rehabilitation

Telerehabilitation is a transformative approach to physical therapy, revolutionizing the accessibility of healthcare in rural communities through the strategic use of Telecommunications technology. This novel approach has the potential to significantly enhance the efficacy of healthcare delivery, particularly considering the critical challenges posed by geographical isolation and resource scarcity. This paper explores the multifaceted benefits of Telerehabilitation, including increased access to care and reduced costs, alongside the challenges of technological barriers and privacy considerations. It provides a comprehensive overview of Telerehabilitation’s impact on rural healthcare, emphasizing its capacity to optimize patient outcomes and proposing strategies for effective implementation. The findings of this study suggest that the use of technology to deliver telecare is a key means of delivering equitable healthcare to underserved populations, a promising way to improve access to rural physiotherapy services address the challenge of telehealth resources, and promote the long-term sustainability of rural Telerehabilitation practices.

Cognitive impairment has been increasingly observed among patients with anxiety disorders and major depressive disorders impacting their normal daily functioning as well as quality of life. A multitude of evidence suggests that the most affected cognitive abilities are memory, attention, perception, and executive functioning in patients with anxiety and depression. Impairment in these higher-order cognitive functions can be attributed to age, education, diet, hormonal changes, stress, and prolonged use of drugs/alcohol/ medicines. To address the issues related to cognitive impairment various non-pharmacological therapeutic modalities such as Cognitive remediation approaches viz; cognitive rehabilitation, cognitive stimulation, and cognitive training; Audio-visual entrainment; mindfulness-based interventions; and neurofeedback have come into play in recent years. It is imperative to understand that the ability to test, measure, and monitor cognitive performance along with implementing cognitive remediation approaches viz; cognitive stimulation, cognitive training, etc. across the lifespan helps in early identification, accessing treatments faster, staying healthy for longer, and improving overall quality of life. This article discusses a case study of a client suffering from generalized anxiety disorder and moderate depression who after undergoing and following a novel therapeutic approach, ‘The Cognitome Program’ has shown credible improvement in cognitive abilities, along with a prominent reduction in the symptoms of anxiety, depression, and better psychological and physical well-being. Guided by the concept of neuroplasticity and cognitive plasticity, our innovative neuroscientific holistic program- ‘The Cognitome Program’ empowers unlocking hidden cognitive potential using cutting-edge methodologies and personalized strategies.

Background: Delaying or slowing functional loss is a valuable goal of Multiple Sclerosis (MS) rehabilitation. The mHealth app-based exercise rehabilitation intervention is expected to overcome barriers related to routine care of MS. Due to the ubiquitous presence of smartphones, they offer an excellent opportunity for remote monitoring, scheduled interaction with experts, and instruction for exercise in a home environment. Challenges in MS routine care include forgotten rehabilitation steps, limited access to local MS experts, and internal barriers such as low health literacy, mobility limitations, and fatigue, alongside external obstacles like service availability and transport costs.Objectives: To develop a mHealth app that is user-centered and context-specific for rehabilitation of MS symptoms, and to evaluate its clinical and cost effectiveness in individuals with RRMS.Methods: The proposed research will be conducted in two phases; the first phase (Phase 1a) will be focused on the development of mHealth app content (ReMiT-MS app trial I). The pilot phase (Phase 1b), where a prototype of the application will be designed, and its usability will be evaluated. Finally, in the second phase (Phase 2), the clinical and cost-effectiveness of the ReMiT-MS app for the rehabilitation of individuals with RRMS will be evaluated (ReMiT-MS app trial II).Conclusion: The findings of this proposed trial may provide a telerehabilitation platform for individuals with RRMS in a resource-limited setting and establish a low-cost healthcare delivery model. In addition, the results of this research work might open a new window in healthcare delivery in India and similar settings.Trial registration:  CTRI/2022/09/045266 [Registered on 06/09/2022]

Severe alcoholic hepatitis is an ethical and clinical conundrum, wherein a liver transplant is often recommended. The adequacy of medical treatment versus the risk of recidivism after transplant is often debated. Complete recovery in 26 of 27 patients with severe alcoholic hepatitis was observed, and hence the data was retrospectively analysed.Methods: 27 patients, with severe alcoholic hepatitis, with Maddrey's discriminant function between 59.7 to 165.2 (mean 107.53), from June 2017 to May 2022, were followed up for between 11 months to 6 years. INR ranged from 1.99 to 3.7 (mean 2.709), and bilirubin was between 7.6 to 37.01, (mean 20.859). 8 patients had pre-existing liver cirrhosis. All patients received probiotics, nutritional support, physical rehabilitation, saturated fat (clarified butter/ desi ghee) supplementation, and anti-oxidant support. At 90 days, total bilirubin improved to between 1.0 to 6.8 (mean 2.625). ALT (Alanine Transaminase/ SGPT) ranged from 65 to 550 (mean ALT – 197); and AST (Aspartate Transaminase / SGOT) ranged from 58 to 810 (mean AST – 271.51). Both the AST and ALT were near normal after 90 days. One patient died due to bacterial pneumonia and sepsis; the remaining 26 patients made a complete recovery. All patients including those with diagnosed liver cirrhosis, had complete resolution of their ascites, and near-normal liver function. At the last outpatient visit, none had ascites, edema, or encephalopathy, and had normal albumin levels and INR values. Conclusion: Probiotics, nutrition, a saturated fat diet, and exercise; all have shown benefits in patients with severe alcoholic hepatitis when tested individually. Concomitant use of all the above has not been reported in the treatment of alcoholic hepatitis. The role of nutrition alone versus the contribution of nutritional deficiencies and the role of gut-derived endotoxemia need to be studied in detail. How to identify patients who need a transplant, if it is needed at all, remains a challenge.

A case study of a non-COPD (Chronic Obstructive Pulmonary Disease) patient with congenital kyphoscoliosis to see the effect of pulmonary rehabilitation after 36 sessions given for chest disease in Kuwait with signs and symptoms, physical capacity, functional level, and Quality of life.

Physiotherapy treatments employ complex approaches tailored to the patient’s diagnosis. Exercise is the primary strategy to enhance rehabilitation processes for most individuals. However, electrophysical agents, such as Photobiomodulation (PBM), that utilize specific wavelengths of light to penetrate tissues and stimulate cellular activity, can modulate various biological processes and may improve physiotherapy outcomes. This non-invasive treatment can reduce pain and inflammation, promote tissue repair, and accelerate tissue healing. Currently, PBM has numerous applications, including pain and inflammation treatment, wound healing (such as diabetic foot ulcers, pressure ulcers, post-surgery wounds, and skin grafts in burn injuries), and the management of musculoskeletal disorders (such as arthritis, tendinopathies, muscle injuries, and spinal disorders). It is also utilized to improve muscle performance and recovery in rehabilitation and sports. Additionally, transcranial PBM has shown promise in enhancing neurorehabilitative processes by facilitating the recovery of cognitive and motor functions in various types of lesions. The safety and efficacy of this treatment allow it to be incorporated alongside regular exercises and manual therapies as an adjunctive treatment, potentially enhancing outcomes in different areas of rehabilitation.

Introduction: Childhood obesity is one of the current themes of medical research, being considered not so much a multidimensional condition but primarily a real problem of worldwide interest.The aim of our randomized study was to evaluate and compare the effects of physical exercise associated with an educational program on clinical-functional status in overweight and obese children.Material and method: Participants were children hospitalized, through the emergency service, in the Pediatric Department, Craiova Municipal Clinical Hospital, between June and November 2023. 93 overweight and obese children, aged between 2 and 16 years, were evaluated (clinical, paraclinical and functional) by a multidisciplinary team and randomized into the control group (group C – 63 children) and the study group (group S – 30 children). After the resolution of the acute digestive or respiratory disease, the children in group S underwent a program to restore their functional status, based on educational measures (following the 5-2-1-0 rule) and physical exercises, for 12 weeks. Anthropometric data were measured (height, weight, body mass index); physical performance wasevaluated by gait analysis (we used the BTS G – WALK / BTS G – SENSOR 2 system, BTS Bioengineering Corp, Italy) with the determination of four parameters – the Timed Up-and-Go (TUG) test, the symmetry index, the walking test six minutes (6 MWT) and walking cadence or average cadence (steps/min) in both groups of children.The results were obtained by analyzing the differences in values obtained in the two moments T1 (initial) and T2 (after three months). The proportion of girls and boys was approximately equal within obesity class in each study group. Although we did not obtain statistically significant differences between the monitored parameters, between the two groups, for the two evaluation moments, the children in Group S had a clearly favorable evolution for physical performance parameters, whose average value was improved in T2. Anthropometric data did not change.Conclusion: The present study confirms the effectiveness of the multimodal (educational-kinetic) program for the physical performance of overweight/obese children. The sustained running of the program at home, with the involvement of the family and the school environment, is essential for the well-being of these children, with a favorable impact on the quality of life later.

Aim and objective: This study aimed to determine the prevalence and characteristics of drug dependency among patients in various rehabilitation centers in the Shimla district. Introduction: Drug abuse is a multifaceted and significant issue impacting individuals worldwide, and the city of Shimla in Himachal Pradesh is no exception. Despite its reputation as a picturesque hill station known for its natural beauty and rich cultural heritage, Shimla faces challenges related to substance abuse. Materials and methods: A cross-sectional survey was conducted, gathering demographic data, drug history, and indicators of dependency from the participants.Results: The findings revealed that 60% of the patients were drug-dependent, with 44% addicted to heroin and 11% to alcohol. Additionally, 60% of the patients reported a family history of chemical dependency. The study also identified associated psychological disorders such as depression and anxiety, as well as interpersonal and environmental factors like peer pressure and coping mechanisms such as avoidance and denial. Conclusion: These findings underscore the complexity of drug dependency, highlighting the need for comprehensive, multidimensional approaches to address the medical, emotional, and social aspects of addiction.

Background: The health professional appears to be concerned given the number of questions surrounding the patient’s post-transplant survival, patient selection method, and the continuous search for scores that reflect their reality and reconcile the results they desire with the patient’s expectations. It is from these considerations that the present work was born with the purpose of understanding the reality of patients hospitalized for hepatocellular carcinoma and what adherence to the Model For End-Stage Liver Disease (MELD) criteria meant in Brazil. Methods: This study is a discrete, univariate time series on emergency hospitalizations that occurred between 2000 and 2018, in the city of São Paulo, Brazil. Python version 3.11 was the software used for statistical treatment and analysis of the time series. Results: There were 6887 hospitalizations for malignant neoplasm of liver and intrahepatic bile ducts, in the period 2000-2006, of which 2898 were elective and 3915 (56.85%) were urgent in the period. There was an increase of 63.97% in the number of emergency hospitalizations in relation to the period 2000-2006 and 2007-2013. To highlight, in 2013 there were 1270 emergency admissions, which represented an increase of 109.22% in relation to the number of emergency admissions in 2006. The contingency correlation analysis demonstrated a significant association between the variables in which the chi-square value was 82.18, the p-value was 1.24 x 10-19, and the critical value was 3.84 with one degree of freedom. There was a 123.65% increase in the number of hospitalizations for chronic hepatitis, not elsewhere classified, between the periods 2000-2006 and 2007-2013. The chi-square value of the contingency association was 221.22, with a p-value of 4.90 x 10-50, a critical value of 9.488, with a significance level of 5% and one degree of freedom. The study showed an increase in hospitalizations of 21.88% for alcoholic liver disease between the periods 2000-2006 and 2007-2013. In the period 2000-2006, there were 21330 hospitalizations, 19224 of which were urgent (90.13%). In the period 2007-2013, there were 25997 hospitalizations, of which 22,802 (87.71%) occurred urgently. The chi-square value was 68.95, the p-value was 1 x 10-16, and the critical value was 3.84, with one degree of freedom. Conclusion: The MELD score, as it is sensitive to the patient’s severity, selects those who are at an advanced stage of the disease for liver transplantation. In this scenario, patients do not necessarily have access to outpatient services and begin to attend them regularly when MELD identifies the advanced stage of the disease, opening a gap between prevention, treatment, and rehabilitation.

Purpose: Stroke frequently causes severe deficits in upper limb function, which makes it difficult for patients to carry out daily tasks. An organized home-based intervention called the Graded Repetitive Arm Supplementary Program (GRASP) was developed to help stroke patients regain function in their hands and arms. This systematic review assesses the data demonstrating beneficial effects of the GRASP approach on hand function, gross and fine motor control of the upper limb in individuals post-stroke.Methods: A systematic search was performed in databases including PubMed, Scopus, CINAHL, and Cochrane Library up to April 2025. We searched the data using Keywords such as “GRASP,” “Graded Repetitive Arm Supplementary Program,” “stroke rehabilitation,” “upper limb recovery,” “fine motor skills,” and “gross motor control.” Inclusion criteria were randomized controlled trials (RCTs), quasi-experimental studies, and cohort studies involving adult stroke survivors undergoing GRASP. Studies were excluded if they were non-English and focused on other forms of intervention. Quality assessment was performed using the PEDro scale and Cochrane risk-of-bias tool.Results: Out of 243 studies initially screened, 8 met the inclusion criteria. Most studies reported significant improvements in upper limb function, including enhanced hand dexterity, grip strength, and coordination following participation in GRASP programs. High adherence rates and participant satisfaction were consistently noted. Some studies indicated that benefits were maintained at follow-up, suggesting long-term efficacy. Common outcome measures included the Fugl-Meyer Assessment (FMA), Box and Block Test (BBT), and Action Research Arm Test (ARAT).Discussion: The findings suggest that GRASP is an effective adjunct to conventional stroke rehabilitation, particularly for enhancing hand function and motor control. The structured yet flexible nature of GRASP allows for scalability and adaptability to various patient needs. Limitations of the reviewed studies include small sample sizes, heterogeneity in intervention duration, and variability in outcome measures. Further research with standardized protocols and larger samples is warranted.Conclusion: The GRASP approach appears to be a promising intervention for improving functional ability of the hand, and gross and fine motor control in the upper limbs post-stroke. Incorporating GRASP into home-based rehabilitation could enhance recovery and reduce long-term disability. Continued research is essential to establish best practices for implementation and to optimize patient outcomes.