Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-40-47
G. Sheiko, N. N. Karyakin, Anna N. Belova, Vadim D. Daminov, William O. Sushin, M. A. Shabanova, Olga V. Vorobyova, Sergey S. Ananyev
INTRODUCTION. An urgent problem of medical rehabilitation is the loss of results that were achieved at various stages due to the interruption of the recovery process and the absence of patients' classes at home after discharge from a medical institution. In this regard, at the third stage of medical rehabilitation, the remote (telemedicine) form of rehabilitation assistance is of particular importance, which has broad prospects for development due to the emergence of new information technologies that allow for active communication between a medical professional and a patient. Nevertheless, the issues of the effectiveness and safety of remote physical rehabilitation remain insufficiently studied, and therefore it is necessary to conduct randomized comparative trials with the analysis of long-term results. AIM. Evaluation of the effectiveness and safety of the remote physical rehabilitation (RPR) model for a group of patients who have undergone hip (HR) or knee (KR) replacement, the study of patient adherence, as well as the selection of the most informative evaluation tools. MATERIALS AND METHODS. The study included 30 patients aged 30 to 75 years who underwent HR or KR. The study participants were distributed by the envelope method into groups for remote rehabilitation in addition to routine clinical practice of providing medical rehabilitation (RPR group) or conducting only routine medical rehabilitation (comparison group), including daily independent physical exercises at home, mastered during inpatient medical rehabilitation, lifestyle modification, taking nonsteroidal anti-inflammatory drugs with the development of pain syndrome. An assessment of the effectiveness and safety of rehabilitation measures was carried out, including an analysis of physical examination data, vital signs, as well as data from various scales, tests and questionnaires (the 10-point visual-analog scale (VAS), the Timed 25-Foot Walk (T25-FW), the "Timed Up and Go Test", the Berg Balance Scale (BBS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC)). RESULTS AND DISCUSSION. 14 patients were randomized to the remote physical rehabilitation group (49.6 ± 12.4 years) and 16 to the comparison group (57.8 ± 11.2 years). Participation in the study was completed by 10 patients from the RPR group and all 16 patients in the comparison group. Comparing the results of rehabilitation between the groups 1 month after the inclusion of participants in the study revealed a more pronounced statistically significant improvement in the functional profile of the patient on the T25-FW (p 0.0001), the "Timed Up and Go Test" (p = 0.0064), the Berg Balance Scale (p = 0.0008) and WOMAC (p 0.0001) in group of RPR. The "Timed Up and Go Test", the visual analog scale and the WOMAC were selected based on the results obtained for further practical work. The most significant predictors of premature termination of RPR were older age (χ2 16.75, p 0.0001), pensioner status (χ2
{"title":"Efficacy and Safety of Remote Physical Rehabilitation in Patients with Hip or Knee Replacement: a Prospective Randomized Comparative Study","authors":"G. Sheiko, N. N. Karyakin, Anna N. Belova, Vadim D. Daminov, William O. Sushin, M. A. Shabanova, Olga V. Vorobyova, Sergey S. Ananyev","doi":"10.38025/2078-1962-2023-22-5-40-47","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-40-47","url":null,"abstract":"INTRODUCTION. An urgent problem of medical rehabilitation is the loss of results that were achieved at various stages due to the interruption of the recovery process and the absence of patients' classes at home after discharge from a medical institution. In this regard, at the third stage of medical rehabilitation, the remote (telemedicine) form of rehabilitation assistance is of particular importance, which has broad prospects for development due to the emergence of new information technologies that allow for active communication between a medical professional and a patient. Nevertheless, the issues of the effectiveness and safety of remote physical rehabilitation remain insufficiently studied, and therefore it is necessary to conduct randomized comparative trials with the analysis of long-term results. \u0000AIM. Evaluation of the effectiveness and safety of the remote physical rehabilitation (RPR) model for a group of patients who have undergone hip (HR) or knee (KR) replacement, the study of patient adherence, as well as the selection of the most informative evaluation tools. \u0000MATERIALS AND METHODS. The study included 30 patients aged 30 to 75 years who underwent HR or KR. The study participants were distributed by the envelope method into groups for remote rehabilitation in addition to routine clinical practice of providing medical rehabilitation (RPR group) or conducting only routine medical rehabilitation (comparison group), including daily independent physical exercises at home, mastered during inpatient medical rehabilitation, lifestyle modification, taking nonsteroidal anti-inflammatory drugs with the development of pain syndrome. An assessment of the effectiveness and safety of rehabilitation measures was carried out, including an analysis of physical examination data, vital signs, as well as data from various scales, tests and questionnaires (the 10-point visual-analog scale (VAS), the Timed 25-Foot Walk (T25-FW), the \"Timed Up and Go Test\", the Berg Balance Scale (BBS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC)). \u0000RESULTS AND DISCUSSION. 14 patients were randomized to the remote physical rehabilitation group (49.6 ± 12.4 years) and 16 to the comparison group (57.8 ± 11.2 years). Participation in the study was completed by 10 patients from the RPR group and all 16 patients in the comparison group. Comparing the results of rehabilitation between the groups 1 month after the inclusion of participants in the study revealed a more pronounced statistically significant improvement in the functional profile of the patient on the T25-FW (p 0.0001), the \"Timed Up and Go Test\" (p = 0.0064), the Berg Balance Scale (p = 0.0008) and WOMAC (p 0.0001) in group of RPR. The \"Timed Up and Go Test\", the visual analog scale and the WOMAC were selected based on the results obtained for further practical work. The most significant predictors of premature termination of RPR were older age (χ2 16.75, p 0.0001), pensioner status (χ2 ","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"13 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140493248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-22-29
G. M. Lutokhin, A. G. Kashezhev, I. V. Pogonchenkova, M. Rassulova, E. Turova, Yu.V. Utegenova, A. V. Shulkina, R. I. Samokhvalov
INTRODUCTION. Impaired gait and balance after a stroke significantly affect patients' daily activities and quality of life. Robotic mechanotherapy and virtual reality technologies are actively studied and used to restore lower limb muscle strength, balance and gait pattern. AIM. To assess the effectiveness and safety of rehabilitation using robotic mechanotherapy (exoskeleton) with functional electrical stimulation (FES) and virtual reality (VR) technology with plantar stimulation in the restoration of gait and balance disorders in patients in acute and early recovery periods of ischemic stroke. MATERIAL AND METHODS. Men and women aged 39 to 75 with ischemic stroke in acute and early recovery periods with gait impairment and lower limb paresis from 0 to 4 MRC scores. The patients were randomized using the envelope method into 4 groups: Group 1 (33 people) — exoskeleton with FES, Group 2 (32 people) — combined application of robotic mechanotherapy with FES and VR with plantar stimulation, Group 3 (35 people) — VR with plantar stimulation, Control group (30 people) — conventional training. RESULTS. Group 2 and 3 had significantly greater increases in muscle strength in the hip extensors, tibia flexors and flexors of the foot compared to the control group. Patients in the main groups also had a significant improvement in Tinetti Walking and balance Scale at follow-up. The analysis of the stabilometry results on the first and last day of the study revealed a decrease in the area of the statokinesiogram in the main groups both in the intragroup comparison and in the comparison with the control group. DISCUSSION AND CONCLUSION. Exoskeleton gait training with FES and exercises on a VR with plantar stimulation, as well as combined use of these techniques allowed to achieve better recovery of lower limb muscle strength, walking functions and balance in patients in acute and early rehabilitation periods of stroke. This is probably due to the large number of steps or their imitation performed by the patient during rehabilitation sessions, which leads to activation of neuroplasticity and better recovery. The study demonstrated the safety and efficacy of an exoskeleton interval training system that prevents the development of orthostatic hypotension in patients in the acute period of ischemic stroke.
{"title":"Effectiveness and Safety of Robotic Mechanotherapy with FES and VR in Restoring Gait and Balance in the Acute and Early Rehabilitation Period of Ischemic Stroke: Prospective Randomized Comparative Study","authors":"G. M. Lutokhin, A. G. Kashezhev, I. V. Pogonchenkova, M. Rassulova, E. Turova, Yu.V. Utegenova, A. V. Shulkina, R. I. Samokhvalov","doi":"10.38025/2078-1962-2023-22-5-22-29","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-22-29","url":null,"abstract":"INTRODUCTION. Impaired gait and balance after a stroke significantly affect patients' daily activities and quality of life. Robotic mechanotherapy and virtual reality technologies are actively studied and used to restore lower limb muscle strength, balance and gait pattern. \u0000AIM. To assess the effectiveness and safety of rehabilitation using robotic mechanotherapy (exoskeleton) with functional electrical stimulation (FES) and virtual reality (VR) technology with plantar stimulation in the restoration of gait and balance disorders in patients in acute and early recovery periods of ischemic stroke. \u0000MATERIAL AND METHODS. Men and women aged 39 to 75 with ischemic stroke in acute and early recovery periods with gait impairment and lower limb paresis from 0 to 4 MRC scores. The patients were randomized using the envelope method into 4 groups: Group 1 (33 people) — exoskeleton with FES, Group 2 (32 people) — combined application of robotic mechanotherapy with FES and VR with plantar stimulation, Group 3 (35 people) — VR with plantar stimulation, Control group (30 people) — conventional training. \u0000RESULTS. Group 2 and 3 had significantly greater increases in muscle strength in the hip extensors, tibia flexors and flexors of the foot compared to the control group. Patients in the main groups also had a significant improvement in Tinetti Walking and balance Scale at follow-up. The analysis of the stabilometry results on the first and last day of the study revealed a decrease in the area of the statokinesiogram in the main groups both in the intragroup comparison and in the comparison with the control group. \u0000DISCUSSION AND CONCLUSION. Exoskeleton gait training with FES and exercises on a VR with plantar stimulation, as well as combined use of these techniques allowed to achieve better recovery of lower limb muscle strength, walking functions and balance in patients in acute and early rehabilitation periods of stroke. This is probably due to the large number of steps or their imitation performed by the patient during rehabilitation sessions, which leads to activation of neuroplasticity and better recovery. The study demonstrated the safety and efficacy of an exoskeleton interval training system that prevents the development of orthostatic hypotension in patients in the acute period of ischemic stroke.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"51 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-30-39
Mohamed S. Zidan, M. M. Elsayed, Azza F. Ismail, Sandra M. Ahmed, Hany E. Obaya
INTRODUCTION. Post-stroke dysphagia is reported in 30–50 % of stroke population. It increases mortality rate and leads to serious complications such as expiratory muscle affection which is a major cause of defective swallowing and ineffective airway protection. Expiratory muscle strength training (EMST) and functional electrical stimulation (FES) are recommended techniques to improve expiratory muscles performance. AIM. To compare the effect of EMST to that of FES on pulmonary and swallowing functions in acute stroke patients. MATERIAL AND METHODS. Seventy-two patients with post-stroke dysphagia were divided into two groups. Both groups received traditional dysphagia treatment. In addition, the first group received EMST and the second received neck and abdominal FES. Pulmonary functions were measured before and after in form of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and peak expiratory flow (PEF), and arterial blood gases (ABG) while the Gugging Swallowing Scale (GUSS) was used as an indicator of swallowing function results of both groups were compared after one month of treatment. RESULTS. The post-treatment GUSS, FVC, FEV1 and PEF of the EMST group showed more significant increase compared to the FES group (p 0.05) with no significant differences in FEV1/FVC (p 0.05). Regarding ABG, there was more significant decrease in PaCO2 and HCO3 of EMST group compared to FES group (p 0.01). CONCLUSION. EMST was more effective than FES when it comes to improving expiratory and swallowing functions in patients with post-stroke dysphagia.
{"title":"Expiratory Muscle Training Versus Functional Electrical Stimulation on Pulmonary and Swallowing Functions in Acute Stroke Patients","authors":"Mohamed S. Zidan, M. M. Elsayed, Azza F. Ismail, Sandra M. Ahmed, Hany E. Obaya","doi":"10.38025/2078-1962-2023-22-5-30-39","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-30-39","url":null,"abstract":"INTRODUCTION. Post-stroke dysphagia is reported in 30–50 % of stroke population. It increases mortality rate and leads to serious complications such as expiratory muscle affection which is a major cause of defective swallowing and ineffective airway protection. Expiratory muscle strength training (EMST) and functional electrical stimulation (FES) are recommended techniques to improve expiratory muscles performance. \u0000AIM. To compare the effect of EMST to that of FES on pulmonary and swallowing functions in acute stroke patients. \u0000MATERIAL AND METHODS. Seventy-two patients with post-stroke dysphagia were divided into two groups. Both groups received traditional dysphagia treatment. In addition, the first group received EMST and the second received neck and abdominal FES. Pulmonary functions were measured before and after in form of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and peak expiratory flow (PEF), and arterial blood gases (ABG) while the Gugging Swallowing Scale (GUSS) was used as an indicator of swallowing function results of both groups were compared after one month of treatment. \u0000RESULTS. The post-treatment GUSS, FVC, FEV1 and PEF of the EMST group showed more significant increase compared to the FES group (p 0.05) with no significant differences in FEV1/FVC (p 0.05). Regarding ABG, there was more significant decrease in PaCO2 and HCO3 of EMST group compared to FES group (p 0.01). \u0000CONCLUSION. EMST was more effective than FES when it comes to improving expiratory and swallowing functions in patients with post-stroke dysphagia.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"90 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-98-109
A. N. Daykhes, A. Shulaev, Natalya V. Machula, A. Stepanova, Anfisa M. Nikitina, E. Gameeva, Vladimir N. Yuschuk, A. A. Shikaleva
INTRODUCTION. Physical therapy, natural healing resources, spa treatment technologies and other medical rehabilitation reduce the negative effects of treatment-related symptoms and improve the physical function of patients with cancer. Despite a growing body of evidence and recommendations to better integrate medical rehabilitation into cancer care, rehabilitation is a relatively underutilized service. AIM. To summarize the available Russian studies on the use of medical rehabilitation and spa treatment in patients after care, in the field of oncology. MATERIALS AND METHODS. Analysis of the published scientific literature. Meta-analyses, systematic reviews, cohort, prospective and controlled studies for the period from 2014 to 2022 were selected for consideration. RESULTS. Treatment of a cancer patient should not only focus on eliminating the disease directly and restoring the physical functions of the body, but also on restoring the person's ability to live as acceptably as possible in and after the disease. Medical rehabilitation is carried out by the efforts of various specialists in a multidisciplinary team, and their work should consider the peculiarities of the course of the underlying disease, the condition of the cancer patient and his/her (the patient's) individual characteristics. CONCLUSION. Improving rehabilitation care in accordance with the recommendations can have a significant impact on the functioning and quality of life of cancer patients.
{"title":"Medical Rehabilitation and Sanatorium Treatment of Patients after Medical Care in The Field of Oncology: а Review","authors":"A. N. Daykhes, A. Shulaev, Natalya V. Machula, A. Stepanova, Anfisa M. Nikitina, E. Gameeva, Vladimir N. Yuschuk, A. A. Shikaleva","doi":"10.38025/2078-1962-2023-22-5-98-109","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-98-109","url":null,"abstract":"INTRODUCTION. Physical therapy, natural healing resources, spa treatment technologies and other medical rehabilitation reduce the negative effects of treatment-related symptoms and improve the physical function of patients with cancer. Despite a growing body of evidence and recommendations to better integrate medical rehabilitation into cancer care, rehabilitation is a relatively underutilized service. \u0000AIM. To summarize the available Russian studies on the use of medical rehabilitation and spa treatment in patients after care, in the field of oncology. \u0000MATERIALS AND METHODS. Analysis of the published scientific literature. Meta-analyses, systematic reviews, cohort, prospective and controlled studies for the period from 2014 to 2022 were selected for consideration. \u0000RESULTS. Treatment of a cancer patient should not only focus on eliminating the disease directly and restoring the physical functions of the body, but also on restoring the person's ability to live as acceptably as possible in and after the disease. Medical rehabilitation is carried out by the efforts of various specialists in a multidisciplinary team, and their work should consider the peculiarities of the course of the underlying disease, the condition of the cancer patient and his/her (the patient's) individual characteristics. \u0000CONCLUSION. Improving rehabilitation care in accordance with the recommendations can have a significant impact on the functioning and quality of life of cancer patients.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"84 8-10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-8-14
M. Maccarone, U. Carraro, Allegra Caregnato, B. Ravara, W. Giuriati, Alessandra Carriero, Giacomo Casellato, Claudia Finamoni, Rossella Jirillo, Olena Laskova, Elena Marigo, Daniela Yolanda Sánchez, Irene Seno, Chiara Venturin, Hillary Veronese, Gianluca Regazzo, Stefano Masiero
INTRODUCTION. The limitations in mobility frequently encountered by the elderly, often linked to advanced age and concurrent medical conditions, have significant implications for their overall well-being and self-reliance. This decrease in physical activity not only curtails their independence but also elevates the likelihood of prolonged hospitalization and the accompanying complications. AIM. To assess the impact of a home-based Full-Body in-Bed Gym program, a 10-exercise protocol consisting of three sessions per week for two months, on the quality of life of elderly individuals. MATERIALS AND METHODS. The study involved participants of both genders aged over 65, who were classified as sedentary, engaging in less than one hour of physical activity per week. Participants with recent orthopedic conditions, severe cardiovascular or oncological diseases, and significant neurological disorders were excluded due to their potential to confound the effects of the Full-Body in-Bed Gym program and impact overall health and quality of life. RESULTS. A total of 22 subjects, with a median age of 71.90 years, participated in the study. Elderly individuals engaging in the Full-Body in-Bed Gym program, experienced improvements in their quality of life. These gains were noticeable in the 12-Item Short Form Health Survey (SF-12) Physical Component Summary (p = 0.07) and reached statistical significance in the Mental Component Summary (p = 0.04). DISCUSSION. The observed gains in the quality of life among elderly participants engaging in the home-based Full-Body in-Bed Gym program are noteworthy. The positive impact on the mental component of the SF-12 is particularly significant, indicating improvements in mental well-being. This aligns with the broader understanding that physical activity in the elderly is intricately linked to various aspects of their health, including mental health. While the preliminary findings suggest positive outcomes, future research with larger and more diverse cohorts could provide a more robust understanding of the Full-Body in-Bed Gym program’s impact. CONCLUSION. Our findings underscore the potential of a home-based Full-Body in-Bed Gym program to enhance the quality of life in elderly participants, highlighting the need for further exploration of rehabilitation and prevention strategies in this context.
{"title":"Enhancing Quality of Life in Sedentary Elderly Individuals: The Impact of the Home-Based Full-Body In-Bed Gym Program — A Prospective, Observational, Single-Arm Study","authors":"M. Maccarone, U. Carraro, Allegra Caregnato, B. Ravara, W. Giuriati, Alessandra Carriero, Giacomo Casellato, Claudia Finamoni, Rossella Jirillo, Olena Laskova, Elena Marigo, Daniela Yolanda Sánchez, Irene Seno, Chiara Venturin, Hillary Veronese, Gianluca Regazzo, Stefano Masiero","doi":"10.38025/2078-1962-2023-22-5-8-14","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-8-14","url":null,"abstract":"INTRODUCTION. The limitations in mobility frequently encountered by the elderly, often linked to advanced age and concurrent medical conditions, have significant implications for their overall well-being and self-reliance. This decrease in physical activity not only curtails their independence but also elevates the likelihood of prolonged hospitalization and the accompanying complications. \u0000AIM. To assess the impact of a home-based Full-Body in-Bed Gym program, a 10-exercise protocol consisting of three sessions per week for two months, on the quality of life of elderly individuals. \u0000MATERIALS AND METHODS. The study involved participants of both genders aged over 65, who were classified as sedentary, engaging in less than one hour of physical activity per week. Participants with recent orthopedic conditions, severe cardiovascular or oncological diseases, and significant neurological disorders were excluded due to their potential to confound the effects of the Full-Body in-Bed Gym program and impact overall health and quality of life. \u0000RESULTS. A total of 22 subjects, with a median age of 71.90 years, participated in the study. \u0000Elderly individuals engaging in the Full-Body in-Bed Gym program, experienced improvements in their quality of life. These gains were noticeable in the 12-Item Short Form Health Survey (SF-12) Physical Component Summary (p = 0.07) and reached statistical significance in the Mental Component Summary (p = 0.04). \u0000DISCUSSION. The observed gains in the quality of life among elderly participants engaging in the home-based Full-Body in-Bed Gym program are noteworthy. The positive impact on the mental component of the SF-12 is particularly significant, indicating improvements in mental well-being. This aligns with the broader understanding that physical activity in the elderly is intricately linked to various aspects of their health, including mental health. While the preliminary findings suggest positive outcomes, future research with larger and more diverse cohorts could provide a more robust understanding of the Full-Body in-Bed Gym program’s impact. \u0000CONCLUSION. Our findings underscore the potential of a home-based Full-Body in-Bed Gym program to enhance the quality of life in elderly participants, highlighting the need for further exploration of rehabilitation and prevention strategies in this context.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"192 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-15-21
O. Odarushchenko, A. Kuzyukova, Margarita B. Nuvakhova, O. V. Yurova, M. Yakovlev
INTRODUCTION. Emotional and personality disorders that occur in patients after a stroke have a negative impact on the rehabilitation process, reducing its effectiveness, disrupting the motivation for treatment and quality of life. Today, comprehensive rehabilitation programs for patients in the late recovery period after acute cerebrovascular accident, aimed at psychological correction of emotional disorders, are becoming relevant. AIM. To study the effectiveness of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy on the emotional state of patients in the late recovery period after an ischaemic stroke. MATERIALS AND METHODS. The study included 40 patients after an acute cerebrovascular accident (ACVA) in the late recovery period (from 6 months to 2 years after ACVA) aged between 45 and 75 years, average age 61.6 [53.95; 68.1]. The patients were randomized into two groups. The main group included patients (n = 20 people, of which 7 men, 13 women, age — 62.09 [53.5; 68.6] years), who underwent a complex basic rehabilitation program, including audiovisual stimulation and psychotherapy techniques; the control group included patients (n = 20, including 6 men, 14 women, age — 61.1 [54.4; 67.5] years) who underwent a basic rehabilitation program. For psychological diagnostics, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program were used to study the current emotional state. The statistical significance of differences before and after the treatment was determined using the nonparametric Wilcoxon test. To assess the statistical comparability of the two groups, the Mann-Whitney test was used (p 0.05). RESULTS. The use of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy in the psychological correction of emotional disorders in patients in the late recovery period after an ischemic stroke allows us to achieve a statistically significant effect in reducing state and trait anxiety, the level of chronic fatigue, as well as increasing the subjective comfort and quality of life (p 0.05). DISCUSSION. The study showed that patients in the late recovery period after a stroke before treatment experienced high levels of anxiety and depression and experienced a severe psycho-emotional stress. As a result of audiovisual stimulation and psychotherapy techniques, indicators of the negative emotional state of patients in the late recovery period after an ischemic stroke significantly decreased, mood improved, activity and tolerance to psychological stress increased. CONCLUSION. A comprehensive rehabilitation of patients in the late recovery period after a stroke, aimed at psychological correction of emotional disorders, significantly improved the emotional background, increased tolerance to psychological stress, and also contributed to increased motivation for restorative treatment and rehabilitation.
{"title":"Results of Audiovisual Stimulation and Psychotherapy in Psychological Correction of Emotional Disorders in Patients in the Late Recovery Period after an Ischaemic Stroke: a Prospective Randomized Study","authors":"O. Odarushchenko, A. Kuzyukova, Margarita B. Nuvakhova, O. V. Yurova, M. Yakovlev","doi":"10.38025/2078-1962-2023-22-5-15-21","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-15-21","url":null,"abstract":"INTRODUCTION. Emotional and personality disorders that occur in patients after a stroke have a negative impact on the rehabilitation process, reducing its effectiveness, disrupting the motivation for treatment and quality of life. Today, comprehensive rehabilitation programs for patients in the late recovery period after acute cerebrovascular accident, aimed at psychological correction of emotional disorders, are becoming relevant. \u0000AIM. To study the effectiveness of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy on the emotional state of patients in the late recovery period after an ischaemic stroke. \u0000MATERIALS AND METHODS. The study included 40 patients after an acute cerebrovascular accident (ACVA) in the late recovery period (from 6 months to 2 years after ACVA) aged between 45 and 75 years, average age 61.6 [53.95; 68.1]. The patients were randomized into two groups. The main group included patients (n = 20 people, of which 7 men, 13 women, age — 62.09 [53.5; 68.6] years), who underwent a complex basic rehabilitation program, including audiovisual stimulation and psychotherapy techniques; the control group included patients (n = 20, including 6 men, 14 women, age — 61.1 [54.4; 67.5] years) who underwent a basic rehabilitation program. For psychological diagnostics, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program were used to study the current emotional state. The statistical significance of differences before and after the treatment was determined using the nonparametric Wilcoxon test. To assess the statistical comparability of the two groups, the Mann-Whitney test was used (p 0.05). \u0000RESULTS. The use of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy in the psychological correction of emotional disorders in patients in the late recovery period after an ischemic stroke allows us to achieve a statistically significant effect in reducing state and trait anxiety, the level of chronic fatigue, as well as increasing the subjective comfort and quality of life (p 0.05). \u0000DISCUSSION. The study showed that patients in the late recovery period after a stroke before treatment experienced high levels of anxiety and depression and experienced a severe psycho-emotional stress. As a result of audiovisual stimulation and psychotherapy techniques, indicators of the negative emotional state of patients in the late recovery period after an ischemic stroke significantly decreased, mood improved, activity and tolerance to psychological stress increased. \u0000CONCLUSION. A comprehensive rehabilitation of patients in the late recovery period after a stroke, aimed at psychological correction of emotional disorders, significantly improved the emotional background, increased tolerance to psychological stress, and also contributed to increased motivation for restorative treatment and rehabilitation.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"55 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-72-82
D. Kulchitskaya, A. D. Fesyun, O. V. Yurova, T. Konchugova, M. Yakovlev, Tatyana V. Apkhanova, Nadezha V. Gushchina, Alexey Е. Kudryavtsev
INTRODUCTION. Chemotherapy-induced peripheral polyneuropathy (CIPN) is one of the most frequent side effects caused by anticancer drugs, with a prevalence ranging from 19 % to 85 %. For effective multicomponent rehabilitation of patients with CIPN at different stages, a number of non-medicinal methods are recommended to improve the tolerance of chemotherapy and reduce the side effects of the antitumor treatment performed. AIM. Study of the effect of high-intensity pulsed magnetotherapy on clinical manifestations and microcirculation state in patients with CIPN. DESIGN. This is a randomized controlled study. SETTING. Randomization, organization of the study and data analysis were performed on the premises of the Department of Medical Rehabilitation in National Medical Research Centre for Rehabilitation and Balneology, Moscow, Russia. POPULATION. Sixty patients with CIPN were included in this study and were randomized by a simple random distribution method in a ratio of 1:1 into 2 groups of 30 people. METHODS. Sixty patients with CIPN four weeks after completion of chemotherapy were examined. The first group, the main group, included patients who received high-intensity pulsed magnetotherapy (HIPMT) in combination with drug therapy. In the second group (control group), the patients received only drug therapy. The EORTC-QLQ-C30 questionnaire (version 3) was used to assess the quality of life. The HADS scale was used to assess the severity of anxiety and depression symptoms. The state of microcirculation was assessed using laser Doppler flowmetry (LDF). The severity of CIPN was assessed according to the CTS-NCIC scale, version 3.0. RESULTS. According to the results of this study, there is a statistically significant difference in the scores on the EORTC-QLQ-C30 questionnaire (version 3), HADS scale and LDF data between the groups in favour of the group receiving HIPMT in combination with drug therapy. CONCLUSION. Based on the LDF study, significant disturbances at the microcirculatory level were detected for the first time in patients with CIPN. The obtained results convincingly demonstrate that the use of HIPMT in patients with CIPN leads not only to improvement of microcirculation in the extremities due to normalisation of arterial vessel tone, elimination of venous stasis and increase in the nutritive blood flow, but also has an analgesic effect, improves initially impaired sensitivity, and improves the quality of life of these patients. CLINICAL REHABILITATION IMPACT. The use of HIPMT in combination with drug therapy in patients with CIPN was more effective than drug therapy alone.
{"title":"High-Intensity Pulsed Magnetotherapy in the Rehabilitation Programme of Patients with Chemotherapy-Induced Peripheral Polyneuropathy: a Prospective Randomized Clinical Study","authors":"D. Kulchitskaya, A. D. Fesyun, O. V. Yurova, T. Konchugova, M. Yakovlev, Tatyana V. Apkhanova, Nadezha V. Gushchina, Alexey Е. Kudryavtsev","doi":"10.38025/2078-1962-2023-22-5-72-82","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-72-82","url":null,"abstract":"INTRODUCTION. Chemotherapy-induced peripheral polyneuropathy (CIPN) is one of the most frequent side effects caused by anticancer drugs, with a prevalence ranging from 19 % to 85 %. For effective multicomponent rehabilitation of patients with CIPN at different stages, a number of non-medicinal methods are recommended to improve the tolerance of chemotherapy and reduce the side effects of the antitumor treatment performed. \u0000AIM. Study of the effect of high-intensity pulsed magnetotherapy on clinical manifestations and microcirculation state in patients with CIPN. \u0000DESIGN. This is a randomized controlled study. \u0000SETTING. Randomization, organization of the study and data analysis were performed on the premises of the Department of Medical Rehabilitation in National Medical Research Centre for Rehabilitation and Balneology, Moscow, Russia. \u0000POPULATION. Sixty patients with CIPN were included in this study and were randomized by a simple random distribution method in a ratio of 1:1 into 2 groups of 30 people. \u0000METHODS. Sixty patients with CIPN four weeks after completion of chemotherapy were examined. The first group, the main group, included patients who received high-intensity pulsed magnetotherapy (HIPMT) in combination with drug therapy. In the second group (control group), the patients received only drug therapy. The EORTC-QLQ-C30 questionnaire (version 3) was used to assess the quality of life. The HADS scale was used to assess the severity of anxiety and depression symptoms. The state of microcirculation was assessed using laser Doppler flowmetry (LDF). The severity of CIPN was assessed according to the CTS-NCIC scale, version 3.0. \u0000RESULTS. According to the results of this study, there is a statistically significant difference in the scores on the EORTC-QLQ-C30 questionnaire (version 3), HADS scale and LDF data between the groups in favour of the group receiving HIPMT in combination with drug therapy. \u0000CONCLUSION. Based on the LDF study, significant disturbances at the microcirculatory level were detected for the first time in patients with CIPN. The obtained results convincingly demonstrate that the use of HIPMT in patients with CIPN leads not only to improvement of microcirculation in the extremities due to normalisation of arterial vessel tone, elimination of venous stasis and increase in the nutritive blood flow, but also has an analgesic effect, improves initially impaired sensitivity, and improves the quality of life of these patients. \u0000CLINICAL REHABILITATION IMPACT. The use of HIPMT in combination with drug therapy in patients with CIPN was more effective than drug therapy alone.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"13 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-110-116
Shakhnoza T. Iskandarova, Zohid A. Abdurakhimov, Rano A. Zakirkhodzhaeva
INTRODUCTION. More than 36 million people die from NCDs each year (63 % of deaths worldwide), of which 14 million people die prematurely, that is, before the age of 70 years, the majority could be prevented through the organization of continuity and consistency in the organization of health care. In 2021, based on the experience of developed countries of the world, a standard form of the «Algorithm» for patient care in an outpatient setting after hospital treatment was developed (including stages of observation, periods of clinical examination and mechanisms for organizing rehabilitation services, including diet, exercise therapy and sanatorium-based treatment). A study was conducted among patients diagnosed with coronary heart disease regarding the organization of continuity and consistency of rehabilitation services after inpatient treatment in conditions outpatient clinics in the Yakkasaray district of Tashkent. AIM. To study the practice of applying the organization of continuity and consistency in the provision of medical care for NCDs in Uzbekistan. MATERIALS AND METHODS. The materials were the results of a study of patients diagnosed with coronary heart disease in 2021 — 537 patients and in 2022 — 596 patients in the Yakkasaray district of Tashkent. Retrospective, analytical research methods were used for the analysis. RESULTS. In 2021, a total of 537 patients diagnosed with coronary heart disease received inpatient treatment in family clinics of the Yakkasaray district, and only 195 (36 %) brought discharge summaries, 195 (100 %) patients were taken for treatment as prescribed by doctors at outpatient clinics — control, 173 (88 %) 10 (5 %) underwent ECG and EchoCG, respectively, and 12 (6 %) patients were sent to sanatorium treatment. In 2022, in family clinics of the Yakkasaray district, a total of 596 patients received inpatient treatment, of which 535 (89 %) brought a discharge summary of inpatient treatment, 535 (100 %) patients were taken for D-control as prescribed by doctors from outpatient clinics, 535 (100 %) active patronage was established with an explanation of proper nutrition, physical activity, physiotherapeutic treatment, and 84 (16 %) patients were sent to sanatorium treatment. CONCLUSION. Continuity and consistency are important in improving the quality of medical care, so healthcare organizers need to introduce new methods and improve existing approaches to improve the relationship between inpatient and outpatient clinics.
{"title":"The Role of Continuity in the Provision of Medical Care to Patients Diagnosed with Coronary Heart Disease","authors":"Shakhnoza T. Iskandarova, Zohid A. Abdurakhimov, Rano A. Zakirkhodzhaeva","doi":"10.38025/2078-1962-2023-22-5-110-116","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-110-116","url":null,"abstract":"INTRODUCTION. More than 36 million people die from NCDs each year (63 % of deaths worldwide), of which 14 million people die prematurely, that is, before the age of 70 years, the majority could be prevented through the organization of continuity and consistency in the organization of health care. In 2021, based on the experience of developed countries of the world, a standard form of the «Algorithm» for patient care in an outpatient setting after hospital treatment was developed (including stages of observation, periods of clinical examination and mechanisms for organizing rehabilitation services, including diet, exercise therapy and sanatorium-based treatment). A study was conducted among patients diagnosed with coronary heart disease regarding the organization of continuity and consistency of rehabilitation services after inpatient treatment in conditions outpatient clinics in the Yakkasaray district of Tashkent. \u0000AIM. To study the practice of applying the organization of continuity and consistency in the provision of medical care for NCDs in Uzbekistan. \u0000MATERIALS AND METHODS. The materials were the results of a study of patients diagnosed with coronary heart disease in 2021 — 537 patients and in 2022 — 596 patients in the Yakkasaray district of Tashkent. Retrospective, analytical research methods were used for the analysis. \u0000RESULTS. In 2021, a total of 537 patients diagnosed with coronary heart disease received inpatient treatment in family clinics of the Yakkasaray district, and only 195 (36 %) brought discharge summaries, 195 (100 %) patients were taken for treatment as prescribed by doctors at outpatient clinics — control, 173 (88 %) 10 (5 %) underwent ECG and EchoCG, respectively, and 12 (6 %) patients were sent to sanatorium treatment. In 2022, in family clinics of the Yakkasaray district, a total of 596 patients received inpatient treatment, of which 535 (89 %) brought a discharge summary of inpatient treatment, 535 (100 %) patients were taken for D-control as prescribed by doctors from outpatient clinics, 535 (100 %) active patronage was established with an explanation of proper nutrition, physical activity, physiotherapeutic treatment, and 84 (16 %) patients were sent to sanatorium treatment. \u0000CONCLUSION. Continuity and consistency are important in improving the quality of medical care, so healthcare organizers need to introduce new methods and improve existing approaches to improve the relationship between inpatient and outpatient clinics.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"183 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-48-53
Singh Shyama, Sibbala Nagaraj
INTRODUCTION. VDT (video display terminal or visual display terminal) is used, especially in ergonomic studies, for the computer display. When using a VDT, static posture raises muscle tension, which causes a variety of neuromuscular symptoms, most frequently in the upper body, including discomfort, numbness, loss of function, and other symptoms. The advent of the technological revolution has rendered modern computing and communication tools indispensable for both professional and recreational purposes. The companies have extended its market reach by introducing their computing products, specifically Video Display Terminals (VDTs), beyond the confines of traditional business settings to include personal laptops used in residential spaces such as bedrooms. AIM. The study aimed to compare the effects of stabilization exercises vs traditional exercise on cervical range of motion and the Craniovertebral angle in VDT users with a forward head posture. MATERIALS AND METHODS. Comparative study design with 26 participants, comprising both genders with forward head posture between the ages of 20 and 35. Following selection, subjects were randomly divided into two groups: Group A, which received stabilization exercises, consist of 12 subjects; Group B, with 14 subjects; the main outcome measures were cervical range of motion and Craniovertebral angle. RESULTS. Group A shows statistically substantial improvement in all the outcomes. Group B also shows statistically significant improvement in selected cervical range of motion; however, the group did not improve the Craniovertebral angle and cervical rotations substantially. CONCLUSION. The results of the current study showed that stabilizing exercises are superior to conventional training in reducing the craniovertebral angle and increasing cervical range of motion in visual display terminal users with a forward head posture.
{"title":"Effect of Stabilization Exercises on Craniovertebral Angle and Cervical Range of Motion among Visual Display Users with Forward Head Posture","authors":"Singh Shyama, Sibbala Nagaraj","doi":"10.38025/2078-1962-2023-22-5-48-53","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-48-53","url":null,"abstract":"INTRODUCTION. VDT (video display terminal or visual display terminal) is used, especially in ergonomic studies, for the computer display. When using a VDT, static posture raises muscle tension, which causes a variety of neuromuscular symptoms, most frequently in the upper body, including discomfort, numbness, loss of function, and other symptoms. The advent of the technological revolution has rendered modern computing and communication tools indispensable for both professional and recreational purposes. The companies have extended its market reach by introducing their computing products, specifically Video Display Terminals (VDTs), beyond the confines of traditional business settings to include personal laptops used in residential spaces such as bedrooms. \u0000AIM. The study aimed to compare the effects of stabilization exercises vs traditional exercise on cervical range of motion and the Craniovertebral angle in VDT users with a forward head posture. \u0000MATERIALS AND METHODS. Comparative study design with 26 participants, comprising both genders with forward head posture between the ages of 20 and 35. Following selection, subjects were randomly divided into two groups: Group A, which received stabilization exercises, consist of 12 subjects; Group B, with 14 subjects; the main outcome measures were cervical range of motion and Craniovertebral angle. \u0000RESULTS. Group A shows statistically substantial improvement in all the outcomes. Group B also shows statistically significant improvement in selected cervical range of motion; however, the group did not improve the Craniovertebral angle and cervical rotations substantially. \u0000CONCLUSION. The results of the current study showed that stabilizing exercises are superior to conventional training in reducing the craniovertebral angle and increasing cervical range of motion in visual display terminal users with a forward head posture.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.38025/2078-1962-2023-22-5-93-97
U. Carraro
In my research I have often found myself on the wrong side of the flow of international beliefs. I have generally been wrong and wasted my time and resources and my co-workers, but, sometimes, we have been on the right side. Such was the case with the role of apoptosis, also known as the programmed cell death, in biology and pathology of skeletal muscle tissue. Indeed, our original and pioneering findings have led to a change of direction in this research area. This role had been dismissed by the leading myologists, but using electron microscopy and molecular analyzes we demonstrated that accepted markers of apoptosis were present in mouse skeletal muscles two days after one night of voluntary running (up to 5 km during the first night). In a few years we have extended this fundamental observation to other experimental models in vivo and in vitro and in human cases of muscular dystrophies. In this paper I will give an overview of how the story began, but I must emphasize that Marzena Podhorska-Okolow and Marco Sandri deserve the highest praise for their most notable roles in the beginning and after, the roles and services that are still notable today.
{"title":"Skeletal Muscle Apoptosis: a Debated Issue Now Well Resolved in Favor of the Padua School of Skeletal Muscle. A Review","authors":"U. Carraro","doi":"10.38025/2078-1962-2023-22-5-93-97","DOIUrl":"https://doi.org/10.38025/2078-1962-2023-22-5-93-97","url":null,"abstract":"In my research I have often found myself on the wrong side of the flow of international beliefs. I have generally been wrong and wasted my time and resources and my co-workers, but, sometimes, we have been on the right side. Such was the case with the role of apoptosis, also known as the programmed cell death, in biology and pathology of skeletal muscle tissue. Indeed, our original and pioneering findings have led to a change of direction in this research area. This role had been dismissed by the leading myologists, but using electron microscopy and molecular analyzes we demonstrated that accepted markers of apoptosis were present in mouse skeletal muscles two days after one night of voluntary running (up to 5 km during the first night). In a few years we have extended this fundamental observation to other experimental models in vivo and in vitro and in human cases of muscular dystrophies. In this paper I will give an overview of how the story began, but I must emphasize that Marzena Podhorska-Okolow and Marco Sandri deserve the highest praise for their most notable roles in the beginning and after, the roles and services that are still notable today.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"174 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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