Indices of Loading and Propulsive Ability in the Gait of Patients With Chronic Stroke With Equinus Foot Deviation: A Correlation Study

In literature, indices of overall walking ability that are based on ground reaction forces have been proposed because of their ease of administration with patients. In this study, we analyzed the correlation between the indices of dynamic loading and propulsion ability of 40 chronic hemiparetic post-stroke patients with equinus foot deviation and a set of clinical assessments of ankle joint deviations and walking ability. Ankle passive and active range of motion (ROM) and triceps surae spasticity were considered, along with walking speed and three complementary scales of walking ability focusing respectively on the need for assistance on functional mobility, including balance and transfers, and the limitation in social participation. The correlation between the ground reaction force-based indices and both clinical and functional variables was carried out using the non-parametric Spearman correlation coefficient. Both indices were correlated to 8 of the 10 investigated variables, thus supporting their use. In particular, the dynamic propulsive ability was correlated with all functional scales (rho = 0.5, p < 0.01), and has the advantage of being a continuous variable. Among clinical assessments, limited ankle ROM affected walking ability the most, while spasticity did not. Since the acquisition of ground reaction forces does not require any patient prepping, the derived indices can be used during the rehabilitation period to quickly detect small improvements that, over time, might lead to the broad changes detectable by clinical scales, as well as to immediately highlight the lack of these improvements, thus suggesting adjustments to the ongoing rehabilitation approach.

Työuupumuksesta toipumisen yksilölliset polut

Tutkimuksen tarkoituksena oli selvittää työuupumuksesta toipumisen kehityspolkuja ja näihin yhteydessä olevia tekijöitä 1,5 vuoden seurannan aikana. Erityisenä kiinnostuksen kohteena oli toimijuus ja sen rakentumisen yhteys työuupumuksesta toipumiseen. Tutkimusaineisto koostui Kuntoutus Peurungan Virveli-kuntoutuskursseille osallistuneista ja kuntoutuksesta lähtökohtaisesti hyötyneistä henkilöistä (n = 9). Kyseessä on tapaustutkimus, jossa näiden henkilöiden toipumisprosessia tutkittiin monipuolisesti sekä haastattelun että kyselyiden avulla. Tulokset osoittivat, että monet työympäristöön liittyvät tekijät olivat yhteydessä toipumisprosessiin, mutta ne eivät yksinään selittäneet sitä, oliko henkilöiden työuupumus uusiutunut vai ei. Aineistosta löydettiin kolme erilaista kehityspolkua, jotka olivat ”työuupumuksesta toipuneet”, ”uudestaan uupuneet” ja ”kovia kokeneet, mutta positiiviseen keskittyvät”. Kuntoutujien toipumispolkuun näyttäisi tämän tutkimuksen perusteella olevan yhteydessä heidän kokemansa henkilökohtainen toimijuus, joka ilmeni erityisesti uskona omaan pärjäämiseen kuntoutusjakson lopussa. Näihin tekijöihin olisikin hyvä kiinnittää huomiota sekä jatkotutkimuksissa että työuupumusinterventioiden kehitystyössä, jotta kuntoutuksen vaikuttavuutta voitaisiin tehostaa. Abstract The individual recovery paths from job burnout: a mixed methods case study on the long-term impact of a rehabilitation intervention The purpose of this study was to examine the developmental paths of burnout recovery and factors associated with it during a 1.5-year follow-up period. A special interest of the study was in agency and whether it is connected to burnout recovery. The study sample (n = 9) included people, who had benefitted from a rehabilitation period arranged earlier in Peurunka Rehabilitation Centre. This research was a case study, which was basedon data collected by interviews and questionnaires in analyzing the recovery process of the participants. Analysis showed that many job-related factors were connected to the recovery process, but none of them was able to explain alone whether participants’ burnout had relapsed or not. Three different recovery paths were found among the sample: ”recovered participants”, ”relapsed participants” and ”participants with difficult experiences but positive mindset”. The results indicate that the personal agency of the people participating in rehabilitation is connected to their recovery paths. Agency was manifested, for example, in participants’ self-efficacy estimates at the end of the rehabilitation period. These factors should be paid more attention in future studies as well as in developing burnout interventions in order to improve the effectiveness of burnout rehabilitation. Keywords: burnout, rehabilitation, agency, follow-up study, mixed methods

WORLD PRACTICE OF ARRANGEMENT OF HOTEL FURNITURE FOR ANIMALS. PROSPECTS OF INTRODUCTION IN UKRAINE

The article covers the establishment and development of specialized hotels for animals, the study of prospects for the introduction of hotels of this type in Ukraine. Zoo hotels have appeared as an alternative to keeping animals in hospitals at veterinary clinics. By the way, they provide such services to them. Small boxes that limit the extra mobility of the pet - a good option after surgery during the rehabilitation period, but not for a perfectly healthy animal. Hotel for animals - a specialized room that meets the established requirements for the accommodation of animals temporarily transferred by their owners for maintenance [azar]. The world of pets is very interesting. Observing and studying it, and people are fascinated not only by amazement and new discoveries, they care about animals and kindness, and love, and indulgence. Knowing animals, man knows himself. Throughout history, pets have played a key role in human life, and have been seen primarily as suppliers of food, clothing, transportation, and time as an object of religious worship. Although animals around the world still use these traditional uses, the role of many animals in society has changed. Yes, there is a sharp increase in the number of animals that are supported and maintained as abilities for pleasure.

Dynamics of the Functional State of the Hip Joint and Quality of Life in Patients After Hip Replacement (During Rehabilitation)

The aim of this study was to determine the functional state of the affected hip joint after hip arthroplasty and to analyse patients’ quality of life during rehabilitation. Materials and methods. The study involved patients with 3rd degree hip osteoarthritis that underwent hip replacement. The research was conducted in three stages: 1) before the operation; 2) early postoperative rehabilitation period (10th – 12th day after the operation); 3) late recovery rehabilitation period (10th – 12th week after the operation). At stages 1 and 2, we examined 140 people (mean age 57.0 ± 9.0 years), at stage 3, 43 patients (mean age 55.81 ± 7.8 years). At all three stages, the patients’ hip range of motion, hip circumference and strength endurance of the affected limb were determined. The function of the hip joint was evaluated using the Harris Hip Score, and the quality of life was estimated with the help of the SF-36 questionnaire. Results. The research revealed that during the rehabilitation period, the range of motion increased significantly, hip flexion being restored best of all. Moreover, we observed a statistically significant increase in strength endurance. However, not all indicators reached normal values by the end of the research. The patients’ quality of life improved due to better physical functioning, general health and vitality as well as lower pain intensity. However, we observed no progress in role functioning due to the emotional state. Evaluation according to the Harris Hip Score showed that before the operation 78.6 % of the patients had unsatisfactory joint function, while during the late rehabilitation period, only 20.9 %, which indicates the treatmentʼs effectiveness. For citation: Ishekova N.I., Ishekov A.N., Goryannaya N.A. Dynamics of the Functional State of the Hip Joint and Quality of Life in Patients After Hip Replacement (During Rehabilitation). Journal of Medical and Biological Research, 2021, vol. 9, no. 4, pp. 426–434. DOI: 10.37482/2687-1491-Z080

TELENURSING IN PHYSICAL AND OCCUPATIONAL THERAPISTS’ TRAINING

The necessity of distance learning of specialists practitioners, in particular in the field of knowledge «Health care», which is induced by COVID-19, causes a significant public response. This is due to a possible decline in the quality of higher education, and therefore the security of citizens and the state. Consequently, the search of modern, effective methods and means of learning and training for healthcare specialists is relevant. Quarantine restrictions of educational communication have sharpened attention, firstly, to telecommunication means, secondly, to active learning methods, and thirdly, to the mobilization of internal reserves to expand the practical educational component. This is how the idea of simulated professional support arose. It was realized by the students of physical therapy during the rehabilitation period of a university lecturer. It was the postoperative period of endoprosthesis and simulated professional support was provided with the help of telenursing. The essence of the simulation was that the real rehabilitation period had already passed, but it was agreed to repeat it for a didactic purpose. 46 first-year students of the specialty «Physical Therapy, Occupational Therapy» took part in the experiment. At first, they were trained a set of exercises (according to the recommendations of the clinic), while paying attention to the practical, psychological and pedagogical aspects of interaction. Then, students conducted rehabilitation classes with the help of telecommunication means, which lasted for a month. An incoming survey was conducted (based on motivation of professional activity): among the students and it showed that 32 of them (69.6%) are positively professionally motivated, 45 respondents (97.8%) felt subjective satisfaction with their professional choice. The final study (an interview) with the question «How has the attitude to professional activity changed») represents that 31 (67.4%) respondents were ready for practical conduction of similar professional support. Telenursing proves its effectiveness not only as a means of actual patient care (according to the literature), but also as a kind of learning, using a case study (according to our data). However, the telecommunication means, which were chosen for rehabilitation, including video communication via Viber and Messenger as more common among the potential customers, did not fully satisfy students who preferred Microsoft Teams and Google Meet as less related to social media and personal profiles data, as well as with better possibilities of lesson planning. This indicates the formation of professional competencies that are based on the combination of psychological and pedagogical, information and communication competencies, hence, the effectiveness of the proposed method.

Ocular manifestations in patients who underwent COVID-19 in the early stages after Phaco surgery with implantation of IOL

Purpose. To study the ocular manifestations in patients with pseudophakia who underwent COVID-19 during the rehabilitation period after surgery. Material and methods. 46 patients with Phaco with implantation of IOL who underwent COVID-19 in the period from 1 week to 2 months after surgery. Of the examined patients, there were 28 men (61%), 18 women (391%). The average age of the patients was 63±1,2 years. Results. In 78% of cases, vascular pathology of the anterior and posterior segments of the eyeball was observed in patients who underwent COVID-19 in the early postoperative period after Phaco with implantation of IOL. Conclusions. The main ocular symptoms from the anterior segment of the eyeball in patients in 17% of cases were the occurrence or intensification of previously existing manifestations of the «dry eye» syndrome, as well as inflammatory phenomena from the anterior part of the uveal tract. From the posterior segment of the eye, in 70% of cases, there was a progression of vascular disorders, as well as the appearance of complications associated with manifestations of hypercoagulation syndrome and systemic vasculopathy. Key words: Covid-19, cataract phacoemulsification, pseudophakia.

Current trends in the treatment of acetabular fractures (literature review)

Acetabular fractures are known for their disabling outcomes, so the search for optimal treatment tactics is an actual problem for modern orthopedics and traumatology. Materials and methods. Randomized trials that reflect the results of acetabular fractures treatment depending on the method of treatment were analyzed. The literature was searched in the PubMed Central database. Hip joint is a complex two-component articulated system. Traumatic lesion of all elements of the joint creates the conditions for the development of a wide range of complications and secondary changes that must be taken into account at preoperative treatment. Aceta­bular fracture is an intra-articular injury, where the visualization methods have the prominent significance. Nowadays the treatment can be conservative and surgical. Surgical treatment can be divided into two areas: osteosynthesis and arthroplasty. Anatomical reposition and stable fixation of fragments, in the most of cases, is the key to a satisfactory functional result, but the development of post-traumatic changes in the joint nullifies the results of even perfect osteosynthesis, encourages repeated surgery and, finally, hip replacement. In recent years, primary arthroplasty has been successfully used to treat acetabular fractures, reducing inpatient and rehabilitation period, compared with osteosynthesis, preventing the possible development of secondary degenerative changes in the joint. Conclusions. Acute hip replacement is an effective treatment, however, the technical aspects of reliable fixation of the ace­tabular component of the implant are insufficiently substantiated and highlighted in actual literature and constitute significant research interest.

A clinical case of endovascular treatment of congenital intrahepatic arterioportal fistulae

The development and wide use of instrumental investigational methods, including multispiral computed tomography, computed tomography with angiography, duplex scanning of blood vessels, subtraction angiography, enabled diagnosis of rare diseases, in particular, of the intrahepatic arterioportal fistulae (IAPF). Methods of surgical treatment of this pathology include both open surgery and endovascular treatment with the use of embolizing implants or coils. The article presents a clinical case of diagnosis and endovascular treatment of IAPF in a 33‑year‑old patient, hospitalized in the Center of Interventional Neuroradiology at Feofaniya Clinical Hospital. The choice of the surgical treatment was based on the account of indications and contraindications to the intervention. The endovascular method was used: exclusion of the intrahepatic arterioportal fistulae by means of implantation of micro‑coils Nester 20 мм, MReye 20 mm, Tornado 10–4 mm. Positive dynamics was observed in the long‑term postoperative period (after 3 months), the control was performed based on such criteria as complaints’ absence, normalization of laboratory parameters, positive dynamics of the data of control hepatic angiography. IAPF elimination promoted the reduction of portal hypertension, and improvement of functional liver state. Endovascular method of treatment of patients with arterioportal fistulae is the method of choice at this pathology. The advantages of endovascular method include the minimization of intraoperative and postoperative complications, the shorter postoperative rehabilitation period. In case of the necessity for other method of surgical treatment, one should follow the indications and contraindications to the surgical intervention.

Alternatives to Knee Braces

Knee braces continue to be a widely utilized piece of medical equipment, ranging from simple over the counter sleeves to more complex functional braces, with the ability to provide electrical stimulation to muscle groups. Despite their popularity, alternatives to knee braces exist for patients who find braces to be ineffective, uncomfortable, cumbersome, or overly expensive. While high-quality studies are lacking for modalities such as neoprene sleeves, compression stockings, and kinesiotaping, there is promising evidence that these interventions can confer an element of stability and pain relief for a variety of knee pathologies both with regard to acute and chronic injuries as well as in the postoperative rehabilitation period. While no “holy grail” exists for the ideal brace, or bracing alternative, it is important for providers to be aware of the options available to patients as well as the current evidence for these various modalities, so that the provider can best guide musculoskeletal care.