Impact of intelligent convolutional neural network -based algorithms on head computed tomography evaluation and comprehensive rehabilitation acupuncture therapy for patients with cerebral infarction.

This work was to evaluate the impacts of comprehensive rehabilitation acupuncture therapy on the recovery of neurological function in cerebral infarction (CI) patients and to utilize convolutional neural network (CNN) intelligent algorithms to optimize head computed tomography (CT) images and improve lesion localization accuracy. 98 CI patients were divided into a control group (Ctrl group) and an experimental group (Exp group), with 48 patients in each group. The patients in the Ctrl group received CT evaluation combined with comprehensive rehabilitation acupuncture therapy. While, those in the Exp group received CT evaluation with the use of CNN algorithms for optimization, along with comprehensive rehabilitation acupuncture therapy. Acupuncture therapy included selecting acupoints on the patient's head, selecting two horizontal needling needles from top to bottom at the acupoints on the front side of the lesion, and then horizontal needling along the top midline. The differences in treatment outcomes were compared between the two groups based on Fugl-Meyer upper limb assessment (FMA) scores, Barthel Index (BI) scores, National Institutes of Health Stroke Scale (NIHSS4) scores, Modified Edinburgh-Scandinavian Stroke Scale (MESSS) scores, and hemodynamics. Simultaneously, the CT images were optimized using CNN intelligent algorithms to improve image quality and lesion localization accuracy. The results showed that the CI CT images processed by the CNN-based intelligent algorithm showed significant improvements in clarity and contrast compared to conventional CT images. The CNN-based intelligent algorithm demonstrated higher sensitivity (97.5 %, 93.8 %), higher PSNR (30.14 dB, 24.72 dB), and lower missed detection rate (0.52 %, 1.88 %) in detecting CI lesions. The total effective rate in the Exp group was 95.83 %, which was significantly higher than the 85.42 % in the Ctrl group (P < 0.05). The Exp group showed significantly higher levels in FMA and BI scores (P < 0.05). After treatment, the NIHSS4 and MESSS scores in the Exp group were lower than those in the Ctrl group (P < 0.05). Additionally, post-treatment, the plasma concentrations and whole-blood viscosity (low shear and high shear) in the Exp group were lower than those in the Ctrl group, and the plasma concentration and whole-blood viscosity (high shear) were also lower than those in the Ctrl group (P < 0.05). In conclusion, comprehensive rehabilitation acupuncture therapy had a positive impact on the recovery of neurological function in CI patients. By applying CNN-based intelligent algorithms to optimize head CT images, lesion localization accuracy can be improved, thereby guiding rehabilitation treatment more effectively.

The clinical effects of Orff music therapy on children with autism spectrum disorder: a comprehensive evaluation.

Objective: This study aimed to investigate the clinical effects of Orff music therapy on children with Autism Spectrum Disorder (ASD) from the perspectives of parents, evaluators, and therapists. Methods: 93 children with ASD aged 3-6 years participated in the study. They were divided into an observation group (n = 48) receiving comprehensive rehabilitation intervention including Orff music therapy, and a control group (n = 45) receiving only comprehensive rehabilitation intervention. The Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Psycho-educational Profile-3rd edition (PEP-3) were used for assessments before and after the intervention. Results: There were no significant demographic differences between the two groups. Both groups showed significant improvements in Sensory, Relating, Language, CVP, EL, RL, VMI, AE, SR, and CARS scores at T1, T2, and T3 (T1 vs. T2, T2 vs. T3, T1 vs. T3) (all p < 0.05). The observation group demonstrated significant changes in Body and Object use and FM, while the control group showed some changes in these domains. Social and self-help, GM, CMB, and CVB also significantly improved in both groups after 6 months of intervention (all p < 0.05). In terms of different time intervals, the observation group showed greater improvements in Sensory, Relating, Language, CARS scores, EL, RL, and SR compared to the control group (all p < 0.05). The improvement levels in Body and Object use, CVP, FM, VMI, and AE did not differ significantly between the two groups in the T1-T2 interval, but were significantly higher in the observation group in the T2-T3 and T1-T3 intervals (all p < 0.05). The magnitude of changes in Social and self-help, GM, CMB, and CVB did not differ significantly between the groups. Conclusion: Orff music therapy showed significant improvements in language expression, language comprehension, social skills, cognitive abilities, imitation abilities, emotional expression and fine motor in children with ASD. These findings provide support for the use of Orff music therapy as an effective intervention for children with ASD.

Effect of early postoperative comprehensive rehabilitation on children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury / 中国康复理论与实践

ObjectiveTo observe the therapeutic effect of early postoperative comprehensive rehabilitation on elbow joint dysfunction and ulnar nerve injury in children and adolecents with supracondylar fracture of humerus complicated with ulnar nerve injury. MethodsA total of 49 children with supracondylar fracture of humerus complicated with ulnar nerve injury after operation were selected from January, 2016 to December, 2021 in Wangjing Hospital, which were randomly divided into control group (n = 24) and treatment group (n = 25). The control group accepted wax therapy and acupuncture, and the treatment group accepted medicine fumigation, joint mobilization and electromyographic biofeedback, for twelve weeks. They were assessed with The Hospital for Special Surgery Elbow score (HSS) and Medical Research Neurotrauma Society Report (MCRR) before and after treatment. ResultsAfter treatent, the HSS scores increased in both groups (|t| > 8.345, P < 0.001). The HSS score was significantly higher in the treatment group than in the control group (t = 4.536, P < 0.001). The d-value of HSS scores before and after treatment was significantly higher in the treatment group than in the control group (t = 3.717, P < 0.05). The rate of excellent recovery of ulnar nerve function was significantly higher in the treatment group than in the control group (χ2 = 5.975, P < 0.05). ConclusionEarly postoperative comprehensive rehabilitation could romote the recovery of elbow function and ulnar nerve injury in children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury.

Septic Arthritis Associated With Hip Joint Subluxation and Epiphyseal Plate Deformation as a Sequala of Sickle Cell Anemia.

This case report emphasizes the critical nature of septic arthritis in pediatric patients, particularly its predilection for large joints like the hip. It underscores the importance of rapid diagnosis and early intervention to preserve joint function. The case involves a six-year-old patient with sickle cell anemia who presented with persistent hip pain and hip subluxation and underwent hip joint arthrotomy. Clinical findings revealed limited mobility, weakness, and radiographic abnormalities. Comprehensive rehabilitation resulted in significant improvements in pain, mobility, and function. The key takeaway is the pivotal role of early diagnosis and comprehensive rehabilitation in managing septic arthritis in pediatric patients, especially those with underlying conditions like sickle cell anemia.

Lumbar Pain in Patients with Multiple Sclerosis and Knowledge about Physiotherapeutic Methods for Combating Pain.

BACKGROUND: The purpose of this study was to evaluate the intensity and frequency of low back pain (LBP) in people with multiple sclerosis (PwMS) and patients' knowledge of physiotherapeutic methods for combating LBP. METHODS: This study included all MS patients attending consecutive follow-up visits for treatment related to MS between March and May 2023. Only current pain sensations in the lumbar spine were taken into account. The inclusion criteria were age 18-60 years, a definite diagnosis of MS according to the 2017 McDonald criteria, treatment with disease-modifying drugs (DMTs), and consent to participate in the study. This study was carried out using an original survey questionnaire and a Visual Analogue Scale. PwMS were divided into three age groups: 18-30 years, 31-50 years, and over 50 years. RESULTS: Ninety PwMS (68 women and 22 men) were included in the study. The mean duration of the disease was 9.5 ± 4.9 years, and the mean EDSS was 3.5 ± 1.6. Most patients had a relapsing-remitting form of the disease. Overall, 68.9% of PwMS felt low back pain (n = 62). The relationship tested was statistically significant (p < 0.001), and the strength of the relationship was high (rc = 0.695). The average level of low back pain among PwMS was 4.7 out of 10 on the VAS. The prevalence of LBP was higher in female patients (p < 0.001), patients with a secondary progressive form of MS (p < 0.001), and patients with a longer duration of disease (p < 0.05). The most widely used methods for treating LBP were kinesitherapy and manual therapy. CONCLUSIONS: LBP is common in patients with multiple sclerosis. Female sex, a secondary progressive form of MS, and a longer duration of disease increase the risk of LBP. It is important to implement properly planned physiotherapy activities and educate patients on how to combat LBP.

Testimonios de españoles amputados de extremidades durante el aislamiento social por la pandemia de la COVID 19: impactos en la movilidad física / Testemunhos de espanhóis amputados de extremidades durante o isolamento social pela pandemia COVID 19: impactos no movimento físico / Testimonies of spanish amputed from the extremities during the social aislamiento by the COVID 19 pandemic: impacts on physical movement

El objetivo fue analizar la percepción que tienen las personas amputadas de los efectos que el aislamiento social, consecuente a la pandemia de la COVID 19, ha provocado en su movilidad. Es un estudio cualitativo realizado a través de un formulario electrónico con dos ejes temáticos: movilidad física y las preocupaciones y soluciones relacionadas con ésta, antes y después de la pandemia. El proceso de análisis consistió en la organización de los testimonios, separación por ejes temáticos e identificación de las palabras clave. La representación del análisis de datos se realizó utilizando la metodología descriptiva de construcción del diagrama lógico de Ishikawa. Se incluyeron 10 participantes, 9 no estaban infectados por el virus SARS-CoV-2. Las palabras clave que más impactaron en la movilidad física: movimiento, actividad física, ayuda para salir y dolor. Entre los términos secundarios, destacaron: fisioterapia y actividades realizadas en el hogar. Las principales repercusiones del aislamiento fueron la disminución de la movilidad y la resistencia a caminar con más agarrotamiento y problemas musculares, dificultad en los movimientos y en las actividades diarias. También revelaron reducción de la actividad física, estilo de vida sedentario, aumento del peso, falta de ayuda externa para salir y desplazarse y aumento del dolor. Las soluciones para los problemas de movilidad fueron volver a la fisioterapia y la actividad física y adelgazar. Se señala la idoneidad, para las personas amputadas aisladas, de intervenciones a distancia que les permitan recibir de forma integral una atención completa, rehabilitando tanto la salud física como la psicológica. (AU)

The objective was to analyze the perception that people with amputation have of the effects of social isolation caused by the COVID-19 pandemic on physical mobility. It is qualitative research was obtained through an electronic form that contained two thematic axes: physical mobility, concerns, and solutions related to physical mobility before and after the pandemic. The analysis process consisted of the organization of the testimonies, separation by thematic axes, and identification of the content keywords. The representation of the data analysis was carried out using the descriptive methodology of construction of the Ishikawa logic diagram. 10 participants were included, being 9 declared had not yet been infected with the SARS-CoV-2. The keywords that most impacted physical mobility were movement; physical activity, help getting out, and pain. Regarding the secondary keywords physiotherapy and activities performed at home stood out. The greatest repercussions of social isolation were decreased mobility and resistance to walking more stiffness and muscle problems, and difficulty in movements and daily activities. They also revealed stopping physical activities and a sedentary lifestyle, weight gain, no outside help to get out and move, and increased pain. The solutions for the mobility problems were to return to physiotherapy and physical activity and lose weight. Importance is given to remote intervention in people isolated with amputations in a comprehensive way to receive complete care rehabilitating both the physical and psychological health condition. (AU)

O objetivo deste estudo foi analisar a percepção das pessoas com amputação sobre os efeitos do isolamento social causado pela pandemia COVID-19 na mobilidade física. Foi um estudo qualitativo, realizado por meio de formulario eletrônico contendo dois eixos temáticos: mobilidade física e preocupações e soluções relacionadas antes e depois da pandemia. O processo de análise consistiu na organização dos testemunhos, separação por eixos temáticos e identificação de palavras-chave. A representação da análise dos dados foi realizada por meio da metodologia descritiva de construção do diagrama lógico de Ishikawa. Foram incluídos 10 participantes, 9 não infectados pelo vírus SARS-CoV-2. As palavras-chave que mais impactaram na mobilidade física foram movimento, atividade física, ajuda para sair e a dor. Em relação às palavras-chave secundárias destacaram fisioterapia e atividades realizadas em casa. As maiores repercussões do isolamento foram a diminuição da mobilidade e resistência à marcha, maior rigidez e problemas musculares, dificuldade de movimentos e atividades diárias. Também destacaram a interrupção da atividade física e estilo de vida sedentário, ganho de peso, nenhuma ajuda externa para sair e o aumento da dor. As soluções para os problemas de mobilidade foram retornar à fisioterapia e a atividade física, bem como perder peso. É importante a intervenção de forma remota de maneira integral em pessoas com amputações em isolamento para receber cuidados completos, reabilitando a sua saúde física e psicológica. (AU)

Risk Factors for Post-Stroke Pneumonia in a Patient Population with Subacute Stroke: A Retrospective Cohort Study.

The risk of pneumonia and death is higher in acute stroke patients with signs of pulmonary infection on chest computed tomography (CT) at admission. However, few reports have examined the incidence of pneumonia and its predictors in subacute stroke patients. The aim of this study was to examine factors related to post-stroke pneumonia in subacute stroke patients. A total of 340 subacute stroke patients were included. Univariable logistic regression analysis was performed using variables that may contribute to pneumonia, with the development of pneumonia as the dependent variable. Multivariable logistic regression analysis using the three independent variables with the lowest p-values on the univariable logistic regression analysis was also performed to calculate adjusted odds ratios. Twenty-two patients developed pneumonia during hospitalization. The univariable logistic regression analysis showed that the top three items were serum albumin (Alb), functional Oral Intake Scale (FOIS) score, and signs of pulmonary infection on chest CT at admission. Multivariable logistic regression analysis adjusted for these three items showed that the presence of signs of pulmonary infection on chest CT at admission was the independent variable (OR: 4.45; 95% CI: 1.54-12.9). When signs of pulmonary infection are seen on admission chest CT, careful follow-up is necessary because pneumonia is significantly more likely to occur during hospitalization.

Revitalizing quality of life: a case report on the beneficial impact of comprehensive rehabilitation therapy in treating upper-limb lymphedema following breast cancer surgery.

Objective: To underscore the paramount significance of incorporating comprehensive rehabilitation therapy as a crucial aspect of managing lymphedema caused by breast cancer surgery, and to illuminate our first-hand experience and insights gained in utilizing this approach. Methods: We present a case report of a breast cancer survivor who had been suffering from persistent left upper-limb edema for over 15 years, who was effectively treated with a combination of conventional rehabilitation (seven-step decongestion therapy) and a comprehensive rehabilitation program (seven-step decongestion therapy, along with core and respiratory function training, as well as functional brace wearing). The efficacy of the rehabilitation therapy was evaluated through a comprehensive assessment. Results: Although the patient underwent the conventional rehabilitation program for one month, only limited improvement was observed. However, after an additional month of comprehensive rehabilitation treatment, the patient exhibited significant improvement in both lymphedema and the overall function of the left upper limb. The patient's progress was quantified by measuring the reduction in arm circumference, which demonstrated a notable decrease. Furthermore, improvements in joint range of motion were observed, with forward flexion of the shoulder enhancing by 10°, forward flexion improving by 15°, and elbow flexion increasing by 10°. In addition, manual muscular strength tests revealed an increase in strength from Grade 4 to Grade 5. The patient's quality of life was also significantly improved, as evidenced by the increase in the Activities of Daily Living score from 95 to 100 points, the increase in the the Functional Assessment of Cancer Therapy: Breast score from 53 to 79 points, and the decrease in the Kessler Psychological Distress Scale score from 24 to 17 points. Conclusion: While seven-step decongestion therapy has been shown to be effective in reducing upper-limb lymphedema caused by breast cancer surgery, it has limitations in treating more chronic cases of the condition. However, when combined with core and respiratory function training and functional brace wearing, seven-step decongestion therapy has been shown to be even more effective in reducing lymphedema and improving limb function, ultimately leading to significant improvements in quality of life.

Comprehensive rehabilitation and job reintegration of people with severe mental illness in a Latin American country: REINTEGRA study protocol.

BACKGROUND: Despite the increasing use of comprehensive rehabilitation models for people with severe mental illness (SMI), there are still limitations to their implementation and replicability in a consensual way, particularly in Latin American countries. The REINTEGRA program aims to be a standardized model of comprehensive rehabilitation focused on psychosocial and cognitive improvement through a set of interventions on different areas of people's functionality, with the goal of reintegrating people with SMI into the labour market. In this paper we summarize the protocol for its subsequent implementation in a mental health institution in Mexico. METHOD: The protocol is based on a quasi-experimental, prospective longitudinal study, with a pragmatic or naturalistic control group. It will be carried out in three phases. Phase 1 consists of a series of interventions focused on psychosocial improvement; Phase 2 focuses on cognitive and behavioral improvement treatments; and Phase 3 targets psychosocial recovery through rehabilitation and reintegration into the labour market. The overall procedure will be monitored with standarized evaluations at different stages of the program. DISCUSSION: This study presents a model of integral rehabilitation of people with SMI. At the moment, one of the obstacles to overcome is the organization and procedural control of the different actors needed for its implementation (nurses, psychologists, doctors, companies, institutions, etc.). REINTEGRA will be the first comprehensive rehabilitation model that includes systematized procedures for job reinsertion for people with SMI in Mexico, which aims to be a standardized tool of easy adaptation and the replicability for other mental health centers and institutions.

Efficacy of Physiotherapy Rehabilitation for Subtrochanteric Femur Fracture: A Case Report.

Proximal femur fractures that occur within 5 cm of the lesser trochanter are commonly referred to as subtrochanteric femur fractures (STF). In this case report, we depicted a 45-year-old who came with a history of road traffic accident (RTA) for which an investigation like an X-ray was performed which revealed STF and the patient was surgically managed. Postoperatively, the patient's main complaints were pain around the hip joint with restriction in performing hip joint full range of motion. For these complaints, she was given physiotherapy. There was a reduction in joint pain, a significant improvement in joint movement, and increased muscle strength which was observed after evaluating the outcome measures.

Oral health status and barriers to oral healthcare among children with cerebral palsy attending a health care center in Kampala, Uganda.

BACKGROUND: Cerebral palsy (CP) is a non-progressive neuromuscular condition diagnosed in childhood. CP as a form of disability, does not cause any specific oral disease. However, some oral conditions are more commonly associated with people with CP compared to the general population. The overarching aim of the current study was to determine the oral hygiene status, gingival status, and the prevalence of dental caries in children with CP attending a leading hospital institution for children with disabilities in Kampala, Uganda. Additionally, we determined the barriers faced by children with CP in accessing oral healthcare. METHODS: This cross-sectional study was carried out at the Comprehensive Rehabilitation Services Uganda hospital in Kampala, Uganda. Our study population consisted of a convenient sample of 90 children diagnosed with CP aged 3-17 years and their caregivers. A validated and interviewer administered structured questionnaire was used to collect socio-demographic data of the participants. A modified World Health Organization oral health assessment form for those aged 3-17 years was used to gather data on oral health status (plaque score, gingival bleeding and dental caries.) The data was subjected to statistical tests with critical value set up at 5%. RESULTS: Only 32.2% of the children evaluated had adequate oral hygiene, while 44.4% of the children experienced gingival bleeding. The prevalence of dental caries for both deciduous and permanent dentition was 63.3%, with DMFT values of 3.8 ± 4.5. The most common barrier reported by the caregivers was the challenge in modality of transportation availability from the children's homes to the health facilities (34.4%). CONCLUSIONS: Children with CP in the study population have a significant prevalence of oral diseases and face several barriers to oral healthcare. Results from this study aim to provide relevant support to advocate for a nationwide change in policy to improve access to dental care to decrease the burden of oral diseases in children with special healthcare needs.

Management of Anti-melanoma Differentiation-Associated Gene 5 (Anti-MDA5)-Positive Dermatomyositis in an Acute Rehabilitation Center: A Case Report.

Dermatomyositis is an immune-mediated myopathy predominantly characterized by skin and musculoskeletal manifestations. Although often described in the context of its pathognomonic cutaneous features, dermatomyositis may have variable presentations depending on the subtype. In this report, we present a case of anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis that initially presented with respiratory symptoms. An appropriate diagnosis and comprehensive interdisciplinary rehabilitation led to a significant improvement in functional status and a better overall prognosis for the patient.

Physiotherapy Rehabilitation to Recuperate a Patient From an Intertrochanteric Fracture: A Case Report.

Intertrochanteric fracture is a prevalent condition among older adults, and it is becoming more so as the population is aging. A 52-year-old man was reported to the hospital with symptoms of pain and swelling in the right hip since the morning. The patient reported a history of unexpected slips and falls in the morning. An X-ray was taken of both hips, and an intertrochanteric fracture was identified. After one month post-fracture, a dynamic hip screw (DHS) was used to perform open reduction internal fixation (ORIF). Early mobility, appropriate lower limb strength, pain reduction, and quality of life are all significant determinants. As evidenced by statistically significant improvements in exercise capacity and well-being, the intertrochanteric fracture rehabilitation program is beneficial. This case study represents a comprehensive rehabilitation program for people who have had post-fracture surgery.

The Physiotherapy Process of a Plegic Patient Who Communicates with Foot Movement-A Case Report.

There are no official recommendations regarding physiotherapy for encephalitis patients. However, such patients, depending on their condition, have to undergo rehabilitation preceded by a detailed functional examination. The paper describes the physiotherapy treatment of a 28-year-old female after acute encephalitis. She suffered three-limb palsy with preserved movement in the right ankle joint. The patient was admitted to a clinic that offers respiratory therapy, where she underwent a comprehensive rehabilitation process. The initial and final functional assessment was conducted based on the International Classification of Functioning, Disability and Health. The therapy aimed to enable social contacts by learning to communicate with the environment, taking advantage of learned motor skills and adapting the body to maintain a sitting position. The goals were implemented with gradual upright standing, electrostimulation of paralyzed muscles, orofacial therapy, methods of respiratory acceleration and the use of communication technologies. As a result of the physiotherapy, the patient can communicate with the environment more efficiently and showed a more assertive attitude towards the disease and greater motivation to exercise and socialize. This paper supports the importance of a rehabilitation program adapted to the needs of a patient with severe disabilities and encourages more studies in this area.

Guillain-Barre Syndrome After Two COVID-19 Vaccinations: Two Case Reports With Follow-up Electrodiagnostic Study.

Guillain-Barre syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy and commonly occurs after a preceding infection or immunization sequalae. Following the severe acute respiratory syndrome-coronavirus-2 virus pandemic with co-introduction of massive vaccinations, several GBS cases associated with coronavirus disease 2019 (COVID-19) infection per se or after vaccination for COVID-19 were reported internationally. Herein, we report two cases of Korean GBS presenting with tetraplegia after two different COVID-19 vaccinations (42-year old man by AstraZeneca and 48-year woman by Pfizer vaccines) within four weeks after vaccination. The patients were diagnosed with clinical examination, serial electromyography, and compatible laboratory results and improved after comprehensive rehabilitative treatment and intravenous immunoglobulin therapy. Furthermore, we performed an electrodiagnostic follow-up study of each case to examine their unique characteristics.

[Hyperbaric oxygenation in outpatient rehabilitation of COVID-19 convalescents]. / Primenenie giperbaricheskoi oksigenatsii v ambulatornoi reabilitatsii patsientov, perenesshikh COVID-19.

Searching for drug and non-drug modalities for the rehabilitation of patients with the post-COVID syndrome is an urgent public health challenge during the COVID-19 pandemic. Hyperbaric oxygenation is a promising method as a part of complex rehabilitation after COVID-19 due to its antihypoxic, anti-inflammatory, antioxidant and anticoagulant effects. OBJECTIVE: To study the effect of hyperbaric oxygenation as a part of comprehensive outpatient rehabilitation on clinical and functional parameters in COVID-19 convalescents. MATERIAL AND METHODS: The effect of hyperbaric oxygenation on clinical and functional parameters of 45 COVID-19 convalescents was studied: 22 males and 23 females aged 40-60 years. Patients were divided into three groups of 15 subjects each, depending on the CT stage of COVID-associated pneumonia (CT-0, CT-1, and CT-2-3). RESULTS: Patients in group 3 (CT-2-3) were on average in the older age group, had a higher body weight and a higher percentage of fat mass according to bioimpedance measurements, compared to the other groups. Most clinical-functional and laboratory parameters in this group were within normal or subnormal ranges. In addition, high cholesterol levels (total cholesterol 6.5±1.2 mmol/L) and subnormal levels of C-reactive protein (9.3 mg/L) were noted in group 3 patients. After comprehensive rehabilitation, an increase in the distance walked in the 6-minute walking test with a significant trend in the CT-0 (467.9±37.7→531.5±44.3 m; p<0.01) and CT-1 (533.9±74.3→570.1±57.8 m; p<0.05) groups was observed. A significant decrease in norepinephrine level in the group of COVID-19 convalescents with CT-2-3 (Δ 13%), and a decrease in glutathione peroxidase in all three groups (6465.0±1637.3→5101.0±1353.3, 6587.8±1919.3→5418.1±1289.7, 7699.5±1747.9→6620.1±1702.1 units/L in groups 1, 2 and 3, respectively; p<0.05) were recorded. CONCLUSION: The use of hyperbaric oxygenation in comprehensive outpatient rehabilitation of COVID-19 convalescents was associated with benefits, given the improvement of functional parameters, laboratory signs of limiting low-grade inflammation, sympathoadrenal activity, and oxidative stress.

[Non-drug technologies in early rehabilitation of patients after hemorrhoidectomy]. / Nemedikamentoznye tekhnologii v rannei reabilitatsii bol'nykh posle gemorroidektomii.

Among all coloproctological diseases, hemorrhoids rank first among the reasons for visiting a proctologist. Its prevalence is 130-145 per 1.000 adults, and its proportion in the structure of colorectal diseases ranges from 34 to 41%. After hemorrhoidectomy, a long period of rehabilitation is necessary. There are long periods of incapacity for work (at least two weeks) and quite high complications rate, which generally leads to economic burden. Therefore, an urgent problem of current coloproctology and physiotherapy is the development of new approaches to medical rehabilitation of the patients after surgery for their fast recovery and prevention of complications. OBJECTIVE: To study effectiveness of comprehensive postoperative rehabilitation program including ozone therapy, laser therapy, recto-tibial myostimulation and biofeedback therapy in patients after hemorrhoidectomy. MATERIAL AND METHODS: The study included 90 patients 20-65 years of age (mean age 41.4±2.1years) with chronic stage III hemorrhoids with prominent external nodules (ICD-10 code: K64.2). All patients underwent Milligan-Morgan hemorrhoidectomy using an ultrasound scalpel by the same coloproctologist to exclude the influence of personality factors. The patients were assigned into two groups by random sampling. The main group consisted of 45 patients who received standard of care and the rehabilitation program, including intravenous ozone therapy, rectal laser therapy, recto-tibial myostimulation, and biofeedback therapy starting from the second day after the surgery. The control group consisted of 45 patients who received the same standard of care in the early postoperative period, including analgesics, local antibacterial ointments (Levomekol, etc.), and rectal suppositories (Relief Pro, etc.). RESULTS: In the early postoperative period, in the patients who received non-drug rehabilitation program, the pain was significantly less intensive, and it relieved faster after surgery, which indicated a strong analgesic effect of the rehabilitation program. Patients in the control group received analgesics (including narcotic drugs) for pain control in 68.9% of cases. Duration of postoperative incapacity for work in the main group patients was 12.9±2.4 days vs. 24.1±2.3 days in the control group patients (p<0.001). The analysis of the quality of life in the early and the late postoperative period by SF-36 scale showed a significant difference between the groups according to the physical health component and psychological component both in the early and in the late postoperative period (after six months), which indicates the higher quality of life in the main group patients. Assessment of the late period quality of life using the I. Yu. Alimzhanova and Yu.M. Sheptunov questionnaire showed good results in 43 (95.6%) patients of the main group. Only in 2 (4.4%) main group patients, anal stenosis was observed. Good results were shown in 38 (84.58%) control group patients. Seven patients had complications: cicatricial anal stenosis (5 [11.1%] patients) and pararectal fistulas (2 [4.4%] patients); in 3 (42.9%) of these 7 patients a persistent pain syndrome was developed. CONCLUSIONS: Introduction of the rehabilitation program in the early postoperative period after hemorrhoidectomy contributes to faster relief of pain and other signs and symptoms, a significant decrease of average postoperative wound healing time due to acceleration of adequate scar formation (according to ultrasound sonoelastography), improvement of life quality, reduction of hospital stay, a decrease of incapacity for work duration, and prevention of postoperative complications.

Early Intensified Rehabilitation Training with Hyperbaric Oxygen Therapy Improves Functional Disorders and Prognosis of Patients with Traumatic Brain Injury.

Objective: Traumatic brain injury (TBI) is a global public health problem. Hyperbaric oxygen (HBO) therapy may be beneficial for TBI because it improves cerebral blood flow into tissues exhibiting low blood flow. This was done to observe the clinical therapeutic effect of different intensities of rehabilitation training and HBO therapy in early stages of TBI. Approach: In this multicenter, randomized, stratified case-controlled prospective clinical trial, we selected 158 patients with moderate-severe TBI and assigned them into (1) a control group receiving routine once-daily (1/d) rehabilitation training without HBO, (2) study group A receiving routine 1/d rehabilitation training with HBO, (3) study group B receiving twice-daily (2/d) intensified rehabilitation training with HBO, and (4) study group C receiving 2/d intensified rehabilitation training without HBO, all for 3 months. The cognitive ability, activities of daily life (ADL), and movement ability were assessed before and after training with the Fugl-Meyer Assessment (FMA), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and Mini-Mental State Examination (MMSE). Results: FIM, FMA, MBI, and MMSE scores were improved significantly after 1-, 2-, and 3-month rehabilitation training in all TBI patients (p < 0.01), and this improvement was especially remarkable in patients who received 2/d intensified rehabilitation training with HBO (p < 0.01). Innovation: With extensive and intensive research on TBI rehabilitation, it was proved that TBI rehabilitation intervention should be initiated as early as possible. Conclusion: Early intensified rehabilitation training in combination with HBO is more beneficial to the recovery of cognitive, ADL, and movement abilities of TBI patients.

Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol.

BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

Clinical efficacy of comprehensive nursing in patients with cerebral hemorrhagic hemiplegia.

OBJECTIVE: To explore the clinical efficacy of comprehensive rehabilitation nursing (CRN) intervention in patients with cerebral hemorrhagic hemiplegia (CHH). METHODS: A total of 102 patients with CHH admitted to our hospital were selected for the prospective study. The patients were randomly divided into the control group (n=51) and the observation group (n=51) according to the random number table method. Routine nursing was performed in the control group, while CRN was conducted in the observation group. Fugl-Meyer motor function assessment scale, activity of daily living scale (Barthel index), self-rating anxiety scale (SAS), complications and muscle strength improvement (Brunnstrom assessment) were compared between the two groups. RESULTS: Compared with those before nursing, Fugl-Meyer score, Barthel index and SAS score in the two groups after nursing were significantly improved (P<0.01). Fugl-Meyer score and Barthel index of the observation group were significantly higher than those of the control group after nursing, while SAS score showed the opposite change (P<0.001). The incidence of complications in the control group was 49.02%, and that in the observation group was 29.41% (P<0.05). The rate of muscle strength improvement in the observation group was 80.39% after nursing, which was significantly higher than that in the control group (60.78%; P<0.05). CONCLUSION: CRN intervention has a positive clinical efficacy in patients with CHH. It can enhance motor ability, improve the ability of daily life, amend psychological mood and reduce the incidence of complications.