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BACKGROUND Routine preclinical interventions for patients with chronic periodontitis such as supragingival cleaning and subgingival curettage, establishing a balanced occlusal relationship, and irrigation with 3% hydrogen peroxide can relieve the symptoms to some extent. However, there is room for improvement in the overall effect. For example, Er:YAG lasers can quickly increase the temperature of the irradiated tissue, effectively eliminate dental plaque and calculus, reduce periodontal pockets, adjust periodontal microecology, and reduce the gingival sulcus. The content of factors in the liquid, and then achieve the purpose of treatment. AIM The aim was evaluate the effect of Er:YAG laser-assisted routine therapy on the periodontal status in chronic periodontitis. METHODS Between October 2018 and January 2020, 106 patients with chronic periodontitis in our hospital were randomly assigned to either the study or control group, with 53 patients in each group. The control group underwent routine therapy, and the study group underwent Er:YAG laser therapy in addition to routine therapy. We evaluated the treatment outcome in both groups. Periodontal status was determined by clinical attachment loss (CAL), gingival index (GI), periodontal probing depth (PD), dental plaque index (PLI), and sulcular bleeding index (SBI), inflammatory factors in the gingival crevicular fluid, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8], and colony forming units (CFUs). RESULTS Total effectiveness in the study group (94.34%) was higher than that in the control group (79.25%, P < 0.05). The clinical parameters in the study group (PD, 5.28 ± 1.08 mm; CAL, 4.81 ± 0.79 mm; SBI, 3.37 ± 0.59; GI, 1.38 ± 0.40; PLI, 2.05 ± 0.65) were not significantly different from those in the control group (PD, 5.51 ± 1.14 mm; CAL, 5.09 ± 0.83 mm; SBI, 3.51 ± 0.62; GI, (1.41 ± 0.37; PLI, 1.98 ± 0.70) before treatment (P > 0.05). However, after treatment, the parameters in the study group (PD, 2.97 ± 0.38 mm; CAL, 2.71 ± 0.64 mm; SBI, 2.07 ± 0.32; GI, 0.51 ± 0.11; PLI, 1.29 ± 0.34) were lower than those in the control group (PD, 3.71 ± 0.42 mm; CAL, 3.60 ± 0.71 mm; SBI, 2.80 ± 0.44; GI, 0.78 ± 0.23; PLI, 1.70 ± 0.51) (P < 0.05). Differences in crevicular TNF-α, IL-6, and IL-8 levels in the study (TNF-α, 7.82 ± 3.43 ng/mL; IL-6, 11.67 ± 2.59 ng/mL; IL-8, 12.12 ± 3.19 pg/mL) and control groups (TNF-α, 9.06 ± 3.89 ng/ml, IL-6, 12.13 ± 2.97 ng/mL, IL-8, 10.99 ± 3.30 pg/mL) before therapy (P > 0.05) were not significant. Following treatment, the parameters were significantly lower in the study group (TNF-α, 2.04 ± 0.89 ng/mL; IL-6, 4.60 ± 1.26 ng/mL; IL-8, 3.15 ± 1.08 pg/mL) than in the control group (TNF-α, 3.11 ± 1.07 ng/mL; IL-6, 6.25 ± 1.41 ng/mL; IL-8, 4.64 ± 1.23 pg/mL, P < 0.05). The difference in the CFU of the study group [(367.91 ± 74.32) × 104/mL and control group (371.09 ± 80.25) × 104/mL] before therapy was not significant (P > 0.05). The CFU decreased in both groups following therapy, however, the CFU values were lower in the study group [(36.09 ± 15.26) × 104/mL] than in the control group [(45.89 ± 18.08) ×104/mL] (P < 0.05). CONCLUSION Combining Er:YAG lasers with routine measures significantly improved the overall periodontal therapy outcomes by improving periodontal status and reducing oral levels of inflammatory factors and CFUs.

The recently published Imperial College study of a Phase II, double-blind, randomized, controlled trial comparing psilocybin-assisted therapy to a six-week titration of escitalopram for Major Depressive Disorder (MDD) should raise concerns for this illness category as a target of early psychedelic research given a goal of FDA approval. There are three reasons why MDD is the wrong target at this stage of research development. Firstly, the psychiatric category of MDD is heterogeneous, vaguely-defined, and overdiagnosed in a way that will problematize finding a reliable signal with psychedelic interventions (or any intervention), particularly within non-severe cases. Secondly, current rating scales for MDD (QIDS used in the Imperial College trial, but also HAM-D) are limited in approximating the kinds of things we ultimately care most about with depressive states, namely functional status, quality of life, and well-being: measures that seem more salient for psychedelic interventions and which are not adequately captured by these rating scales used in a majority of clinical trials. And thirdly, there are inherent conflicts between psychiatric conceptualizations of MDD (and its symptom amelioration) and the kinds of perspectives on one’s suffering often occasioned by psychedelic experiences themselves: while these kinds of psychedelic-catalyzed openings may lead to a form of acceptance or equanimity with regards to one’s life circumstances this could be in many ways orthogonal to reductions in HAM-D scores. We argue that for these reasons MDD is a non-ideal target at this stage of the science and propose alternative directions.

Psychedelics are a class of psychoactive substances that were studied extensively between 1943 and 1970 as potential therapies for treating a host of mental health disorders, including addiction. Despite promising early results, U.S. psychedelic research was halted in the early 1970s with the enactment of the Controlled Substances Act. As the field of psychedelic-assisted therapy develops, nurses can decide the role they will play in the continuing clinical and scholarly research of these substances, which may soon be used in controlled settings to treat some of the most widespread mental health disorders. To prepare for this task, this article proposes that nurses become familiar with the history, relevant language, and scientific findings related to the field of psychedelic research. learn about existing psychedelic-assisted therapy and research resources. examine their thoughts, judgments, and opinions about therapeutic psychedelic use. consider the potential role of nursing in psychedelic-assisted therapies going forward.

DISCLOSURES: Funding for this summary was contributed by Arnold Ventures, California Health Care Foundation, The Donaghue Foundation, Harvard Pilgrim Health Care, and Kaiser Foundation Health Plan ...

The gold-standard cognitive–behavioral therapy (CBT) for psychosis offers at best modest effects. With advances in technology, virtual reality (VR) therapies for auditory verbal hallucinations (AVH), such as AVATAR therapy (AT) and VR-assisted therapy (VRT), are amid a new wave of relational approaches that may heighten effects. Prior trials have shown greater effects of these therapies on AVH up to a 24-week follow-up. However, no trial has compared them to a recommended active treatment with a 1-year follow-up. We performed a pilot randomized comparative trial evaluating the short- and long-term efficacy of VRT over CBT for patients with treatment-resistant schizophrenia. Patients were randomized to VRT (n = 37) or CBT (n = 37). Clinical assessments were administered before and after each intervention and at follow-up periods up to 12 months. Between and within-group changes in psychiatric symptoms were assessed using linear mixed-effects models. Short-term findings showed that both interventions produced significant improvements in AVH severity and depressive symptoms. Although results did not show a statistically significant superiority of VRT over CBT for AVH, VRT did achieve larger effects particularly on overall AVH (d = 1.080 for VRT and d = 0.555 for CBT). Furthermore, results suggested a superiority of VRT over CBT on affective symptoms. VRT also showed significant results on persecutory beliefs and quality of life. Effects were maintained up to the 1-year follow-up. VRT highlights the future of patient-tailored approaches that may show benefits over generic CBT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is underway.

The aim of this systematic review was, first, to determine whether or not individuals with cognitive deficits after stroke were enrolled in trials that investigated upper limb robot-assisted therapy effectiveness, and, second, whether these trials measured cognitive outcomes. We retrieved 6 relevant systematic reviews covering, altogether, 66 articles and 2214 participants. Among these 66 clinical trials, only 10 (15%) enrolled stroke participants with impaired cognition, whereas 50 (76%) excluded those with impaired cognition. The remaining six trials (9%) were classified as unclear as they either excluded individuals unable to understand simple instructions or did not specify if those with cognitive disorders were included. Furthermore, only 5 trials (8%) used cognitive measures as outcomes. This review highlights a lack of consideration for individuals with cognitive impairments in upper limb robotic trials after stroke. However, cognition is important for complex motor relearning processes and should not be ignored.

Contains fulltext : 225794.pdf (Publisher’s version ) (Open Access) Social communication and self-esteem are often affected in adults with autism spectrum disorder. Implementation and evaluation of interventions targeting social skills are challenged due to specific characteristics of autism. Intensive, valid evaluation of social skills programs is needed. In this explorative multiple case study, we examined effects and working mechanisms of dog-assisted therapy on social communication and self-esteem, by analyzing detailed observations with Monte Carlo permutation tests (testing against 10,000 random samples) and using self- and other-reports in N=6 high-functioning adults with ASD. Results showed significant positive effects on secure body posture. There was an indication of improved self-esteem and more spontaneous touching of the dog, while no convincing increase was found for verbal initiatives. Cross-correlation analyses revealed that touching the therapy dog may be an important determinant to elicit social development in Animal Assisted Therapy (AAT). Considering preliminary results, we recommend exploring underlying mechanisms more thoroughly with real-time observations, accounting for possible gender-effects.

Objetivo: Confirmar la factibilidad y analizar los cambios ocurridos en el equilibrio y la motricidad fina de un grupo de personas con discapacidad física tras un programa de rehabilitación física realizado con perros de terapia. Método: Un total de 10 personas adultas con discapacidad física participaron en un programa de terapia asistida con perros durante un trimestre, a razón de una sesión mensual de dos horas de duración. La muestra se dividió en dos grupos en función de su nivel de afectación física y se establecieron objetivos distintos para los mismos: mejora del equilibrio estático, dinámico y riesgo de caídas, valorado mediante la escala Tinetti (Grupo 1), mejora de la motricidad fina y coordinación valorada mediante la batería MABC-2 (Grupo 2). Resultados: El programa se mostró factible sin registro de efectos adversos ni abandonos. En el grupo-1 se observaron cambios pre-post en todas las variables de equilibrio y marcha evaluadas. En todos los casos fueron cambios interpretables como mejora y estadísticamente significativos. En el grupo-2 se observaron también cambios pre-post se observó un modesto porcentaje de ensayos fallidos y mientras que en el 49.6% restante se documentaron ensayos fallidos. Las 2/3 partes de los cambios observados en el grupo-2 fueron interpretables como mejora, pero ninguno estadísticamente significativo. Conclusiones: El empleo de perros como estrategia de terapia asistida en personas con discapacidad física es una opción rehabilitadora factible y de interés, que puede conllevar mejoras en su equilibrio, si bien tiene un impacto de poca magnitud en su nivel de motricidad fina y coordinación Objective: To confirm the feasibility and analyze the changes occurred in the balance and fine motor function of a group of people with physical disability after a physical rehabilitation program performed with therapy dogs. Methods: A total of 10 adult people with physical disability took part in a program of assisted therapy with dogs during a trimester through a 2-hours monthly session. The sample was divided into two groups according to their level of physical involvement, and different objectives were established for each of the groups: static balance enhancement, dynamic and falling risk valued with Tinetti scale (Group 1), fine motor function enhancement and coordination valued with battery MABC-2 (Group 2). Results: The program was shown to be feasible with no record of adverse effects or dropouts. In group 1, pre-post changes were observed in all balance and gait variables evaluated. In all cases these were changes that could be interpreted as improvements and were statistically significant. In group 2, prepost changes were observed in only half of the cases (51.4%), while in the remaining 49.6% failed trials were documented. Two-thirds of the changes observed in group-2 were interpretable as improvement, but none were statistically significant. Conclusions: Using dogs as strategy of assisted therapy in people with physical disability is a feasible and interesting rehabilitation option, which can carry improvements in their balance, while it has a small impact in their fine motor function and coordination

Introduction The routine use of evidence-based upper limb rehabilitation interventions after stroke has the potential to improve function and increase independence. Two such interventions are Constraint Induced Movement Therapy and Robot Assisted Therapy. Despite evidence to support both interventions, their use within the National Health Service appears, anecdotally, to be low. We sought to understand user perceptions in order to explain low uptake in clinical practice. Methods A combination of a cross-sectional online survey with therapists and semi-structured interviews with stroke patients was used to explore uptake and user opinions on the benefits, enablers and barriers to each intervention. Findings The therapists surveyed reported low use of Constraint Induced Movement Therapy and Robot Assisted Therapy in clinical practice within the Scottish National Health Service. Barriers identified by therapists were inadequate staffing, and a lack of training and resources. Interviews with stroke patients identified themes that may help us to understand the acceptability of each intervention, such as the impact of motivation. Conclusion Barriers to the uptake of Constraint Induced Movement Therapy and Robot Assisted Therapy within the clinical setting were found to be similar. Further qualitative research should be completed in order to help us understand the role patient motivation plays in uptake.

Background Worldwide, populations are aging exponentially. Older adults and people with dementia are especially at risk of social isolation and loneliness. Social robots, including robotic pets, have had positive impacts on older adults and people with dementia by providing companionship, improving mood, reducing agitation, and facilitating social interaction. Nevertheless, the issue of affordability can hinder technology access. The Joy for All (JfA) robotic pets have showed promise as examples of low-cost alternatives. However, there has been no research that investigated the usability and impact of such low-cost robotic pets based on perceptions and experiences of its use with older adults and people with dementia. Objective The aim of our study was to explore the usability and impact of the JfA robotic cat, as an example of a low-cost robot, based on perceptions and experiences of using the JfA cat for older adults and people with dementia. Methods We used a novel methodology of analyzing a large volume of information that was uploaded by reviewers of the JfA cat onto online consumer review sites. Data were collected from 15 consumer websites. This provided a total of 2445 reviews. Next, all reviews were screened. A total of 1327 reviews that contained information about use of the JfA cat for older adults or people with dementia were included for analysis. These were reviews that contained terms relating to “older adults,” “dementia,” and “institutional care” and were published in the English language. Descriptive statistics was used to characterize available demographic information, and textual data were qualitatively analyzed using inductive content analysis. Results Most reviews were derived from consumer sites in the United States, and most reviewers were family members of users (ie, older adults and people with dementia). Based on the qualitative content analysis, 5 key themes were generated: prior expectations, perceptions, meaningful activities, impacts, and practicalities. Reviewers had prior expectations of the JfA cat, which included circumstantial reasons that prompted them to purchase this technology. Their perceptions evolved after using the technology, where most reported positive perceptions about their appearance and interactivity. The use of the robot provided opportunities for users to care for it and incorporate it into their routine. Finally, reviewers also shared information about the impacts of device and practicalities related to its use. Conclusions This study provides useful knowledge about the usability and impact of a low-cost pet robot, based on experiences and perceptions of its use. These findings can help researchers, robot developers, and clinicians understand the viability of using low-cost robotic pets to benefit older adults and people with dementia. Future research should consider evaluating design preferences for robotic pets, and compare the effects of low-cost robotic pets with other more technologically advanced robotic pets.

OBJECTIVE: Opioid use disorder (OUD) is a notable concern in the United States (US) and strongly associated with mortality. There is a high prevalence of OUD in patients with posttraumatic stress disorder (PTSD) and the mortality associated with OUD may be exacerbated in patients with PTSD. Medication-assisted treatment (MAT) for OUD has become standard of care for OUD and has been shown to reduce mortality. However, there has been little study of MAT and mortality in patients with PTSD and OUD. METHODS: We conducted a retrospective cohort study in U.S. veterans who had newly engaged in PTSD treatment, were diagnosed with OUD and were provided MAT for at least one day between 2004 and 2013. We assessed mortality for one year following the index diagnosis date. We calculated all-cause mortality as well as death by external cause, overdose plus suicide, overdose, and suicide rates per 100,000. We used hazard ratios (HR) and 95% confidence intervals (CI) to compare death rates between patients with high versus low adherence to MAT. We evaluated the impact of high versus low exposure to general substance abuse care. We considered a confidence interval that did not cross one to be significant. RESULTS: A total of 5,901 patients met inclusion criteria. Most patients were men and the average age was 43.3 years (SD=13.8). The all-cause mortality rate was 1,370 per 100,000 patients. High adherence to MAT resulted in a non-significant, decreased risk for death due to all-cause (HR=0.73, 95% CI [0.47, 1.13]), external cause (HR=0.71, 95% CI [0.38, 1.35]), and overdose or suicide (HR=0.66, 95% CI [0.33, 1.35]). Patients with high exposure ( 60 days) to general substance abuse care were significantly less likely to die due to external cause (HR=0.39, 95% CI [0.18, 0.85]) and overdose or suicide (HR=0.31, 95% CI [0.12, 0.77]). CONCLUSIONS: In patients with PTSD and OUD, improved adherence to MAT and greater exposure to general substance abuse care may result in lower mortality. Studies with longer follow-up and larger sample sizes to assess the impact of MAT on suicide are needed to confirm our findings.

Robotic-assisted therapy (RAT) is a task-specific approach for treating gait disorders in individuals with neurological impairments. However, the effectiveness of RAT is not clear for different severities of involvement, pathologies, and ages. This study aimed to assess the functional and clinical status outcomes after RAT in individuals with cerebral palsy (CP). Twenty-eight individuals with bilateral spastic CP were enrolled (female = 10; male = 18; age = 15.2 ± 2.0 years). The RAT program consisted of 30 sessions: five sessions weekly for six weeks. Gross Motor Function Measure (GMFM) and clinical physical examinations were evaluated before and after RAT. Our results suggested that the RAT program with the described protocol can improve the general gross motor functions of individuals with CP in Gross Motor Function Classification System (GMFCS) levels I and II, and primarily improves performance on less complex GMFM items for those in GMFCS levels III and IV. The lower baseline functional level was related to a greater functional improvement. Older individuals were noticed to improve more in GMFM dimension D. Regarding impairments evaluated by clinical examinations, no change was found after RAT intervention. It is worth mentioning that the strength of knee muscles was not affected either.

Namen magistrske naloge je bil ugotovili, ali terapevtskim konjem sodelovanje v hipoterapiji predstavlja stres. Poskus smo izvajali na lokaciji CIRIUS Kamnik, kjer smo opazovali 4 terapevtske konje med hipoterapijo. Spremljali smo pogostost oblik obnašanja, ki nakazujejo na stres (položaj ušes in glave ter gibanje) in v določenih časovnih razmakih (pred terapijo, po terapiji, 45 minut po terapiji) merili očesno temperaturo ter odvzeli vzorce sline za določanje koncentracije kortizola. Konje smo štirikrat spremljali v poletni in štirikrat v jesenski sezoni. Pripravili smo tudi anketo za ocenjevanje osebnosti konj. Na podlagi zbranih podatkov smo v poletni sezoni zabeležili značilno več sprememb v gibanju konja kot v jesenski sezoni in večjo pogostost sprememb položaja glave, ko je konja jahal pokreten uporabnik. Višjo koncentracijo kortizola v slini smo izmerili v jesenski sezoni, značilna interakcija med sezono in meritvijo pa je pokazala razliko med prvo in četrto meritvijo v jesenski sezoni. Glede na čas odvzema vzorca sline smo zabeležili značilno višjo koncentracijo kortizola tik po terapiji v primerjavi z meritvijo 45 minut po terapiji. Med meritvama pred terapijo in po terapiji nismo ugotovili značilnih razlik. Pri meritvah očesne temperature je bila izmerjena značilno višja očesna temperatura v poletni sezoni v primerjavi z jesensko sezono, značilne so bile tudi razlike med posameznimi meritvami. Interakcija med sezonama in meritvami je pokazala nihanja očesne temperature le v jesenski sezoni, značilna interakcija med sezono in časom meritve pa značilno razliko v očesni temperaturi pred terapijo in 45 minut po terapiji, vendar le v jesenski sezoni. Podatki očesnih temperatur morda niso optimalni, saj ni bilo možno zagotoviti optimalnih pogojev za merjenje. Na podlagi ankete o osebnosti konj nismo ugotovili stopnje strinjanja med tremi ocenjevalci za posameznega konja, so se pa ocenjevalci med seboj strinjali na podlagi vseh 69 osebnostnih lastnosti za vse 4 konje. Na podlagi vseh zbranih rezultatov lahko sklepamo, da so konji med sodelovanjem pri hipoterapiji doživeli nekaj stresa. The purpose of the master's thesis was to find out whether participation in hippotherapy stresses out therapeutic horses. The research was performed in CIRIUS Kamnik, where 4 therapeutic horses were observed during hippotherapy. We monitored the frequency of behaviours indicating stress (ear and head position and movement). Before therapy, right after the therapy and 45 minutes after the therapy we measured the eye temperature and took saliva samples to determine cortisol concentration. The horses were monitored four times in the summer and four times in the autumn season. We also prepared a survey to assess the personality of the horses. We recorded significantly more changes in the horse movement in the summer season than in the autumn season and a higher frequency of changes in head position when the horse was ridden by a mobile user. Higher cortisol concentrations in saliva were measured in the autumn season. The interaction between the season and the measurement showed a significant difference between the first and the fourth measurement in the autumn season. Significantly higher cortisol concentration was recorded right after therapy compared to the measurement 45 minutes after the therapy. No significant differences were recorded between pre-therapy and post-therapy measurements. A significantly higher eye temperature was measured in the summer season compared to the autumn season differences between individual measurements were also significant. The interaction between the seasons and the measurements showed significant fluctuations in eye temperature only in the autumn season. The interaction between the season and the time of the measurement showed a significant difference in the eye temperature before the therapy and 45 minutes after the therapy, but only in the autumn season. It was not possible to provide optimal measuring conditions for measuring eye temperature and therefore the eye temperature data may not be accurate. Based on the horse personality survey, we did not find a degree of agreement between the three evaluators for each horse, but the evaluators agreed on all 69 personality characteristics for all 4 horses. Based on the all collected data, we can conclude that the horses experienced some stress while participating in the hippotherapy.

Mindfulness-based interventions and psychedelic-assisted therapy have been experimentally utilised in recent years as alternative treatments for various psychopathologies with moderate to great success. Both have also demonstrated significant post-acute and long-term decreases in clinical symptoms and enhancements in well-being in healthy participants. These two therapeutic interventions share various postulated salutogenic mechanisms, such as the ability to alter present-moment awareness and anti-depressive action, via corresponding neuromodulatory effects. Recent preliminary evidence has also demonstrated that psychedelic administration can enhance mindfulness capacities which has already been demonstrated robustly as a result of mindfulness-based interventions. These shared mechanisms between mindfulness-based interventions and psychedelic therapy have led to scientists theorising, and recently demonstrating, synergistic effects when both are used in combination, in the form of potentiated therapeutic benefit. These synergistic results hold great promise but require replication in bigger sample groups and better controlled methodologies, to fully delineate the effect of set and setting, before they can be extended onto clinical populations.

Objectives Several studies have evaluated the impact of oral medication on the gut microbiome (GM) in Parkinson’s disease (PD). However, the impact of PD device-assisted therapies (DAT) on the GM remains to be investigated. We profiled acute temporal GM stability around the initiation of PD DAT. Methods The GM of 21 PD patients initiating either Deep Brain Stimulation (DBS) or levodopa-carbidopa intestinal gel (LCIG) were compared to 10 spousal healthy control (HC) subjects. 16S amplicon sequencing of the V3-V4 region of stool bacterial DNA was used to compare temporal GM stability between groups and with clinical outcome measures, including disease alternations relative to therapy initiation. GM response to therapy in the PD group was assessed by comparing pre-therapy (-2 and 0 weeks) with post-therapy initiation timepoints (+2 and +4 weeks) and HCs at baseline (0 weeks). Results Altered GM compositions were noted between the PD and HC groups at various taxonomic levels, including specific differences for DBS and LCIG therapies. Beta diversity changes were also identified across the 4 week post-treatment initiation period, implying a therapy-effect on the GM. Conclusions We present the first acute longitudinal assessment of GM response to PD DAT. The pre-treatment PD-specific GM (consistent with previous studies) was altered following DAT initiation, indicating DATs have a modulatory impact on the GM in PD.

Dog-assisted therapy (DAT) consists of an intervention, applied and supervised by duly qualified health professionals, in which the dog is an integral part of the treatment, causing behavioral changes and the health of people with different types of needs. This article aims to identify, through a literature review, the health areas capable of receiving intervention with dogs and their benefits in treatment. The results showed the possibility of implementing DAT in different configurations such as hospitals, nursing homes, clinics or schools and demonstrated the beneficial potential of this intervention for physical, mental and emotional rehabilitation. Keywords: Assisted therapy; Dog; Animal.

Psychedelic substances such as psilocybin and ketamine may represent the future of antidepressant treatment, due to their rapid and prolonged effects on mood and cognition. The current body of psychedelic research has focused on administration and treatment within a psychiatric context. Here, instead, we put to the test the contention that it is necessary to evaluate the current state of this literature from a broader biopsychosocial perspective. Examining these arguably neglected social and psychological aspects of psychedelic treatment can provide a more holistic understanding of the interplay between the interconnected domains. This review of six major clinical trials applies a biopsychosocial model to evaluate the antidepressant effects of psilocybin and ketamine assisted therapy. We conclude that combination psychedelic treatment and psychotherapy facilitate more enduring and profound antidepressant effects than produced by ketamine or psilocybin alone. Emphasising the advantages of therapeutic intervention will encourage those who may attempt to self-medicate with psychedelics to instead seek a framework of psychological support, minimising associated risks of unregulated use.

The ankle is that the commonest site of sprain injuries within the physical body , with over 23,000 cases estimated to occur per day within the us...

Introduction Dog-assisted therapy is a method that facilitates rehabilitation and therapy of persons with disabilities. Therapy sessions are attended by a patient, a therapist, and a trainer with a dog specially selected and trained for this purpose. Aim The aim of the study is to evaluate the impact of a dog’s presence on the therapy, and consequently on the motor development of children with physical and intellectual disabilities. Material and methods This study was conducted during a period from January 2014 to May 2014. We enrolled 25 children with various disorders. The subjects were students of “Always Together” Private Elementary and Middle School in Poznań. The majority of the children have been diagnosed with cerebral palsy or meningomyelocele. Three tests were used for the assessment of the results of the therapy: The EUROFIT Special Test, an original Manual Skills Test, and a Satisfaction Survey. Results The results show significant improvement both in the EUROFIT and the manual skills tests accompanied by a high level of satisfaction. The results were not affected by the severity of intellectual disability, sex, or the type of the disorder. Conclusions The presence of a specially trained and selected dog had a positive impact on the results of physical fitness tests achieved by children with disabilities

This article describes ethical issues related to the design and use of social robots in sensitive contexts like psychological interventions and provides insights from one user design study and two controlled experiments with adults and children. User expectations regarding privacy with a therapeutic robotic dog, Therabot, gathered from a 16 participant design study are presented. Furthermore, results from 142 forensic interviews about bullying experiences conducted with children (ages 8 to 17) using three different social robots (Nao, Female RoboKind, Male RoboKind) and humans (female and male) as forensic interviewers are examined to provide insights into child beliefs about privacy and social judgment in sensitive interactions with social robots. The data collected indicates that adult participants felt a therapeutic robotic dog would be most useful for children in comparison to other age groups, and should include privacy safeguards. Data obtained from children after a forensic interview about their bullying experiences shows that they perceive social robots as providing significantly more socially protective factors than adult humans. These findings provide insight into how children perceive social robots and illustrate the need for careful considerationwhen designing social robots that will be used in sensitive contexts with vulnerable users like children.

Psychedelics have been investigated for their therapeutic applications in end-of-life care as early as 1960. Recently, there have been four main groups conducting clinical trials for either lysergi...

This paper presents a patient-centered interaction design of Robot-Assisted Therapy or Robot-Assisted Play (RAP) applications for children with a diverse form of Autism Spectrum Disorder (ASD) combined with Attention Deficit Hyperactivity Disorder (ADHD). Through our iterative evaluation process based on observations of fourteen children over several sessions and interviews with their parents, we continuously refined the behaviors of a humanoid robot NAO that are now ready to be used for research on Robot-Assisted Therapy. This paper also reports the design of RAP methodology that might be helpful in assimilating iterative input from stakeholders such as children, parents and therapists to customize technology for other populations with special needs.

The field of digital mental health is rapidly expanding with digital tools being used in assessment, intervention, and supporting self-help. The application of digital mental health to hallucinations is, however, at a very early stage. This report from a working group of the International Consortium on Hallucinations Research considers particular synergies between the phenomenon of hallucinations and digital tools that are being developed. Highlighted uses include monitoring and managing intermittently occurring hallucinations in daily life; therapeutic applications of audio and video media including virtual and augmented reality; targeting verbal aspects of hallucinations; and using avatars to represent hallucinatory voices. Although there is a well-established Internet-based peer support network, digital resources for hallucinations have yet to be implemented in routine practice. Implementation may benefit from identifying how to market resources to the broad range of populations who experience hallucinations and identifying sustainable funding models. It is envisaged that digital tools will contribute to improved self-management and service provision for people experiencing hallucinations. Keywords: digital mental health, mHealth, Internet, smartphones, hearing voices, schizophrenia publishedVersion

In 2014 methadone as part of Medically Assisted Therapy (MAT) was introduced in Kenyan public health facilities as part of a comprehensive approach to HIV prevention and treatment. This paper explo...

Background The overlap between criminal justice system involvement and drug use is well‐documented, and criminal justice agencies have been particularly overwhelmed by the recent opioid epidemic. Treating opioid (and other substance) addiction as a means to reduce risk for future criminality and improve public safety is inherently a responsibility for the criminal justice system. In turn, the criminal justice system has a responsibility to manage and treat addiction among the individuals under its purview. Policy recommendations place emphasis on the use of medication‐assisted treatments (MAT) as a front‐line defense among correctional populations, because its efficacy and effectiveness has been well‐established in other contexts. Despite this, criminal justice agencies have been reluctant or slow to do so. Objectives The current review will provide criminal justice and substance use treatment decision‐makers with information regarding the efficacy and effectiveness of opioid‐specific MAT on offending and overdose outcomes. Specifically, the authors will address the following research questions: Do opioid‐specific MATs reduce the frequency or likelihood of criminal justice outcomes, as defined by official or self‐reported indices of criminal reconviction or rearrest, revocation of community supervision, mandated treatment failure, and specialized court docket failure? Do opioid‐specific MATs reduce the frequency of opioid overdose among individuals with current or prior self‐reported or official record of criminal justice system involvement? Inclusion Criteria Studies were required to use strong quasi‐experimental or randomized experimental designs. All studies used individual level unit of analysis and examined adults and adolescents who are male, female, or nonbinary and racially/ethnically diverse, with current opioid use and who have current or prior criminal justice involvement. Studies had to prospectively test the effects of heroin and methadone maintenance, buprenorphine, or naltrexone on criminal conviction, arrest, revocation of community supervision, technical probation or parole violation, mandated treatment failure, and specialized court docket failure. Overdose outcomes were also examined for samples in criminal justice settings such as jails, prisons, probation, and parole. Search Strategy and Data Collection This review builds upon a prior review conducted by Egli et al. (2009) and examined studies meeting the inclusion criteria above published between 1960 and October 31, 2020. The following platforms and databases (in parentheticals) were used: EBSCOhost (Criminal Justice Abstracts, SocINDEX with Full Text, Legal Collection, Wilson Omnifile, PsycINFO, Social Work Abstracts, and Women's Studies International [includes grey literature]); ProQuest (Criminal Justice Database, PAIS [includes grey literature], Dissertations and Theses Global [includes grey literature]); Gale (Expanded Academic ASAP, Opposing Viewpoints Resource Center); FirstSearch (GPO Monthly Catalog, PapersFirst [includes grey literature]); ISI Web of Knowledge (Web of Science Core Collection); Office of Justice Programs (National Criminal Justice Reference Service); Summon; and Nexis Uni. The following open access platforms and databases will also be consulted: Elsevier (Scopus [includes grey literature]); Science.gov; ClinicalTrials.gov; WHO International Clinical Trials Registry Platform (ICTRP) portal; and Google Scholar. Search terms were harvested according to their demonstrated success in drawing out relevant and complete results for studies regarding the effectiveness of opioid‐specific medication‐assisted therapies (MATs). From this process 5 core search strings were created, each one with the same general base terms, but unique outcome measure(s). Analysis For binary offending outcomes (e.g., arrest, conviction, incarceration, specialty court failure, mandated treatment failure, or community supervision failure) and overdose outcomes, odds ratios were computed, and for continuous or quasi‐continuous outcomes (e.g., total number of arrests), a standardized mean difference type effect size was computed and then transformed into an odds ratio. We used the χ2 test that goes with the forest plot and computed the I2 statistic to assess heterogeneity. Risk of bias was assessed with (1) the revised Cochrane risk‐of‐bias tool for randomized trials; and (2) the risk of bias in non‐randomized studies of interventions assessment tool.

Simple Summary Dolphin Assisted Therapies (DAT) can be used with any person or group with specific needs and it can be as disparate as people at risk of social exclusion, eating disorders, terminally ill, mental health disorders, among many others. This paper is focused on measuring and analyzing dolphins brain activity when DAT is taking place, in order to identify if there is any differences in female dolphin’s neuronal signal when it is interacting with control or intervention subjects. In addition, we designed a wireless and portable electroencephalographic single-channel signal capture device to monitor the brain activity of a female bottle-nose dolphin. Our findings also validate the evidence that the interaction between a patient with a certain disease or disorder and undergoes to a DAT modifies usual brain activity behavior of a female bottle-nose dolphin. Abstract Dolphin-Assisted Therapies (DAT) are alternative therapies aimed to reduce anxiety levels, stress relief and physical benefits. This paper is focused on measuring and analyzing dolphins brain activity when DAT is taking place in order to identify if there is any differences in female dolphin’s neuronal signal when it is interacting with control or intervention subjects, performing our research in Delfiniti, Ixtapa, Mexico facilities. We designed a wireless and portable electroencephalographic single-channel signal capture sensor to acquire and monitor the brain activity of a female bottle-nose dolphin. This EEG sensor was able to show that dolphin activity at rest is characterized by high spectral power at slow-frequencies bands. When the dolphin participated in DAT, a 23.53% increment in the 12–30 Hz frequency band was observed, but this only occurred for patients with some disease or disorder, given that 0.5–4 Hz band keeps it at 17.91% when there is a control patient. Regarding the fractal or Self-Affine Analysis, we found for all samples studied that at the beginning the dolphin’s brain activity behaved as a self-affine fractal described by a power-law until the fluctuations of voltage reached the crossovers, and after the crossovers these fluctuations left this scaling behavior. Hence, our findings validate the hypothesis that the participation in a DAT of a Patient with a certain disease or disorder modifies the usual behavior of a female bottle-nose dolphin.

Although several studies have shown that dolphin-assisted therapy (DAT) may be beneficial for children with autism spectrum disorder (ASD), most of these studies have methodological weaknesses. This study tested the effectiveness of DAT in improving the social and communicative skills of children with ASD. We used a pretest- posttest design with a control group. The 48 participants were selected according to the following inclusion criteria: age between 4 and 5 years, diagnosis of ASD, and clear impairment in communication. Participants were randomly assigned to the groups: DAT and Therapy Without Dolphins (TWD). The research lasted 10 weeks. The intervention phase lasted 6 weeks and consisted of three weekly 45-min sessions, with a total of 18 sessions per participant. Therapy sessions for both groups, DAT and TWD, were conducted by a dolphin trainer and a health professional in the same facilities and under the same conditions, except for the use of the interaction with the dolphin as support for the activities. Three instruments were used to assess communicative and social skills: The Autism Diagnostic Observation Schedule-Generic, the Reynell Developmental Language scales, and the Vineland Adaptive Behavior scales. Significant improvements were observed between the pretests and posttests in both groups, DAT and TWD, on the total scores of all the scales, except for the Social Interaction Domain of the ADOS-G. These improvements were significantly greater for the DAT group on only two items of the Language and Communication Domain, ADOS-G: "frequency of vocalizations toward others" and "gestures" (η2 = 0.11, p < 0.05) in both cases. In conclusion, we found some evidence that DAT is a useful therapeutic intervention to foster the social and communication skills of children with ASD and that dolphins specifically can enhance the improvement of some communication-related aspects.

In the last 15 years, psychedelic substances, such as LSD and psilocybin, have regained legitimacy in clinical research. In the general population as well as across various psychiatric populations, mental well-being has been found to significantly improve after a psychedelic experience. Mental well-being has large socioeconomic relevance, but it is a complex, multifaceted construct. In this naturalistic observational study, a comprehensive approach was taken to assessing well-being before and after a taking a psychedelic compound to induce a “psychedelic experience.” Fourteen measures of well-being related constructs were included in order to examine the breadth and specificity of change in well-being. This change was then analysed to examine clusters of measures changing together. Survey data was collected from volunteers that intended to take a psychedelic. Four key time points were analysed: 1 week before and 2 weeks, 4 weeks, and 2 years after the experience (N = 654, N = 315, N = 212, and N = 64, respectively). Change on the included measures was found to cluster into three factors which we labelled: 1) “Being well”, 2) “Staying well,” and 3) “Spirituality.” Repeated Measures Multivariate Analysis of Variance revealed all but the spirituality factor to be improved in the weeks following the psychedelic experience. Additional Mixed model analyses revealed selective increases in Being Well and Staying Well (but not Spirituality) that remained statistically significant up to 2 years post-experience, albeit with high attrition rates. Post-hoc examination suggested that attrition was not due to differential acute experiences or mental-health changes in those who dropped out vs. those who did not. These findings suggest that psychedelics can have a broad, robust and sustained positive impact on mental well-being in those that have a prior intention to use a psychedelic compound. Public policy implications are discussed.

Background: Although dog-assisted therapy (DAT) has been used for years, there is still a scarcity of research findings confirming efficacy of the method. The current study was designed to assess effects of DAT on psychomotor development of children with mild intellectual disabilities. Material and method: The study involved 60 children with mild intellectual disabilities, aged 10&ndash, 13 years, divided into a group participating in a 10-month DAT program, and the control group. Four tests were applied, i.e., finger identification, postural imitation, kinaesthesia, and Bourdon-Wiersma Dot Cancellation Test. The examinations were carried out before the start and at the end of the DAT, and at a two-month follow-up. Results: The results obtained by the DAT group in all the four tests, at all the three timepoints, were not the same (p &lt, 0.001). No statistically significant differences were found in the measurement at the end of the therapy between the DAT group and the controls. On the other hand, the DAT group achieved significantly better scores (p = 0.001 and p = 0.001), compared to the control, in the follow-up measurements two months after the end of the therapy in postural imitation and finger identification tests. Conclusions: Some of the scores achieved by the children in the DAT group improved in the measurements performed over time. Two months after the therapy ended, the children in the DAT group presented greater gains in motor planning (postural imitation test) and in the sense of touch, attention, and concentration (finger identification test), compared to the control group. Although the measurement performed immediately after the therapy did not show significant differences between the DAT group and the controls, the examination carried out at the two-month follow-up identified long-term gains in the treatment group in the domain of motor planning (postural imitation test).

(1) Background: Currently, the scientific evidence on the benefits of assisted therapy with dogs in dementia is not clear. In this study, we want to evaluate such benefits through a randomized controlled clinical trial in multiple centers across the country. (2) Methods: The participants were people over 65 years old with dementia, residing in senior centers in Spain (n = 334). The experimental group underwent assisted therapy with dogs based on the Comprehensive Cognitive Activation Program in Dementia, for 8 months, with weekly sessions of 45 min. Data were collected at the commencement, middle, and end of the program, to evaluate the aspects using the Mini-Examination Cognitive, the modified Bartell Index, the Cornell Scale for Depression in Dementia and the Neuropsychiatric Inventory. (3) Results: The results show significant improvements in the experimental group versus the control group in the affective (T1 = p 0.000, T2 = p 0.000) and behavioral (T1 = p 0.005, T2 = 0.000) aspects, with the affective aspect displaying greater progress in participants with additional depressive (p = 0.022) or anxiety (p = 0.000) disorders, shorter institutionalization periods (r = −0.222, p = 0.004), and those undergoing complementary psychotherapy (p = 0.033) or alternative therapy (p = 0.011). (4) Conclusions: Dog therapy is effective in improving the affective and behavioral aspects of institutionalized patients with dementia.

The recent proliferation of sensors technology applications in therapies to children disabilities to promote positive behavior among such children has produced optimistic results in developing a variety of skills and abilities in them. Dolphin-Assisted Therapy (DAT) has also become a topic of public and research interest for these disorders intervention and treatment. This work exposes the development of a computational system that controls brain-computer interaction whena patient with different abilities takes a DAT. The study was carried out at Definiti Ixtapa, Guerrero facilities and shows that brain activity increases by 376% during a DAT. A TGAM1 sensor was used to develop the system, which is connected to the Bluetooth 4.0 communication protocol, which is isolated from environmental conditions, which is brackish and humid. In this way, we explore the behavior of Obsessive Compulsive Disorder and neurotypic children using Fast Fourier Transform (FFT) from Electroencephalogram (EEG). The EEG RAW data are time series that showed the cerebral brain activity, voltage versus time, at restand during a DAT for both children, as recorded by the first frontopolar electrode (FP1) by means of an EEG biosensor TGAM1 Module. Our findings indicate that this computational system measures the RAW EEG fluctuations during DAT display a collective behavior with positive increments of neuronal activity that could be followed by much more neural activity. Thus, the brain could react to DAT gradually over a period oftime. In addition, the patient with OCD gets an apparent relaxation since its Power Spectrum Density (PSD) decreases 20% regarding its initial rest state meanwhile the control patient increases its PSD 53% regarding its initial rest state.

Functional neurological disorders (FNDs), which are sometimes also referred to as psychogenic neurological disorders or conversion disorder, are common disabling neuropsychiatric disorders with limited treatment options. FNDs can present with sensory and/or motor symptoms, and, though they may mimic other neurological conditions, they are thought to occur via mechanisms other than those related to identifiable structural neuropathology and, in many cases, appear to be triggered and sustained by recognizable psychological factors. There is intriguing preliminary evidence to support the use of psychedelic‐assisted therapy in a growing number of psychiatric illnesses, including FNDs. We review the theoretical arguments for and against exploring psychedelic‐assisted therapy as a treatment for FNDs. We also provide an in‐depth discussion of prior published cases detailing the use of psychedelics for psychosomatic conditions, analyzing therapeutic outcomes from a contemporary neuroscientific vantage as informed by several recent neuroimaging studies on psychedelics and FNDs.

Background Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic, and little is known regarding the gut microbiota dynamics of the disease that often features a drastic and swift progression. Here we employed analyses of 16S rRNA gene sequencing and metatranscriptome to investigate the gut microbiome characteristics of a group of COVID-19 patients over the course of a probiotics-assisted therapy. Results The COVID-19 patients exhibited apparent microbiota alterations characterized by prominent compositional and functional shifts, which included taxonomic changes (e.g., increased relative abundance of Enterococcus and Rhodococcus, and decreased relative abundance of Faecalibacterium and Clostridium XlVa) and transcriptional changes (e.g., increased transcriptional activities of Escherichia coli and Klebsiella pneumoniae, virulence factors, and antibiotic resistance genes, and decreased activities of Faecalibacterium prausnitzii). Importantly, there were great interpersonal heterogeneity and intertimepoint fluctuations, as the most abundant or transcriptionally active taxa often greatly differed among individual patients and timepoints. Coincided with the resolution of respiratory symptoms, after the therapy some patients showed signs of recovery in the gut microbiome abnormalities. Associations were identified between gut and airway taxa and serum factors. Conclusion Our findings suggested that there is a lack of gut microbiota stability in COVID-19 patients and that measures are needed to ameliorate the gut microbiome perturbations in the patients to improve the prognosis. In addition, inclusion of probiotics is safe for treating COVID-19 patients and may improve their prognosis. Trial registration ISRCTN, ChiCTR2000029999. Registered 19 February 2020, http://www.chictr.org.cn/showprojen.aspx?proj=49717

The recent proliferation of sensor technology applications in therapies to children disabilities to promote positive behavior among such children has produced optimistic results in developing a variety of skills and abilities in them. Dolphin-Assisted Therapy (DAT) has also become a topic of public and research interest for these disorders intervention and treatment. This work exposes the development of a system that controls brain-computer interaction when a patient with different abilities undergoes a DAT. To develop the proposed system, TGAM1, i.e., ThinkGear-AM1 series of NeuroSky company was used, connecting it to an isolated Bluetooth 4.0 communication protocol from a brackish and humid environment, and a Notch Filter was applied to reduce the input noise. In this way, at Definiti Ixtapa-Mexico facilities, we explored the behavior of three-children with Infantile Spastic Cerebral Palsy (Experiment 1), as well as the behavior of Obsessive Compulsive Disorder and neurotypic children (Experiment 2). This was done applying the Power Spectrum Density (PSD) and the Self-Affine Analysis (SSA) from EEG biosignals. The EEG Raw data were time series showing the cerebral brain activity (voltage versus time) Before and During DAT for the Experiment 1, and Before, During DAT and After for the Experiment 2. Likewise, the EEW RAW data were recorded by the first frontopolar electrode (FP1) by means of an EEG biosensor TGAM1 Module. From the PSD we found that in all child-patients an huge increment of brain activity During DAT regarding the Before and After therapy around of 376.28 %. And from the SSA we found that the structure function of the all five child-patients displayed an antipersistent behavior, characterized by &sigma, &delta, t H , for Before, During DAT and After. Nonetheless, we propose that one way to assess whether a DAT is being efficient to the child-patients is to increase the During DAT time when the samples are collected, supposing the data fitting by a power law will raise over the time, displaying a persistent behavior or positive correlations, until appear a crossover and the curve tends to be horizontal, pointing out that our system has reached a stationary state.

This work presents the HSS-Cognitive project, which is a Healthcare Smart System that can be applied in measuring the efficiency of any therapy where neuronal interaction gives a trace whether the therapy is efficient or not, using mathematical tools. The artificial intelligence of the project underlies in the understanding of brain signals or Electroencephalogram (EEG) by means of the determination of the Power Spectral Density (PSD) over all the EEG bands in order to estimate how efficient was a therapy. Our project HSS-Cognitive was applied, recording the EEG signals from two patients treated for 8 min in a dolphin tank, measuring their activity in five experiments and for 6 min measuring their activity in a pool without dolphin in four experiments. After applying our TEA (Therapeutic Efficiency Assessment) metric for patient 1, we found that this patient had gone from having relaxation states regardless of the dolphin to attention states when the dolphin was presented. For patient 2, we found that he had maintained attention states regardless of the dolphin, that is, the DAT (Dolphin Assisted Therapy) did not have a significant effect in this patient, perhaps because he had a surgery last year in order to remove a tumor, having impact on the DAT effectiveness. However, patient 2 presented the best efficiency when doing physical therapy led by a therapist in a pool without dolphins around him. According to our findings, we concluded that our Brain-Inspired Healthcare Smart System can be considered a reliable tool for measuring the efficiency of a dolphin-assisted therapy and not only for therapist or medical doctors but also for researchers in neurosciences.

Pawluczuk Paulina, Kusz Monika, Maślak Agnieszka, Alzubedi Adam, Polski Paweł. Positive effects of Dog Assisted Therapy in the Pediatric Population. Journal of Education, Health and Sport. 2020;10(5):128-132. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.05.013 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.05.013 https://zenodo.org/record/3831102 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 24.04.2020. Revised: 30.04.2020. Accepted: 17.05.2020. Positive effects of Dog Assisted Therapy in the Pediatric Population Pawluczuk Paulina1, Kusz Monika1, Maślak Agnieszka1, Alzubedi Adam2, Polski Paweł2 1. Department of Paediatric Nephrology, Medical University of Lublin 2. Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin Abstract Dog Assisted Therapy is a prevalent part of therapeutic process in pediatric population. It is a modern and constantly developing intervention. Dog Assisted Therapy is utilized with pervasive development disorders. Most of studies confirmed that Autistic Spectrum Disorder, Down Syndrome or Cerebral Palsy may benefit from Dog Assisted Therapy. It is important to emphasise the role od Dog Assisted Therapy in improving children mental and physical development. Key worlds: Dog Assisted Therapy; pediatrics

Introduction: Robot-assisted therapy is an emerging approach that performs highly repetitive, intensive, task oriented and quantifiable neuro-rehabilitation. In the last decades, it has been increasingly used in a wide range of neurological central nervous system conditions implying an upper limb paresis. Results from the studies are controversial, for the many types of robots and their features often not accompanied by specific clinical indications about the target functions, fundamental for the individualized neurorehabilitation program. Areas covered: This article reviews the state of the art and perspectives of robotics in post-stroke rehabilitation for upper limb recovery. Classifications and features of robots have been reported in accordance with technological and clinical contents, together with the definition of determinants specific for each patient, that could modify the efficacy of robotic treatments. The possibility of combining robotic intervention with other therapies has also been discussed. Expert commentary: The recent wide diffusion of robots in neurorehabilitation has generated a confusion due to the commingling of technical and clinical aspects not previously clarified. Our critical review provides a possible hypothesis about how to match a robot with subject’s upper limb functional abilities, but also highlights the need of organizing a clinical consensus conference about the robotic therapy.

Objetivo: Confirmar la factibilidad y analizar los cambios ocurridos en el equilibrio y la motricidad fina de un grupo de personas con discapacidad física tras un programa de rehabilitación física realizado con perros de terapia. Método: Un total de 10 personas adultas con discapacidad física participaron en un programa de terapia asistida con perros durante un trimestre, a razón de una sesión mensual de dos horas de duración. La muestra se dividió en dos grupos en función de su nivel de afectación física y se establecieron objetivos distintos para los mismos: mejora del equilibrio estático, dinámico y riesgo de caídas, valorado mediante la escala Tinetti (Grupo 1), mejora de la motricidad fina y coordinación valorada mediante la batería MABC-2 (Grupo 2). Resultados: El programa se mostró factible sin registro de efectos adversos ni abandonos. En el grupo-1 se observaron cambios pre-post en todas las variables de equilibrio y marcha evaluadas. En todos los casos fueron cambios interpretables como mejora y estadísticamente significativos. En el grupo-2 se observaron también cambios pre-post se observó un modesto porcentaje de ensayos fallidos y mientras que en el 49.6% restante se documentaron ensayos fallidos. Las 2/3 partes de los cambios observados en el grupo-2 fueron interpretables como mejora, pero ninguno estadísticamente significativo. Conclusiones: El empleo de perros como estrategia de terapia asistida en personas con discapacidad física es una opción rehabilitadora factible y de interés, que puede conllevar mejoras en su equilibrio, si bien tiene un impacto de poca magnitud en su nivel de motricidad fina y coordinación, Objective: To confirm the feasibility and analyze the changes occurred in the balance and fine motor function of a group of people with physical disability after a physical rehabilitation program performed with therapy dogs. Methods: A total of 10 adult people with physical disability took part in a program of assisted therapy with dogs during a trimester through a 2-hours monthly session. The sample was divided into two groups according to their level of physical involvement, and different objectives were established for each of the groups: static balance enhancement, dynamic and falling risk valued with Tinetti scale (Group 1), fine motor function enhancement and coordination valued with battery MABC-2 (Group 2). Results: The program was shown to be feasible with no record of adverse effects or dropouts. In group 1, pre-post changes were observed in all balance and gait variables evaluated. In all cases these were changes that could be interpreted as improvements and were statistically significant. In group 2, prepost changes were observed in only half of the cases (51.4%), while in the remaining 49.6% failed trials were documented. Two-thirds of the changes observed in group-2 were interpretable as improvement, but none were statistically significant. Conclusions: Using dogs as strategy of assisted therapy in people with physical disability is a feasible and interesting rehabilitation option, which can carry improvements in their balance, while it has a small impact in their fine motor function and coordination

Background In the past years, robotic systems have become increasingly popular in upper limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients’ individual motor deficits has been suggested as a pivotal step to improve the clinical outcome of such approaches. Methods Here, we present a model-based approach to personalize robot-aided rehabilitation therapy within training sessions. The proposed method combines the information from different motor performance measures recorded from the robot to continuously estimate patients’ motor improvement for a series of point-to-point reaching movements in different directions. Additionally, it comprises a personalization routine to automatically adapt the rehabilitation training. We engineered our approach using an upper-limb exoskeleton. The implementation was tested with 17 healthy subjects, who underwent a motor-adaptation paradigm, and two subacute stroke patients, exhibiting different degrees of motor impairment, who participated in a pilot test undergoing rehabilitative motor training. Results The results of the exploratory study with healthy subjects showed that the participants divided into fast and slow adapters. The model was able to correctly estimate distinct motor improvement progressions between the two groups of participants while proposing individual training protocols. For the two pilot patients, an analysis of the selected motor performance measures showed that both patients were able to retain the improvements gained during training when reaching movements were reintroduced at a later stage. These results suggest that the automated training adaptation was appropriately timed and specifically tailored to the abilities of each individual. Conclusions The results of our exploratory study demonstrated the feasibility of the proposed model-based approach for the personalization of robot-aided rehabilitation therapy. The pilot test with two subacute stroke patients further supported our approach, while providing encouraging results for the applicability in clinical settings. Trial registration This study is registered in ClinicalTrials.gov (NCT02770300, registered 30 March 2016, https://clinicaltrials.gov/ct2/show/NCT02770300)