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Although previous studies have shown that preoperative pulmonary rehabilitation training may improve postoperative prognosis in patients with lung cancer, the literature included in the existing meta-analysis is highly heterogeneous and lacks effective subgroup analysis. Therefore, an updated meta-analysis is needed to integrate the latest published randomized controlled clinical trials (RCT). This updated analysis was performed to identify the clinical effects of preoperative pulmonary rehabilitation on physical rehabilitation (lung function, activity endurance, and dyspnea), psychological rehabilitation, quality of life, length of hospital stay, and postoperative pulmonary complications in patients with lung cancer. The PubMed, Embase, Cochrane Library, and Web of Science database were searched since inception up to March 2024. A random-effects model was used to pool data, and sensitivity and subgroup analyses were performed to explore the stability of outcomes and potential sources of heterogeneity. All analyses were conducted via Review Manager 5.4.1 and STATA 15.0. The final analysis included 11 RCTs with 1250 patients. The results of meta-analysis suggest that preoperative pulmonary rehabilitation can significantly improve the quality of life of patients with lung cancer after surgery (SMD: 0.16; 95% CI: 0.01, 0.32; P = 0.04) and significantly reduce the risk of postoperative pulmonary complications (PPCs) (RR: 0.39; 95% CI: 0.25, 0.60; P < 0.0001). The results of subgroup analysis suggested that the effect of combined preoperative and postoperative rehabilitation was significantly better than that of preoperative rehabilitation alone, and the effect of short-term preoperative pulmonary rehabilitation (≤ 3 weeks) was significantly better than that of long-term rehabilitation. Preoperative pulmonary rehabilitation for patients with lung cancer can significantly improve their postoperative quality of life and reduce postoperative complications, but factors such as intervention time and intervention method may affect the rehabilitation effect. [ABSTRACT FROM AUTHOR]

Objective To explore the application effect of nutritional pre-rehabilitation in perioperative period of patients with gynecological malignant tumor surgery. Methods A total of 100 patients with gynecological malignant tumors who underwent open surgery in the hospital from January 2022 to July 2023 were selected and divided into control group and experimental group by random number table method, with 50 cases in each group. The patients in the control group were treated with stepwise rapid rehabilitation diet management and nursing. The patients in the experimental group were treated with nutritional pre-rehabilitation nursing on the basis of the control group. The serum total protein and albumin were compared between the two groups at the time of admission, the second day after operation and the fifth day after operation. The incidence of poor wound healing, postoperative malnutrition, postoperative hypoproteinemia, intestinal obstruction, urinary tract infection, deep venous thrombosis of lower extremity, pneumonia and pressure injury, the first anal exhaust time, the first time to get out of bed and the hospitalization time were compared between the two groups. Results The serum total albumin and albumin values of the two groups of patients on admission, on the 2nd and 5th day after operation decreased first and then increased. The serum total protein and albumin on the 2nd and 5th day after operation were significantly different from those on admission (P<0.001). There was no significant difference in serum total protein value between the two groups on the 2nd day after operation and the 5th day after operation (P > 0.05) . The albumin values of the two groups on the second day after operation were significantly different from those on the fifth day after operation (P < 0.05) The serum total albumin and albumin values of the experimental group were higher than those of the control group on the 2nd and 5th day after operation, and the differences were statistically significant (P < 0.05) . The incidence of poor wound healing, postoperative malnutrition and postoperative hypoproteinemia in the experimental group were lower than those in the control group, the differences were statistically significant (P < 0.05) . There were no significant differences in postoperative urinary tract infection, lower extremity deep venous thrombosis, pneumonia and pressure injury between the two groups (P > 0.05) The first anal exhaust time, first ambulation time and hospitalization time in the experimental group were shorter than those in the control group, and the differences were statistically significant (P < 0.05) . Conclusion Nutritional pre-rehabilitation can improve perioperative nutrition, improve prognosis, reduce postoperative complications, shorten postoperative gastrointestinal function recovery time and hospitalization time, and accelerate patient recovery in patients with gynecological malignant tumors. [ABSTRACT FROM AUTHOR]

Abstract Although previous studies have shown that preoperative pulmonary rehabilitation training may improve postoperative prognosis in patients with lung cancer, the literature included in the existing meta-analysis is highly heterogeneous and lacks effective subgroup analysis. Therefore, an updated meta-analysis is needed to integrate the latest published randomized controlled clinical trials (RCT). This updated analysis was performed to identify the clinical effects of preoperative pulmonary rehabilitation on physical rehabilitation (lung function, activity endurance, and dyspnea), psychological rehabilitation, quality of life, length of hospital stay, and postoperative pulmonary complications in patients with lung cancer. The PubMed, Embase, Cochrane Library, and Web of Science database were searched since inception up to March 2024. A random-effects model was used to pool data, and sensitivity and subgroup analyses were performed to explore the stability of outcomes and potential sources of heterogeneity. All analyses were conducted via Review Manager 5.4.1 and STATA 15.0. The final analysis included 11 RCTs with 1250 patients. The results of meta-analysis suggest that preoperative pulmonary rehabilitation can significantly improve the quality of life of patients with lung cancer after surgery (SMD: 0.16; 95% CI: 0.01, 0.32; P = 0.04) and significantly reduce the risk of postoperative pulmonary complications (PPCs) (RR: 0.39; 95% CI: 0.25, 0.60; P

Objective The purpose of this study is to explore the promotion and obstacle factors of virtual reality technology in the pre-rehabilitation application of degenerative lumbar spine diseases. Methods The method is based on the Comprehensive Framework for Implementation Research (CFIR) and adopts a qualitative research method. Through purposive sampling, semi-structured interviews were conducted with 10 patients and 5 nurses using virtual reality devices in The Second Hospital of Tangshan, and the interview content was analyzed. Results The promoting factors for the implementation of pre-rehabilitation projects based on virtual reality technology in patients with degenerative lumbar spine diseases include relative advantages in innovation and communication in internal feature areas, urgency for change, and compatibility with existing workflows; Obstacle factors include innovation costs, design quality, and packaging in the field of innovation, collaborative relationships in external feature factors, incentive systems, and accessibility of knowledge and information in internal feature areas; Neutral factors include locations in the internal feature domain, implementation facilitators in the individual feature domain, and feedback and evaluation in the implementation process domain. Conclusion Virtual reality technology can promote better implementation of pre-rehabilitation for degenerative lumbar spine diseases, thereby reducing perioperative kinesiophobia, alleviating pain, and promoting rapid recovery; But it is important to choose appropriate and comfortable equipment to provide personalized, diversified, and gamified rehabilitation programs to overcome its obstacles. (目的 探讨虚拟现实技术在退行性腰椎疾病预康复中应用的促进和障碍因素。方法 以实施性研究综合框架(CFIR)为理论基础, 采用质性研究方法, 通过目的抽样, 对唐山市第二医院脊柱科10名应用虚拟现实设备的患者和5名护士进行半结构式访谈, 并对访谈内容进行分析。结果 基于虚拟现实技术预康复项目在退行性腰椎疾病患者中实施的促进因素包括创新领域中的创新相对优势及内部特征领域中的沟通、变革的迫切性和与现有工作流程相符的兼容性; 障碍因素包括创新领域中的创新成本及设计质量和包装, 外部特征因素领域的协作关系, 内部特征领域中的激励制度及知识和信息的可及性; 中性因素包括内部特征领域中的场所, 个体特征领域中的实施促进者, 实施过程领域中的反馈与评价。结论 虚拟现实技术可以促进退性腰椎疾病预康复更好的实施, 从而降低患者围手术期恐动程度, 减轻疼痛, 促进快速康复; 但要选择合适舒适的设备提供个性化、多元化、游戏化的康复项目以克服其障碍因素。)

There is no universally accepted definition for surgical prehabilitation. The objectives of this scoping review were to (1) identify how surgical prehabilitation is defined across randomised controlled trials and (2) propose a common definition. The final search was conducted in February 2023 using MEDLINE, Embase, PsycINFO, Web of Science, CINAHL, and Cochrane. We included randomised controlled trials (RCTs) of unimodal or multimodal prehabilitation interventions (nutrition, exercise, and psychological support) lasting at least 7 days in adults undergoing elective surgery. Qualitative data were analysed using summative content analysis. We identified 76 prehabilitation trials of patients undergoing abdominal (n=26, 34%), orthopaedic (n=20, 26%), thoracic (n=14, 18%), cardiac (n=7, 9%), spinal (n=4, 5%), and other (n=5, 7%) surgeries. Surgical prehabilitation was explicitly defined in more than half of these RCTs (n=42, 55%). Our findings consolidated the following definition: 'Prehabilitation is a process from diagnosis to surgery, consisting of one or more preoperative interventions of exercise, nutrition, psychological strategies and respiratory training, that aims to enhance functional capacity and physiological reserve to allow patients to withstand surgical stressors, improve postoperative outcomes, and facilitate recovery.' A common definition is the first step towards standardisation, which is needed to guide future high-quality research and advance the field of prehabilitation. The proposed definition should be further evaluated by international stakeholders to ensure that it is comprehensive and globally accepted. [ABSTRACT FROM AUTHOR]

The literature review evaluates the rehabilitation measures in the country's oncological institutions, assesses regulations in other countries, and scientific publications related to the rehabilitation of cancer patients. Studies were analysed using electronic databases PubMed, Medline, Science Direct, Scopus, Web of Science, e-Library, RSL. Over 47,900 sources were found, of which 50 papers over the past ten years were selected and included in the article. The criteria for inclusion were the rehabilitation of cancer patients, stages of rehabilitation, pre-rehabilitation, nutritional support, psychological assistance, and quality of patients’ life. Considering the urgency of the problem, WHO 2017 took the initiative and adopted the Rehabilitation 2030 program, which provides expanding global access to high-quality rehabilitation as an essential health service for people with non-communicable diseases. According to summarized data, rehabilitation is based on the following principles: stage-by-stage process, consistency, complexity, and individual approach. The stages of medical rehabilitation of cancer patients include pre-rehabilitation; stage I – a period of specialized treatment; stage II – rehabilitation in a hospital setting after discharge; and stage III – early and late rehabilitation periods. An analysis of the situation in Tajikistan showed that in oncology-related institutions, rehabilitation of cancer patients is carried out within the framework of existing protocols for individual nosology, where a set of measures for the stages of rehabilitation is not sufficiently developed. A practical assessment of the effectiveness of rehabilitation is not set up. The stereotype about limiting the use of physiotherapy and sanatorium-resort treatment for cancer patients persists. There are no regulations for comprehensive rehabilitation of cancer patients. The need to optimize treatment results, prolong the survival of patients with various functional disorders, and improve the quality of life dictates the necessity for the development and systematic implementation of comprehensive rehabilitation of cancer patients.

Objective: To explore the effectiveness and feasibility of strengthening inspiratory muscle training program matching the preoperative waiting time for patients with valvular heart disease in China with limited resources in preventing postoperative pulmonary complications(PPCs). Method: Patients undergoing elective heart valve surgery were randomly divided into control group and intervention group, with 65 patients in each group. All the enrolled patients received a routine physical therapy program before surgery, and the intervention group received an additional 3 days of enhanced inspiratory muscle training program before surgery. The incidence of postoperative complications was recorded for all patients within 14 days after surgery, respiratory function and motor capacity (6-minute walking test) were tested for all patients on the day of admission and discharge, and the length of postoperative hospital stay was counted. Result: Compared with the control group, the incidence of PPCs was lower in the intervention group (OR 2.18, 95% CI 1.07—4.47, P=0.03), and the walking distance was longer (P=0.01). There was no statistical difference in lung function and length of hospital stay (P>0.05), and no adverse events occurred during training. There was no significant difference in general demographic characteristics between the two groups before treatment. The incidence of PPCs in the intervention group was lower than that in the control group (P< 0.05), and the 6minute walking distance at discharge was higher than that in the control group (P<0.05). There were no statistically significant differences in lung function and postoperative hospital stay between the intervention group and the control group (P>0.05), and no adverse events occurred during training. Conclusion: Enhanced inspiratory muscle training 3 days before surgery is safe and feasible in patients with elective heart valves and can reduce postoperative pulmonary complications and improve the level of motor function at discharge. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of pre‐rehabilitation interventions such as nutrition and exercise for patients with head and neck cancer (HNC). Methods: Web of Science, PubMed, Scopus, Google Scholar, and Cochrane databases were searched up to December 2022. Quality of life, length of hospital stay, postoperative complications, change in body mass index or muscle mass, and functional assessments were the primary outcomes. PRISMA guidelines were adhered to, and the study was registered on PROSPERO. The Cochrane Collaboration tool and Newcastle Ottawa scale assessed the quality of included studies. Pooled data are presented as odds ratios (OR) and 95% confidence intervals (CI). Analysis was conducted using RevMan5.4. Results: A total of 31 articles were included for quantitative analysis and 15 for qualitative synthesis. Nutrition alone resulted in significant weight retention (2.60; 2.32, 2.88, p < 0.00001), length of stay (−4.00; −6.87, −1.13), p = 0.0006) and complications (0.64; 0.49, 0.83, p = 0.0009). Nutrition and psychoeducation resulted in a significant reduction in mortality rate (0.70; 0.49, 1.00, p = 0.05 and 0.60; 0.48, 0.74, p < 0.00001), and exercise resulted in a significant reduction in dysphagia (0.55; 0.35, 0.87, p = 0.01). Exercise with nutrition resulted in significant improvements in weight loss, length of stay, complications, and dysphagia. Randomized controlled trials (RCTs) had a moderate risk of bias and cohort studies were of fair to good quality. Conclusion: Prehabilitation programs based on exercise, nutrition, or psychoeducation demonstrated improved post‐interventional outcomes in HNC, such as quality of life, and mortality and morbidity. Studies with longer follow‐ups and larger sample sizes, and investigations comparing nutritional supplements with exercise programs are needed. [ABSTRACT FROM AUTHOR]

Background: Despite gradually increasing evidence for pre-rehabilitation for heart valve surgery, it remains underused, especially in developing countries with limited resources. The study aimed to investigate the feasibility and effects of an innovative three-day prerehabilitation bundle for patients undergoing elective heart valve surgery. Methods: This was a single-center, assessor-blind, randomized clinical trial. A total of 165 patients were randomly assigned to either usual care (control group, n = 83) or usual care with an additional 3-day pre-rehabilitation bundle (Three-day of Inspiratory muscle training, aerobic Muscle training, and Education (TIME) group, n = 82). The main outcome of the study was the incidence of postoperative pulmonary complications (PPCs). Secondary outcomes included the feasibility of the intervention, duration of the non-invasive ventilator, length of stay, and PPCs-related medical costs on discharge. Results: Of 165 patients 53.94% were male, the mean age was 63.41 years, and PPCs were present in 26 of 82 patients in the TIME group and 44 of 83 in the control group (odds ratio (OR), 0.60; 95% CI, 0.41–0.87, p = 0.006). The feasibility of the pre-rehabilitation bundle was good, and no adverse events were observed. Treatment satisfaction and motivation scored on 10-point scales, were 9.1 ± 0.8 and 8.6 ± 1.4, respectively. The TIME group also had fewer additional PPCs-related medical costs compared to the control group (6.96 vs. 9.57 thousand CNY (1.01 vs. 1.39 thousand USD), p < 0.001). Conclusions: The three-day accessible pre-rehabilitation bundle reduces the incidence of PPCs, length of stay, and PPCs-related medical costs in patients undergoing elective valve surgery. It may provide an accessible model for the expansion of pre-rehabilitation in countries and regions with limited medical resources. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of preoperative pre-rehabilitation on postoperative gastrointestinal function, nutritional indicators, quality of life and adverse reactions in patients with gastric cancer. Methods A total of 66 patients who underwent radical gastrectomy for gastric cancer in the 901st Hospital of Joint Logistics Support Force of the CPLA from November 2019 to March 2022 were selected as the research subjects. The patients were divided into control group (n=35) and study group (n=31) by random number table method. The control group received routine preoperative preparation, and the study group received preoperative pre-rehabilitation. Postoperative gastrointestinal function recovery (first postoperative exhaust time, defecation time and the time to first oral feeding), serum nutritional indicators ［total protein (TP), albumin (Alb), prealbumin (PA) and hemoglobin (Hb)］, postoperative gastrointestinal adverse reactions during enteral nutrition, and the generic quality of life inventory-74 (GQOL-74) scores were compared between two groups. Results The time to first oral feeding, defecation recovery time and exhaust time in the study group after operation were significantly shorter than those in the control group (P

Abstract Background Secondary anterior cruciate ligament (ACL) ruptures are a relevant clinical concern after surgical treatment of a primary ACL rupture. However, there is a lack of scientific evidence related to the role of muscle strength prior to revision surgery in a second ACL rupture. The aim of this study was to assess differences in knee extensor and flexor strength in patients before primary and secondary ACL reconstruction compared to healthy controls. Methods In total, n = 69 age, weight and sex matched individuals were included in the study: n = 23 patients with isolated primary ACL rupture, n = 23 with secondary ACL rupture, and n = 23 matched healthy controls. Maximal isokinetic knee extension and flexion torque normalized to body mass was assessed for both legs. Results For patients with secondary ACL ruptures, torques were reduced in the non-injured (extension: 1.94 Nm/kg vs. 2.46 Nm/kg, p

During the past decades, the prevalence of cancer diseases of female reproductive system has been constantly growing. The issue is especially acute in reproductive-age women because of earlier oncological pathology onset. Morpho-functional disorders and aggressive methods of anti-tumor therapy significantly affect the patients’ quality of life, psychological well-being, emotional stability, and family relationship, which leads to a limitation of physiological and social possibilities. Rehabilitation programs for oncological patients target to prevent unwanted sequela of the disease, its therapy, and relapses. Pre-rehabilitation plays a special role. It includes psychological and specialized medical care for the patient during the period from the disease verification to the start of therapy. Timely rehabilitation measures reduce the rate of repeated hospitalizations for side effects of chemotherapy, radiotherapy complications, antitumor therapy, and radical surgical interventions. Rehabilitation as a part of standard therapeutic strategy can reduce pharmacoeconomical burden for the health care system. However, further clinical and pharmacoeconomic studies are required for the implementation of rehabilitation at the level of the health care system.

Background: Secondary anterior cruciate ligament (ACL) ruptures are a relevant clinical concern after surgical treatment of a primary ACL rupture. However, there is a lack of scientific evidence related to the role of muscle strength prior to revision surgery in a second ACL rupture. The aim of this study was to assess differences in knee extensor and flexor strength in patients before primary and secondary ACL reconstruction compared to healthy controls. Methods: In total, n = 69 age, weight and sex matched individuals were included in the study: n = 23 patients with isolated primary ACL rupture, n = 23 with secondary ACL rupture, and n = 23 matched healthy controls. Maximal isokinetic knee extension and flexion torque normalized to body mass was assessed for both legs. Results: For patients with secondary ACL ruptures, torques were reduced in the non-injured (extension: 1.94 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.25 Nm/kg vs. 1.59 Nm/kg, p < 0.05) and the injured leg (extension: 1.70 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.14 Nm/kg vs. 1.59 Nm/kg, p < 0.05) compared to healthy controls. For patients with a primary ACL rupture torques were reduced in the non-injured (extension: 1.92 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.24 Nm/kg vs. 1.59 Nm/kg, p < 0.05) and the injured leg (extension: 1.38 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.01 Nm/kg vs. 1.59 Nm/kg, p < 0.05) compared to healthy controls. There were no differences between patients with primary and secondary ruptures, except of the knee extension on the injured leg showing higher values after a secondary ACL rupture (1.38 Nm/kg vs. 1.70 Nm/kg, p < 0.05). Conclusions: The findings indicate that maximal knee torques were significantly reduced in patients with primary and secondary ACL ruptures before surgical reconstruction for the non-injured and injured leg as compared to healthy controls. Further investigations are needed to assess strength abilities before and after a second revision within a prospective design. [ABSTRACT FROM AUTHOR]

Background and Study Aim. The aim of this study is to investigate the effects CoBAgi Training which apply neuromuscular training, sport specific movements that couple with perturbation variation on coordination, dynamic balance and agility among adolescent handball players. Material and Methods. Quantitative randomized controlled trials quasi-experimental design with pretest and posttest evaluation used for this study. A total of 30 adolescent handball players (aged: 14.00 ± 0.83 years) were recruited as participants. Purposive sampling methods were used for these purposes. The participants were randomly assigned into two groups i.e. control group (CG: n=15) and experimental group (EG: n=15). EG undergone six weeks CoBAgi training while CG followed their usual training routine with supervision of the researcher, there times a week for 6 weeks. In order to measure the effect of these training on coordination, dynamic balance and agility, participants have performed Carioca Test, Star Excursion Balance Test (SEBT) and L-Run Test during pre-training and post-training session. The data were analyzed through Independent Samples t-test with p

Introduction and hypothesis: The objective was to evaluate pelvic floor muscle (PFM) function regarding strength, activation and incontinence, approximately 1 month before and after radiation therapy in women with cervical cancer. Methods: This was a pilot study of 49 women with cervical cancer at stages I to III. These women attended an educational session with a physical therapist who taught them to perform preventive pelvic floor muscle exercises (PFMEs; slow and fast contractions and the "knack") at home before, during and after radiation therapy. The women received instructions for performing PFME prior to radiation therapy. The modified Oxford scale, electromyography (EMG), the International Consultation on Incontinence Questionnaire Short Form to assess urinary incontinence and two questions for faecal and gas incontinence were used. Results: Twenty-eight women (57%; mean age = 44 years, range 27–66) completed the study, 21 (43%) were lost to follow-up. There was no significant change from baseline to post-radiation therapy in muscle strength, EMG records and incontinence (p > 0.05). The median of PFM strength was equal at baseline and after intervention (median = 2; IQR = 1). Conclusions: The results of this study suggest that pre-rehabilitation teaching PFMEs might be a protective factor for preserving PFM strength and preventing incontinence 1 month after radiation therapy. It is a feasible intervention. [ABSTRACT FROM AUTHOR]

Surgery is one of the leading treatment methods of patients with primary or recurrent malignant neoplasms in the thoracic or abdominal cavity. Extensive abdominal interventions are accompanied by such adverse outcomes as blood loss, hypoxia, inflammation, blood clotting abnormality, emotional and cognitive disorders, that increases the incidence of serious complications and worsens the treatment outcome and life quality in weakened oncological patients. Multimodal pre-rehabilitation before surgery can significantly decrease the incidence and severity of postoperative complications. The rehabilitation complex includes exercise therapy, nutritional and psychological support, smoking cessation and pharmacotherapy. Currently, there are a number of questions facing rehabilitation specialists and oncologists, that are related to the determination of pre-rehabilitation optimal timing and process duration, the choice of specific physical exercises, determining the load intensity. This review presents a current view on understanding of surgical stress in extensive abdominal interventions, its effect on the oncological process course, summarizes the experience of last years in choosing pre-rehabilitation program taking into account pathogenetic mechanisms of surgical stress and individual patient's characteristics. Special attention is paid to the comparison of physical exercises' various types, their action mechanisms at different stages of pathological process, the issues of load dosing during pre-rehabilitation activities.

: Introduction: The process of strengthening the functional capacity of the individual, which allows him to withstand operational stress, is called "pre-rehabilitation". In ERAS systems, patients are prepared for the stress of surgery through preoperative training, optimal nutrition and a set of physical exercises. Objective: The aim of the present study was to demonstrate the benefits and advantages of pre-rehabilitation in the early postoperative recovery of patients after diaphragmatic hernia surgery. TASKS: Identifying the need and opportunities for the introduction of pre-rehabilitation through a survey of nurses. Study of patients' needs for pre-rehabilitation. Performing a comparative analysis between two groups of comparable patients "With" and "Without" applied rehabilitation program. Methods: Documentary method - prospective and retrospective analysis of hospital documentation. Sociological method - a survey was conducted in 60 of the patients. Results and discussion: The 112-month period September 2010 - December 2019 was analyzed, during which 330 patients with diaphragmatic hernias were operated, of which 322 laparoscopic and 8 conventional. Of the hernias in the laparoscopic group, 306 were primary and 16 recurrent. 12 of the recurrences were after laparoscopic antireflux surgery and 4 after conventional surgery. The protocol for early postoperative recovery was applied in 240 of the patients, which is the analyzed group (Group A), and the remaining 90 patients are the control group (Group B). Patients in the study and control groups were comparable in age, comorbidity, risk factors for postoperative complications and type of hiatal hernia and surgery performed. Criteria analyzed: period of movement of the patient (with help and independently), term for recovery of the intestinal passage, presence, type and severity of postoperative complications and postoperative hospital stay. In study group A, in which the PCB protocol was applied, postoperative complications were 6.66% versus 11.2% in patients in group B, exercise was in the second postoperative hour, and postoperative hospital stay was 48 hours. Conclusion: The implementation of a RSV protocol allows for maximum reduction of hospital stay, reduction of postoperative complications, better quality of life for patients and minimization of costs (in the optimal amount, without compromising the quality of activity). [ABSTRACT FROM AUTHOR]

A diverse group of idiopathic inflammatory arthritis that affects children under the age of 16 and lasts six weeks or longer is known as juvenile idiopathic arthritis (JIA) or juvenile rheumatoid arthritis (JRA). It causes joint pain and morning stiffness, and the affected joints swell and become difficult to move. During flares, patients may experience flu-like symptoms such as muscle aches and fatigue. Disease-modifying antirheumatic drugs (DMARDs) are the mainstay of rheumatoid arthritis (RA) treatment. If necessary, immunosuppressive medications can be administered in stages. Nonsteroidal anti-inflammatory drugs (NSAIDs) are pain relievers for joints. Physical therapy treatment aims to reduce pain, improve joint range, correct movement patterns, strengthen weak structures, improve cardiovascular endurance, and improve patients' quality of life. We present a case of a 12-year-old boy who presented to the hospital with knee pain and an inability to walk without assistance after falling on the ground one month prior. Medical history revealed that the patient had juvenile rheumatoid arthritis, which was confirmed on investigations. The consultant physician referred the patient for pre-rehabilitation physiotherapy before corrective surgery., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Meghe et al.)

Objective: To explore the effects of trimodal pre-rehabilitation on the rehabilitation of patients with gastrointestinal tumors in the perioperative period., Methods: Clinical data of 878 patients with gastrointestinal tumors undergoing surgical treatment in our hospital were analyzed in this retrospective study. They were divided into a control group and an observation group. The patients in the control group received only routine preoperative education and guidance before operation, while those in the observation group received preoperative trimodal pre-rehabilitation. The nutritional status, sleep quality, psychological status, and physical function of two groups were compared 1 day before operation and at discharge. The postoperative complications, length of hospital stays, and hospitalization expenses were compared. The patients were followed up for three months after discharge from the hospital, and the quality of life between groups was compared., Results: The nutritional status of two groups 1 day before operation and at discharge was improved compared with that at admission (all P<0.001). The nutritional status in the observation group was better than that in the control group 1 day before operation. The scores of sleep quality, psychological status, and physical function of the observation group were higher than those in the control group 1 day before surgery and at discharge (all P<0.001). The observation group had shorter hospital stays and lower hospitalization expenses than the control group (all P<0.001). The 3-month follow-up after discharge showed that the observation group had higher quality of life than the control group (all P<0.05)., Conclusion: Trimodal pre-rehabilitation can improve the preoperative nutritional status, sleep quality, psychological state, and physical function of patients with gastrointestinal tumors during the perioperative period. Besides, it can shorten the hospital stays, reduce the total hospitalization expenses, and improve the quality of life of patients after discharge. It is worthy of clinical promotion., Competing Interests: None., (AJTR Copyright © 2022.)

Bronchopulmonary complications are one of the leading causes of morbidity after cardiac surgery; they lengthen a patient's hospital stay and increase the cost of treatment. The most common postoperative bronchopulmonary complications include pneumonia, atelectasis, respiratory failure, pneumothorax, and bronchospasm. These complications are the consequences of anesthesia and surgical trauma aggravated by the presence of risk factors in the patient in the preoperative period such as any chronic disease involving the lungs, smoking history, persistent cough and / or wheezing, chest and spinal deformities, obesity, senior age. In addition, the presence of chronic heart failure, diabetes mellitus, and chronic kidney disease also increase the risk of developing bronchopulmonary complications. In the prevention and treatment of bronchopulmonary complications the clinical effectiveness of rehabilitation programs after coronary artery bypass grafting is undeniable. The effectiveness of the programs has been proven on the basis of both domestic and foreign long-term in-practice and scientific research. However, despite the significant advances in cardiac rehabilitation there are a number of unresolved issues. Is it possible in a short period of time of the first stationary rehabilitation stage to form the patient's skill to perform breathing exercises and, accordingly, to obtain the maximum effect in the prevention of bronchopulmonary complications? What factors can affect the speed of motor skill formation in the patient's mastering of breathing exercises? What should be the frequency of procedures per day and the number of exercises when a physical therapy instructor works with a patient to increase the effectiveness of the prevention of bronchopulmonary complications in the postoperative period? What category of patients is strictly required for the pre-rehabilitation stage? How should the pre-rehabilitation stage be organized and how long should it take? All these questions require the work-out and implementation of scientifically grounded individual rehabilitation programs with a step-by-step algorithm for managing the patient by a rehabilitation multi-team from the first hours after surgery with the mandatory inclusion of pre-rehabilitation and taking into account the social, anamnestic, clinical and psychological characteristics of the patient.

Population aging is one of the most significant health problems of the 21st century and has led to an increased need for surgery in elderly patients. Only chronological age should not be decisive when indicating patients for elective procedures. Other objective findings should be taken into account too. The complex geriatric examination is an optimized, detailed and accurately defined method, which leads to better postoperative outcomes in elderly patients. In everyday practice it is sufficient to evaluate the mental, physical and nutritional state of the patient. The goal of our study was to evaluate the perioperative morbidity and mortality of elderly patients undergoing hepatopancreatobiliary procedures. In our retrospective study we evaluated prospectively collected data of patients who underwent surgical procedures between 2015 and March 2019. In total 245 patients underwent pancreatic procedures and 156 underwent hepatic procedures. Morbidity and mortality were evaluated in the first 75 postoperative days and classified according the Clavien-Dindo classification. Our results show that when surgical procedures are correctly indicated in elderly patients, acceptable postoperative morbidity and mortality can be achieved. Since the year 2018 we have been actively using prerehabilitation in our center and it has led to improved postoperative outcomes in elderly and high-risk patients.