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Los datos presentados constituyen las respuestas a un cuestionario de 36 preguntas de tipo multiple elección, o ecala lickert. Las preguntas son relativas a cuestiones demograficas, habilidades de comunicación y movilidad y aspecto relacionados con la frecuencia y duración de la actividad física que realiza la población. La población considerada son personas con parálisis cerebral.

Introduction : Les issues cliniques pourraient être significativement optimisées en intégrant les éléments à valeur pronostique au processus de décision clinique. L’outil MAPS (Mesure de résultAt Pronostic muSculosquelettique), un questionnaire standardisé intégrant des outils pronostiques validés, permet d’identifier de manière systématique la présence de facteurs pronostiques pouvant influencer le potentiel de récupération d’un patient. Ce mémoire vise trois objectifs: 1) évaluer la faisabilité d’implantation de l’outil MAPS en milieu clinique; 2) évaluer l’acceptabilité du tableau de bord par les cliniciens; et 3) évaluer l’acceptabilité de l’outil MAPS par les patients qui l’ont complété. Méthodes : Étude de faisabilité d’implantation et d’acceptabilité de l’outil MAPS en contexte réel de pratique. Des professionnels de la réadaptation travaillant avec des patients consultant pour un trouble musculosquelettique (TMS) en milieu orthopédique externe (privé) furent recrutés. Leur mandat fut d’utiliser l’outil MAPS avec leurs patients sur une période de 3 mois. Les patients étaient invités à remplir un sondage quantitatif concernant l’acceptabilité de l’outil MAPS. À la fin de la période de 3 mois, les cliniciens ont été invités à remplir un sondage quantitatif d’acceptabilité quant à l’utilisation du tableau de bord et à participer à une entrevue semi-dirigée à propos de leur expérience avec l’outil MAPS. Résultats : Cent trente-six patients ayant consulté 11 physiothérapeutes ont accédé à l’outil MAPS, dont 78% ont entièrement complété le questionnaire. Parmi eux, 106 ont répondu au sondage d’acceptabilité. Neuf des douze critères furent considérés comme acceptables par au moins 80% des répondants. Les 3 critères n’ayant pas atteint le seuil d’acceptabilité sont l’appréciation (73%), la pertinence (79%) et l’utilité perçue (77%) de l’outil. Neuf des onze cliniciens ont complété le sondage d’acceptabilité et participé à l’entrevue semi-dirigée. Dix des douze critèr

BackgroundTraditionally, weight loss (WL) trials utilize dual energy X-ray absorptiometry (DXA) to measure lean mass. This method assumes lean mass, as the sum of all non-bone and non-fat tissue, is a reasonable proxy for muscle mass. In contrast, the D3 -creatine (D3 Cr) dilution method directly measures whole body skeletal muscle mass, although this method has yet to be applied in the context of a geriatric WL trial. The purpose of this project was to (1) describe estimates of change and variability in D3 Cr muscle mass in older adults participating in an intentional WL intervention and (2) relate its change to other measures of body composition as well as muscle function and strength.MethodsThe INVEST in Bone Health trial (NCT04076618), used as a scaffold for this ancillary pilot project, is a three-armed, 12-month randomized, controlled trial designed to determine the effects of resistance training or weighted vest use during intentional WL on a battery of musculoskeletal health outcomes among 150 older adults living with obesity. A convenience sample of 24 participants (n = 8/arm) are included in this analysis. At baseline and 6 months, participants were weighed, ingested a 30 mg D3 Cr tracer dose, provided a fasted urine sample 3-6 days post-dosage, underwent DXA (total body fat and lean masses, appendicular lean mass) and computed tomography (mid-thigh and trunk muscle/intermuscular fat areas) scans, and performed 400-m walk, stair climb, knee extensor strength, and grip strength tests.ResultsParticipants were older (68.0 ± 4.4 years), mostly White (75.0%), predominantly female (66.7%), and living with obesity (body mass index: 33.8 ± 2.7 kg/m2 ). Six month total body WL was -10.3 (95% confidence interval, CI: -12.7, -7.9) kg. All DXA and computed tomography-derived body composition measures were significantly decreased from baseline, yet D3 Cr muscle mass did not change [+0.5 (95% CI: -2.0, 3.0) kg]. Of

Clear speech can be more intelligible and better remembered than casual speech. Intelligibility and memory are assumed to be related—under the effortfulness hypothesis, the intelligibility-enhancing properties of clear speech (e.g., slower speech rate) facilitate processing, which frees up working memory resources and confers a memory advantage. However, prior work has only investigated naturally produced clear speech. How does clear speech influence memory for computer voices? The current study examines intelligibility and recognition memory of clear and casual speech for a text-to-speech (TTS) voice and a human voice, and compares older and younger adult listeners. In a speech-perception-in-noise task, clear speech was more intelligible than casual speech for both voices, the human was more intelligible than the TTS voice, and the younger adults performed better than the older adults. In an old-new recognition task, memory was better for the human voice relative to the TTS voice, consistent with the intelligibility results and the effortfulness hypothesis. However, inconsistent with the effortfulness hypothesis, there was no clear speech memory benefit, and the older adults performed better than the younger adults. The current findings are relevant for our understanding of human-computer interaction and theories about the relationship between speaking style and memory.

Inverse dynamics from motion capture is the most common technique for acquiring biomechanical kinetic data. However, this method is time-intensive, limited to a gait laboratory setting, and requires a large array of reflective markers to be attached to the body. A practical alternative must be developed to provide biomechanical information to high-bandwidth prosthesis control systems to enable predictive controllers. In this study, we applied deep learning to build dynamical system models capable of accurately estimating and predicting prosthetic ankle torque from inverse dynamics using only six input signals. We performed a hyperparameter optimization protocol that automatically selected the model architectures and learning parameters that resulted in the most accurate predictions. We show that the trained deep neural networks predict ankle torques one sample into the future with an average RMSE of 0.04 ± 0.02 Nm/kg, corresponding to 2.9 ± 1.6% of the ankle torque's dynamic range. Comparatively, a manually derived analytical regression model predicted ankle torques with a RMSE of 0.35 ± 0.53 Nm/kg, corresponding to 26.6 ± 40.9% of the ankle torque's dynamic range. In addition, the deep neural networks predicted ankle torque values half a gait cycle into the future with an average decrease in performance of 1.7% of the ankle torque's dynamic range when compared to the one-sample-ahead prediction. This application of deep learning provides an avenue towards the development of predictive control systems for powered limbs aimed at optimizing prosthetic ankle torque.

BACKGROUND AND OBJECTIVES: In Italy, approximately 650 individuals receive a diagnosis of primary progressive aphasia (PPA) every year. Unfortunately, the frequency with which patients are referred to speech-language services is suboptimal, likely due to skepticism regarding the value of speech-language therapy in the context of neurodegeneration. MATERIALS AND METHODS: We conducted a virtual survey of speech and language therapists (SLTs) across Italy, to collect information about the assessment, intervention and management of patients with PPA. To ensure that as many SLTs as possible received the survey, the Italian Federation of SLTs (Federazione Logopedisti Italiani, FLI) aided in disseminating the survey. RESULTS: In total, 336 respondents participated in the online survey, 140 of whom had previous experience with PPA patients. Respondents indicated having seen a total of 428 PPA patients in the previous 24 months (three patients on average, range: 0-40). SLTs who reported never working with PPA identified underdiagnoses, low referral rates and the rarity of the clinical syndrome as major reasons for their lack of experience with PPA. SLTs with experience working with PPA indicated that patients may not have accessed services because of service dysfunction and geographical barriers. Respondents reported using informal interviews during assessments and tests developed for post-stroke aphasia, while impairment-based/restitutive interventions were utilised most often. CONCLUSION: Findings may serve to inform health policy organisations regarding the current shortcomings and needed recommendations for improving the care of individuals with PPA in Italy. Improving awareness of the utility of rehabilitation among SLTs and other clinical service providers may serve to facilitate access to intervention, which in turn will serve to better support individuals living with PPA. WHAT THIS PAPER ADDS: What is already known on the subject Speech and language therapists (SLTs)

INTRODUCTION: It would be valuable if home-based rehabilitation training technologies could automatically assess arm impairment after stroke. Here, we tested whether a simple measure-the repetition rate (or rep rate) when performing specific exercises as measured with simple sensors-can be used to estimate Upper Extremity Fugl-Meyer (UEFM) score. METHODS: 41 individuals with arm impairment after stroke performed 12 sensor-guided exercises under therapist supervision using a commercial sensor system comprised of two pucks that use force and motion sensing to measure the start and end of each exercise repetition. 14 of these participants then used the system at home for three weeks. RESULTS: Using linear regression, UEFM score was well estimated using the rep rate of one forward-reaching exercise from the set of 12 exercises (r2 = 0.75); this exercise required participants to alternately tap pucks spaced about 20 cm apart (one proximal, one distal) on a table in front of them. UEFM score was even better predicted using an exponential model and forward-reaching rep rate (Leave One Out Cross Validation (LOOCV) r2 = 0.83). We also tested the ability of a nonlinear, multivariate model (a regression tree) to predict UEFM, but such a model did not improve prediction (LOOCV r2 = 0.72). However, the optimal decision tree also used the forward-reaching task along with a pinch grip task to subdivide more and less impaired patients in a way consistent with clinical intuition. At home, rep rate for the forward-reaching exercise well predicted UEFM score using an exponential model (LOOCV r2 = 0.69), but only after we re-estimated coefficients using the home data. DISCUSSION: These results show how a simple measure-exercise rep rate measured with simple sensors-can be used to infer an arm impairment score and suggest that prediction models should be tuned separately for the clinic and home environments.

Background: The Uganda version of Pediatric Evaluation of Disability Inventory (PEDI-UG) was culturally adapted and validated from the PEDI-US, a tool used to evaluate the functional capability of children with or without disability aged 6 months to 7.5 years in the areas of self-care, mobility and social domains. A group of Ugandan occupational therapists with experience of using PEDI-UG participated in this study to explore the question: What do Ugandan occupational therapists say about the utility and value of the PEDI-UG for children with disabilities? Methods: A qualitative research design was chosen to explore the participants' viewpoints concerning the utility and value of the PEDI-UG for children with disabilities. Purposive sampling was used to recruit health professionals for the focus group discussions. Focus group discussions were carried out with 18 occupational therapists and nurses. Thematic analysis was performed to establish patterns and themes. Results: Several challenges concerning the contextual use of PEDI-UG were reported. For example, PEDI-UG being culturally adapted in two languages (English and Luganda) makes it difficult for health professionals to use it for children whose caregivers are non-English or non-Luganda speakers. In addition, participants reported adapting the way they asked the assessment questions, struggling with how they interpreted the scores and observing the child's skills if required during PEDI-UG interviews with caregivers. Conclusions: The findings of this study suggest that health professionals are challenged with the use of the PEDI-UG assessment in diverse cultural contexts and/or languages. These challenges are important considerations for the PEDI-UG translation in different Uganda cultural languages and training health professionals on the use and value of PEDI-UG for children with disabilities.

Virtual reality (VR)-based rehabilitation has been widely implemented to maintain and increase patient motivation during therapy sessions. Researchers nowadays design VR-based rehabilitation by leveraging off-the-shelf VR devices for easy access and application. However, researchers need to implement additional custom hardware or incorporate a specific algorithm to perform a real-time evaluation of each therapeutic movement. This study aims to design and develop a system with features for recognizing and measuring the upper limb rehabilitation movement in VR using off-the-shelf VR devices such as VR headsets, controllers, and trackers. This system is bundled and distributed as a single toolkit to accommodate other researchers in providing the evaluation feature for their VR-based rehabilitation system. The user experiment was conducted to verify the usability of this proposed design system. The experiment results show that the system can recognize 16 upper limb movements and provide several measurement data that researchers can use in providing the evaluation feature based on their design requirements.

Background: The Determinants of Implementation Behavior Questionnaire (DIBQ) measures facilitators or barriers of healthcare professionals’ implementation behaviors based on the current implementation research on practice and policy. The DIBQ covers 18 domains of the Theoretical Domains Framework and consists of 93 items. A previously tailored version (DIBQ-t) covering 10 domains and 28 items focuses on implementing best-practice low back pain care. Aim: To tailor a shortened version of DIBQ to multiprofessional rehabilitation context with cross-cultural adaptation to Finnish language. Design: A two-round Delphi study. Setting: National-level online survey. Population: Purposively recruited experts in multiprofessional rehabilitation (N.=25). Methods: Cross-cultural translation of DIBQ to Finnish was followed by a two-round Delphi survey involving diverse experts in rehabilitation (physicians, physiotherapists, occupational therapists, psychologists, nursing scientists, social scientists). In total, 25 experts in Round 1, and 21 in Round 2 evaluated the importance of DIBQ items in changing professionals’ implementation behavior by rating on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree) of including each item in the final scale. Consensus to include an item was defined as a mean score of ≥4 by ≥75% of Delphi participants. Open comments were analyzed using inductive content analysis. Items with agreement of ≤74% were either directly excluded or reconsidered and modified depending on qualitative judgements, amended with experts’ suggestions. After completing an analogous second-round, a comparison with DIBQ-t was performed. Lastly, the relevance of each item was indexed using content validity index on item-level (I-CVI) and scale-level (S-CVI/Ave). Results: After Round 1, 17 items were included and 48 excluded by consensus whereas 28 items were reconsidered, and 20 items added for Round 2. The open comments were categorized as: 1) ”modifyi

Purpose: To investigate acute and long-term changes in hormonal and inflammatory biomarkers in nonambulant children with cerebral palsy in response to dynamic standing exercise. Methods: Fourteen children with severe cerebral palsy were recruited. Anthropometrics and body composition measures were obtained. Physical activity levels before the study were assessed using hip-worn accelerometry. All children underwent a 30-minute dynamic standing exercise using the Innowalk standing aid. Respiratory data during exercise were collected using indirect calorimetry. Blood samples were collected before and after exercise. Blood samples were also obtained after two 16-week exercise protocols, in a resting state. Hormonal and inflammatory metabolites were measured from blood serum/plasma, and acute and long-term changes in biomarker levels were assessed using Wilcoxon signed-rank tests. Results: Of the 14 children at baseline, all had slightly/moderately/severely elevated C-reactive protein and cortisol levels. C-reactive protein levels were decreased following a 30-minute bout of dynamic standing (before exercise: 53 mg/L [interquartile range: 40-201]; after exercise: 39 mg/L [interquartile range: 20-107]; P = .04). Conclusions: We show that several hormonal and inflammatory biomarkers are dysregulated in children with cerebral palsy. Our preliminary results from a small, but deep-phenotyped prospective cohort indicate acute and long-term alterations of several biomarkers in response to exercise. ©2023TheAuthors.

Rehabilitation is an important stage in mining operations for environmental conservation. However, the shortage of topsoil makes it difficult to achieve rehabilitation in open-cast coal mines. Securing topsoil by mixing soil with fly ash (FA), which is treated as an industrial waste, is expected to solve this issue in coal mines. While mixing soil with FA makes it possible to secure the topsoil and treat industrial waste simultaneously, the high alkalinity of FA and the dissolution of heavy metals from FA may inhibit plant growth. This study investigated the effects of FA in the topsoil on plant growth via vegetation tests with simulated topsoil mixed with FA using Acacia mangium, a species of flowering tree: the FA mixing ratios were set to 0%, 20%, 40%, 60%, and 100%. The growth of Acacia mangium was inhibited with increasing FA mixing ratio, especially from 60% to 80%. However, the growth rate of Acacia mangium in an FA mixing ratio of 100% was nearly comparable to that in a mixing ratio of 40%. Furthermore, there were no effects of the physical characteristics and pH conditions in the topsoil on the plant growth at any of the mixing ratios; meanwhile, the accumulated concentration of Al in the plant body increased significantly at an FA mixing ratio of 60%–80%. This suggests that the accumulation of Al, which inhibits plant growth, including root growth and its functions, in the plant body inhibited the growth of Acacia mangium. Therefore, the most important aspect in terms of rehabilitation concerning the use of FA for securing topsoil is not the mixing ratio of FA but the amount of Al in the FA and the accumulation of Al in the plant body., Rekultywacja jest ważnym etapem w eksploatacji górniczej wzakresie ochrony środowiska. Brak wierzchniej warstwy gleby utrudnia osiągnięcie efektu rekultywacji w kopalniach odkrywkowych. Oczekuje się, że zabezpieczenie wierzchniej warstwy gleby przez zmieszanie gleby z popiołem lotnym (FA), który jest traktowany jako odpad przemysłowy, rozwiąże ten problem w odkrywkowych kopalniach węgla. Podczas mieszania gleby z FA możliwe jest jednoczesne zabezpieczenie wierzchniej warstwy gleby i utylizacja odpadów przemysłowych. Jednak wysoka alkaliczność FA i rozpuszczanie metali ciężkich z FA może hamować wzrost roślin. W artykule przedstawiono wpływ dodatku FA do wierzchniej warstwy gleby na wzrost roślin poprzez testy roślinności z symulowaną wierzchnią warstwą gleby zmieszaną z FA przy użyciu Acacia mangium i gatunków drzew kwitnących. Proporcje mieszanek FA zostały określone na 0%, 20%, 40%, 60% i 100%. Wzrost Acacia Mangium był hamowany wraz ze wzrostem zawartości FA, zwłaszcza od 60% do 80%. Jednak tempo wzrostu w mieszance FA w proporcji 40% było praktycznie takie jak bez dodatku FA. Ponadto nie zaobserwowano wpływu właściwości fizycznych i warunków pH w wierzchniej warstwie gleby na wzrost roślin w żadnej mieszance. Oznacza to, że skumulowane stężenie Al w roślinie znacznie wzrosło dla mieszanek z dodatkiem FA 60% -80%. Sugeruje to, że nagromadzenie Al, które hamuje wzrost roślin, w tym wzrost korzeni i jego funkcje, w organizmie rośliny hamuje wzrost Acacia Mangium. Dlatego najważniejszym aspektem rekultywacji z zastosowaniem FA do zabezpieczania wierzchniej warstwy gleby nie jest wielkość dodatku FA, lecz ilość Al w FA i akumulacja Al w roślinie.

Fly ash generated as industrial waste in coal-fired power plants is usually disposed of in landfills, but it is necessary to promote its effective use more because of the restrictions on landfill sites. It is expected to be used in the agricultural and greening fields since fly ash is alkaline, e.g., as an amelioration for acidic soil. Rehabilitation of post-mine land in open-cut mines is necessary for sustainable development. However, soil acidification caused by mixing acid sulfate rocks or soils mined in the operation influences the revegetation. / In this study, the utilization of fly ash is discussed as a soil amelioration by the pot trials; the experiments carried out under the various soil conditions mixed with acidic soil and fly ash using Acacia mangium which is a typical species planted for a fast-growing tree in Southeast Asia. As a result, the mixture of fly ash is effective to neutralize the acidic soil and improve plant growth although there are limitations of the application due to osmotic and ionic stress when the acidic soil has a high potential of metal dissolution.

BackgroundRehabilitation is an essential medical service for patients who have suffered acute stroke. Although the effectiveness of 7-days-per-week rehabilitation schedule has been studied in comparison with 5- or 6-days-per-week rehabilitation schedule, its cost-effectiveness has not been analyzed. In this research, to help formulate more cost-effective medical treatments for acute stroke patients, we analyzed the cost-effectiveness of 7-days-per-week rehabilitation for acute stroke from public health payer's perspective, and public healthcare and long-term care payer & apos;s perspective in Japan.MethodsCost-effectiveness of 7-days-per-week rehabilitation for acute stroke patients was analyzed based on the result from a previous study using a Japanese database examining the efficacy of 7-days-per-week rehabilitation. Cost utility analysis was conducted by comparing 7-days-per-week rehabilitation with 5- or 6-days-per-week rehabilitation, with its main outcome incremental cost-effectiveness ratio (ICER) calculated by dividing estimated incremental medical and long-term care costs by incremental quality-adjusted life years (QALY). The costs were estimated using the Japanese fee table and from published sources. The time horizon was 5 years, and Markov modeling was used for the analysis.ResultsThe ICER was $6339/QALY from public health payer's perspective, lower than 5,000,000 Yen/QALY (approximately US$37,913), which was the willingness-to-pay used for the cost-effectiveness evaluation in Japan. The 7-day-per-week rehabilitation was dominant from public healthcare and long-term care payer & apos;s perspective. The result of sensitivity analysis confirmed the results.ConclusionThe results indicated that 7-days-per-week rehabilitation for acute stroke rehabilitation was likely to be cost-effective.

Objective: This study aimed to compare postoperative patients with breast cancer aged >= 65 years with those aged <65 years and clarify the characteristics of postoperative patients with breast cancer aged >= 65. Methods: In total, 376 patients in whom we were able to evaluate survey items one month after surgery were included in the study. Comorbidity, including diabetes mellitus and hypertension, shoulder range of motion (ROM), upper-limb function, and psychological problems, was evaluated. Results: Hypertension and diabetes mellitus were significantly higher in patients aged >= 65 years (the elderly group) than in those aged <65 years (the non-elderly group) (p < 0.05). Preoperative shoulder flexion ROM was significantly restricted in the elderly group compared with the non-elderly group (p < 0.05). Preoperative shoulder abduction ROM was significantly restricted in the elderly group compared with the non-elderly group (p < 0.05). At one month after surgery, upper-limb function was more impaired in the non-elderly group than in the elderly group (p < 0.05). In both groups, both ROM and upper-limb function were significantly impaired one month after surgery compared with before surgery (p < 0.05). Conclusions: Postoperative patients with breast cancer aged >= 65 years should be careful about risk management and intervention during rehabilitation. Preoperative evaluation of shoulder ROM should be performed because patients aged >= 65 years have limited ROM before surgery.

Asymmetry in knee extensor moment during double-leg squatting was observed after anterior cruciate ligament reconstruction, even after the completion of the rehabilitation program for return to sports. The purpose of this study was to clarify the association between asymmetry in the knee extensor moment and pelvic rotation angle during double-leg squatting after anterior cruciate ligament reconstruction. Twenty-four participants performed double-leg squatting. Kinetics and kinematics during squatting were analyzed using a 3-dimensional motion analysis system with 2 force plates. The limb symmetry index of knee extensor moment was predicted by the pelvic rotation angle (R2 = .376, P = .001). In addition, the pelvic rotation and the limb symmetry index of the vertical ground reaction force independently explained the limb symmetry index of the knee extensor moment (R2 = .635, P< .001, beta of pelvic rotation = -0.489, beta of vertical ground reaction force = 0.524). Pelvic rotation toward the involved limb was associated with a smaller knee extensor moment in the involved limb than in the uninvolved limb. The assessment of pelvic rotation would be useful for partially predicting asymmetry in the knee extensor moment during double-leg squatting. Minimizing pelvic rotation may improve the asymmetry in the knee extensor moment during double-leg squatting after anterior cruciate ligament reconstruction.

This report describes a case in which Pilates exercise was used successfully to treat age-related kyphosis. The patient was a 72-year-old woman who presented to us complaining of abnormal posture and being unable to stand for more than 3 min without using a walker or cane. A standing lateral plain radiograph showed kyphotic deformity of the thoracic spine and a C7 sagittal vertical axis to be 185 mm. We recommended thoracic to iliac spinal correction and fusion surgery. However, the patient opted for conservative treatment, so was referred for rehabilitation. Her kyphosis was flexible, with a decrease in the thoracic kyphosis angle from about 50 degrees in the standing position to about 10 degrees in the lying position. The basic concept when using Pilates exercise for rehabilitation in patients with kyphosis is stretching of the ventral aspect of the body and strengthening exercises for the dorsal aspect of the spine. After 4 weeks of rehabilitation, the patient’s posture became more upright and she could stand without support for more than 10 min. Even though we have had only one such case, our experience is that Pilates exercise can be a useful rehabilitation tool for patients with age-related kyphosis.

type:Original Articles, Soil erosion is one of the major environmental problems in open-cut mines in tropical regions. It causes negative impacts including the removal of nutrient rich topsoil and subsequent reduction of agricultural productivity in the rehabilitation process. Therefore, it is important to predict soil erosion in advance and establish the proper process to minimize the phenomenon for the success of rehabilitation in the disturbed land. Field investigation to understand soil characteristics in rehabilitation areas and artificial rainfall experiment in laboratory scales were used to assess soil erosion. From a series of investigations, the soil characteristics that spread to the rehabilitation areas were uneven due to mixing overburden as contamination; moreover, it can increase the risk of soil erosion when the soil has high soil erodibility. Another study finding shows the importance of selective placement of erosion-resistant soil in an area which has a high potential for soil erosion to occur, such as slope with an establishment of rapid growing cover crop species on the surface. This paper describes soil erosion under the various soil characteristics and effective countermeasures in situ, and discusses the design of the self-sustainable land surface against soil erosion.

type:Text, Patients undergoing hematopoietic stem cell transplantation (HSCT) tend to experience decline in physical function, mental function, and quality of life (QOL) after HSCT due to low activity caused by adverse reactions to chemotherapy used in pre-transplantation treatment and post-transplant complications. Rehabilitation for HSCT patients is effective in preventing decline in physical function, reducing fatigue, and improving QOL. A combination of aerobic exercise and strength training is recommended for exercise therapy. Risk management is also important in the implementation of exercise therapy, and the exercise intensity should be determined according to the presence of anemia, low platelet counts, or post-transplant complications. On the other hand, post-transplant complications can decrease the patient's motivation and daily activity level. A multidisciplinary approach, which includes physicians and nurses, is important to achieve early discharge from the hospital and as quick a return to society as possible.

This study aimed to investigate the basic data on the effectiveness and safety of the system in healthy subjects using an immersive virtual reality (VR) exercise system specialized for therapeutic exercise therapy during dialysis or hospital use. A total of 15 healthy adult subjects performed four exercises, namely lifting and rowing exercises using VR and each movement exercise without VR (control). The simulator sickness questionnaire (SSQ) was administered pre- and post-operatively to assess for VR sickness. Blood pressure, heart rate (HR), rating of perceived exhaustion, Profile of Mood States 2nd Edition Japanese version, and muscle activity (iEMG) were measured using electromyography. The correlation between changes in mood states and HR or iEMG results was examined. The SSQ measured post-VR exercise was 11.2 (18.7–7.5) and 11.2 (7.5–29.9) points in the lifting and rowing VR, respectively. The HR in lifting (VR, 82.5 ± 12.7 vs control, 71.6 ± 10.6 bpm, P<0.05) and rowing (VR, 94.2 ± 13.1 vs control, 83.5 ± 12.0, P<0.05) with VR exercise was significantly higher than in control. No significant differences were observed between the other variables. There was a positive correlation between HR and negative mood in the lifting VR condition (r=0.64, P<0.05), but not in the control group. Contrastingly, there was a positive correlation between iEMG and negative mood in rowing control (r=0.56), but not VR. Safety was confirmed, with no VR sickness or discontinuation of the system. Exercise therapy using VR resulted in a higher exercise load. This VR system has the potential for additional effective intradialytic exercises and hospital use.

This project, was carried out in Yverdon-les-Bains, Switzerland, between the University of Applied Sciences and Arts Western Switzerland (HEIG-VD / HES-SO) and the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, it focuses on the detection of grasp types from an egocentric point of view. The objective is to accurately determine the kind of grasp (power, precision and none) performed by a user based on images captured from their perspective. The successful implementation of this grasp detection system would greatly benefit the evaluation of patients undergoing upper limb rehabilitation. Various computer vision frameworks were utilized to detect hands, interacting objects, and depth information in the images. These extracted features were then fed into deep learning models for grasp prediction. Both custom recorded datasets and open-source datasets, such as EpicKitchen and the Yale dataset, were employed for training and evaluation. In conclusion, this project achieved satisfactory results in the detection of grasp types from an egocentric viewpoint, with a 0.76 F1-macro score in the final test set. The utilization of diverse videos, including custom recordings and publicly available datasets, facilitated comprehensive training and evaluation. A robust pipeline was developed through iterative refinement, enabling the extraction of crucial features from each frame to predict grasp types accurately. Furthermore, data mixtures were proposed to enhance dataset size and improve the generalization performance of the models, which played a crucial role in the project's final stages.

Introduction: Tuning the control parameters is one of the main challenges in robotic gait therapy. Control strategies that vary the control parameters based on the user’s performance are still scarce and do not exploit the potential of using spatiotemporal metrics. The goal of this study was to validate the feasibility of using shank-worn Inertial Measurement Units (IMUs) for clinical gait analysis after stroke and evaluate their preliminary applicability in designing an automatic and adaptive controller for a knee exoskeleton (ABLE-KS). Methods: First, we estimated the temporal (i.e., stride time, stance, and swing duration) and spatial (i.e., stride length, maximum vertical displacement, foot clearance, and circumduction) metrics in six post-stroke participants while walking on a treadmill and overground and compared these estimates with data from an optical motion tracking system. Next, we analyzed the relationships between the IMU-estimated metrics and an exoskeleton control parameter related to the peak knee flexion torque. Finally, we trained two machine learning algorithms, i.e., linear regression and neural network, to model the relationship between the exoskeleton torque and maximum vertical displacement, which was the metric that showed the strongest correlations with the data from the optical system [r = 0.84; ICC(A,1) = 0.73; ICC(C,1) = 0.81] and peak knee flexion torque (r = 0.957). Results: Offline validation of both neural network and linear regression models showed good predictions (R2 = 0.70–0.80; MAE = 0.48–0.58 Nm) of the peak torque based on the maximum vertical displacement metric for the participants with better gait function, i.e., gait speed > 0.7 m/s. For the participants with worse gait function, both models failed to provide good predictions (R2 = 0.00–0.19; MAE = 1.15–1.29 Nm) of the peak torque despite having a moderate-to-strong correlation between the spatiotemporal metric and control parameter. Discussion: Our preliminary results indi, Peer Reviewed, Postprint (published version)

Durant la pandèmia, el confinament va posar en evidència la importància dels espais exteriors. Per abordar els desafiaments socials i ambientals es va proposar un taller intensiu per desenvolupar un prototip de balcó de fusta que pogués instal·lar-se en edificis existents. L'aprenentatge a través de l'experimentació genera coneixement profund i motiva els estudiants, per la qual cosa el taller es va basar en learning by building. Per apropar la realitat de la professió a les aules, el taller es va desenvolupar des de la fase de disseny fins a l'execució i en col·laboració amb empreses estratègiques del sector, tot aportant una visió completa dels processos implicats. L'èxit mediàtic del taller i els resultats van facilitar la transferència de coneixement a través de modificacions de la normativa existent., During the pandemic, confinement highlighted the importance of outdoor living spaces. To address social and environmental challenges, an intensive Service-Learning workshop was proposed to develop a prototype of a wooden balcony that could be installed on existing buildings. Learning through experimentation generates deep knowledge and motivates students, so the workshop was based on learning by building. To bring the reality of the profession closer to the classroom, the workshop was developed from the design phase to the execution phase and in collaboration with strategic companies in the sector, providing a complete vision of the processes involved. The media success of the workshop and its results generated knowledge transfer through the modification of existing local regulations related to construction and urban planning, and the workshop will be continued in future editions., Durante la pandemia, el confinamiento puso en evidencia la importancia de los espacios al aire libre. Para abordar los desafíos sociales y ambientales se propuso un taller intensivo para desarrollar un prototipo de balcón de madera que pudiera instalarse en edificios existentes. El aprendizaje a través de la experimentación genera conocimiento profundo y motiva a los estudiantes, por lo que el taller se basó en “learning by building”. Para acercar la realidad de la profesión a las aulas, el taller se desarrolló desde la fase de diseño hasta la ejecución y en colaboración con empresas estratégicas del sector, aportando una visión completa de los procesos implicados. El éxito mediático del taller y sus resultados facilitaron la transferencia de conocimiento a través de modificaciones de la normativa existente., Peer Reviewed

BACKGROUND: Active upper extremity (UE) assistive devices have the potential to restore independent functional movement in individuals with UE impairment due to neuromuscular diseases or injury-induced chronic weakness. Academically fabricated UE assistive devices are not usually optimized for activities of daily living (ADLs), whereas commercially available alternatives tend to lack flexibility in control and activation methods. Both options are typically difficult to don and doff and may be uncomfortable for extensive daily use due to their lack of personalization. To overcome these limitations, we have designed, developed, and clinically evaluated the NuroSleeve, an innovative user-centered UE hybrid orthosis. METHODS: This study introduces the design, implementation, and clinical evaluation of the NuroSleeve, a user-centered hybrid device that incorporates a lightweight, easy to don and doff 3D-printed motorized UE orthosis and a functional electrical stimulation (FES) component. Our primary goals are to develop a customized hybrid device that individuals with UE neuromuscular impairment can use to perform ADLs and to evaluate the benefits of incorporating the device into occupational therapy sessions. The trial is designed as a prospective, open-label, single-cohort feasibility study of eight-week sessions combined with at-home use of the device and implements an iterative device design process where feedback from participants and therapists informs design improvement cycles. RESULTS: All participants learned how to independently don, doff, and use the NuroSleeve in ADLs, both in clinical therapy and in their home environments. All participants showed improvements in their Canadian Occupational Performance Measure (COPM), which was the primary clinical trial outcome measure. Furthermore, participants and therapists provided valuable feedback to guide further development. CONCLUSIONS: Our results from non-clinical testing and clinical evaluation demonstrate that

Background: The World Health Organization claims that rehabilitation is important to meet the needs of persons with dementia. Rehabilitation programmes, however, are not routinely available. Person-centred, multidimensional, and interdisciplinary rehabilitation can increase the opportunities for older adults with dementia and their informal primary caregivers to continue to live an active life and participate in society. To our knowledge, staff team experiences of such rehabilitation programmes, involving older adults with dementia and their informal caregivers has not been previously explored. Methods: The aim of this qualitative focus group study was to explore the experiences of a comprehensive staff team providing person-centred multidimensional, interdisciplinary rehabilitation to community-dwelling older adults with dementia, including education and support for informal primary caregivers. The 13 staff team members comprised 10 professions who, during a 16-week intervention period, provided individualised interventions while involving the rehabilitation participants. After the rehabilitation period the staff team members were divided in two focus groups who met on three occasions each (in total six focus groups) and discussed their experiences. The Grounded Theory method was used for data collection and analysis. Results: The analysis resulted in four categories: Achieving involvement in rehabilitation is challenging, Considering various realities by acting as a link, Offering time and continuity create added value, and Creating a holistic view through knowledge exchange, and the core category: Refining a co-creative process towards making a difference. The core category resembles the collaboration that the staff had within their teams, which included participants with dementia and caregivers, and with the goal that the intervention should make a difference for the participants. This was conducted with flexibility in a collaborative and creative process. Concl

Background: Stroke is the third-leading cause of disability worldwide, and there are rehabilitation needs not only in the first year but throughout the lifetime. The ability to walk is crucial in everyday life since it affects mobility, self-care, and social activities. National guidelines recommend treating impairments with repetitive task- and goal-oriented exercises. One form of highly intensive and task-specific treatment is constraint-induced movement therapy (CIMT), a treatment method developed based on understanding brain plasticity with a behavioural explanatory model. There is insufficient evidence regarding CIMT for the lower extremities (LE-CIMT) since it has only been investigated in a few published studies involving only a small number of participants. Aim: The overall aims of this thesis were to explore the extent to which LE-CIMT (six hours per day for two weeks) can improve impaired body functions and limited activities, describe how the treatment is experienced, and investigate whether it affects the health-related quality of life (HRQoL) in individuals with stroke. Methods: This thesis contains five papers that analysed data from two study populations using quantitative and qualitative research methods. A single-subject experimental study with five subjects and a longitudinal uncontrolled cohort study with 147 subjects with stroke treated with LECIMT and follow-up after three and six months were conducted. Subjects were assessed with Fugl–Meyer assessment, the Berg balance scale (BBS), single-leg stance, step test, timed up and go with and without dual-task, ten-metre (10MWT) and six-minute (6MWT) walk tests, one repetition maximum, and weight-bearing standing on two scales. Data were analysed with the two-standard deviation band method and linear mixed modelling, controlling for heterogeneity. Seven individual semistructured interviews were performed and analysed with qualitative content analysis to explore LE-CIMT experiences. Finally, a question

Purpose: To describe the sociodemographic and cognitive profile of participants enrolled in an adapted driving program for individuals with neurological conditions, to explore the association between cognitive functioning and driving program outcome, and to describe driving habits after program completion. Methods: This study combined retrospective chart review and cross-sectional data collection. Results: The sample included 71 participants with neurological disorders (aged 15-56 years, M = 22.2 ± 8.6; 39% women). Driving program was either successful (47%), failed (7%), discontinued (34%), or ongoing (13%). Among 35 participants with complete neuropsychological and driving program outcome data, those who successfully completed the program showed better attention functioning, and better performance relative to global functioning for attention, executive functions, and working memory, compared to those who discontinued/failed the program. Among 21 participants who completed a telephone questionnaire on average 3.7 years after program enrollment, 67% obtained their driver's license and drove regularly. Participants reported high levels of satisfaction with the program. Conclusion: These results suggest that approximately half of the persons enrolled in a driver training program designed for learners with neurological conditions, obtain a driver's license; and that attention, and to a lesser extent executive functioning and working memory, are related to driving program success. IMPLICATIONS FOR REHABILITATION: In individual with neurological conditions, learning how to drive can be challenging. An adapted driver training program, involving collaboration between driving instructors and healthcare professionals, simplification of theoretical learning, and increasing driving practice opportunities, can be effective, both in terms of licensing success and client satisfaction.Conducting a pre-driving program neuropsychological assessment, with identification of cognitive

Background: Best practice goal-setting in rehabilitation involves having a common goal focus across the team, ensuring goals are specific and meaningful, including action planning, coping planning, feedback, and review of goals, and including the client in shared decision-making throughout the goal-setting process. While these elements are considered best practices in rehabilitation goal-setting, they are inconsistently implemented in clinical practice. Aim: This program of research aims to enhance the implementation of best practice elements of goal-setting in five services across the continuum of rehabilitation., Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Health Sci & Soc Wrk, Griffith Health, Full Text

Purpose: Attributes conveying cultural significance play a key role in heritage management, as well as in differentiating interventions in built heritage. However, seldom the relation between interventions and attributes, either tangible or intangible, has been researched systematically. How do both tangible and intangible attributes and interventions relate? What attributes make interventions on built heritage differ? Design/methodology/approach: This paper conducts a systematic content analysis of forty-one international doctrinal documents—mainly adopted by the Council of Europe, UNESCO and ICOMOS, between 1877 and 2021. The main aim is to reveal and compare the selected eight intervention concepts, namely—restoration (C1), preservation (C2), conservation (C3), adaptation (C4), rehabilitation (C5), relocation (C6), reconstruction (C7) and renewal (C8)—and their definitions, in relation to attributes, both tangible and intangible. The intensity of the relationship between intervention concepts and attributes is determined based on the frequency of the mentioned attributes per intervention. Findings: There were three key findings. First, although the attention to intangible attributes has increased in the last decades, the relationship between interventions and tangible attributes remains stronger. The highest frequency of referencing the tangible attributes was identified in “relocation” and “preservation,” while the lowest was in “rehabilitation.” Second, certain attributes play contradictory roles, e.g. “material,” “use” and “process,” which creates inconsistent definitions between documents. Third, as attributes often include one another in building layers, they trigger the intervention concepts in hierarchical patterns. Originality/value: This paper explores and discusses the results of a novel comparative analysis between different intervention concepts and definitions, with a particular focus on the attributes. The results can support further research and, Heritage & Architecture

Children with dyslexia, compared with typically reading peers, are at increased risk of internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns; why this is the case is largely unknown. Our aim was to explore the socio-emotional experience of growing up with dyslexia from both child and parent perspectives. In so doing, we aimed to gain a better understanding of self-esteem and mental health in the context of dyslexia. One-to-one semi-structured interviews with 17 children with reading difficulties (aged 9–14 years; 16 with a diagnosis of dyslexia) and their mothers (interviewed separately) were analysed using Braun and Clarke's reflexive thematic analysis approach with a neurodiversity lens. We developed three themes to address the research aim: (1) Different in a good/bad way; (2) Exhausted and overwhelmed; and (3) It takes a community: Family school connections. Children discussed having “worries” and experiencing school-related stress and embarrassment. Mothers perceived children's internalising and externalising behaviour (meltdowns), school refusal, and homework resistance as emotional responses to children's school struggles due to poor “person-environment fit.” Our analysis highlights the particular importance of parent support, friendship, and school-connectedness for the wellbeing of children with dyslexia.

Introduction: Parents of children with dyslexia may be at elevated risk for parenting stress and mental health concerns. Our aim was to explore the emotional experience of growing up with dyslexia in Australia from parents' perspectives. In so doing, we also developed an understanding of parents' own mental health and support needs informed by their lived experience. Methodology: Seventeen interviews with mothers of children (9–14 years; 16 with a diagnosis of dyslexia) were analysed using Braun and Clarke's reflexive thematic analysis approach. Analysis: Five themes were developed to address our aim: Theme 1: Years in the wilderness: Life before diagnosis; 2: “I struggle at times to see her struggle”; 3. School struggles: Advocating for our children and managing distress; 4. “It's a full-time job” and a “long slog”; 5: Care for the carer: Social support and coping strategies. Conclusions: Our analysis suggests that mothers of children with dyslexia may be at elevated risk for mental health concerns. Specifically, chronic worry and stress, secondary distress, challenges to parenting self-efficacy, and lack of support and understanding (feeling isolated) were highlighted as plausible risk factors. Mothers described coping strategies at the community level (e.g., school connectedness) and at the individual level (e.g., “acceptance”) as protective.

Introduction: Active aging is a European concern that requires health and social professionals to rethink their practices. Methodology: We seek to understand the care model for the elderly in a Group of Health Centers (ACES) in the North of Portugal to deduce the role of rehabilitation nurses in the community. We carried out a qualitative, phenomenological study. The intentional non-probabilistic sample consisted of eight Doctors, eight Nurses and eight Social Workers who develop their activity for people over 65 years old in an ACES. Data collection was carried out through a semi-structured interview, constituting the results of the body of analysis that sustains this research. Results: 83% of participants had no training in gerontology. There were care evaluation focuses, in which all professionals estimated the same data, but there were data necessary for monitoring the elderly that were not evaluated by any professional. The sharing of information for assistance, when it occurred, fell into situations of illness or changes in the social context. Discussion: It was possible to verify that in all themes there is information that converges in the three groups of professionals, mainly in the data collected in the initial evaluation. As advocated by some authors, sharing information and dividing teamwork is important for a more specialized intervention aimed mainly at this age group. Conclusion: In this way, it was possible to perceive that the work of the three groups of professionals interviewed often intersects and that there is a need for data sharing between the multidisciplinary team, with the specialized work of the Rehabilitation Nurse being valued and important., Introducción: El envejecimiento activo es una preocupación europea que requiere que los profesionales sociales y de la salud reconsideren sus prácticas. Metodología: Buscamos comprender el modelo de atención a los ancianos en un Grupo de Centros de Salud (ACES) en el Norte de Portugal para deducir el papel de las enfermeras de rehabilitación en la comunidad. Realizamos un estudio cualitativo, fenomenológico. La muestra no probabilística intencional estuvo constituida por ocho Médicos, ocho Enfermeros y ocho Trabajadores Sociales que desarrollan su actividad para personas mayores de 65 años en un ACES. La recolección de datos se realizó a través de una entrevista semiestructurada, constituyendo los resultados del cuerpo de análisis que sustenta esta investigación. Resultados: El 83% de los participantes no tenían formación en gerontología. Existían focos de evaluación del cuidado, en los que todos los profesionales estimaban los mismos datos, pero había datos necesarios para el seguimiento de los ancianos que no eran evaluados por ningún profesional. El intercambio de información para la asistencia, cuando ocurrió, cayó en situaciones de enfermedad o cambios en el contexto social. Discusión: Fue posible verificar que en todos los temas hay informaciones que convergen en los tres grupos de profesionales, principalmente en los datos recogidos en la evaluación inicial. Como defienden algunos autores, compartir información y dividir el trabajo en equipo es importante para una intervención más especializada dirigida principalmente a este grupo de edad. Conclusión: De esa forma, fue posible percibir que el trabajo de los tres grupos de profesionales entrevistados muchas veces se entrecruza y que existe la necesidad de compartir datos entre el equipo multidisciplinario, siendo valorado e importante el trabajo especializado de la Enfermera de Rehabilitación., Introdução: O envelhecimento ativo é uma preocupação europeia que exige aos profissionais de saúde e sociais repensar as suas práticas. Metodologia: Procuramos compreender o modelo de assistência dos idosos num Agrupamento de Centros de Saúde (ACES) do Norte de Portugal para deduzir o papel dos enfermeiros de reabilitação na comunidade. Realizamos um estudo qualitativo, do tipo fenomenológico. A amostra não probabilística intencional foi constituída por oito Médicos, oito Enfermeiros e oito Assistentes Sociais que desenvolvem a sua atividade para pessoas com mais de 65 anos num ACES. A recolha de dados foi elaborada através de uma entrevista semi-estruturada, constituindo os resultados do corpo da análise que sustenta esta pesquisa. Resultados: 83% dos participantes não possuíam formação em gerontologia. Havia focos de avaliação da assistência, em que todos os profissionais estimavam os mesmos dados, mas havia dados necessários ao acompanhamento dos idosos que não eram avaliados por nenhum profissional. A partilha da informação para a assistência, quando ocorria, recaía nas situações de doença ou de alterações do contexto social. Discussão: Foi possível verificar que em todas as temáticas há informação que converge nos três grupos de profissionais, principalmente nos dados colhidos na avaliação inicial. Tal como defendem alguns autores a partilha de informação e divisão do trabalho de equipa é importante para uma intervenção mais especializada e dirigida principalmente nesta faixa etária. Conclusão: Desta forma foi possível perceber que o trabalho dos três grupos de profissionais entrevistados muitas vezes se cruza e que há necessidade de partilha de dados entre a equipa multidisciplinar, sendo valorizado e importante o trabalho especializado do Enfermeiro de Reabilitação.

Introduction: Functional capacity refers to the person's autonomy to carry out tasks that are part of their day-to-day life and ensure the possibility of living alone. Carrying out this study leads to reflection on the effectiveness of providing rehabilitation nursing care in terms of promoting gains in the user's functional independence in the home context. Objectives: The research aimed to describe and explain the existence of associations between the variables: degree of functional dependence; rehabilitation nursing care provided and some sociodemographic factors in order to understand how the care provided by the rehabilitation nurse contributes to the reduction of the user's degree of dependence. Methodology: We carried out a descriptive, retrospective study, with the purpose of evaluating the functional evolution of the patient from the moment of admission to the time of discharge from the Integrated Continuing Care Team. We used the Barthel index to monitor functionality. We constituted a sample of 63 users. Results: At time of admissions there were no independent users or patients with mild dependence. The total dependence represented 20.6%, the severely dependence 44.4% and the moderate dependence 34.9%. After the services of rehabilitation nursing care, at the time of discharge, the value of total dependents was 12.7%, severely and moderate dependence decreased to 19.0% each. Also, there was a light dependence with 15.9% and 33.3% of users were already independent. Conclusion: There was a statistically significant evolution in all activities of daily living, except for those of elimination, so it was concluded that rehabilitation nursing care, in a home context, translates into gains in functionality for the studied users., Introducción: La capacidad funcional se refiere a la autonomía de la persona para realizar las tareas que forman parte de su día a día y asegurar la posibilidad de vivir sola. La realización de este estudio lleva a reflexionar sobre la eficacia de la prestación de cuidados de enfermería de rehabilitación en la promoción de ganancias en la independencia funcional de los pacientes en el contexto domiciliario. Objetivos: La investigación tuvo como objetivo describir y explicar la existencia de asociaciones entre las variables: grado de dependencia funcional; cuidados de enfermería de rehabilitación prestados y algunos factores sociodemográficos para comprender cómo el cuidado prestado por la enfermera de rehabilitación contribuye a reducir el grado de dependencia del paciente. Metodología: Realizamos un estudio descriptivo, retrospectivo, con la finalidad de evaluar la evolución funcional del paciente desde el momento del ingreso hasta el alta del Equipo Integrado de Atención Continuada. Utilizamos el Índice de Barthel para monitorizar la funcionalidad. Constituimos una muestra de 63 pacientes. Resultados: Al ingreso no había pacientes independientes ni pacientes con dependencia ligera, representando la dependencia total el 20,6%, la dependencia severa el 44,4% y la dependencia moderada el 34,9%. Después de la prestación de los cuidados de enfermería de rehabilitación, en el momento del alta, el valor de los dependientes totales fue de 12,7%, la dependencia severa y moderada disminuyó al 19,0% cada una. También hubo dependencia ligera con un 15,9% y un 33,3% de los pacientes ya eran independientes. Conclusión: Hubo evolución estadísticamente significativa en todas las actividades de la vida diaria, excepto en las de eliminación, por lo que se concluyó que el cuidado de enfermeira de rehabilitación, en contexto domiciliario, se traduce en ganancias de funcionalidad para los pacientes estudiados. es., Introdução: A capacidade funcional, reporta-se à autonomia da pessoa para a realização de tarefas que fazem parte do seu dia-a-dia e lhe asseguram a possibilidade de viver sozinho. A realização deste estudo leva à reflexão sobre a eficácia da prestação de cuidados de enfermagem de reabilitação no sentido da promoção de ganhos em independência funcional do utente em contexto domiciliário. Objetivos: A investigação teve como objetivo descrever e explicar a existência de associações entre as variáveis: grau de dependência funcional; cuidados de enfermagem de reabilitação prestados e alguns fatores sociodemográficos de modo a compreender de que forma os cuidados prestados pelo enfermeiro de reabilitação contribuem para a diminuição do grau de dependência do utente. Metodologia: Efetuamos um estudo descritivo, retrospetivo, com a finalidade de avaliar a evolução funcional do utente desde o momento de admissão até à alta na Equipa de Cuidados Continuados Integrados. Utilizamos o Índice de Barthel para monitorização da funcionalidade. Constituímos uma amostra de 63 utentes. Resultados: Na admissão não existiam utentes independentes ou com dependência ligeira, sendo que a dependência total representava 20,6%, a dependência grave 44,4% e a dependência moderada 34,9%. Após a prestação de cuidados de enfermagem de reabilitação, no momento da alta, o valor de dependentes totais foi de 12,7%, a dependência grave e moderada decresceu para 19,0% cada. Surgiu ainda a dependência ligeira com 15,9% e 33,3% dos utentes já se encontravam independentes. Conclusão: Existiu uma evolução estatisticamente significativa em todas as atividades de vida diária exceto nas de eliminação, pelo que se concluiu que os cuidados de enfermagem de reabilitação, em contexto domiciliário, se traduziram em ganhos de funcionalidade para os utentes estudados.

Introduction: After the incubation period of the SARS-CoV-2 virus, which causes Covid-19, some symptoms may last for months or years, such as respiratory and peripheral muscle weakness. Objectives: To seek and identify the profile of individuals who were affected by Covid-19 and who had complications and a decrease in their lung and functional capacities, quality of life and peripheral muscle strength, after hospital discharge or home isolation. Methodology: Individuals who contracted Covid-19 and who sought the Extension Project Physical Therapy Assistance to Post-Covid-19 Patients participated in the study. Assessment data were collected using tests, questionnaires and scales. Results: The profile of 30 individuals was identified, who had mild, moderate and severe cases. In addition to the collected comorbidities, fatigue was the predominant symptom in this population. Conclusion: Participants showed changes in aspects related to quality of life, in addition to changes in sleep, fatigue, breathing capacity and handgrip strength., Introdução: Após o período de incubação do vírus SARS-CoV-2, alguns sintomas podem perdurarar por meses ou anos, como fraqueza dos músculos respiratórios e periféricos. Objetivos: Buscar e identificar o perfil dos indivíduos que foram acometidos pela Covid-19 e que tiveram complicações e diminuição das suas capacidades pulmonar e funcional, qualidade de vida e força muscular periférica, pós-período de alta hospitalar ou isolamento domiciliar. Metodologia: Participaram do estudo indivíduos que contraíram a Covid-19 e que buscaram o Projeto de extensão Assistência Fisioterapêutica aos Pacientes Pós-Covid-19. Foram coletados dados da avaliação, utilizando testes, questionários e escalas. Resultados: Foi identificado o perfil de 30 indivíduos, que apresentaram casos leves, moderados e graves. Além das comorbidades coletadas, a fadiga foi o sintoma predominante nessa população. Conclusão: Os participantes apresentaram alterações nos aspectos ligados a qualidade de vida, além de alterações em relação ao sono, fadiga, capacidade respiratória e força de preensão palmar., Introducción: Después del período de incubación del virus SARS-CoV-2, algunos síntomas pueden durar meses o años, como la debilidad respiratoria y de los músculos periféricos. Objetivos: Buscar e identificar el perfil de las personas que fueron afectadas por el Covid-19 y que presentaron complicaciones y disminución de sus capacidades pulmonares y funcionales, calidad de vida y fuerza muscular periférica, luego del alta hospitalaria o aislamiento domiciliario. Metodología: Participaron del estudio personas que contrajeron Covid-19 y que solicitaron el Proyecto de Extensión de Asistencia en Terapia Física a Pacientes Post-Covid-19. Los datos de evaluación se recogieron mediante pruebas, cuestionarios y escalas. Resultados: Se identificó el perfil de 30 individuos, que presentaban casos leves, moderados y severos. Además de las comorbilidades recogidas, la fatiga fue el síntoma predominante en esta población. Conclusión: Los participantes mostraron cambios en aspectos relacionados con la calidad de vida, además de cambios en el sueño, fatiga, capacidad respiratoria y fuerza de agarre de la palma.

Mass housing neighborhoods emerged in the second half of the twentieth century as an important part of the affordable social housing stock in Southern Europe, but now these are suffering from social problems and physical degradation. This article, which focuses on a case study of an archetypical transformation of a housing estate in Barcelona (Canyelles), aims at identifying the conditions needed to reduce social inequalities in this type of neighborhood and implement urban rehabilitation programs. The mixed methodology applied consisted of a combination of semi-structured interviews with the main actors involved, a focus group with the neighborhood council, and a multivariate statistical analysis of intra-urban fine-scale social indicators. Based on these methods, the urban transformation projects and their social consequences, which can be observed in the evolution of the social composition of the neighborhood, are analyzed. A significant improvement in the quality of life of the neighbors is seen as a result of the housing rehabilitation and renovation of public spaces programs. Ultimately, these changes are contributing to increasing social integration, as well as initiating a gentrification process., Los barrios de vivienda masiva desarrollados en la segunda mitad del siglo XX constituyen una parte importante del parque de viviendas sociales y asequibles del sur de Europa, pero sufren problemas sociales y degradación física. Centrado en un estudio de caso de transformación arquetípica de una urbanización en Barcelona (Canyelles), este artículo pretende identificar las condiciones necesarias para reducir las desigualdades sociales en este tipo de barrios, además de la implementación de programas de rehabilitación urbana. La metodología mixta aplicada consistió en una combinación de entrevistas semiestructuradas con los principales actores involucrados, un grupo focal con la junta de vecinos y un análisis estadístico multivariante de indicadores sociales a escala fina intraurbana. A partir de estos métodos, analizamos los proyectos de transformación urbana, así como sus consecuencias sociales, que se pueden observar en la evolución de la composición social del barrio. Por lo tanto, observamos una mejora significativa en la calidad de vida de los vecinos como resultado de programas, tanto de rehabilitación de viviendas como de renovación de espacios públicos. Finalmente, estos cambios están contribuyendo a aumentar la integración social, así como también a iniciar un proceso de gentrificación

The rotator cuff injury is a significant cause of shoulder pain and dysfunction. Treating massive and irreparable rotator cuff tears remains a major challenge for orthopedists due to their complexity and severity. One promising alternative for managing these cases is the use of subacromial balloons. In this study, we present the case of a 67-year-old woman diagnosed with a massive and irreparable rotator cuff tear in her right shoulder (Grade III Patte, Grade IV Goutallier, and Grade II Hamada), without glenohumeral arthritis, intact biceps tenosynovitis, and subscapularis. The preoperative Constant score was 40 points. The patient underwent partial arthroscopic repair of the supraspinatus and infraspinatus tendons, along with a suprapectoral biceps tenodesis and subacromial balloon placement. Postoperative rehabilitation led to improved range of motion, reduced pain, and increased strength in the right shoulder. The postoperative Constant score reached 80 points at the twelve-week mark. The subacromial balloon proves to be a promising treatment alternative for irreparable rotator cuff injuries, providing optimal short-term results in terms of pain relief and functionality., La lesión del manguito rotador es una causa importante de dolor y disfunción del hombro. El tratamiento de las roturas masivas e irreparables del manguito rotador sigue siendo un gran reto para los ortopedistas por su complejidad y severidad. Una de las alternativas prometedoras para su manejo es el uso del balón subacromial. Presentamos el caso de una mujer de 67 años con diagnóstico de rotura masiva e irreparable del manguito rotador en el hombro derecho (grado III de Patte, grado IV Goutallier y grado II de Hamada) sin artrosis glenohumeral, tenosinovitis del bíceps y subescapular íntegro. La escala de constant preoperatorio fue de 40 puntos. Se realizó una reparación parcial artroscópica del tendón supraespinoso e infraespinoso asociado a una tenodesis suprapectoral del bíceps y la colocación del balón subacromial. La paciente realizó rehabilitación con mejoría de los arcos de movilidad, disminución del dolor e incremento de la fuerza del hombro derecho. La escala de constant postoperatorio fue de 80 puntos a la semana doce. El balón subacromial es una buena alternativa de tratamiento para las lesiones irreparables del manguito rotador con resultados óptimos a corto plazo en cuanto a dolor y función.

Introduction. Traffic accidents (TA) are a public health problem worldwide, with an estimated 1.3 million deaths per year from collisions and leaves traumatic sequels in the survivors. Of the total number of victims affected in an AT, injured pedestrians represent 22%. The objective of this study was to determine the factors associated with the requirement of physical rehabilitation of pedestrians injured by any TA in the Peruvian territory. Methods. An observational cross-sectional study was carried out with the data provided by the National Center for Epidemiology, Prevention, and Control of Diseases (CDC Peru) through epidemiological records. A regression analysis was performed, and prevalence ratios (PR) were reported, having the rehabilitation requirement as a dependent variable. Results. A total of 14,186 records of pedestrians injured by being hit by a motor vehicle on the road between 2016 and 2021 were analyzed. 87.89% of the victims did not require post-event rehabilitation. There is a greater probability of rehabilitation if the injured person is older and if the time of the accident occurred between 00:00 and 05:59 hours of the day. There is a lower probability of rehabilitation if the accident is caused by a minor motor vehicle. Conclusions. Many young people and adults are injured; however, older age is a factor associated with the need for rehabilitation, likewise, the type of road and the type of vehicle responsible influence the outcome of the victim., Introducción. Los accidentes de tránsito (AT) son un problema de salud pública a nivel mundial, se estiman 1,3 millones de muertes anuales, y en los sobrevivientes deja secuelas traumáticas que pueden disminuir la calidad de vida. De las víctimas, los peatones lesionados representan el 22%. El objetivo del presente estudio fue determinar los factores asociados al requerimiento de rehabilitación física de los peatones lesionados por algún AT en el territorio peruano. Métodos. Se realizó un estudio observacional de corte transversal con los datos secundarios brindados por el Centro Nacional de Epidemiología, Prevención y Control de Enfermedades (CDC Perú) por medio de fichas epidemiológicas. Resultados. Se analizaron 14 186 registros que involucran a peatones lesionados por atropellamiento en carretera por algún vehículo motorizado entre el 2016 y el 2021. El 87,89% de las víctimas no requirieron rehabilitación posterior al suceso. Existe una mayor probabilidad de rehabilitación si el lesionado tiene una mayor edad y si la hora del accidente fue entre las 00:00 y 05:59 horas del día. Existe una menor probabilidad de rehabilitación si el accidente lo ocasiona un motocarro. Conclusiones. Existe una gran cantidad de accidentados jóvenes y adultos, sin embargo, la edad mayor se comporta como un factor asociado a la necesidad de rehabilitación, así mismo, el tipo de carretera y el tipo de vehículo causante influyen en el desenlace de la víctima

Shoulder pain is the third cause of consultation in primary care related to joint pain and rotator cuff tendinopathy is the most common of them, it affects the quality of life of those how suffer from it. The pathology comprises an umbrella of terms that makes research difficult to make; in addition, the physiopathology is complex and not entirely known. The most widely accepted theory of pathogenesis is the mechanical theory. The diagnosis is mainly clinical without the need of radiological confirmation. To this day, management of the pathology is still conservative, with therapeutic modalities focused on reduction of pain and improvement in function of the joint. Furthermore, none of the therapeutic approaches have proved to regenerate the tendons. Progressive load exercises to the tendon have shown to be the most effective treatment modality in the conservative approach to the pathology, although the best protocol has not been stablished yet; moreover, many of the patients don´t respond adequately to this modality, therefore, it is important to consider adjunct therapies as a complement to exercises without substituting them. One of the most recent adjunct therapies is platelet rich plasma, it has been theoretically suggested that it has the capacity to regenerate the injured tendon since platelets are rich in growth factors. Nonetheless, its role has only been evaluated in terms of reduction of pain and improvement in function of the joint. Rehabilitation programs should be multimodal and individualized in order to be successful., El dolor de hombro es la tercera causa de consulta por dolor articular en la atención primaria, siendo la tendinopatía del manguito rotador la patología más frecuente, la cual afecta la calidad de vida de quienes la padecen. Corresponde a una sombrilla de términos, lo cual ha dificultado su estudio. La fisiopatología es compleja y no totalmente comprendida. El mecanismo fisiopatológico más comúnmente aceptado es la teoría mecánica. El diagnóstico de la patología sigue siendo clínico sin necesidad de confirmación radiológica. Hasta la fecha, el tratamiento es conservador y las modalidades terapéuticas se han enfocado en la disminución del dolor y la mejoría en la función de la articulación. Además, ninguna de estas modalidades terapéuticas ha demostrado regenerar el tendón. Se ha visto que los programas progresivos con cargas al tendón son los más eficaces en el tratamiento conservador de la patología, aunque no se ha establecido el mejor protocolo; no obstante, un gran número de pacientes no responde adecuadamente por lo que se deben considerar terapias adjuntas como complemento a esta sin que la sustituyan. Entre las terapias complementarias más recientes se encuentra la infiltración de plasma rico en plaquetas, de la cual se ha planteado, teóricamente, podría ayudar en la regeneración del tendón lesionado debido al contenido de factores de crecimiento que poseen las plaquetas. No obstante, solo se ha logrado evaluar su aporte en mejoría del dolor y función de la articulación. Los programas de rehabilitación deben ser multimodales e individualizados para ser más exitosos.

90% of the population with stroke suffer sequelae that disable the individual for their independence in the activities of daily life. We sought to determine the effects of interventions in adults after stroke of the motor relearning program vs different physiotherapeutic treatments on functional independence. A systematic review of the literature was carried out. in PubMed, PEDro, LILACS, Cochrane, Scopus and ScienceDirect databases, and a manual search, taking into account clinical trials, Spanish, English or Portuguese. The methodological quality was carried out using the PEDro scale and the risk of bias assessment was applied according to the Cochrane Manual. Eight studies out of a potential 984 were included. A clinically significant improvement was found in the motor relearning groups and only in one study is this improvement significant compared to another intervention. There are significant clinical effects in the use of the motor relearning program., El 90% de la población con Accidente Cerebrovascular sufre secuelas que incapacitan al individuo para su independencia en las actividades de la vida diaria. Se buscó determinar los efectos de las intervenciones en personas adultas después del accidente cerebrovascular del programa de reaprendizaje motor vs diferentes tratamientos fisioterapéuticos en la independencia funcional. Se realizó una revisión sistemática de la literatura. en bases de datos PubMed, PEDro, LILACS, Cochrane, Scopus y ScienceDirect, y una búsqueda manual, teniendo en cuenta ensayos clínicos, idioma español, inglés o portugués. La calidad metodológica se realizó por escala de PEDro y la evaluación del riesgo de sesgo se aplicó según el Manual Cochrane. Se incluyeron 8 estudios de 984 potenciales. Se encontró una mejora clínicamente significativa en los grupos de reaprendizaje motor y solamente en un estudio esta mejora es significativa con respecto a otra intervención. Existen efectos clínicos significativos en el uso del programa de reaprendizaje motor.

Introduction: Because of the the complex physiopathology of spasticity, it is distinguished as one of the most significant positive clinical signs of upper motor neuron syndrome, constituting a clinical feature that has great impact in the neurorehabilitation setting. Thus, the current study aimed to determine the prevalence, onset, evolution, and prediction of spasticity after a stroke. Materials and Methods: A correlational, longitudinal design was used. A total of 136 patients were evaluated at the following times: 10 days (T1), 3 months (T2), and 12 months (T3) poststroke. The initial evaluation included sociodemographic and clinical data (T1). Muscle tone was measured (T1, T2, and T3) using the Modified Ashworth Scale. Results: The prevalence of poststroke spasticity in the elbow was 37.5% at T1 and 57.4% at T2 and T3. Among patients with motor damage, the onset of spasticity occurred at T1 in 44.7%, between T1 and T2 in 23.7%, and between T2 and T3 in 0.9%. Significant predictors of the alteration in muscular tone for at least two of the evaluation times were ethnic self-classification, type, area, extent of stroke, and number of sessions. Conclusions: Spasticity onset occurs during the first 10 days after a stroke. More clinical than sociodemographic variables predicted spasticity., Introdução: a espasticidade destaca-se como um dos sinais clínicos positivos mais significativos da síndrome do neurônio motor superior, devido à sua fisiopatologia complexa, e constitui uma característica clínica de grande impacto no campo da neurorreabilitação. Portanto, nosso objetivo foi determinar a prevalência, início, evolução e predição da espasticidade após o acidente vascular cerebral. Materiais e métodos: foi utilizado um desenho correlacional longitudinal. Foram avaliados 136 pacientes: 10 dias (T1), 3 meses (T2) e 12 meses (T3) pós-avc. A avaliação incluiu dados sociodemográficos e clínicos (T1) e o tônus ​​muscular (T1, T2 e T3) foi medido por meio da Escala Modificada de Ashworth. Resultados: a prevalência no cotovelo foi de 37,5% em T1 e 57,4% em T2 e T3. Entre os pacientes com prejuízo motor, o início da espasticidade ocorreu em T1 em 44,7% deles, entre T1 e T2 em 23,7% e entre T2 e T3 em 0,9% dos pacientes. A autoclassificação étnica, o tipo, a área, a extensão do avc e o número de sessões predisseram significativamente as anormalidades do tônus ​​muscular em pelo menos duas ocasiões. Conclusões: o início da espasticidade ocorre durante os primeiros 10 dias após o acidente vascular cerebral. Mais variáveis ​​clínicas do que sociodemográficas previram a espasticidade., Introducción: la espasticidad se destaca como uno de los signos clínicos positivos más significativos del síndrome de motoneurona superior, por su compleja fisiopatología, y constituye una característica clínica de gran impacto en el ámbito de la neurorrehabilitación. Por lo tanto, nuestro objetivo fue determinar la prevalencia, el inicio, la evolución y la predicción de la espasticidad después de un accidente cerebrovascular. Materiales y métodos: Se utilizó un diseño longitudinal correlacional. Se evaluaron 136 pacientes: 10 días (T1), 3 meses (T2) y 12 meses (T3) post ACV. La evaluación incluyó datos sociodemográficos y clínicos (T1) y se midió el tono muscular (T1, T2 y T3) mediante la Escala de Ashworth Modificada. Resultados: La prevalencia en el codo fue del 37,5% en T1 y del 57,4% en T2 y T3. Entre los pacientes con daño motor, el inicio de la espasticidad ocurrió en T1 para el 44,7% de ellos, entre T1 y T2 para el 23,7% y entre T2 y T3 para el 0,9%. La autoclasificación étnica, el tipo, el área, la extensión del ictus y el número de sesiones predijeron significativamente la alteración del tono muscular en al menos dos ocasiones. Conclusiones: El inicio de la espasticidad ocurre durante los 10 primeros días después de un accidente cerebrovascular. Más variables clínicas que sociodemográficas predijeron espasticidad.

La visualización se ha utilizado en programas de intervención psicológica para la rehabilitación de deportistas lesionados ya que diferentes estudios la asocian con una mejoría en el afrontamiento psicológico y reducción de la ansiedad por el temor a volver a lesionarse. Por esto, el objetivo es revisar las publicaciones que utilizan la visualización en la rehabilitación de deportistas lesionados y determinar su eficacia. Se realizó una búsqueda sistemática siguiendo la guía PRISMA, en la Web of Science, usando como palabras clave: sport injur*, psycho* y rehabilitation. Los criterios de inclusión fueron ser un estudio empírico y la aplicación de la visualización en la rehabilitación de la lesión deportiva. Se obtuvieron 394 artículos, que se redujeron a cinco. Los resultados muestran que cuatro trabajos emplean la visualización junto con otras técnicas psicológicas. Se emplearon, en su mayoría, instrumentos de evaluación ad hoc. La visualización se mostró eficaz en cuatro de los cinco estudios, consiguiendo los efectos deseados. Las variables psicológicas más estudiadas fueron el dolor, la adherencia a la rehabilitación, la autoeficacia, la motivación y la ansiedad. Se deduce que la visualización, ha resultado útil en la rehabilitación de lesiones deportivas como parte de un programa de tratamiento integral del deportista lesionado., Guided imaginary has been used in psychological intervention programs for the rehabilitation of injured athletes, since different studies associate it with an improvement in psychological coping and a reduction in anxiety due to the fear of being injured again. Therefore, the objective is to review the publications that use guided imaginary in the rehabilitation of injured athletes and determine its effectiveness. A systematic search was carried out following the PRISMA guide, in the Web of Science, using as keywords: sport injury*, psycho* and rehabilitation. The inclusion criteria were to be empirical and the application of guided imaginary in the rehabilitation of sports injury. 394 articles were acquired, which were reduced to 5. The results show that 4 works carried out guided imaginary together with other psychological techniques. Ad hoc evaluation instruments were used for the most part. Guided imaginary was shown to be affective in 4 of the 5 studies, achieving the desired effects. The most studied psychological variables were pain, adherence to rehabilitation, self-efficacy, motivation and anxiety. It follows that guided imaginary has been useful in the rehabilitation of sports injuries as part of a comprehensive treatment program for the injured athlete.

The cardiorespiratory fitness of individuals after stroke is lower compared to their peers. Also, the aerobic energy expenditure of daily-life activities is higher after stroke. However, to define the experienced cardiorespiratory strain of an activity, cardiorespiratory fitness and aerobic energy expenditure should be assessed together. The fraction of cardiorespiratory fitness that an individual needs to use to perform an activity- the relative aerobic load - defines the experienced cardiorespiratory strain of that activity. Performing activities at a high relative aerobic load will likely lead to earlier fatigue or induce a slower movement speed. To gain insight in the impact of cardiorespiratory fitness on performance of daily-life activities, this thesis investigated the relative aerobic load of daily-life activities after stroke. In chapter 2, we provided reference values of cardiorespiratory fitness post-stroke in clinical rehabilitation based on more than 400 individuals. The results of this study can give individuals after stroke insight in their cardiorespiratory fitness compared to their peers. Also, they could help guide rehabilitation treatment, for example by identifying patients for whom training cardiorespiratory fitness should be prioritized to increase functioning. In chapter 3 we showed that individuals after stroke experience a higher relative aerobic load during walking at preferred walking speed on a treadmill. We also showed that walking faster, although being more economic, would lead to unsustainable relative aerobic loads for individuals after stroke. It might be that individuals after stroke choose a pace that enables them to walk as fast as possible within sustainable relative aerobic load values. Thus, they appear limited in movement speed by a high relative aerobic load. In chapter 4 we assessed relative aerobic load in daily-life activities such as walking and sweeping. This showed a similar pattern of higher relative aerobic loads for

Introduction : La lombalgie est la principale cause d’incapacité dans le monde. La réadaptation est recommandée par les guides de pratiques cliniques (GPC). Or, ces recommandations comportent des limitations, puisqu’elles mettent l’emphase sur une perspective biomédicale au détriment d’une vision psychosociale. Comme solution potentielle, le Modèle de Gestion des Vecteurs de Douleur et d’Incapacités (MGVDI) a été développé et vise à identifier les principaux vecteurs de douleur et d’incapacité. Objectifs : 1) Déterminer la faisabilité de conduire un essai clinique. 2) Explorer l’efficacité préliminaire du MGVDI à et 12 semaines comparées aux recommandations provenant des plus récents GPC afin d’améliorer la prise en charge des patients avec lombalgie. 3) Mesurer la proportion de patients s’étant améliorés significativement et identifier des prédicteurs d’une telle amélioration à la suite d’une approche en physiothérapie guidée par le MGVDI. Méthodologie : Une étude pilote d’un essai clinique pragmatique contrôlé non randomisé en grappes a été réalisée. Des cliniques de physiothérapie (grappes) ont été recrutées et assignées aux groupes intervention (MGVDI) ou contrôle (GPC). Les participants incluaient des professionnels de la physiothérapie et leurs nouveaux patients âgés de 18 ans et plus présentant une lombalgie. Les mesures de résultats principales portaient sur la faisabilité de conduire une telle étude (recrutement, rétention, critères d’admissibilité et adhésion au protocole) via une approche descriptive en fonction de critères de succès prédéfinis. L’efficacité préliminaire du MGVDI a été explorée par des mesures de résultats pertinentes à 6 et 12 semaines via des modèles linéaires mixtes. Une analyse secondaire de données a été effectuée afin de calculer la proportion d’individus ayant atteint un seuil d’amélioration significatif basé sur la littérature et d’identifier des prédicteurs d’une réponse positive suivant 12 semaines de physiothérapie basée sur le, Introduction: Low back pain (LBP) is the leading cause of disability worldwide. Rehabilitation is recommended by clinical practice guidelines (CPG), but these recommendations have shown limitations as they focus on biological deficits and poorly integrate psychosocial factors. As a potential solution, the Pain and Disability Drivers Management (PDDM) model has been developed to identify the main drivers of pain and disability. Objectives: 1) To determine the feasibility of conducting a clinical trial. 2) To explore the preliminary effectiveness of the PDDM at 6 and 12 weeks compared to the latest CPG to improve the management of patients with LBP. 3) To measure the proportion of patients who improved significatively and to identify predictors of such improvement following a PDDM-based physiotherapy approach. Methodology: A pilot study of a nonrandomized, cluster-controlled pragmatic clinical trial was conducted. Physiotherapy clinics (clusters) were recruited and assigned to the intervention (PDDM) or control (CPG) groups. Participants included physiotherapists and their new patients aged 18 and over presenting with LBP. The main outcome measures focused on the feasibility of conducting such a study (recruitment, retention, eligibility criteria, and protocol compliance) through a descriptive approach based on pre-defined success criteria. The preliminary effectiveness of the PDMM was explored on relevant outcome measures at 6 and 12 weeks through linear mixed models. A secondary data analysis was performed to calculate the proportion of patients reaching a significant improvement threshold based on the literature and to identify predictors of a positive response after 12 weeks of PDDM-based physiotherapy. Results: The feasibility of the study procedures was confirmed, but losses to follow-up at 12 weeks were higher than anticipated and clinician compliance was lower than our predefined threshold. Recommendations were made for a future study. The intervent

Unsafe, offensive, and damaging to the environment. Homeowners and builders are searching for efficient ways to transform worn-out houses into desirable ones in light of these difficulties. In this study, we sought to address the issue of rehabilitation and reforms in parking lots for vehicles (VP) and tower buildings (TB). The most effective cladding system for building envelope purposes currently has been discovered to be a new generation of rainproof substructures, whose installation is actually much easier than it first appears and is a constructive solution that perfectly fits with current sustainable architecture trends., Inseguros, ofensivos y dañinos para el medio ambiente. Los propietarios de viviendas y los constructores están buscando formas eficientes de transformar casas desgastadas en casas deseables a la luz de estas dificultades. En este estudio se buscó abordar el tema de rehabilitación y reformas en estacionamientos de vehículos (VP) y edificios torre (TB). Se ha descubierto que el sistema de revestimiento más eficaz para la envolvente de edificios en la actualidad es una nueva generación de subestructuras impermeables, cuya instalación es mucho más fácil de lo que parece y es una solución constructiva que encaja perfectamente con las tendencias actuales de arquitectura sostenible.

Mass housing neighborhoods emerged in the second half of the twentieth century as an important part of the affordable social housing stock in Southern Europe, but now these are suffering from social problems and physical degradation. This article, which focuses on a case study of an archetypical transformation of a housing estate in Barcelona (Canyelles), aims at identifying the conditions needed to reduce social inequalities in this type of neighborhood and implement urban rehabilitation programs. The mixed methodology applied consisted of a combination of semi-structured interviews with the main actors involved, a focus group with the neighborhood council, and a multivariate statistical analysis of intra-urban fine-scale social indicators. Based on these methods, the urban transformation projects and their social consequences, which can be observed in the evolution of the social composition of the neighborhood, are analyzed. A significant improvement in the quality of life of the neighbors is seen as a result of the housing rehabilitation and renovation of public spaces programs. Ultimately, these changes are contributing to increasing social integration, as well as initiating a gentrification process., Los barrios de vivienda masiva desarrollados en la segunda mitad del siglo XX constituyen una parte importante del parque de viviendas sociales y asequibles del sur de Europa, pero sufren problemas sociales y degradación física. Centrado en un estudio de caso de transformación arquetípica de una urbanización en Barcelona (Canyelles), este artículo pretende identificar las condiciones necesarias para reducir las desigualdades sociales en este tipo de barrios, además de la implementación de programas de rehabilitación urbana. La metodología mixta aplicada consistió en una combinación de entrevistas semiestructuradas con los principales actores involucrados, un grupo focal con la junta de vecinos y un análisis estadístico multivariante de indicadores sociales a escala fina intraurbana. A partir de estos métodos, analizamos los proyectos de transformación urbana, así como sus consecuencias sociales, que se pueden observar en la evolución de la composición social del barrio. Por lo tanto, observamos una mejora significativa en la calidad de vida de los vecinos como resultado de programas, tanto de rehabilitación de viviendas como de renovación de espacios públicos. Finalmente, estos cambios están contribuyendo a aumentar la integración social, así como también a iniciar un proceso de gentrificación

Introduction:  Comprehensive care for complex fractures is essential to optimize clinical outcomes. The collaboration between General Surgery, Traumatology, and Plastic Surgery has emerged as a crucial approach. This article examines the synergy of these specialties, highlighting surgical strategies, advances in tissue reconstruction, and the application of innovative technologies. Development: The development addresses multidisciplinary collaboration in complex fractures. Traumatology stands out for its precise assessment and fixation strategies, while Plastic Surgery focuses on tissue reconstruction. Advances include the use of biomaterials and external fixation devices. Attention to open fractures and comprehensive rehabilitation is crucial. The importance of research in microsurgery and fixation technologies is highlighted. Practical applications:  Current practical applications include optimizing bone fixation strategies and advances in tissue reconstruction. Conclusions: In conclusion, the comprehensive collaboration between General Surgery, Traumatology, and Plastic Surgery significantly enhances care for complex fractures. Advanced surgical strategies, personalized approach, and innovative technologies are crucial to optimize clinical outcomes and improve patients' quality of life., Introducción:  La atención integral de las fracturas complejas es esencial para optimizar resultados clínicos. La colaboración entre Cirugía General, Traumatología y Cirugía Plástica ha emergido como un enfoque crucial. Este artículo examina la sinergia de estas especialidades, destacando estrategias quirúrgicas, avances en reconstrucción tisular y la aplicación de tecnologías innovadoras. Desarrollo: El desarrollo aborda la colaboración multidisciplinaria en fracturas complejas. La Traumatología destaca por su evaluación precisa y estrategias de fijación, mientras que la Cirugía Plástica se centra en la reconstrucción tisular. Avances incluyen el uso de biomateriales y dispositivos de fijación externa. La atención a fracturas abiertas y la rehabilitación integral son cruciales. Se destaca la importancia de la investigación en microcirugía y tecnologías de fijación. Aplicaciones prácticas:  Las aplicaciones prácticas actuales incluyen la optimización de estrategias de fijación ósea y avances en reconstrucción tisular. Conclusiones, En conclusión, la colaboración integral entre Cirugía General, Traumatología y Cirugía Plástica mejora significativamente la atención a fracturas complejas. Estrategias quirúrgicas avanzadas, enfoque personalizado y tecnologías innovadoras son clave para optimizar resultados clínicos y mejorar la calidad de vida de los pacientes.

Athletic injuries are common in youth sports, and much research has focused on the injury experience of athletes. However, less attention has been given to the impact of adolescent injury on relevant others within athletes' recovery orbit, particularly parents. This narrative review examines the impact of adolescent injury on parents using the Multilevel Model of Sport Injury (MMSI). Results revealed that parents' experience of their adolescent's injury is influenced by intra- and interpersonal factors (e.g., thoughts, emotions, behaviors, and interactions with coaches, and sport medicine providers), as well as institutional, cultural, and policylevel factors (e.g., lack of organizational support, internalization of sport norms about playing with pain, and sport injury policies and guidelines). The review provides a more nuanced understanding of the factors and interactions that parents have following adolescent sport injury. Further research using the MMSI can extend current conceptualization and theorizing regarding parents' experiences following adolescent injury.