Polyetheretherketone Cages Alone with Allograft for Three-Level Anterior Cervical Fusion

A total of 25 consecutive patients suffering from degenerative cervical disc disease who underwent three-level anterior cervical discectomy and fusion (ACDF) including polyetheretherketone (PEEK) cages packed with allograft were followed up for at least two years. The fusion rate reached 72% (18/25), and asymptomatic pseudarthrosis was seen in 6 patients but without mobility on flexion-extension radiographs, and revision surgery was not needed. Cage subsidence occurred at one level (C67), but it was not progressive, and reoperation was not necessary. A significant increase (P < 0.001) in fused segment angle (FSA) and fused segment height (FSH) was observed postoperatively. Similarly, a significant clinical improvement (P < 0.001) was demonstrated postoperatively in terms of Japanese Orthopedic Association (JOA) score and visual analog scales (VASs) score. PEEK cages alone with allograft proved to be a safe and effective surgical option in the treatment of three-level degenerative cervical disc disease. Although the fusion rate was not high, this technique may offer improvement of symptomatology and maintenance of cervical spine's sagittal profile

The Experience of Gender in Spousal Caregiving: A Phenomenological Psychological Study (Greece)

Purpose/Objective: To explore how spousal caregivers of older people undergoing rehabilitation experience gender within the Greek community. Research method/Design: A psychological phenomenological design and analysis were used to illuminate the unique meanings eleven spousal caregivers attribute to their experience of gender by gathering qualitative data via interviews. Results: The data provided an insight into the structure of the experience of gender for the spousal caregivers as a normative diachronic identity in a succession of phases: normative constitution, alienation, and reparation. Conclusions/ Implications: The findings highlight the influence of gender stereotypes on spousal caregivers' self-concept, agency, caregiving evaluations, and practices, emphasizing the importance of adopting an intersectional perspective in future research and interventions, considering various factors such as ethnicity, gender, sexuality, age, power dynamics, and cultural norms. Spousal caregivers experience alienation on entering the caregiving journey, with gender-related vulnerabilities affecting their psychological well-being. Addressing these vulnerabilities can improve caregivers' mental health and foster effective coping strategies. The study emphasizes the moral aspect of caregiving, highlighting the relationship between a sense of obligation, feelings of guilt, gender norms, and motivations calling for challenging self-sacrificial morals and societal norms associated with them to empower caregivers to prioritize their well-being while maintaining their caregiving motivations. This shift in perspective can lead to a more positive and fulfilling caregiving experience

Older adults' lived experiences of physical rehabilitation for acquired brain injury and their perceptions of well-being: A qualitative phenomenological study

Abstract Aim To explore the experiences of older adults (65+) living with acquired brain injury regarding their sense of well-being during physical rehabilitation within the Greek Healthcare System. Background With the increasing ageing population and the life-changing effects of acquired brain injury, there is a need to focus on care for older people and their potential to live well. Rehabilitation systems deserve greater attention, especially in improving the well-being of those who are using them. Design A qualitative study design with a hermeneutic phenomenological approach was used. Methods Fourteen older adults living with acquired brain injury and undergoing physical rehabilitation in Greece were purposively sampled. Semi-structured interviews were conducted to collect data and were thematically analysed using van Manen's and Clarke and Braun's methods. The COREQ checklist was followed. Results Four themes emerged from the analysis: (1) Challenges of new life situation, (2) Seeking emotional and practical support through social interaction, (3) Identifying contextual processes of rehabilitation, (4) Realising the new self. Conclusions The subjective experiences, intersubjective relations and contextual conditions influence the sense of well-being among older adults living with acquired brain injury, thus impacting the realisation of their new self. The study makes the notion of well-being a more tangible concept by relating it to the degree of adaptation to the new situation and the potential for older adults to create a future whilst living with acquired brain injury. Relevance for Clinical Practice Identifying the factors that impact older adults' sense of well-being during rehabilitation can guide healthcare professionals in enhancing the quality of care offered and providing more dignified and humanising care. Patient or Public Contribution Older adults living with acquired brain injury were involved in the study as participants providing the research data

O R I G I N A L P A P E R .r . Informal Care Provision by the Family to Hospitalized Patients in a Rehabilitation Clinic of Western Greece

Abstract Introduction: Recognizing the burden imposed on families and society by long-term care of chronically ill patients, there is a need to empower caregivers and take measures for slowing the deterioration of the quality of life for the caregiver and the patient. Aim: The main aim of the present study was to investigate the caregivers&apos; views regarding the services provided by them for their hospitalized relatives and their opinions about the their health education needs, informational needs and needs for support in a rehabilitation clinic of Western Greece. Methodology: The sample consisted of 75 caregivers of hospitalized patients who provided unpaid services and they wanted after informed consent to participate in the study. Data were collected in 2012 within a period of 6 months. A self-reported questionnaire was completed and the statistical analysis was performed by the use of SPSS. Results: This study shows the need for caregivers&apos; health education on technical care and general knowledge about the disease, on how to handle an emergency situation at home. Obvious were also the need for information about the benefits to disabled people from public and non-profit organizations, but also the need for learning how to support emotionally patient. Information about the transition from hospital to home, emerged as necessary through this study. Caregivers felt that it is the obligation of the hospital to provide training and health education and indicated nurses as appropriate health professionals for the role. Also the need for emotional support for caregivers by health professionals was highlited and caregivers believe that adequate staffing of rehabilitation units will allow health professionals to provide time for emotional support of caregivers, but also time for casual conversation on general subjects, in a civilized environment, aiming to empower caregivers for better care of patients. Conclusion: The health education needs of the caregiver must be sufficient, after careful assessment of training needs, information and emotional support and by strengthening the concept of self-care of the caregiver. To address these needs, specific training plan is required, preparing the caregiver in his new role and adjustment to the new lifestyle

The efficacy of Equine Assisted Therapy intervention in gross motor function, performance, and spasticity in children with Cerebral Palsy

PurposeTo evaluate the efficacy of Equine Assisted Therapy in children with Cerebral Palsy, in terms of gross motor function, performance, and spasticity as well as whether this improvement can be maintained for 2 months after the end of the intervention.MethodsChildren with Cerebral Palsy participated in this prospective cohort study. The study lasted for 28 weeks, of which the equine assisted therapy lasted 12 weeks taking place once a week for 30 min. Repeated measures within the subject design were used for the evaluation of each child’s physical performance and mental capacity consisting of six measurements: Gross Motor Function Measure-88 (GMFM-88), Gross Motor Performance Measure (GMPM), Gross Motor Function Classification System (GMFCS), Modified Ashworth Scale (MAS) and Wechsler Intelligence Scale for Children (WISC III).ResultsStatistically significant improvements were achieved for 31 children in Gross Motor Function Measure and all its subcategories (p &lt; 0.005), also in total Gross Motor Performance Measure and all subcategories (p &lt; 0.005). These Gross Motor Function Measure results remained consistent for 2 months after the last session of the intervention. Regarding spasticity, although an improving trend was seen, this was not found to be statistically significant.Conclusion and implicationsEquine Assisted Therapy improves motor ability (qualitatively and quantitatively) in children with Cerebral Palsy, with clinical significance in gross motor function

Gendered Experiences of Providing Informal Care for Older People: A Systematic Review and Thematic Synthesis

Background and Purpose: The caregiving's impact on informal carers' quality of life and gender-based stereotypes make older individuals' informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers' experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020. Design and Methods: The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework. Results: This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers' experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers' healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers' negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men's and women's mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role Conclusion and Implications:. Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people's care

Surgical treatment of lumbar spinal stenosis with microdecompression and interspinous distraction device insertion. A case series

<p>Abstract</p> <p>Background</p> <p>Interspinous distraction devices (IPDD) are indicated as stand-alone devices for the treatment of spinal stenosis. The purpose of this study is to evaluate the results of patients undergoing surgery for spinal stenosis with a combination of unilateral microdecompression and interspinous distraction device insertion.</p> <p>Methods</p> <p>This is a prospective clinical and radiological study of minimum 2 years follow-up. Twenty-two patients (average age 64.5 years) with low-back pain and unilateral sciatica underwent decompressive surgery for lumbar spinal stenosis. Visual Analogue Scale, Oswestry Disability Index and walking capacity plus radiologic measurements of posterior disc height of the involved level and lumbar lordosis Cobb angle were documented both preoperatively and postoperatively. One-sided posterior subarticular and foraminal decompression was conducted followed by dynamic stabilization of the diseased level with an IPDD (X-STOP).</p> <p>Results</p> <p>The average follow-up time was 27.4 months. Visual Analogue Scale and Oswestry Disability Index improved statistically significantly (p < 0.001) in the last follow-up exam. Also, the walking distance increased in all patients but two. Posterior intervertebral disc height of the diseased level widened average 1.8 mm in the postoperative radiograph compared to the preoperative. No major complication, including implant failure or spinous process breakage, has been observed.</p> <p>Conclusions</p> <p>The described surgical technique using unilateral microdecompression and IPDD insertion is a clinically effective and radiologically viable treatment method for symptoms of spinal stenosis resistant to non-operative treatment.</p