Baltaduonienė, Daiva

Introduction. Parkinson's disease is one of the fastest growing neurological disorders in the world and poses a growing public health challenge. The prevalence of the disease has risen significantly over the last two decades, highlighting the need to improve access to healthcare, promote research and develop effective prevention and treatment strategies [1]. In today's society, technology has a clear impact on everyone's daily life, and healthcare professionals are looking for innovative and effective ways to improve impaired function, and are increasingly turning to the use of new technologies [2,3]. The aim of the study- To evaluate the effect of an interactive rehabilitation tool on independence and hand function in patients with Parkinson's disease. Research methods and organization. The study was conducted from October 11, 2024 to February 1, 2025 at the Abromiskes Rehabilitation Centre. Approval for the study was obtained from the Bioethics Center of the Lithuanian University of Health Sciences. The study involved 28 individuals, including: 20 women and 8 men who had Parkinson's disease. Individuals were included in the study based on the following selection criteria: individuals who voluntarily agreed to participate in the study; individuals with Parkinson's disease; Mini-Mental State Examination score ≥ 21. The subjects were randomly divided into 2 study groups by purposeful selection. Group I (T1) received individual regular occupational therapy (OT) sessions 5 times a week, group II (T2) received individual regular OT sessions 2 times a week, and 3 times OT sessions with the RAPAEL smart pegboard. The duration of all OT sessions was 30- 40 min. The subjects were assessed at the beginning and end of the study, after 13 sessions (3 weeks). T1 consisted of 11 women and 3 men, and T2 consisted of 9 women and 5 men. The average age of the subjects participating in the study was 71.5 ± 7.94 years. The average age of the subjects in T1 was 73.7 ± 7.32 years, and in T2 - 69.2 ± 8.12 years. The average duration of disease8.92 ± 4.11 years. Data were collected using selected research tools: hand function was assessed by Nine-Hole Peg Test (9HPT) and independence was assessed by The Functional Independence Measure (FIM). Statistical data analysis was performed using IBM SPSS 30 software program. The nonparametric Manney Whitney test was used to compare two independent samples. The non-parametric Wilcoxon test was used to compare two dependent samples. Quantitative data are presented as median (Md), minimum value (min), maximum value (max) and mean (m) - Md (min-max; m). A difference was considered statistically significant when p < 0.05. Results. In T1 the total pre-study FIM score was 86 (70–98; 84.07) points, post-study- 98 (83–111; 96.85). When comparing results within a group, independence improved significantly (Z=3.304; p<0.001). In T2, the total pre-study FIM score was 89.50 (53–109; 85.07) points, post-study- 105.50 (63–120; 99.42). The independence in T2 also improved significantly (Z=3.302; p<0.001). Comparing FIM scores before the study, no statistically significant difference was found (U=112.50; p=0.511). Comparing FIM scores between the groups after the study, no statistically significant difference was found (U=121.50; p=0.285). Analysis of the right-hand finger dexterity data obtained from the 9HPT showed that, before the study, the finger dexterity speed in T1 was 29.50s (22–46; 32.21), after- 27s (20–43; 29.71). Comparing results within a group finger dexterity improved significantly (Z=-3.234; p=0.001). In T2 finger dexterity speed was 29s (20–59; 32.21), after study- 25s (16–50; 27.28). Comparing results within a group finger dexterity also improved significantly (Z=-3,330; p=0,001). There was no statistically significant difference before the study (U=93.50; p=0.839). Comparing results obtained between the groups after the study, a significant difference was found (U=53.50; p=0.041). The participants in T2 showed a better improvement. Analysis of the left-hand finger dexterity showed that, before the study, the finger dexterity speed in T1 was 30s (24–49; 33.57), after28.50s (24–48; 32). Comparing results, finger dexterity after the study improved significantly (Z=- 2.829; p=0.005). In T2, the pre-study finger dexterity speed was 30s (23–50; 33.42), after- 25s (19– 46; 28.42). Comparing results, finger dexterity improved significantly (Z=-3.313; p=0.001). There was no statistically significant difference before the study (U=90.00; p=0.734). A post-study comparison between the groups revealed a significant difference (U=43.00; p=0.011). The participants in T2 showed a better improvement. Conclusions. 1. The independence after the study in both groups increased significantly. Conventional occupational therapy and occupational therapy with interactive rehabilitation tool equally improve independence. 2. The finger dexterity of all individuals improved significantly. Individuals who used an interactive rehabilitation tool during occupational therapy sessions had statistically significantly greater improvement in finger dexterity compared to those who underwent conventional occupational therapy.

Introduction Inclusive education is a completely different approach to the education of differently-abled children. Children with or without disabilities - can all learn together (Hasan et al, 2018). The main principle of inclusive education is that school is an environment where students with disabilities are equally involved in the educational process and with their peers, where they can fulfill their potential and be accepted (Goldan et al, 2021). According to the literature, using some rehabilitation specialists' services reduces behavioral, social, and physical problems that can cause difficulties in the school environment (Suc et al, 2017). These specialists must also consult teachers who educate children with special educational needs (Milašius et al, 2018). Research aim: analyze and summarize scientific publications that examine rehabilitation specialists' role in inclusive education. Methodology A review of the scientific literature was carried out. The literature review included all full English-language articles available in databases under 10 years old and addressed inclusive education and the role of rehabilitation professionals. The research for scientific publications took place from 2023-04-01 to 2023-05-01. PubMed (MEDLINE), EBSCO Publishing and Google Scholar databases were used during the search, using keywords and their combinations. Results After matching, 1,951 publications were found in databases, but 15 publications remained for the intended selection criteria. The analyzed literature indicates that interdisciplinary collaboration, including health and education professionals, is fundamental in providing inclusive education services (Kaelin et al., 2019). A study conducted in Holland and Sweden (2022) observed that in inclusive education, children work more independently, seek less confirmation from teachers, and feel more secure in completing assigned tasks and testing them without asking for help (Meuser et al., 2022). Rehabilitation specialists involved in inclusive education aim to improve the child's academic and functional achievements, provide guidance to parents and encourage active participation in and out of the classroom (Talley et al, 2016). An integrated model of health care delivery in educational institutions is essential to ensure that the needs of this vulnerable group are met. Effective collaboration between healthcare professionals, the child's parents, and teachers is essential to the model (Gallagher et al, 2022). Conclusions/Insights

1. The experience of foreign countries, based on scientific research, shows that intersectoral cooperation is an effective method for including all students, and rehabilitation specialists work successfully in schools, solving problems corresponding to their competence.
2. In order for rehabilitation specialists to play important roles they should be absorbed into the Education Service to serve as resource persons.
3. The analysis of rehabilitation practices of inclusion in the educational process suggest that the current situation of inclusion undoubtedly provides answers to many of today’s challenges. However, they need to be further modernized and optimized, following the best domestic and foreign practices

Įvadas. COVID-19 pandemija, prasidėjusi 2019 metais, palietė ne tik Lietuvą, bet ir visą pasaulį. Šio viruso taikiniu tapo ne tik jauni, bet ir senyvo bei pagyvenusio amžiaus žmonės [1]. Lietuvoje ir daugelyje pasaulio šalių buvo įvestas griežtas karantinas, kurio metu žmonės ėmė laikytis socialinės distancijos, nutraukė laisvalaikio veiklas ir visą karantino laikotarpį leido namuose [2]. Yra žinoma, kad senyvo amžiaus žmonių imunitetas yra daug kartų silpnesnis už jaunų ir jie priklauso rizikos grupei, todėl vyriausieji populiacijos nariai buvo priversti saugotis koronaviruso labiau nei kiti [3]. Dėl to labai pablogėjo senyvo ir pagyvenusio amžiaus žmonių emocinė būsena. Atlikti tyrimai parodė, kad pandemijos laikotarpiu senyvo ir pagyvenusio amžiaus žmonių depresijos simptomai padidėjo penkis kartus, o nerimo simptomai – 3 kartus, palyginti su laiku prieš pandemiją [4]. COVID-19 pandemijos laikotarpiu labiausiai sutriko senyvo ir pagyvenusio amžiaus žmonių laisvalaikio veiklos. Pagyvenę žmonės turėjo atsisakyti jiems svarbiausios laisvalaikio veiklos, tai yra bendravimo su giminaičiais, vaikais ir anūkais, aktyvaus laisvalaikio leidimo būdo [5]. Norint užtikrinti kuo geresnę gyvenimo kokybę ir sveikatos gerovę, ergoterapeutas privalo padėti rasti ar koreguoti kasdienių bei laisvalaikio veiklų atlikimą, kad asmuo galėtų kuo geriau funkcionuoti. Ypač pandemijos laikotarpiu ergoterapeutas gali padėti senyvo amžiaus žmonėms rasti laisvalaikio veiklų, kurios padėtų pagerinti psichinę savijautą. [...].

Metodinės rekomendacijos skirtos Lietuvos sveikatos mokslų universiteto Medicinos akademijos Slaugos fakulteto Reabilitacijos krypties, antrosios pakopos studijų programų studentams, rengiantiems baigiamąjį darbą. Pirmojoje šių metodinių rekomendacijų dalyje išdėstytos bendrosios nuostatos, antrojoje – pagrindinės sąvokos, studentų ir darbo vadovų funkcijos, pareigos ir atsakomybė, trečiojoje – baigiamojo darbo rengimo ir gynimo tvarka, ketvirtojoje – baigiamojo darbo reikalavimai, o penktojoje dalyje pateikiami priedai, kuriuose yra dokumentai, reikalingi rengiant baigiamąjį darbą. Tikimės, kad šios metodinės rekomendacijos atsakys į klausimus, iškylančius rengiant baigiamąjį darbą ir padės rasti tinkamus sprendimus. Dėkojame visiems kolegoms, padėjusiems parengti šias metodines rekomendacijas. Laukiame pastebėjimų ir pasiūlymų elektroniniu paštu edita.jazepcikiene@lsmuni.lt. Jūsų patarimai leis tobulinti metodines rekomendacijas ateityje.

Įžanga Metodinės rekomendacijos skirtos Lietuvos sveikatos mokslų universiteto Medicinos akademijos Slaugos fakulteto Reabilitacijos krypties, pirmosios pakopos studijų programų studentams, rengiantiems baigiamąjį darbą. Pirmojoje šių metodinių rekomendacijų dalyje išdėstytos bendrosios nuostatos, antrojoje – pagrindinės sąvokos, studentų ir darbo vadovų funkcijos, pareigos ir atsakomybė, trečiojoje – baigiamojo darbo rengimo ir gynimo tvarka, ketvirtojoje – baigiamojo darbo reikalavimai, o penktojoje dalyje pateikiami priedai, kuriuose yra dokumentai, reikalingi rengiant baigiamąjį darbą. Tikimės, kad šios metodinės rekomendacijos atsakys į klausimus, iškylančius rengiant baigiamąjį darbą ir padės rasti tinkamus sprendimus. Dėkojame visiems kolegoms, padėjusiems parengti šias metodines rekomendacijas. Laukiame pastebėjimų ir pasiūlymų elektroniniu paštu edita.jazepcikiene@lsmuni.lt. Jūsų patarimai leis tobulinti metodines rekomendacijas ateityje.

Introduction. Methodical recommendations are intended for students of the first-cycle Rehabilitation study programmes of the Faculty of Nursing, Lithuanian University of Health Sciences, who are preparing their final thesis. The first part of these methodological recommendations sets out the general provisions, the second part - basic concepts, functions, duties and responsibilities of students and work supervisors, the third part - the procedure for preparation and defence of the final thesis, the fourth part - requirements for the final thesis, and the fifth part contains appendices containing the necessary documents in the preparation of the thesis. We hope that these methodological recommendations will answer the questions that arise during the preparation of the thesis and will help you find appropriate solutions. We are grateful to all colleagues and experts who helped to prepare these methodological recommendations

[...]. Darbo tikslas: Įvertinti interaktyvių reabilitacijos priemonių poveikį asmenų, patyrusių išeminį galvos smegenų insultą, pažinimo funkcijoms ir savarankiškumui ankstyvuoju reabilitacijos etapu. Uždaviniai: 1. Įvertinti ir palyginti asmenų, patyrusių išeminį galvos smegenų insultą, pažinimo funkcijų kaitą taikant skirtingus poveikio meto-dus ergoterapijos užsiėmimų metu ankstyvuoju reabilitacijos etapu. 2. Įvertinti ir palyginti skirtingų poveikio metodų įtaką asmenų, patyrusių išeminį galvos smegenų insultą, savarankiškumo kaitai ergoterapijos užsiėmimų metu ankstyvuoju reabilitacijos etapu. 3. Išanalizuoti asmenų, patyrusių išeminį galvos smegenų insultą, savarankiškumo ir pažinimo funkcijų tarpusavio sąsajas. 4. Įvertinti asmenų, patyrusių išeminį galvos smegenų insultą, pažini-mo funkcijų atgavimą, taikant skirtingus poveikio metodus atsi-žvelgiant į veiksnius. Darbo mokslinis naujumas ir praktinė vertė Lietuvoje neradome atliktų įrodymais grįstų mokslinių tyrimų, kurių metu būtų ištirtas ir palygintas skirtingų naujų metodų – KPLP ir VR reabilitacijos sistemų – poveikis pažinimo funkcijoms ir savarankiškumui taikant jas asmenims, patyrusiems išeminį[...].

The objective of this study is to assess and compare the effect of applying a computerised cognitive training programme and virtual environment rehabilitation system on cognitive functions in patients after a stroke. METHODS: A controlled trial included 121 persons referred to second stage rehabilitation. The subjects were differentiated into three impact groups by a single blinded trial. RESULTS: The trial revealed that cognitive functions improved in all patient groups (p<0.001). A paired comparison analysis of all groups demonstrated a tendency for cognitive functions, evaluated by the MoCA-LT test, to be more strongly improved in patients who practised a computerised cognitive training programme during their OT sessions than those who did not (p=0.054). CONCLUSIONS: The final outcome of the trial was that cognitive functions significantly improved in patients who practised computerised cognitive training programmes or virtual environment rehabilitation systems, compared to those participants who only had occupational therapy sessions.

Aim: According to literature sources, cognitive dysfunction is one of the most common stroke-induced disorders. Despite the high number of cases of cognitive disorders after stroke, treatment options are still rather limited. The aim of this study was to assess the efficiency of cognitive training in individuals after stroke, in particular computer-based cognitive rehabilitation (CBCR) programmes. Methods: The analysis included studies where intervention of a CBCR programme was applied to subjects after stroke. We searched PubMed (Medline), Cochrane Database, and EBSCO for publications between January 2007 and July 2016. All the included studies were published in English. Results: Ten studies met the inclusion criteria. The included studies consisted of nine randomised controlled trials and one randomised pilot study. All the studies targeted general or domain-specific cognitive functions. The majority of the included studies resulted in the improvement of the assessed functional outcome measures. Conclusion: The overview conducted by the authors of this article allows us to claim that CBCR programmes may help to improve cognitive functions in subjects after stroke.

Aim. To evaluate the short term effects of community-based occupational therapy on health-related quality of life and engagement in meaningful activities among women with breast cancer. Methods. In this open label randomized controlled trial the participants were selected according to predetermined criteria: women with diagnosed breast cancer who were familiarized with the aim of the study and volunteered to participate, were capable of understanding the essence of the study and simple instructions, and whose functional status was ≤2b according to the ECOG. In total, 22 women have met the inclusion criteria and participated in the study, 1 of them withdrew during the course, therefore 21 - completed the study successfully. The participants were members of various societies of women with cancer, who were randomly distributed into two groups: the experimental and the control groups. During the course of the study, participants of the experimental group participated in a 6-week community-based occupational therapy program and the usual activities of various societies, whereas the control group women participated in the usual activities of the societies only. During the study, we evaluated the health-related quality of life of women with breast cancer by applying the EORTC QLQ-C30 questionnaire and its breast cancer module QLQ-BR23. The engagement of the participants of the experimental group in meaningful activities was evaluated by using the Engagement in Meaningful Activities Survey (EMAS); the evaluation was carried out during the non-acute period of the disease – at the beginning of the study and after 6 weeks. When comparing the results of the groups, we evaluated the effect of community-based occupational therapy on breast cancer patients’ health-related quality of life and engagement in meaningful activities. Results. [...].