This case study evaluated the efficacy of semi-occluded vocal tract (SVT) therapy as a speech intervention for functional dysphonia in a 53-year-old patient. Laryngoscopic examination revealed mild erythema and mucosal irregularity in the posterior third, edema, slight interarytenoid erythema, and phonatory hiatus in the posterior third of the posterior wall. Vocal assessments were conducted before and after rehabilitation, focusing on the perceptual, acoustic, and aerodynamic aspects. The treatment plan incorporated sustained, oscillatory, and transient occlusions over 10 sessions. The results (...) showed enhanced voice timbre quality and normalization of the fundamental frequency appropriate for the patient's age and sex. The jitter, shimmer, and harmonic noise disturbances decreased, indicating improved wave stability and harmonic structure definition. The maximum expiratory and phonatory times, along with the s/z ratio, increased, leading to improved vocal efficiency. Additionally, the vocal risk indicator decreased, articulatory stability improved, and energy utilization became more efficient, resulting in more stable formants. The study concluded that SVT exercises produce positive vocal changes, suggesting that techniques aimed at modifying the vocal tract are effective for speech therapy rehabilitation in patients with functional dysphonia. (shrink)

ObjectiveTo assess the impact of the closure of group-based cardiac rehabilitation training during the first COVID-19 lockdown in spring 2020 on patients’ physical activity, cardiorespiratory fitness, and cardiovascular risk, and to describe the patient experience of lockdown and home-based exercise training during lockdown.DesignMixed methods study. Prospectively collected post-lockdown measurements were compared to pre-lockdown medical record data. Quantitative measurements were supplemented with qualitative interviews about the patient experience during lockdown.SettingOutpatient CR centre in Salzburg, Austria.ParticipantsTwenty-seven patients [six female, mean age (...) 69 years] who attended weekly CR training sessions until the first COVID-19 lockdown in March 2020.Outcome MeasureQuantitative: exercise capacity, cardiovascular risk. Qualitative: individual semi-structured interviews.ResultsExercise capacity had significantly reduced from pre- to post-lockdown: mean power in maximal ergometry 165 vs. 151, p < 0.001; submaximal ergometer training 99 vs. 97, p = 0.038. There was no significant difference in Framingham risk score and other cardiovascular risk factors. Qualitative data showed that almost all patients had kept physically active during lockdown, but 17 said they had been unable to maintain their exercise levels, and 15 felt their cardiorespiratory fitness had deteriorated. Many patients missed the weekly CR training and the motivation and sense of community from training together with others. Several patients stated that without professional supervision they had felt less confident to carry out home-based exercise training at high intensity.ConclusionThis study highlights the importance of group-based supervised exercise training for patients who engage well in such a setting, and the detrimental impact of disruption to this type of CR service on physical activity levels and exercise capacity. Additionally, learning from the COVID-19 pandemic may inform the development and implementation of remote CR modalities going forward. (shrink)

Exercise-based rehabilitation forms a key part of the UK National Health Service patient-care pathway for cardiac rehabilitation (CR). Only around half of all eligible patients attend core CR, however, with social inequalities affecting participation. Few qualitative studies have explored in-depth the key factors influencing engagement with CR, specifically from a sociological theoretical, and ethnographic perspective. Utilising an ethnographic approach allowed us to get a sense of the embodied experiences of 10 participants attending or declining core CR, together (...) with a further seven family members/significant others. This provided in-depth appreciation of participants’ lifeworld contexts as key influences on CR participation. The article draws on these qualitative data and focuses on 1) participants’ initial thoughts about CR; and 2) navigating the field of CR, analysed via thematic analysis. We utilise a Bourdieusian theoretical perspective to theorise the findings, including salient socio-cultural factors influencing attendance/non-attendance and (non)adherence. The article findings highlight how perceptions of CR and the ability to navigate the field are strongly influenced by habitus and capital, and how personal biographies and socio-material conditions affect adherence to CR programmes. The study provides original insights into embodied experiences of exercise-based CR, and novel understandings of the reasons for drop-out/poor adherence, theorised from a Bourdieusian perspective. (shrink)

This paper presents an approach for monitoring exercises of hand rehabilitation for post stroke patients. The developed solution uses a leap motion controller as hand-tracking device and embeds a supervised machine learning. The K-nearest neighbor methodology is adopted for automatically characterizing the physiotherapist or helper hand movement resulting a unique movement pattern that constitutes the basis of the rehabilitation process. In the second stage, an evaluation of the patients rehabilitation exercises results is compared to the movement pattern (...) of the patient and results are presented, saved and statistically analyzed. Physicians and physiotherapists monitor and assess patients’ rehabilitation improvements through a web application, furthermore, offer medical assisted rehabilitation processes through low cost technology, which can be easily exploited at home. Recorded tracked motion data and results can be used for further medical study and evaluating rehabilitation trends according to patient’s rehabilitation practice and improvement. (shrink)

Pulmonary rehabilitation has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. A 12-week community-based PR will be implemented (...) in primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea, fatigue, cough and sputum, impact of the disease, emotional state, number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion. Other clinical outcomes will be peripheral and respiratory muscle strength, muscle thickness and cross sectional area, exercise capacity, balance and physical activity. Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted. This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. The trial was registered in the ClinicalTrials. gov U.S. National Library of Medicine, on 10th January, 2019. (shrink)

BackgroundChronic airway diseases are prevalent and costly conditions. Interdisciplinary rehabilitation programs that include Acceptance and Commitment-based components could be important to tackle the vicious circle linking progression of the disease, inactivity, and psychopathological symptoms.MethodsA retrospective evaluation of routinely collected data of an interdisciplinary rehabilitation program was performed. The program included group sessions including patient education, breathing exercise, occupational therapy and an ACT-based psychological treatment, and individual sessions of physical therapy. Demographic data, clinical characteristics of the patients and (...) the values of outcome variables before treatment, at discharge, at 3 months, and at 6 months were extracted from medical records. Multiple imputation was employed to address missing data. Linear mixed models were employed to assess changes over time. Multivariable logistic regression was performed to assess predictors of a minimum clinically important change of health status from baseline to the 6-months follow-up.ResultsData from 31 patients with chronic obstructive pulmonary disease and 12 patients with bronchiectasis were extracted. Health status improved from baseline to discharge to the 3 months follow-up, but not to the 6 months follow-up. Anxiety and depression improved across all the time points. Quality of life did not improve over time. Having a worse health status at baseline and fewer depressive symptoms were significantly associated with achieving a minimum clinically important change of health status at 6 months. The effects of the interdisciplinary program were not different for patients with COPD or with bronchiectasis.DiscussionInterdisciplinary programs including ACT-based components are promising treatments for the rehabilitation of patients with chronic airway diseases. (shrink)

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and implicit (...) pathways to ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)

While robot-assisted arm and hand training after stroke allows for intensive task-oriented practice, it has provided only limited additional benefit over dose-matched physiotherapy up to now. These rehabilitation devices are possibly too supportive during the exercises. Neurophysiological signals might be one way of avoiding slacking and providing robotic support only when the brain is particularly responsive to peripheral input. We tested the feasibility of three-dimensional robotic assistance for reach-to-grasp movements with a multi-joint exoskeleton during motor imagery-related desynchronization of sensorimotor (...) oscillations in the β-band only. We also registered task-related network changes of cortical functional connectivity by electroencephalography via the imaginary part of the coherence function. Healthy subjects and stroke survivors showed similar patterns – but different aptitudes – of controlling the robotic movement. All participants in this pilot study with nine healthy subjects and two stroke patients achieved their maximum performance during the early stages of the task. Robotic control was significantly higher and less variable when proprioceptive feedback was provided in addition to visual feedback, i.e. when the orthosis was actually attached to the subject’s arm during the task. A distributed cortical network of task-related coherent activity in the θ-band showed significant differences between healthy subjects and stroke patients as well as between early and late periods of the task. Brain-robot interfaces may successfully link three-dimensional robotic training to the participants’ efforts and allow for task-oriented practice of activities of daily living with a physiologically controlled multi-joint exoskeleton. Changes of cortical physiology during the task might also help to make subject-specific adjustments of task difficulty and guide adjunct interventions to facilitate motor learning for functional restoration. (shrink)

Against the backdrop of eliminitivist versus critical conservationist approaches to the racial category of whiteness, this article asks whether a rehabilitated version of whiteness can be worked out concretely. What might a non-oppressive, anti-racist whiteness look like? Turning to Josiah Royce’s “Provincialism” for help answering this question, I show that even though the essay never explicitly discusses race, it can help explain the ongoing need for the category of whiteness and implicitly offers a wealth of useful suggestions for how to (...) transform it. “Provincialism” is an exercise in critical conservation of the concept of provincialism, and while not identical, provincialism and whiteness share enough in common that “wise” provincialism can serve as a model for “wise” whiteness. Royce’s concept of provincialism thus can be a great help to critical philosophers of race wrestling with questions of whether and how to transformatively conserve whiteness. Exploring similarities and differences between wise provincialism and wise whiteness, I use Royce’s analyses of provincialism to shed light on why whiteness should be rehabilitated rather than discarded and how white people today might begin living whiteness as an anti-racist category. (shrink)

Background: The new human coronavirus that leads to COVID-19 has spread rapidly around the world and has a high degree of lethality. In more severe cases, patients remain hospitalized for several days under treatment of the health team. Thus, it is important to develop and use technologies with the aim to strengthen conventional therapy by encouraging movement, physical activity, and improving cardiorespiratory fitness for patients. In this sense, therapies for exposure to virtual reality are promising and have been shown to (...) be an adequate and equivalent alternative to conventional exercise programs.Aim: This is a study protocol with the aim of comparing the conventional physical therapy intervention with the use of a non-immersive VR software during COVID-19 hospitalization.Methods: Fifty patients hospitalized with confirmed diagnosis of COVID-19 will be divided in two groups under physiotherapy treatment using conventional or VR intervention: Group A: participants with COVID-19 will start the first day of the protocol with VR tasks in the morning and then in the second period, in the afternoon, will perform the conventional exercises and Group B: participants with COVID-19 will start the first day with conventional exercises in the morning and in the second period, in the afternoon, will perform activity with VR. All participants will be evaluated with different motor and physiologic scales before and after the treatment to measure improvements.Conclusion: Considering the importance of benefits from physical activity during hospitalization, VR software shows promise as a potential mechanism for improving physical activity. The results of this study may provide new insights into hospital rehabilitation.Trial Registration:ClinicalTrials.gov, identifier: NCT04537858. Registered on 01 September 2020. (shrink)

In order to re-examine what role Plato gives to images in the Republic, this chapter argues against modern commentators’ views and demonstrates that for Plato, images represent reality in special ways and that the simile is not simply a didactic method of explaining familiar objects, but is an effective method of inquiry to reveal a reality unknown to us. First it shows that Plato ascribes to images a special role of transforming our souls, by examining the famous story of Gyges’ (...) ring; second, by analysing the simile of the Sun, it shows that images are real in the sense that they reveal to us the world beyond sensible things. These two examples represent two important aspects, namely, a psychological exercise for changing ourselves and an ontological possibility for such images. In order to rehabilitate our conception of the image, the chapter considers views on images by Japanese philosophers, Megumi Sakabe and Toshihiko Izutsu. (shrink)

Taking regular walks when living with Parkinson’s disease has beneficial effects on movement and quality of life. Yet, patients usually show reduced physical activity compared to healthy older adults. Using auditory stimulation such as music can facilitate walking but patients vary significantly in their response. An individualized approach adapting musical tempo to patients’ gait cadence, and capitalizing on these individual differences, is likely to provide a rewarding experience, increasing motivation for walk-in PD. We aim to evaluate the observance, safety, tolerance, (...) usability, and enjoyment of a new smartphone application. It was coupled with wearable sensors and delivered individualized musical stimulation for gait auto-rehabilitation at home. Forty-five patients with PD underwent a 1-month, outdoor, uncontrolled gait rehabilitation program, using the BeatWalk application. The music tempo was being aligned in real-time to patients’ gait cadence in a way that could foster an increase up to +10% of their spontaneous cadence. Open-label evaluation was based on BeatWalk use measures, questionnaires, and a six-minute walk test. Patients used the application 78.8% of the prescribed duration and enjoyed it throughout the program. The application was considered “easy to use” by 75% of the patients. Pain, fatigue, and falls did not increase. Fear of falling decreased and quality of life improved. After the program, patients improved their gait parameters in the six-minute walk test without musical stimulation. BeatWalk is an easy to use, safe, and enjoyable musical application for individualized gait rehabilitation in PD. It increases “walk for exercise” duration thanks to high observance.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02647242. (shrink)

This article takes a further step towards recovering the Stoic dimension of Shaftesbury's philosophical project and contributes to recent scholarly work uncovering the Stoic elements that specifically shape his poetics and aesthetics. I propose that Shaftesbury's famous rehabilitation of enthusiasm may be further reconsidered in light of his strong reliance on late Roman Stoic philosophical exercises for managing impressions and training the imagination. I begin by surveying the main imaginative exercises exemplified in Shaftesbury's writings and foreground his specific understanding (...) of affective harmony, with the purpose of highlighting his hospitable views around imagination and extravagant passion. My main argument is that, in light of these features, enthusiasm becomes an essential ingredient in various practical exercises that Shaftesbury proposes towards the ethical transformation of the self, particularly the well-known Stoic exercise seeking alignment with the point of view of the cosmos. Not only is reasonable enthusiasm a sign of the inner harmony needed to grasp the perfect and orderly design of the cosmos, but it allows the contemplative mind to redirect attention from partial beauty to the beauty of nature as a whole, thus exercising the right Stoic perspective required in order to accept the will of the universe. (shrink)

Advances in neuroscience might make it possible to develop techniques for directly altering offenders’ brains, in order to make offenders more responsible and law-abiding. The idea of using such techniques within the criminal justice system can seem intuitively troubling, even if they were more effective in preventing crime than traditional methods of rehabilitation. One standard argument against this use of brain interventions is that it would undermine the individual’s free will. This paper maintains that ‘free will’ (at least, as (...) that notion is understood by those who adopt the influential compatibilist approach) is an inadequate basis for explaining what is problematic about some direct brain interventions. This paper then defends an alternative way of objecting to certain kinds of direct brain interventions, focusing on the relationship between the offender and the state rather than the notion of free will. It opposes the use of interventions which aim to enhance ‘virtue responsibility’ (by instilling particular values about what is right and wrong), arguing that this would objectify offenders. In contrast, it argues that it may be acceptable to use direct brain interventions to enhance ‘capacity responsibility’ (i.e. to strengthen the abilities necessary for the exercise of responsible agency, such as self-control). Finally it considers how to distinguish these different kinds of responsibility enhancement. (shrink)

Bouts of exercise performed either prior to or immediately following study periods enhance encoding and learning. Empirical evidence supporting the benefits of interventions that simultaneously pair physical activity with material to be learned is not conclusive, however. A narrative, theory-based review of dual-task experiments evaluated studies in terms of arousal theories, attention theories, cognitive-energetic theories, and entrainment theories. The pattern of the results of these studies suggests that cognitive-motor interference can either impair or enhance memory of semantic information and (...) the manner in which physical activity impacts working memory within executive processing appears to explain disparate outcomes. The integration and timing of physical movements in concert with the type of information to be encoded and remembered appears to be a critical requirement for learning. These observations have implications for the role of physical activity in education, rehabilitation, and gerontological settings. (shrink)

This paper presents a reconceptualization of autonomy as the iterative realization of one’s capacity for “effective self-definition,” that is, possessing a sense of clarity and coherence in “who I am,” and exercising the decisional and volitional ownership over my life that this engenders. This process is “Relational,” wherein people’s interpersonal interactions have a deep and pervasive influence on their ability to recognize and exercise their autonomous capacities. This Relational understanding of autonomy is contextualized within the field of addiction rehabilitative (...) practice. Addiction is a pathology that progressively and insidiously undermines autonomy – producing a number of negative consequences that present themselves along a “continuum of pervasiveness.” In order to most fully foster rehabilitation, therapeutic alliances should to be attentive to facilitating autonomy’s dialogical antecedents. Here, interpersonal recognition can help clients to more fully recognize their own autonomous resources – enabling them to embark on their rehabilitative journey and achieve broader autonomous living. This paper concludes by proposing ways that practitioners can manifest their recognition of their clients’ autonomy within the therapeutic encounter. (shrink)

ObjectiveVirtual reality grasping exercise training helps patients participate actively in their recovery and is a critical approach to the rehabilitation of hand dysfunction. This study aimed to explore the effects of active participation and VR grasping on brain function combined with the kinematic information obtained during VR exercises.MethodsThe cerebral oxygenation signals of the prefrontal cortex, the motor cortex, and the occipital cortex were measured by functional near-infrared spectroscopy in 18 young people during the resting state, grasping movements, and (...) VR grasping movements. The EPPlus plug-in was used to collect the hand motion data during simulated interactive grasping. The wavelet amplitude of each cerebral cortex and the wavelet phase coherence of each pair of channels were calculated by wavelet analysis. The total difference in acceleration difference of the hand in the VR grasping movements was calculated to acquire kinematic characteristics. The cortical activation and brain functional connectivity of each brain region were compared and analyzed, and a significant correlation was found between VR grasping movements and brain region activation.ResultsCompared with the resting state, the WA values of LPFC, RPFC, LMC, RMC, and ROC increased during the grasping movements and the VR grasping movements, these changes were significant in LPFC and LMC. The WA values of LMC in the VR grasping movements were significantly higher than those in the grasping movements. The WPCO of the cerebral cortex increased during grasping exercise compared with the resting state. Nevertheless, the number of significant functional connections during VR grasping decreased significantly, and only the WPCO strength between the LPFC and LMC was enhanced. The increased WA of the LPFC, RPFC, LMC, and RMC during VR grasping movements compared with the resting state showed a significant negative correlation with KCs.ConclusionThe VR grasping movements can improve the activation and FC intensity of the ipsilateral brain region, inhibit the FC of the contralateral brain region, and reduce the quantity of brain resources allocated to the task. Thus, ordered grasping exercises can enhance active participation in rehabilitation and help to improve brain function. (shrink)

BackgroundExercise is one of the effective ways to improve cognition. Different forms of exercises, such as aerobic exercise, resistance exercise, and coordination exercise, have different effects on the improvement of cognitive impairment. In recent years, exergames based on Non-Immersive Virtual Reality have been widely used in entertainment and have gradually been applied to clinical rehabilitation. However, the mechanism of NIVR-Exergames on improving motor cognition has not been clarified. Therefore, the aim of this study is to find (...) whether NIVR-Exergames result in a better neural response mechanism to improve the area of the cerebral cortex related to motor cognition under functional near-infrared spectroscopy dynamic monitoring in comparison with resistance exercise.MethodsA cross-over study design was adopted in this study, and 15 healthy young subjects were randomly divided into group A and group B according to a computerized digital table method. Task 1 was an NIVR-Exergame task, and Task 2 was resistance band stretching. Group A first performed Task 1, rested for 30 min, and then performed Task 2. Group B had the reverse order. The fNIRS test was synchronized in real time during exercise tasks, and heart rate measurements, blood pressure measurements, and 2-back task synchronization fNIRS tests were performed at baseline, Post-task 1, and Post-task 2. The primary outcomes were beta values from the general linear model in different regions of interest, and the secondary outcomes were heart rate, blood pressure, reaction time of 2-back, and accuracy rate of 2-back.ResultsThe activation differences of Task 1 and Task 2 in the right premotor cortex and the left PMC were statistically significant. There were statistically significant differences in the activation of the right supplementary motor area, left dorsolateral prefrontal cortex, left and right PMC between baseline and Post-task 1. The differences in systolic pressure between the two groups at three time points among women were statistically significant.ConclusionIn this study, we found that NIVR-Exergames combined with motor and challenging cognitive tasks can promote the activation of SMA, PMC and DLPFC in healthy young people compared with resistance exercise alone, providing compelling preliminary evidence of the power for the rehabilitation of motor and cognitive function in patients with central nervous system diseases. (shrink)

This is Warrior Yoga, New York Times bestselling author and retired Navy SEAL Commander Mark Divine's latest contribution to mental and physical achievement exercises started with 8 Weeks to SEALFIT and Unbeatable Mind. This is not your average yoga book. Using Coach Divine's signature integrated training curriculum, Warrior Yoga is an intense physical workout designed for both the nation's elite special ops soldiers, and the regular athlete with the heart and mind of a warrior. His tried and true warrior sequences (...) are designed to be simple and flexible. These short, powerful drills can be done from home or on the road to enhance existing workout regimens and cultivate new ones. The sequences are targeted and focused to adapt to any athlete's physical and mental capabilities including those rehabilitating from injuries and suffering from PTSD. Mark's decades of experience with amateur and professional athletes, active and aspiring Navy SEALS, and wounded warriors uniquely qualify him as an expert motivator and teacher. To be a SEALFITTM Yoga Warrior requires a harmonious balance between mental and physical toughness, strength, and agility. Mark's short digestible exercises will help any athlete hone their fitness routine to reach their fullest potential, combining the physical, emotional and spiritual aspects of an unbeatable mind and body program. (shrink)

Recently, there has been a shift in attitude among some feminists towards the practice of cosmetic surgery away from that of outright rejection. Kathy Davis, for instance, offers a guarded `defence' of the practice as a strategy that enables women to exercise a degree of control over their lives in circumstances where there are very few other opportunities for self-realization. Others, such as Kathryn Morgan, Anne Balsamo and Orlan, though highly critical of the current practice of cosmetic surgery, go (...) even further than Davis in advocating its redeployment as a tool to subvert the dominant patriarchal ideals of feminine beauty. In this article I critically appraise this `rehabilitation' of cosmetic surgery, arguing, in the case of Davis, that she leaves unchallenged the social structures of inequality responsible for women's dissatisfaction with their bodies. The proposal to use cosmetic surgery as a tool of political critique is equally problematic insofar as it shares with the cosmetic industry its instrumentalization of the body as mere matter, which is almost infinitely transformable, and also effaces the economic inequalities within which such body transformations occur. (shrink)

BackgroundAn injury followed by surgery poses many challenges to an athlete, one of which is rehabilitation, with the goal of returning to sport. While total restoration of physical abilities is a primary goal for most athletes, psychosocial factors also play an important role in the success of an athlete's return to sport. The purpose of this review was to examine the effectiveness of exercise and psychosocial interventions on RTS rates, which might be one of the most important outcomes (...) for elite athletes.MethodsTo carry out this review, PubMed, SAGE Journals, Web of Science, SPORTDiscus, ScienceDirect, and Google Scholar databases were searched from inception to July 2022. The inclusion criteria consisted exercise or psychosocial intervention for athletes after anterior cruciate ligament reconstruction, with reporting RTS rates as an outcome.ResultsFrom 1032 identified articles, four reports met inclusion criteria, all of which examined the recovery after ACLR. The mean MINORS score for the included studies was 16.3 ± 6.1, of which non-comparative studies scored 11.0 ± 1.4, while comparative studies scored 21.5 ± 0.7. There were consistent findings for benefits of exercise and psychosocial interventions on RTS rates. Return to preinjury rates in the reviewed studies vary between 63 and 95% with lower % observed in female athletes and with shorter follow-up. Interventional studies reporting RTS rates with a larger sample size and longer follow-up are needed.ConclusionPhysical and psychological function, as well as social support can be influenced by appropriate interventions, indicating future work on rehabilitation programs for return to preinjury might consider taking the holistic approach addressing those. (shrink)

Rhetoric is at present the object of a rehabilitation on a grand scale, all the more as it overlaps the fields of literature, linguistics, and philosophy. Actually, if philosophy rejects and removes rhetoric, it is nevertheless, as a method of word, wholly impregnated with it. To investigate the complex relationship of mutual implication in which rhetoric and philosophy are involved is part and parcel of this plan of re-evaluation of rhetoric as “discourse art” with a view to a re-definition (...) of its field and functions. In this perspective, rhetoric articulates itself within, in relation to, and with Plato's dialogues in a much more subtle and complex manner than warranted by the process of “anti-rhetoricalness” initiated by philosophy against rhetoric after Plato. Going back to the origins of this conflict and recalling the system of oppositions supporting the official Platonic vulgate, this study begins to pave the way for a micr-reading of the Platonic text regarded as a paradigm of philosophic textuality. It is certainly true that the Phaedrus, the Gorgias, and the Symposium set up a system of oppositions between between rhetoric and dialectrics which are in contrast with each other in the word practices, in the rules and methods of discourse, and which are antinomic in their ends. This system of oppositions always seems to be referable to the opposition between “speaking fair” and “speaking the truth”. But the strategies and procedures set going in the Symposium, in particular in “Agathon's speech” and in “Diotima and Socrates' speech” betray a much closer connection between the supposed “bad rhetoric” revealed by Phaedrus and the “good rhetoric” which is dialectrics.The search for this connection is conducted through two types of reading of the Symposium. In actual fact, between the paronomasia on the agathoi and that on “Gorgias' head” (this Gorgon of rhetoric) there takes place a speech, Agathon's, whose parodied, exacerbated, and counterfeit rhetoric allows us to gauge Plato's own rhetoric in this artefact which distances itself, more or less openly, from Gorgian rhetoric. This “hyper-rhetoricalness” and “over-grammaticalness” cannot be there with the sole aim of serving as evidence against rhetoric. It is in fact possible to perceive through the web of the text the ends, quite rhetorical themselves, which preside over the structure of Agathon's speech, seen from the viewpoint of the figure of the antithesis.Thus, it is in the play of a “neo-rhetoricalness” where we must, in the last analysis, look for the spring allowing the philosophical discourse to overturn the rhetorical one. And while in Giorgias what clothes the discourse is actually the truth, in Plato it is the antinomy between “speaking fair” and “speaking the truth”, conveniently set up, which forms the basis of the function of diversion by which Socrates points out — in the complex network of the continuity and discontinuity existing between rhetoric and philosophy — the structures of reversal and the original upheavals which Plato imposes on the relation between rhetorical and dialectric discourse. Actually, dialectrics is found in “Socrates and Diotima's speech”, not as “anti-rhetoric”, but rather as a “transposition” of the rhetorical discourse, thus acquiring the traits of a “neo-rhetoric”. The analysis of this discourse, which constitutes the second reading exercise of the Symposium, allows us to pick out the aversion and inversion strategies that turn dialectrics in an overtuned rhetoric. The founding deed of this “inversion” (rather than “separation”) is recognizable in the alteration it introduces in the first plase in the type of discourse, which from a rhetorical, explicitly addressed, macrological, monological, and continuous discourse turns into a dialectical, brachylogous, dialogic discourse with partners and interlocutors, i.e. into a dialogue; in the second place, the subject of the discourse shifts from the locuteur, author and signer of the discourse to ever-present interlocutors who end up by making room for a talking and knowing speaker in a regime of anonymous subjectivity: this is an extreme alteration of the anthropological and epistemic subject, culminating in the scientific discourse of Euclidean geometry. Finally, the inversion is recognizable in the object of the discourse, whose prâgma slips from being the predicate of a qualified grammatical subject into a process of objectivation and substantivation, thereby moving from the rhetorical question “What is beautiful?” to the philosophical question “What is the beautiful?”.The hypothesis of a “neo-rhetoricalness” of dialectics, underlying this research, is therefore more Platonic than it appears, insofar as between rhetoric and dialectics there has been a tradition which has tried to wipe out the traces of its transmission, but where the neo-rhetoricalness of dialectics shows through quite clearly, taking advantage, without admitting it, from a more ancient rhetoric than it is itself. (A.T.). (shrink)

Collectively, lawyers probably seek in vain to be sufficiently trusted, even when most individual lawyers appear to do their utmost to behave responsibly. Efforts to address lawyers' behavioural failures remain an important social policy objective and a professional obligation. In this article we argue that it is politically sensible and socially responsible for the legal profession to continue to address its misbehaving members in a more fundamental manner than just the post-facto disciplinary process. We suggest that pre-emptive (pre-offence), ethics self-assessments (...) may limit the later incidence of misbehaviour and assist in rehabilitation programs for disciplined lawyers. We report on an experimental approach to lawyers' discovering more about their innate ethics. We have trialled lawyers' responses to a series of concrete statements about their ethical priorities and developed a statistically valid 'scale' (or set of statements) to allow lawyers in an Australian context to observe and reflect upon, their differing ethical approaches. To date, no such a scale has been developed for lawyers' ethics. The results of this scale development process are sufficiently encouraging to justify further work on similar scales for different cultures and legal traditions, in the interest of producing a tailored, reliable and valid instrument for general pre-emptive use within each local profession. The proposition that awareness improves conscious decision-making is not revolutionary or particularly contentious. While raising lawyers' awareness of how they make choices may only make a modest contribution to enhancing the ethical quality of their professional behaviour, it nevertheless seems plausible that it will raise their awareness and is therefore a worthwhile exercise. (shrink)

Providing effective feedback to patients in a rehabilitation training program is essential. As technologies are being developed to support patient training, they need to be able to provide the users with feedback on their performance. As there are various aspects on which feedback can be given, it is important to ensure that users are not overwhelmed by too much information given too frequently by the assistive technology. We created a rule-based set of guidelines for the desired hierarchy, timing, and (...) content of feedback to be used when stroke patients train with an upper-limb exercise platform which we developed. The feedback applies to both success on task completion and to the execution of compensatory movements, and is based on input collected from clinicians in a previous study. We recruited 11 stroke patients 1–72 months from injury onset. Ten participants completed the training; each trained with the rehabilitation platform in two configurations: with motor feedback and with no motor feedback. The two conditions were identical, except for the feedback content provided: in both conditions they received feedback on task success; in the MF condition they also received feedback on making undesired compensatory movements during the task. Participants preferred the configuration that provided feedback on both task success and quality of movement. This pilot experiment demonstrates the feasibility of a system providing both task-success and movement-quality feedback to patients based on a decision tree which we developed. (shrink)

ALTHOUGH I shall be attempting to examine the function of judgment, or what Aristotle called φρόνησις, in moral deliberation, I shall begin by discussing some previous opinions about what kind of importance examples have in moral experience. This strategy is only apparently circuitous. The role which one assigns to examples is symptomatic of the conception one has of judgment in moral decision-making, because the use of examples forms one way in which judgment is exercised. Indirectly, then, I shall be trying (...) to rehabilitate the significance of examples in moral deliberation. But the chief aim of this paper will be to determine both what is the function of judgment in moral deliberation and how we are to understand the activity of exercising it. (shrink)

The use of upper limb vibration during exercise and rehabilitation continues to gain popularity as a modality to improve function and performance. Currently, a lack of knowledge of the pathways being altered during ULV limits its effective implementation. Therefore, the aim of this study was to investigate whether indirect ULV modulates transmission along spinal and corticospinal pathways that control the human forearm. All measures were assessed under CONTROL and ULV conditions while participants maintained a small contraction of the (...) right flexor carpi radialis muscle. To assess spinal pathways, Hoffmann reflexes elicited by stimulation of the median nerve were recorded from FCR with motor response amplitudes matched between conditions. An H-reflex conditioning paradigm was also used to assess changes in presynaptic inhibition by stimulating the superficial radial nerve 37 ms prior to median nerve stimulation. Cutaneous reflexes in FCR elicited by stimulation of the SR nerve at the wrist were also recorded. To assess corticospinal pathways, motor evoked potentials elicited by transcranial magnetic stimulation of the contralateral motor cortex were recorded from the right FCR and biceps brachii. ULV significantly reduced H-reflex amplitude by 15.7% for both conditioned and unconditioned reflexes. Therefore, ULV inhibits cutaneous and H-reflex transmission without influencing corticospinal excitability of the forearm flexors suggesting increased presynaptic inhibition of afferent transmission as a likely mechanism. A general increase in inhibition of spinal pathways with ULV may have important implications for improving rehabilitation for individuals with spasticity. (shrink)

In recent years, direct brain interventions have shown increased success in manipulating neurobiological processes often associated with moral reasoning and decision-making. As current DBIs are refined, and new technologies are developed, the state will have an interest in administering DBIs to criminal offenders for rehabilitative purposes. However, it is generally assumed that the state is not justified in directly intruding in an offender’s brain without valid consent. Thomas Douglas challenges this view. The state already forces criminal offenders to go to (...) jail without their consent. This represents a serious interference with an offender’s rights. If criminal offenders are already morally liable to incarceration, why is the state not also entitled to administer DBIs without consent for the purposes of rehabilitation? Douglas argument focuses on the right to ‘bodily integrity’. He argues that there is no compelling reason to believe that bodily rights that protect an offender from non-consensual DBIs are stronger than rights that protect an offender from incarceration. This paper will extend Douglas’ analysis. It will consider the more fundamental right to ‘mental integrity’. The right to mental integrity defends an inner sphere of liberty. It protects critical capacities necessary for the exercise of autonomous human agency—without which a vast majority of moral rights could not exist. Thus, the right to mental integrity is ultimately more important for a moral assessment of DBIs. The right strongly suggests that both presently, and in the future, there may be many cases in which the state is not entitled to administer DBIs to criminal offenders without valid consent. (shrink)

Taking its cue from Augustine’s hesitancy to punish, this article develops an account of punishment as an exercise in Christian subjectivity, understanding by the latter term ‘self-knowledge’ and ‘being subject to another’s control.’ Framed in terms of the sacrament of reconciliation and mediated through the Late Medieval Ecclesiastical Courts, the explicit contours of this Christian subjectivity gradually eroded as secular practices and theories (retribution, rehabilitation, deterrence, and restorative) developed during the nineteenth and twentieth centuries. In the process, the (...) rehabilitative ethos that this subjectivity upheld was lost also. Retrieving it is essential for understanding contemporary punishment from a Christian perspective. (shrink)

It is widely agreed that the ‘Logical’ Argument from Evil (LAFE) is bankrupt. We aim to rehabilitate the LAFE, in the form of what we call the Normatively Relativised Logical Argument from Evil (NRLAFE). There are many different versions of a NRLAFE. We aim to show that one version, what we call the ‘right relationship’ NRLAFE, poses a significant threat to personal-omniGod-theism—understood as requiring the belief that there is an omnipotent, omniscient, perfectly good person who has created our world—because it (...) appeals to value commitments theists themselves are likely to endorse. The ultimate success of this NRLAFE will rest on developing a theological ethics of right relationship that rejects as morally flawed the exercise of omnipotence first to sustain horrors and then to redeem them. Yet a vindicated NRLAFE of this sort need not require atheism, but only rejection of the standard conception of God as a personal omniGod. (shrink)

Invasive neural devices offer novel prospects for motor rehabilitation on different levels of agentive behavior. From a functional perspective, they interact with, support, or enable human intentional actions in such a way that movement capabilities are regained. However, when there is a technical malfunction resulting in an unintended movement, the complexity of the relationship between the end user and the device sometimes makes it difficult to determine who is responsible for the outcome – a circumstance that has been coined (...) as “responsibility gap” in the literature. So far, recent accounts frame this issue around the theme of control but more work is needed to explore the complicated terrain of assigning responsibility for neural device-mediated actions from this control perspective. This paper aims at contributing to this tendency by offering more fine-grained distinctions of how that control capacity is facilitated by the machine and how it can be exercised by the end user. This results in a novel framework that depicts an in-depth exploration of the control aspect of responsibility in a way that incorporates the diversity of relationships between neurotechnologies, the various conditions they treat, and the individual end user’s experience. (shrink)

This collection of thirty yoga and mindfulness tools will help support those in recovery from addiction of all kinds. Thirty accessible, pointed teachings offer inspiration, comfort, and solidarity in the moment, helping us cultivate a powerful and purposeful life in recovery, and to create a new design for living. Each chapter focuses on a quality-such as vigilance, acceptance, accountability, among others-and delves into how to manifest it in your recovery journey. Brian Hyman, a yoga teacher and recovery activist, understands deeply (...) what people need to maintain sobriety and strengthen recovery-and knows that those who struggle with addiction also often need support with other mental health challenges, like obsession, anxiety, depression. He uses yogic philosophy, mindfulness teachings, personal anecdotes, and secular wisdom to illuminate each quality and the role it plays in helping us create the life we want. The practices--which include inquiry questions, meditations, awareness exercises, breathing practices, yoga nidra, among others--will quiet the mind in difficult moments, support us as we establish meaningful relationships, and reinforce the power that recovery offers us. Hyman offers resources and additional reading suggestions in the back matter. Based on Hyman's popular online course, this book is essential reading for people of all ages in recovery-along with their family members and friends, and anyone in a health care profession who works with those struggling with addiction of any kind. Hyman includes a list of recovery organizations and a reading list in the back matter. (shrink)

This book consists of ten chapters, an Introduction, and an Appendix. Of these twelve sections, eight have appeared previously. Although in the Acknowledgments he writes that "the essays have been revised for publication in this volume," the Introduction is more honest when it admits the failure of his "original plan... to rewrite essays in order to relate a coherent narrative". The disdain for coherence and narrative unity is of course part of what Bernstein calls the "'modern/postmodern' Stimmung", and the title's (...) use of composite terms, as well as the guiding concepts of "constellation" and "force-field" borrowed from the Frankfurt School via Martin Jay demonstrate the author's attempts at a sympathetic engagement with a direction of thought that is obviously at odds with his deepest philosophical impulses. Viewed as a whole, the book bears a strong resemblance to the The Philosophical Discourse of Modernity of Habermas, a philosopher with whose work Bernstein has long been identified and who is prominently mentioned in the Acknowledgments. Three introductory chapters precede a chapter on Heidegger in which a lengthy and sympathetic textual discussion is followed by a shorter, harsh judgment of Heidegger's silence concerning the criminality of the National Socialist regime, and of the connection of this ethical failure with his philosophy. Bernstein follows, as does Habermas, with chapters on Foucault and Derrida, in addition to one on the Derrida-Habermas controversy itself which arose from the publication of Habermas's book. Rather than treating Bataille, Bernstein devotes two chapters to the political implications of Richard Rorty's recent writings, and Bernstein also concludes with two chapters on his own position, the first proposing a rehabilitation of determinate negation, and the second outlining his pragmatic "engaged fallibilistic pluralism" based on a "model of dialogical encounter". Nietzsche, for Habermas the "turning point" of modernity, is thematically absent from Bernstein's book. This is emblematic of the collection as a whole, robbing postmodernism of its philosophical point and encouraging treatment of it as a "pervasive, amorphous mood". The thrust of Bernstein's analysis is less theoretical than Habermas's though often dependent on Habermas's conclusions. Replacing his previous focus on praxis with one on ethos, Bernstein is especially concerned with ethical and political implications of the positions he examines. The level of Bernstein's ethical-political "analysis," however, is concrete in what often seems to be an arbitrary way. He is indulgent of Foucault and Derrida, but Rorty is warned about his similarity to "neo-conservatives" and "[Daniel] Bell and his fellow travelers". Nothing is said about Derrida's ambiguous apologias for Heidegger and Paul de Man as exercises in the ethics of deconstruction. Bernstein notes similarities between Rorty's irony and Mussolini's cynicism, but is silent about Foucault's advocacy of Khomeini's Islamic revolution. Perhaps most bizarrely, Bernstein notes at the beginning of chapter 4 that "throughout his writings, Heidegger typically uses masculine forms of speech. To avoid artificiality, I have followed his usage". Needless to say, this "usage" is not "typical" only of Heidegger. The question of the ethical and political implications of postmodernism is certainly a deeply significant one. But this is philosophy that is "political" in a way that many will find repugnant as well as unedifying. Despite all talk of a "new constellation" and "openness to the Other," many--not only those who are familiar with Bernstein's previous publications--who sit down with this book will find themselves faced with the same old thing.--Robert Rethy, Xavier University. (shrink)

Giving Voice to Values is a very important tool that has helped many professionals better align what they do with what they value and believe. This book introduces the methodology of Socratic Dialogue as a complementary set of tools for creating spaces of joint reflection in which one can gain clarity about one's values and gain the confidence to voice them effectively. Socrates' main concern was to progressively reach a higher alignment between ideas and actions: that is, to achieve a (...) harmony between what we think, what we say and what we do. The first step to giving voice to our values involves introspection and dialogue with others - which is how we can become aware of what we really think and value. An examined life, Socrates reminds us, is a fulfilled one. Based on more than 10 years' experience teaching Socratic Dialogue to business and law students, executives and professionals, faculty, incarcerated people and other vulnerable groups, the book provides teachers and practitioners with a roadmap to conceive, design and conduct Socratic Dialogue courses and sessions. It provides context for the method and its adaptation to the challenges of the 21st century. The book also offers guidance on how to structure a Socratic Dialogue classroom, as well as a series of tried-and-true activities and exercises, practical recommendations, and testimonies of the transformative impact that dialogue courses have had on participants. The book is of prime interest to professors and educators of business ethics, as well as professional consultants working to help organizations become more responsible and introduce ethical reasoning in their decisions. It also serves as a valuable resource for social educators and practitioners in prisons and rehabilitation units, as well as teachers in primary and secondary education. (shrink)

This paper develops computational models to monitor patients with hip replacement surgery. The Kinect camera is used to capture the movements of patients who are performing rehabilitation exercises with both lower limbs, specifically, ‘side step’ and ‘knee lift’ with each leg. The information is measured at 25 body points with their respective coordinates. Features selection algorithms are applied to the 75 attributes of the initial and final position vector of each rehab exercise. Different classification techniques have been tested (...) and Bayesian networks, supervised classifier system and genetic algorithm with neural network have been selected and jointly applied to identify the correct and incorrect movements during the execution of the rehabilitation exercises. Besides, prediction models of the evolution of a patient are developed based on the average values of some motion related variables. These models can help to fasten the recovery of these patients. (shrink)

Motor imagery is often used inducing changes in electroencephalographic (EEG) signals for imagery-based brain-computer interfacing (BCI). A BCI is a device translating brain signals into control signals providing severely motor-impaired persons with an additional, non-muscular channel for communication and control. In the last years, there is increasing interest using BCIs also for healthy people in terms of enhancement or gaming. Most studies focusing on improving signal processing feature extraction and classification methods, but the performance of a BCI can also be (...) improved by optimizing the user’s control strategies, e.g., using more vivid and engaging mental tasks for control. We used multichannel EEG to investigate neural correlates of a sports imagery task (playing tennis) compared to a simple motor imagery task (squeezing a ball). To enhance the vividness of both tasks participants performed a short physical exercise between two imagery sessions. EEG was recorded from 60 closely spaced electrodes placed over frontal, central, and parietal areas of 30 healthy volunteers divided in two groups. Whereas Group 1 (EG) performed a physical exercise between the two imagery sessions, Group 2 (CG) watched a landscape movie without physical activity. Spatiotemporal event-related desynchronization (ERD) and event-related synchronization (ERS) patterns during motor imagery (MI) tasks were evaluated. The results of the EG showed significant stronger ERD patterns in the alpha frequency band (8–13 Hz) during MI of tennis after training. Our results are in evidence with previous findings that MI in combination with motor execution has beneficial effects. We conclude that sports MI combined with an interactive game environment could be a future promising task in motor learning and rehabilitation improving motor functions in late therapy processes or support neuroplasticity. (shrink)

In this chapter I use virtue theory to critique certain contemporary punishment practices. From the perspective of virtue theory, respect for rational agency indicates a respect for choice-making as the process by which we form dispositions which in turn give rise to further choices and action. To be a moral agent one must be able to act such that his or her actions deserve praise or blame; virtue theory thus demands that moral agents engage in rational choice-making as a means (...) to develop and exercise the character traits from which culpable action issues. With respect to criminal offenders, virtue theory indicates the state is obligated to recognize offenders’ right to form their own moral character via rational choice-making, even while under state supervision. I will argue below that punishment practices should limit choice-making only to the extent necessary to achieve the functions of punishment : whenever possible, punishment should preserve opportunities for the rational exercise of character and development of virtue. This means that even within a prison setting incarcerated offenders should be able to make some choices about their daily lives. Offenders should also be offered opportunities to develop virtuous traits through rehabilitative programming such as drug addiction treatment, educational programming, and job training. I will also argue that two contemporary punishment practices unjustly undermine an offender’s moral agency. The first is the overuse of isolation sanctions, which very severely limits offender choice-making. The second is chemical castration, which results in limiting an offender’s capacity to develop his character within a specific realm of choice-making. I conclude that these two punishments violate offenders’ moral agency, and that this violation cannot be justified by appeal to the aims of incapacitation, deterrence, retribution, and rehabilitation. (shrink)

This essay examines how Michel Henry's and Jean‐Luc Marion's continuation of phenomenology's turn to the invisible relates to painting, aesthetics, and theology. First, it discusses Henry and Marion's redefinition of phenomenality. Second, it explores Henry's “Kandinskian” description of abstract painting as expressing “Life.” Third, it explicates Marion's “Rothkoian” rehabilitation of the idol and renewed zeal for the icon—both phenomena exemplify “givenness.” Fourth, it unpacks my thesis: Henry's phenomenology, theologically applied, exercises an inadequate Kantian apophasis, characterized by a sublime sacrifice (...) of the imagination; although Marion's work sometimes evidences a similar tendency, its prevailing momentum offers theology a fully catholic scope. (shrink)

Motor training to improve walking and balance function is a common aspect of rehabilitation following motor-incomplete spinal cord injury. Evidence suggests that moderate- to high-intensity exercise facilitates neuroplastic mechanisms that support motor skill acquisition and learning. Furthermore, enhancing corticospinal drive via transcranial direct current stimulation may augment the effects of motor training. In this pilot study, we investigated whether a brief moderate-intensity locomotor-related motor skill training circuit, with and without tDCS, improved walking and balance outcomes in persons with (...) MISCI. In addition, we examined potential differences between within-day and between-day effects of MST. Twenty-six adults with chronic MISCI, who had some walking ability, were enrolled in a 5-day double-blind, randomized study with a 3-day intervention period. Participants were assigned to an intensive locomotor MST circuit and concurrent application of either sham tDCS or active tDCS. The primary outcome was overground walking speed measured during the 10-meter walk test. Secondary outcomes included spatiotemporal gait characteristics, peak trailing limb angle, intralimb coordination, the Berg Balance Scale, and the Falls Efficacy Scale-International questionnaire. Analyses revealed a significant effect of the MST circuit, with improvements in walking speed, cadence, bilateral stride length, stronger limb TLA, weaker limb ACC, BBS, and FES-I observed in both the MST+tDCSsham and MST+tDCS groups. No differences in outcomes were observed between groups. Between-day change accounted for a greater percentage of the overall change in walking outcomes. In persons with MISCI, brief intensive MST involving a circuit of ballistic, cyclic locomotor-related skill activities improved walking outcomes, and selected strength and balance outcomes; however, concurrent application of tDCS did not further enhance the effects of MST.Clinical Trial Registration[ClinicalTrials.gov], identifier [NCT03237234]. (shrink)

Descartes entitled the Sixth Meditation "The existence of material things, and the real distinction between mind and body." But these topics take up only two paragraphs, about one-third of the way into the Sixth Meditation (which is the longest of the six). The other topics in the Meditation partly pertain to the cognitive faculties that a seeker after knowledge must employ: senses, imagination, and intellect. They also concern the mind–body relation: not only is it to be shown that mind and (...) body are distinct, but also that they are “closely joined” together. The joining of mind to body contributes to explanations of the cognitive faculties, for such a joining is, in Descartes’ view, necessary for the operation of sense and imagination, whereas the exercise of the intellect in the pursuit of metaphysical results -- as in his argument for mind–body distinctness -- takes place without the mind interacting with the body. But this still doesn't account for the most sustained discussion in the Sixth Meditation, which concerns the role of the senses in informing us about the world around us. While the trustworthiness of the senses has been under suspicion up to this point in the Meditations, now the senses are rehabilitated. They can serve to acquaint us with the world of bodies, for the purposes of empirical investigation serving natural philosophy but, more usually, for the practical purpose of informing us of potential benefits and harms in our immediate environment. In this regard, Descartes considers the ways in the senses might be subject to local errors or might, if used inappropriately, draw us into systematic error. But the previous results of the Meditations now offer the means for avoiding such systematic error, and the reflections of the Sixth Meditation can guide us toward practical uses of the senses in ways that reduce error. In the end, the senses are found to be trustworthy for the guidance of action, and this trustworthiness extends even to a qualitative experience such as color, which helps us to discriminate among the bodies that we see. (shrink)

This study examined Flow with Nature treatment, which is an integrative intervention based on eco and environmental psychology, psychotherapeutic theories and professional psychological practice. FWN is intended for depression rehabilitation with the help of social support, nature environments and FWN exercises. Exercises encourage sensing the environment, mindful awareness, psychological processing and focusing on the future. The FWN treatment proceeds in separate stages, which emphasise nature, group and FWN exercises differently. This study focused on the experiences of the participants in (...) the FWN treatment. Finnish adults who had been diagnosed with clinical depression took part in the FWN treatment and answered feedback questions. Answers were analysed using theory-based content analysis. Data were collected between spring 2019 and spring 2020. The majority of the participants were women and on average 44 years old. Content analysis revealed that the participant feedback answers were in agreement with the central theoretical themes of FWN. The participants emphasised the significance of nature, social support and exercises differently. Moreover, the significance of these ingredients differed according to the stages of treatment: in the horizon stage restorative and comprehensive nature experiences, in the growth stage social support and in the path stage environmental self-regulation were emphasised. These results are in accordance with the objectives of the stages and seem to support the phase-based rationale. The participants’ experiences of the key elements of the intervention, social support and nature environment were experienced mainly positively, which supports their inclusion in future intervention versions. In the future, FWN exercises should be developed to better enable participants’ possibilities for concentration and being present in the moment. Exercises should also be simplified to match the target group’s cognitive abilities. (shrink)

In this paper, we focus on the human upper limb rehabilitation scheme that utilizes the concept ofteleoperation. Teleoperation can help the therapist demonstrate different rehab exercises to a different group of people at the same time remotely. Different groups of people from a different place connected to the same network can get therapy from the same therapist at the same time using the telerehabilitation scheme. Here, we presented a humanoid robot NAO that can be operated remotely by a therapist (...) to demonstrate the exercise to a patient. To mimic the movement demonstrated by the therapist, Kinect V2 sensor which is a markerless vision-based motion-tracking device, was used. Modified Denavit-Hartenberg (DH) convention was used for the kinematic modeling of the human upper arm. From the Kinect data, a geometric solution was developed to find a unique inverse kinematic solution of human upper-extremity. Experimental results revealed that NAO could be teleoperated successfully to instruct and demonstrate patients to perform different arm movement exercises in real-time. (shrink)

A major concern of public health authorities is to also encourage adults to be exposed to enriched environments during the pandemic lockdown, as was recently the case worldwide during the COVID-19 outbreak. Games for adults that require physical activity, known as exergames, offer opportunities here. In particular, the output of the gaming industry nowadays offers computer games with extended reality which combines real and virtual environments and refers to human-machine interactions generated by computers and wearable technologies. For example, playing the (...) game in front of a computer screen while standing or walking on a force plate or treadmill allows the user to react to certain infrastructural changes and obstacles within the virtual environment. Recent developments, optimization, and minimizations in wearable technology have produced wireless headsets and sensors that allow for unrestricted whole-body movement. This makes the virtual experience more immersive and provides the opportunity for greater engagement than traditional exercise. Currently, XR serves as an umbrella term for current immersive technologies as well as future realities that enhance the experience with features that produce new controllable environments. Overall, these technology-enhanced exergames challenge the adult user and modify the experience by increasing sensory stimulation and creating an environment where virtual and real elements interact. As a therapy, exergames can potentially create new environments and visualizations that may be more ecologically valid and thus simulate real activities of daily living that can be trained. Furthermore, by adding telemedicine features to the exergame, progress over time can be closely monitored and feedback provided, offering future opportunities for cognitive-motor assessment. To more optimally serve and challenge adults both physically and cognitively over time in future lockdowns, there is a need to provide long-term remote training and feedback. Particularly related to activities of daily living that create opportunities for effective and lasting rehabilitation for elderly and sufferers from chronic non-communicable diseases. The aim of the current review is to envision the remote training and monitoring of physical and cognitive aspects for adults with limited mobility, through the implementation of concurrent telehealth and exergame features using XR and wireless sensor technologies. (shrink)

BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this trial (...) aims to assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

One of the ways our legal system has avoided confronting this ugly reality is through a commitment to legal formalism. Legal formalism allows us to ignore the social determinants that my AUSA friend saw every day as he prosecuted federal drug cases. As my colleague Professor Michael Seidman has suggested, legal formalism, which has been effectively critiqued and displaced by legal realism in many other areas of law, continues to exercise considerable influence over the way we think about criminal (...) law. This formalist approach, in my view, has strongly affected the way we approach the drug problem. One consequence is that we continue to pursue an increasingly futile war on drugs and refuse to see the issue in its broader, realist dimension. A little realism on the subject of drugs, I suggest, would go a long way. There is much to be said for formalism in the criminal law. Formalism, with its commitment to fair procedures, clear rules, and restricted discretion, is a necessary part of any fair system of criminal law. The sanctions involved in the criminal system are too severe to permit them to be allocated in an open ended discretionary or regulatory manner. The criminal law's commitment to formalism is thus not a fault, but a strength. Discretionary regulatory schemes too often invite subjective judgments susceptible to abuse, prejudice, and favoritism. Formalist rules, by contrast, are built on the promise of treating likes alike. Precisely for this reason, however, we ought to reconsider whether the criminal approach makes sense when there is substantial evidence that the commitment to equality has been seriously compromised. Our dual commitments to equality and to the reduction of the human damage that drug abuse inflicts suggest that we should reduce our reliance on the criminal justice system. Alternative approaches, such as treatment and rehabilitation, promise to be both more effective and more fair. (shrink)

Many have written of imperial qualities perceived or publicized, particularly of those attached to the emperor Constantine. Although only a tediously exhaustive volume could do justice to the whole subject, and any essay which does not embrace the whole runs the risk of being faulted for some omission or other, one may yet justify a particular concern. The subject of the present paper is the tension between form and function, which appears nowhere so readily as in a series of similar (...) literary exercises spanning a number of years, and the demonstration that form will always yield to practical necessity. For example, the rise, fall, and rehabilitation of Maximian through seven of the Panegyrici Latini clearly illustrates the many functions of a standard form. Constantine's is a more complicated case which involves two kinds of form and a certain amount of Augustan posturing. (shrink)

This doctoral dissertation deals with the psychotherapeutic factor that permeates the whole Epicurean philosophical program. It is the aim of this study to research and to rehabilitate its healing function. Since the Garden’s philosophy is a very systematic one, the question about the natural reality, φύσις, had to be addressed firstly. Anti-nihilism, materialism, eternal atoms, infinite void, perpetual movement, clinamen and the plurality worlds are key notions of the axiomatic and scientific Epicurus’ physics. Once we had gained clarity about those (...) core concepts, the central role of human beings in the system was to be discussed. As natural, yet exceptional, atomic compounds, men and women do have flesh and soul and are, therefore, completely mortal. Nevertheless, they possess numerous qualities, originating in their ψυχή, which render them unique : freedom, rationality and even a material community with the gods. According to Epicurus, there is a fourth element constituting the souls of both people and deities, so that a physical continuity and material formation are preserved through the entire nature. Gods are studied from a naturalistic physiologic perspective and at the very same time they act exemplary and, freed from any providential, governing tasks, they provide a regula uitae in order to achieve a pleasant, authentic happiness. In fact, this research tries to demonstrate that complete curation is not to be linked to an eternal extra-corporeal soul, but arises from the removal of pain and fear, aponia and ataraxia. These two are the paramount pleasures, far distant from a gross hedonism. Ethics are, then, presented as a soothing practice, having a nuclear medical purpose. Taking this into account, it was necessary to explore the historical connections between philosophy and rational Hellenic medicine before Epicurus. After that, multiple therapeutic forms conceived or applied by the Samian philosopher were analyzed. The λόγος proved to be the unifying element among them and involved not only human reason but also analogy. Epicurus’ diagnose is very sad: we are in pain. To reverse that, he presented exercises such as meditation, confession, self-examination, laugh therapy, emotional intelligence, intrusive thoughts control, companionship, solidarity and friendship. There are still two additional therapies completing the above mentioned: an Epicurean thanatology, because we miss the point when considering (im)mortality and forget about sensation as the ground of any life; and an ars desidrandi, because we should accept only natural and necessary desires, instead of chasing whimsy dreams with vain hopes. All this will help us regain our primal bodily and mental health and happiness, our essential, frugal and glad wellbeing. By means of prudence and reflection, governing our body and cultivating our mind we will liberate ourselves and taste a durable, profound, stable joy, comparable to that of the gods. (shrink)

This book deals with the psychotherapeutic factor that permeates the whole Epicurean philosophical program. It is the aim of this study to research and to rehabilitate its healing function. Since the Garden’s philosophy is a very systematic one, the question about the natural reality, φύσις, had to be addressed firstly. Anti-nihilism, materialism, eternal atoms, infinite void, perpetual movement, clinamen and the plurality worlds are key notions of the axiomatic and scientific Epicurus’ physics. Once we had gained clarity about those core (...) concepts, the central role of human beings in the system was to be discussed. As natural, yet exceptional, atomic compounds, men and women do have flesh and soul and are, therefore, completely mortal. Nevertheless, they possess numerous qualities, originating in their ψυχή, which render them unique: freedom, rationality and even a material community with the gods. According to Epicurus, there is a fourth element constituting the souls of both people and deities, so that a physical continuity and material formation are preserved through the entire nature. -/- Gods are studied from a naturalistic physiologic perspective and at the very same time they act exemplary and, freed from any providential, governing tasks, they provide a regula uitae in order to achieve a pleasant, authentic happiness. In fact, this research tries to demonstrate that complete curation is not to be linked to an eternal extra-corporeal soul, but arises from the removal of pain and fear, aponia and ataraxia. These two are the paramount pleasures, far distant from a gross hedonism. Ethics are, then, presented as a soothing practice, having a nuclear medical purpose. Taking this into account, it was necessary to explore the historical connections between philosophy and rational Hellenic medicine before Epicurus. After that, multiple therapeutic forms conceived or applied by the Samian philosopher were analyzed. The λόγος proved to be the unifying element among them and involved not only human reason but also analogy. Epicurus’ diagnose is very sad: we are in pain. To reverse that, he presented exercises such as meditation, confession, self-examination, laugh therapy, emotional intelligence, intrusive thoughts control, companionship, solidarity and friendship. There are still two additional therapies completing the above mentioned: an Epicurean thanatology, because we miss the point when considering (im)mortality and forget about sensation as the ground of any life; and an ars desidrandi, because we should accept only natural and necessary desires, instead of chasing whimsy dreams with vain hopes. All this will help us regain our primal bodily and mental health and happiness, our essential, frugal and glad wellbeing. (shrink)

Although the neural bases of the brain associated with movement disorders in children with developmental coordination disorder are becoming clearer, the information is not sufficient because of the lack of extensive brain function research. Therefore, it is controversial about effective intervention methods focusing on brain function. One of the rehabilitation techniques for movement disorders involves intervention using motor imagery. MI is often used for movement disorders, but most studies involve adults and healthy children, and the MI method for children (...) with DCD has not been studied in detail. Therefore, a review was conducted to clarify the neuroscientific basis of the methodology of intervention using MI for children with DCD. The neuroimaging review included 20 magnetic resonance imaging studies, and the neurorehabilitation review included four MI intervention studies. In addition to previously reported neural bases, our results indicate decreased activity of the bilateral thalamus, decreased connectivity of the sensory-motor cortex and the left posterior middle temporal gyrus, bilateral posterior cingulate cortex, precuneus, cerebellum, and basal ganglia, loss of connectivity superiority in the abovementioned areas. Furthermore, reduction of gray matter volume in the right superior frontal gyrus and middle frontal gyrus, lower fractional anisotropy, and axial diffusivity in regions of white matter pathways were found in DCD. As a result of the review, children with DCD had less activation of the left brain, especially those with mirror neurons system and sensory integration functions. On the contrary, the area important for the visual space processing of the right brain was activated. Regarding of characteristic of the MI methods was that children observed a video related to motor skills before the intervention. Also, they performed visual-motor tasks before MI training sessions. Adding action observation during MI activates the MNS, and performing visual-motor tasks activates the basal ganglia. These methods may improve the deactivated brain regions of children with DCD and may be useful as conditioning before starting training. Furthermore, we propose a process for sharing the contents of MI with the therapist in language and determining exercise strategies. (shrink)