Organizational aspects of neurorehabilitation at the outpatient stage

The study was aimed to evaluate the effectiveness of IRP implementation in patients of a specialized clinic providing long-term care to neurological and neurosurgical patients. Material and methods. The study was conducted in 2020-2021. on the basis of the MC "Expert Health" (Odessa, Ukraine). 83 patients undergoing neurorehabilitation program were examined. The correspondence of the fulfillment of key rehabilitation tasks in terms of time and quality was assessed. Additionally, the level of motivation and compliance of the patient was assessed using the MOT-Q questionnaires (for patients with previous TBI (n = 13), SRMS (for patients with stroke (n = 54) and with SRQ-E (for patients with other types of neurological pathology (n = 16). The overall level of compliance was assessed using the General Rehabilitation Adherence Scale (GRAS). The level of safety was assessed according to the following criteria: the presence of FAST certificates for personnel, a system for monitoring vital functions, equipment and consumables for the provision of emergency care. Statistical processing was carried out by methods of variance and correlation analysis, using the MedCalc 1.3 software. Results. There were not recorded any significant violations of safety principles in the provision of rehabilitation assistance in the certification of personnel according to FAST. The frequency of detecting cases of improper implementation of IRP did not exceed 6.0% (5 cases out of 83 analyzed). When assessing the relationship between the effectiveness of IRP and the level of compliance, a strong positive correlation was found - r = 0.78 Conclusion. 1. Provision of rehab services for neurological patients in the long term requires coordination of the actions of specialists at the intra-, inter-, and transdisciplinary levels. 2. A necessary condition for the functioning of a multidisciplinary team in the provision of rehabilitation care is certification of staff in the BLS systems - for allied health specialists and ACLS for physicians. 3. The effectiveness of IRP depends on the patient's compliance level (r = 0.78). 4. For the continuity of the rehabilitation process, it is necessary to involve relatives and facilitate their training in the basics of "home" rehabilitation.

Academic motivation among senior students majoring in rehabilitation related professions in China

Objective/background In mainland China, most universities offer general rehabilitation curricula rather than specialized curricula. The purpose of the current study is to investigate senior students’ academic motivation for rehabilitation and examine whether it varies among different curriculum structures, students’ gender, specific interests, and parental average education level. Methods This cross-sectional study recruited both senior students in general and those who specialized in rehabilitation curricula using an online survey. The Academic Motivation Scale (AMS) was used to measure academic motivation. Results The response rate was 74.68%, and 59 senior students in total (male: 34.48%; female: 65.52%) were analyzed. Twenty-nine (50.00%) students were from a general rehabilitation curriculum at Guangxi Medical University, and the rest (n = 29, 50.00%) were from a specialized curriculum at West China Medical School of Sichuan University. The overall average academic motivation score was 30.96 ± 5.92. Students in the specialized rehabilitation curriculum (32.85 ± 6.26) showed a significantly higher academic motivation score than those in the general rehabilitation curriculum (29.10 ± 5.00, p<0.05). Male (31.13 ± 5.67) and female (30.88 ± 6.12) students had equally high scores (p = 0.88). Students who had specific interests (29.81 ± 4.73) and those who did not (24.69 ± 4.92) shared the same academic motivation (t = 2.00, p = 0.06). Conclusions Senior rehabilitation science students in specialized curricula have higher levels of academic motivation than those in general curricula. There was no significant difference in academic motivation scores based on students’ gender, specific interests, or parental average education levels.

Mindfulness-based intervention improves residual negative symptoms and cognitive impairment in schizophrenia: a randomized controlled follow-up study

Background Residual negative symptoms and cognitive impairment are common for chronic schizophrenia patients. The aim of this study was to investigate the efficacy of a mindfulness-based intervention (MBI) on negative and cognitive symptoms of schizophrenia patients with residual negative symptoms. Methods In this 6-week, randomized, single-blind, controlled study, a total of 100 schizophrenia patients with residual negative symptoms were randomly assigned to the MBI or control group. The 6-week MBI group and the control group with general rehabilitation programs maintained their original antipsychotic treatments. The scores for the Positive and Negative Syndrome Scale (PANSS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Symptom Checklist 90 (SCL-90) were recorded at baseline and week 6 to assess psychotic symptoms, cognitive performance, and emotional state, respectively. Results Compared with general rehabilitation programs, MBI alleviated the PANSS-negative subscore, general psychopathology subscore, and PANSS total score in schizophrenia patients with residual negative symptoms (F = 33.77, pBonferroni < 0.001; F = 42.01, pBonferroni < 0.001; F = 52.41, pBonferroni < 0.001, respectively). Furthermore, MBI improved RBANS total score and immediate memory subscore (F = 8.80, pBonferroni = 0.024; F = 11.37, pBonferroni = 0.006), as well as SCL-90 total score in schizophrenia patients with residual negative symptoms (F = 18.39, pBonferroni < 0.001). Conclusions Our results demonstrate that MBI helps schizophrenia patients with residual negative symptoms improve clinical symptoms including negative symptom, general psychopathology symptom, and cognitive impairment. Trial registration ChiCTR2100043803.

Dynamic fixation using rigid tape in rehabilitation after surgery of terrible triad injury of the elbow: A randomized trial

OBJECTIVE: The aim of the study was to identify the efficacy of dynamic fixation using rigid tape (RT) in rehabilitation after surgery of terrible triad injury of the elbow (TTIE). METHODS: Sixty patients who underwent surgery of TTIE were equally randomly divided into RT group and hinged external fixation brace (HEFB) group. Dynamic fixations were applied for 8 weeks. General rehabilitation programs were performed for 3 months, 5 times a week. Follow-up (FU) was at six months. Main outcomes included pain (Visual Analogue Scale, VAS), muscle strength, range of motion (ROM), Elbow Function (Mayo Elbow Performance Index, MEPI), Quality of Life (QOL) (Short Form 36 Questionnaire, SF-36). RESULTS: There were significant time x group interactions for pain, ROM, MEPI, SF-36 (all p= 0.000), which demonstrated positive efficacy of both the two interventions. Difference at each time-point (except for baseline) of pain and ROM between the two groups was statistically significant (all p< 0.05). Some differences between the two groups were not statistically significant which at 14d on MEPI (p= 0.108) and at 21d (p= 0.259) and FU (p= 0.402) on QOL. Moreover, the increased muscle strength at each time-point had no statistically significant difference between the two groups (all p> 0.05). CONCLUSIONS: Both RT and HEFB could significantly improve the postoperative functional outcomes of the TTIE. However, early rehabilitation intervention could increase pain, which affected the corresponding function (MEPI) and QOL. Note that this kind of impact was short-term and reversible. The muscle strength and ROM were not affected by the increased severe pain, maintaining a trend of improvement. In addition, the subjects in the RT group improved faster and more efficiently and had better results with pain, ROM, MEPI, and QOL compared to the subjects in the HEFB group.

The Effect of Electrical Muscle Stimulation on Muscle Mass and Balance in Older Adults with Dementia

Background: Electrical muscle stimulation (EMS) is effective for increasing physical function. However, there is no evidence regarding the effects of EMS on muscle mass and physical function in older adults with dementia. The aim of the present study was to quantify the effects of EMS on muscle mass and balance in older adults with dementia. Methods: A total of 32 participants were randomly assigned to an intervention group (n = 16, age = 89.4 ± 4.8 years) and a control group (n = 16, age = 88.1 ± 5.2 years). Participants in the intervention group underwent a general rehabilitation program (20 min for three days/week) and an EMS intervention (23 min for three days/week) for 23 weeks. Participants in the control group underwent general rehabilitation only. The efficacy of EMS was evaluated by lower limb muscle mass, the Berg Balance Scale (BBS), and the functional independence measure (FIM). Results: Muscle mass was significantly increased in the intervention group after 12 weeks (p = 0.008), but average muscle mass in the control group did not change (p = 0.18). Participants in the control group showed a significant decrease in BBS after 12 weeks (p = 0.007), unlike those in the intervention group. Furthermore, there was a strong correlation between the mini-mental state examination (MMSE) results and the change in muscle mass, the BBS, and the FIM in the control group (p < 0.05). Conclusions: These findings suggest that EMS is a useful intervention for increasing muscle mass and maintaining balance function in older adults with dementia.

PENTINGNYA PENANGANAN PASCABENCANA YANG BERFOKUS PADA PENDUDUK UNTUK MEWUJUDKAN BUILD BACK BETTER: PEMBELAJARAN DARI BENCANA PALU, SIGI, DAN DONGGALA

Sendai Framework 2015-2030 highlights the importance of build back better after a disaster. Post-disaster management is an important stage to reach this goal. In general, rehabilitation process tends to focus on physical aspects and rarely considering people as the center. This paper aims to examine the rehabilitation process after earthquake and tsunami in Central Sulawesi in 2018 focused on opportunities and challenges to build back better. The temporary shelter (Huntara) is selected as the case study as it is the most urgent need after disaster. Data analysis is based on literature reviews and primary data from rapid assessment in December 2018 in Palu, Sigi, and Donggala. Based on the people-centered concept, results show that most of the temporary shelters are provided as a product and less concern about its function as a process. However, some temporary shelters have considered the process that comes from civil society’s initiatives. They propose Huntara as a transition by proposing a feeling of comfort and secure. To conclude, survivors need to be involved in the rehabilitation process to build back better.

Digital Technologies in Rehabilitation of Patients with Focal Brain Injury

Focal damage of the brain leads to cognitive impairments, which sufficiently limit the person’s functional capabilities, which, in turn, can lead to secondary disorders of the emotional and personal sphere and social maladjustment. The need to include cognitive rehabilitation in the system of complex treatment methods for patients with focal brain lesions is generally recognized. The article describes methods of neurorehabilitation based on high technologies and indicates their place in the general rehabilitation process. Data yielded by domestic and foreign studies on the effectiveness of digital technologies in the cognitive rehabilitation of patients with focal brain lesions is presented.

Effectiveness of Combined General Rehabilitation Gymnastics and Muscle Energy Techniques in Older Women with Chronic Low Back Pain

Objective. The aim of this study was to determine the effect of general rehabilitation gymnastics on subjective and objective characteristics of locomotor system in older women with chronic LBP. To satisfy this goal, the outcomes in exercising women were compared with the results of nonexercising controls. Material and Methods. The study group included 21 women with chronic LBP (age 65-75 years), participating in a 3-year general rehabilitation program combining strength, stretching, endurance, balance, and stabilization exercises with Muscle Energy Techniques (MET). Control group included 20 women with chronic LBP, who neither undertook the gymnastics nor participated in other forms of physical activity. The list of outcome measures included pain severity (Numeric Rating Scale), limitations in the activities of daily living (Oswestry Disability Index and Roland-Morris Disability Questionnaire), mobility of all spinal segments (tensometric electrogoniometry), and bioelectrical activity of back muscles (kinesiologic electromyography). Results. Exercising women presented with lesser severity of current pain (by 62%, p<0.001) and pain experienced during the last three months (by 32.5%, p<0.001), reported less ailments during the last three months, and had fewer limitations in the activities of daily living (a 30% decrease in Oswestry Disability Index, p<0.05, and a 65% decrease in Roland-Morris Disability Questionnaire scores, p<0.001) than the controls. Moreover, they showed significantly higher values of nearly all spondylometric parameters except for cervical lateral flexion. The study groups did not differ in the amplitudes of bioelectrical signal from the back muscles. Conclusions. These findings may point to beneficial effects of the combined exercise program.