Therapeutic Benefits of Short-Arm Human Centrifugation in Multiple Sclerosis–A New Approach

Short-arm human centrifugation (SAHC) is proposed as a robust countermeasure to treat deconditioning and prevent progressive disability in a case of secondary progressive multiple sclerosis. Based on long-term physiological knowledge derived from space medicine and missions, artificial gravity training seems to be a promising physical rehabilitation approach toward the prevention of musculoskeletal decrement due to confinement and inactivity. So, the present study proposes a novel infrastructure based on SAHC to investigate the hypothesis that artificial gravity ameliorates the degree of disability. The patient was submitted to a 4-week training programme including three weekly sessions of 30 min of intermittent centrifugation at 1.5–2 g. During sessions, cardiovascular, muscle oxygen saturation (SmO2) and electroencephalographic (EEG) responses were monitored, whereas neurological and physical performance tests were carried out before and after the intervention. Cardiovascular parameters improved in a way reminiscent of adaptations to aerobic exercise. SmO2 decreased during sessions concomitant with increased g load, and, as training progressed, SmO2 of the suffering limb dropped, both effects suggesting increased oxygen use, similar to that seen during hard exercise. EEG showed increased slow and decreased fast brain waves, with brain reorganization/plasticity evidenced through functional connectivity alterations. Multiple-sclerosis-related disability and balance capacity also improved. Overall, this study provides novel evidence supporting SAHC as a promising therapeutic strategy in multiple sclerosis, based on mechanical loading, thereby setting the basis for future randomized controlled trials.

AKSESIBILITAS LAYANAN FISIK BAGI PENYANDANG DISABILITAS DI PERPUSTAKAAN UMUM DAERAH KABUPATEN JEMBER

The Government of Jember Regency is actively implementing the Regional Regulation (PERDA) of Jember Regency No. 7 of 2016 concerning the Protection and Fulfillment of the Rights of Persons with Disabilities, especially on equal distribution of access to information in public spaces, one of which is the library. This study discusses the accessibility of disabled users at the Regional Public Library of Jember Regency. The method used in this study is a qualitative description through data collection, interviews, observations and literature. The analysis of physical accessibility which includes parking areas, pedestrian paths, guide paths for library door services, circulation desks, signs, ramps, layouts and toilets so far has carried the spirit of a disability-friendly library, although it is not fully compliant with IFLA standards, but this is a capital for its development. management of the main causes of the program and the diversity of types of services with consideration of the degree of disability in the Jember Regency Public Library.

On the Question of the Reflexotherapy Action Mechanisms in the Ischemic Stroke Acute Period (Literature Review)

A high degree of disability in stroke patients, along with severe social and economic losses, determine the enduring urgency of the problem of early rehabilitation for post-stroke patients. Despite the proven effectiveness of the various reflexotherapy techniques in rehabilitation of patients with ischemic stroke, the underlying mechanisms remain unclear. The aim of the review was to analyze the mechanisms of the acupuncture intervention effect on the main links of the ischemic stroke pathogenesis, on neurological deficit and the volume of cerebral infarction (based on publications in international databases). The use of acupuncture in the acute period of ischemic stroke can improve the ability to cerebrovascular reserve, reduce the severity of arterial stiffness and endothelial dysfunction, induce neuroprotection, inhibit cell apoptosis and stimulate neuroplasticity, alleviate the inflammatory response in acute cerebral ischemia, regulate mediators of inflammation and oxidative stress etc., thus improving cerebral blood flow. The analysis of literature data has shown that acupuncture induces multilevel regulation through complex mechanisms, and one factor may not be enough to explain the positive effect against cerebral ischemia.

Association Between Pain with Disability in the Elderly with Dementia

Background: Elderly is one of the most important and critical periods of life, and paying attention to the issues and problems of this period is very important. Objectives: The present study was performed to investigate the relationship between pain and disability in the elderly with dementia in 2021. Methods: In the present cross-sectional descriptive study, 120 elderly people with dementia were included. The instruments used in the four sections were the demographic profile form, the P-APS pain observation tool, and Stanford Disability Questionnaire questions. the researcher identified the elderly with dementia by available sampling method and if the elderly with dementia were eligible and written informed consent was obtained from the elderly and their primary caregivers, the questionnaires were completed. Conditions of pain and disability were described by descriptive tests, and then the relationship between pain and the degree of disability in patients was analyzed by statistical analysis using SPSS16 software. Results: The results showed mean (SD) pain score was 14.45 (4.23), disability score was 12.75 (3.09), and fall score was 37 (30.8%). According to pain score status classification, 4 (3.3%) of the elderly had no pain, 8 (6.7%) had mild pain, 27 (22.5%) had moderate pain, and 81 (67.5%) had severe pain. There is a significant relationship between pain status and disability in the elderly with dementia. By increase in pain, the patients had more disability (P = 0.000, F = 79.971). Conclusions: As the pain increased, the disability of the elderly with dementia decreased. For this reason, preventive interventions are explained in this field.

Preoperative ODI and Intake of Analgesics Predict Outcome after Lumbar Microdiskectomy: Results from a Prospective Register

Background Lumbar disk herniation (LDH) typically causes leg pain and neurologic deficits, but can also be a source of low back pain (LBP). Lumbar microdiskectomy (LMD) is among the most common neurosurgical procedures to relieve radicular symptoms. It is important for both surgeon and patient to understand potential predictors of outcome after LMD. The aim of this study was to investigate if the presence and intensity of preoperative LBP, the ODI score, and analgesic intake can predict the outcome of patients undergoing LMD. Methods This is a single-center retrospective study based on the analysis of prospectively acquired data of patients in the SwissDisc Registry. A total of 685 surgeries on 640 patients who underwent standardized LMD at our institution to treat LDH were included in this study. We performed multivariable linear regression analysis to determine preoperative predictors for patient outcomes based on the Oswestry Disability Index (ODI) scores, recorded on average 39.77 (±33.77) days after surgery. Results Our study confirmed that surgery overall improves patient degree of disability as measured by ODI score. Following model selection using Aikake Information Criterion (AIC), we observed that higher preoperative ODI scores (β: 0.020 [95% CI: 0.008 to 0.031]) and higher number of analgesic medication usage by patients prior to surgery (β: 0.236 [95% CI: 0.057 to 0.415]) were both associated with an increased postoperative ODI score. Conclusion LDH surgery generally improves patient degree of disability. The analysis of patients with a high preoperative ODI score and increased intake of analgesics before surgery predicted a worsening of patients' disability after LMD in this subgroup.

The Risk Factors Affecting Disability Level of Lumbar Disc Herniation

Background. Lumbar disc herniation (LDH) is a disorder that involves rupture of the annulus fibrosus so that the nucleus pulposus protrudes and compresses the lumbar canal. LDH is the most common cause of lumbar radiculopathy. LDH causes functional disorders in patients, causing disability to carry out daily activities. The purpose of this study was to determine the risk factors that influence the degree of disability in lumbar nucleus pulposus herniation. Methods. Analytical research with a consecutive cross-sectional study approach in patients with lumbar LDH at the Neurology Outpatient Clinic, Dr. M. Djamil General Hospital Padang from March to November 2021. The risk factors assessed were age, gender, occupation, length of illness, and body mass index (BMI). The measurement of the degree of disability uses the Oswestry disability index (ODI) score. The relationship between risk factors and the degree of disability was analyzed using chi-square test. Differences in the mean age of groups with mild and moderate degrees of disability using unpaired t-test. Results. 40 subjects met the inclusion and exclusion criteria. Mean age 57 ± 10,976 years, male and female ratio 1:2, work with heavy lifting activities was found in 70% of subjects, duration of suffering from LDH more than one year in 60% of subjects. BMI overweight and obesity as many as 77.5% subjects. As many as 60% of the subjects experienced mild to moderate degrees of disability. There is a difference in the average age of the subjects with mild to moderate degree of disability with a severe degree of p-value of 0.044. There was no significant relationship between gender (p=0.054), occupation (p=0.398), length of illness (p=0.503) and body mass index (p=0.757), and the degree of disability. Conclusion. The degree of disability in patients with LDH is influenced by age. Meanwhile, gender, occupation, length of illness and body mass index were not significantly related to the degree of disability in patients.

The spectrum of vital activity restrictions in disabled people due to thyroid cancer

BACKGROUND: The most common malignant neoplasm of the endocrine system is thyroid cancer. In Russia, as in other countries of the world, the incidence rate is steadily increasing. Thus, it is extremely important to assess the problem of health disorders due to thyroid cancer within the framework of socially significant disability caused by malignant neoplasms in the Russian Federation. AIMS: To analyze the spectrum of types and degree of disability in people with disabilities due to thyroid cancer. MATERIAL AND METHODS: The article presents the results of the analysis of the spectrum of the main types of disability in the general contingent of disabled people due to thyroid cancer among the adult population of Moscow (20152019). RESULTS: The dynamics of disability both in the contingent of first recognized and in the contingent of re-recognized disabled people (VPI and PPI) was characterized by an increase in the number of disabled people and the transformation of the structure of general disability. There is a clear change in the ratio towards an increase in the share of PPI from 55.1% in 2015. up to 68.0% in 2019, while the share of VPI decreased from 44.9% in 2015 to 32.0% in 2019. The predominant gender cohort was women, and the age category was the elderly. The main types of life restrictions were the restriction of the ability to self-serve (98.6% of the VPI and 97.9% of the PPI), to work (94.7% of the VPI and 94.6% of the PPI) and to move (21.3% of the VPI, 21.8% of the PPI). A low proportion of restrictions on the ability to control ones behavior, learning, communication and orientation was revealed (0.31.2%). The first degree of disability prevailed in the contingents of VPI and PPI (p 0.0001). In the contingent of men, the proportion of disabled people with the third degree of disability was higher compared to the contingent of women. CONCLUSION: Dynamic assessment of the degree of severity of functional disorders and associated life restrictions should be carried out at all stages of medical and social rehabilitation in order to monitor the effectiveness of medical and rehabilitation measures, assess the quality of life and prevent progression (secondary prevention of disability).

Comparison of the effect of the McKenzie method and spiral stabilization in patients with low back pain: A prospective, randomized clinical trial

BACKGROUND: Low back pain (LBP) causes disability in daily life, and presents not only a health but also a socio-economic problem. New treatment options need to be tested and confirmed. OBJECTIVE: Compare the effect of the McKenzie method and spiral stabilization in patients with LBP. METHODS: Sixty patients with an average age of 47 years, which were included in our prospective, comparative study were randomly divided into two 30-member groups. One group exercised according to the McKenzie method (MDT), the other one according to the Spiral Stabilization Method (SPS). During the initial examination the Aberdeen Back Pain Scale was used to determine the degree of managing with daily activities and functionality, and the Roland-Morris Disability Questionnaire was used to determine the degree of disability. Check- up was performed after 2 and 6 weeks of treatment. RESULTS: In both groups, there was a significant improvement in results after 2 and 6 weeks of treatment (p< 0.05). When comparing the effect of 2 and 6 weeks of treatment of both therapeutic procedures (MDT and SPS), the difference was insignificant (p> 0.05). CONCLUSIONS: None of these two treatment methods achieved better results, as they both have a comparable effect on reducing disability and improving the management of daily activities and physical functions. Therefore, both are equally effective in patients with LBP.

Double Burden of Disability and Poverty: Does Vocational Rehabilitation Ease the School‐to‐Work Transition?

Poor young people more often face health difficulties, (learning) disabilities, and are overrepresented in special schools. Consequently, youth from poor households disproportionately frequently participate in disability‐specific programs aiming to improve their educational levels and labor market opportunities. They face a double burden of disability and poverty. In our study, we look at poor and non‐poor youth with disabilities (YPWD) who participate in vocational rehabilitation (VR) and whether VR helps them (a) in transitioning into employment and (b) in leaving poverty. We examine the association between the receipt of initial basic income support (BIS) as a poverty indicator, later labor market outcomes, and earned vocational qualification using administrative data. We make use of a sample of all persons accepted for VR in 2010 (N = 36,645). We employ logit models on VR attendees’ labor market outcomes three and five years after being accepted for VR as well as on their earned vocational qualifications. Beside initial poverty status, we control for educational level, type, and degree of disability and program pattern during the VR process. Our findings show that YPWD from poor households have a decreased likelihood of a vocational certificate and employment. Additionally, they are more likely to receive BIS than young people not from poor households and thus more likely to remain poor. In conclusion, VR seems to support poor YPWD less in their school‐to‐work transitions. Thus, disability‐specific programs should be more tailored to the social situations of participants, and counsellors should be more sensitive to their social backgrounds.