm the relevance of the problem, unsolved problems and prospects for scientific research on this topic.


2020 ◽  
Vol 51 (4) ◽  
pp. 914-938
Author(s):  
Anna Cronin ◽  
Sharynne McLeod ◽  
Sarah Verdon

Purpose Children with a cleft palate (± cleft lip; CP±L) can have difficulties communicating and participating in daily life, yet speech-language pathologists typically focus on speech production during routine assessments. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY; World Health Organization, 2007 ) provides a framework for holistic assessment. This tutorial describes holistic assessment of children with CP±L illustrated by data collected from a nonclinical sample of seven 2- to 3-year-old children, 13 parents, and 12 significant others (e.g., educators and grandparents). Method Data were collected during visits to participants' homes and early childhood education and care centers. Assessment tools applicable to domains of the ICF-CY were used to collect and analyze data. Child participants' Body Functions including speech, language, and cognitive development were assessed using screening and standardized assessments. Participants' Body Structures were assessed via oral motor examination, case history questionnaires, and observation. Participants' Activities and Participation as well as Environmental and Personal Factors were examined through case history questionnaires, interviews with significant others, parent report measures, and observations. Results Valuable insights can be gained from undertaking holistic speech-language pathology assessments with children with CP±L. Using multiple tools allowed for triangulation of data and privileging different viewpoints, to better understand the children and their contexts. Several children demonstrated speech error patterns outside of what are considered cleft speech characteristics, which underscores the importance of a broader assessment. Conclusion Speech-language pathologists can consider incorporating evaluation of all components and contextual factors of the ICF-CY when assessing and working with young children with CP±L to inform intervention and management practices.


2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.


2014 ◽  
Vol 19 (5) ◽  
pp. 13-15
Author(s):  
Stephen L. Demeter

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.


Author(s):  
Alessandro Umbrico ◽  
Gabriella Cortellessa ◽  
Andrea Orlandini ◽  
Amedeo Cesta

A key aspect of robotic assistants is their ability to contextualize their behavior according to different needs of assistive scenarios. This work presents an ontology-based knowledge representation and reasoning approach supporting the synthesis of personalized behavior of robotic assistants. It introduces an ontological model of health state and functioning of persons based on the International Classification of Functioning, Disability and Health. Moreover, it borrows the concepts of affordance and function from the literature of robotics and manufacturing and adapts them to robotic (physical and cognitive) assistance domain. Knowledge reasoning mechanisms are developed on top of the resulting ontological model to reason about stimulation capabilities of a robot and health state of a person in order to identify action opportunities and achieve personalized assistance. Experimental tests assess the performance of the proposed approach and its capability of dealing with different profiles and stimuli.


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