Randomized controlled study on pulmonary rehabilitation in COVID-19 patients with pneumonia

Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis

OBJECTIVE

Assessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases.

DATA SOURCES

Systematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023.

REVIEW METHODS

Evaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies.

RESULTS

The most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, -1.85; 95% CI, -3.00 to -0.70, low certainty), the mMRC Dyspnea Scale (MD, -0.45; 95% CI, -0.72 to -0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, -4.64; 95% CI, -6.54 to -2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33-51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07-5.01, low certainty).

CONCLUSION

Rehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.

Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section)

Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PRM) physician's professional practice for persons with COVID-19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PRM physician's role for persons with COVID-19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section.

Respiratory rehabilitation in patients recovering from severe acute respiratory syndrome: A systematic review and meta-analysis

BACKGROUND

With an increase in published reports on respiratory rehabilitation (RR) in severe acute respiratory syndrome (SARS), there is a need for a meta-analysis and systematic review to measure the effects of the RR in SARS.

OBJECTIVE

Objective of the review was to evaluate the efficacy and safety of RR in patients recovering from SARS.

METHODS

PubMed/ MEDLINE, CENTRAL, EMBASE, and Clinical Trial Registries were systematically searched (between January 1, 2003, to July 31, 2021) to identify all patients who received RR, at least for six days, following SARS. The primary outcome was exercise capacity [6-meter walking distance (6-MWD)], and secondary outcomes were change in pulmonary function test (PFT) parameters, activities in daily livings (ADLs), and quality of life (QoL). Meta-analysis was performed by using RevMan 5.4.

RESULTS

Twenty-one observational studies, including eight comparative studies, were included. Eight comparative studies participated in quantitative meta-analysis. The intervention group, who received RR, improved significantly in exercise capacity (6-MWD) [mean difference (MD):45.79, (95% CI:31.66-59.92)] and PFT parameters, especially in forced vital capacity (FVC%) [MD:4.38, (95% CI:0.15-8.60)], and diffusion lung capacity for carbon monoxide (DLCO%) [MD:11.78, (95% CI:5.10-18.46)]. The intervention group failed to demonstrate significant improvement in ADLs and QoL outcomes. No significant adverse events were reported during the intervention.

CONCLUSION

Respiratory rehabilitation can improve exercise capacity and PFT parameters in patients recovering from SARS infection. The RR does not cause serious adverse events. Clinical trials to determine the best RR program (in terms of initiation, duration, and components) in SARS and its treatment efficacy, both in the short and long- term are needed.

Optimization of urolithiasis treatment and diagnosis in the Turkestan region

The article aims to identify the main problems in treating urological pathologies by analyzing scientific literature from this field and developing recommendations. The quantitative excretion of uric acid, urine volume, and pH are essential in the formation of uric acid stones. The most important risk factor for uric acid nephrolithiasis is the acidic reaction of urine, which is a prerequisite for the formation of urinary stones. When urine is alkalized, the pH should be 6-6.5. Drugs alkalize urine, and one should titrate using urine pH indicator paper until the level is stable. This study found that the spread of genitourinary diseases is increasing. This situation can be improved by monitoring and assessing epidemiological processes, preventing urological pathology, and optimizing medical care organization in the context of health care reform.

Single Vibroacoustic Impact Effect of Singing Bowls over the Psycho-Emotional State and Cardiovascular System Work

This article presents a two-stage study result of the author's method of vibroacoustic massage using singing bowls application. At the first stage, the effect of vibroacoustic massage single application over psycho-emotional characteristics was studied. 19 studied volunteers took part in our study. The testing results before and after exposures were compared according to the WAM (Weighted average mark), Zung, and Spielberg-Khanin tests. The study of the psycho-emotional sphere showed that after the vibroacoustic massage procedure, the indicators of "well-being" and "activity" of the WAM test significantly improved (p = 0.002). In addition, the depression level determined by the Zung test, personal anxiety indicators (p = 0.004), and situational anxiety ones (p = 0.028) decreased. At the second stage, 62 volunteers were divided into two groups. The first group underwent a vibroacoustic massage session according to the patented author's method. The second group received only acoustic exposure using only singing bowls. Differences in the Kerdo index were revealed in the dynamics, and in the first group, the changes were less significant than in the second one. Changes in heart rate variability characteristics for both groups were similar: there was an increase in parasympathetic influences at rest and during the orthostatic test (increased levels of RMSSD (Root Mean Square of Successive Differences), NN50, pNN50) and a decrease in sympathetic effects at rest and their slight increase with orthostatic loading (TINN, RR triangular index). The dynamics were more significant in the first group that received a vibroacoustic massage session. When assessing changes in the neurovegetative regulation levels activity of the heart rhythm, the main difference was associated with very low-frequency waves power dynamics during the orthostatic test. Thus, vibroacoustic massage using singing bowls improves the psycho-emotional state, reduces depression and anxiety, and increases Parasympaticus (autonomic nervous system) activity.

Emotional Intelligence and Burnout of Teachers of Higher Education Institutions

Emotional intelligence is an important resource for overcoming professional stress in members of socionomic professions. The research objective is to determine the role of its components in the development of emotional burnout. A natural experiment was conducted, which determined the manifestations of emotional burnout of 56 university teachers at the end of the academic year. The author used the questionnaire. Two experimental groups were identified in the general sample: teachers with burnout and those resistant to burnout (16 and 30 people, respectively). At the end of the academic year, signs of burnout were detected in one-third of university teachers. The leading symptoms are emotional exhaustion and depersonalisation, with no reduction in professional achievement. The dynamics of emotional life during the annual professional cycle are shown. The integrated indicator of emotional intelligence (EI) remains at the same level, but there are structural changes in the components of intrapersonal intelligence. At the end of the year, teachers' attention to their emotional states, work roles, and communication increase significantly. At the same time, there is a decrease in the ability to manage their own emotions. Resistance to burnout is accompanied by a high ability to realise and control their own emotions with a relatively vague focus on the emotional states of others. It was concluded that individual components of EI (intrapersonal and interpersonal, understanding and management) have different effects on burnout symptoms.

Fundamentals and Main Provisions of the Functional-Procedural Concept of Mental Deprivation

Science still does not have a single scientifically sound concept of mental deprivation, which would explain its psychological essence, this mental phenomenon cannot be adequately assessed, or measures to prevent or eliminate negative mental phenomena it provoked cannot be developed. The article aims to reveal the basic principles and substantiate the main provisions of the functional-procedural concept of mental deprivation. Psycho-energetic and energy-psycho-functional approaches were used, as well as methods of analysis, synthesis, abstraction, specification, comparison, generalisation, and grouping of knowledge about the human psyche. The functional-procedural concept of mental deprivation of humans covers an interconnected system of provisions. According to them, mental deprivation is a course of more or less powerful destructive processes in the functioning of his psyche. Such processes arose from the destruction of mental parameters in various areas due to long-term unfulfilling necessary for normal functioning and development. The development of a functional-procedural concept of mental deprivation of a human will make it possible, first, to adequately define its essence and content in the scientific dimension as a phenomenon of the psyche; secondly, to assess its impact on the functioning of the whole psyche; third, to disclose the impact on development or its delay, actions, behaviour, and activities of an individual; fourth, to develop psychotherapeutic measures to prevent the occurrence of mental deprivation and eliminate its negative consequences.

Formation Mechanisms of Emotional Intelligence of a Future Psychologist in the Context of Vocational Education

Objective: Emotional intelligence is an indicator of a person's ability to communicate, the ability to be aware of their emotions and understand the feelings of others. Background: The development of the emotional intelligence of junior university students occurs through various activities, especially in the process of specially organised training and education. This work aims to study the mechanisms of formation of emotional intelligence and stages of formation of emotional intelligence in psychology  students. Method: Data analysis, synthesis and pedagogical modelling were used. Scientific works on the formation of emotional intelligence were studied. Results: This paper presents a model of the formation of emotional intelligence in students of psychology and practical recommendations for the formation of emotional intelligence in students. Conclusion: The results obtained in this work can be used in practice during the training of psychological and pedagogical faculties students. Also, the materials presented in this paper can be used by teachers of psychology and pedagogy.

Rehabilitation and COVID-19: a rapid living systematic review by Cochrane Rehabilitation Field updated as of December 31st, 2020 and synthesis of the scientific literature of 2020

INTRODUCTION

COVID-19 infection significantly increased mortality risk and the burden of disability in most survivors, regardless of symptom severity at onset. The rehabilitation needs of people infected are receiving growing attention, as evidenced by the increasing number of publications, including those addressing the chronic consequences of infection. This rapid living systematic review reports the evidence published in November and December 2020 and summarises the entire body of literature on rehabilitation in COVID-19 patients published in 2020.

EVIDENCE ACQUISITION

This update was performed using the methodology reported by the second edition conducted by Cochrane Rehabilitation REH-COVER Action. We searched PubMed, Embase, CINAHL, Scopus, Web of Science, and Pedro databases. Papers related to COVID-19 and rehabilitation were retrieved and summarised descriptively.

EVIDENCE SYNTHESIS

The search retrieved 4441 studies. After the removal of duplicates and the screening for title and abstract, we retained 105 studies. Of these, we included 54 in the qualitative synthesis of this update. According to OCEBM 2011 levels of evidence table, most studies (64.8%) fall within the category of level 4 evidence. Up to 40.7% of papers included COVID-19 patients in the postacute phase. In 2020, our rapid living systematic review included 230 studies; most of these (73.9%) were level 4 studies, 25.7% were level 3, and only one study was level 2. The evidence level improved over time. While most studies (44.8%) included patients with acute COVID-19, we observed a gradual increase in the number of reports about chronic symptoms and the long-term consequences of the infection.

CONCLUSIONS

The update of the rapid living systematic review by Cochrane Rehabilitation Field demonstrates an increase in the level of evidence of studies addressing the rehabilitation needs associated with COVID-19 infection. Although most studies are still case reports/series, there is a trend towards conducting prospective investigations of the early natural history of the disease (first months post onset). High-quality-level studies on the efficacy of rehabilitation, and long-term monitoring of the disease and its sequelae are yet to emerge.