Stroke is a common and frequently-occurring disease, which seriously endangers human health. Rehabilitation treatment can effectively reduce the disability rate of stroke and improve the quality of life. The tertiary rehabilitation treatment system for stroke can effectively improve the motor function of stroke patients and improve the quality of life. This paper focuses on the choices and methods of physical therapy and occupational therapy at all levels of the hospitals and in different periods of the disease. It also aims to summarize the tertiary rehabilitation strategy for motor dysfunction in stroke patients, to provide references for all levels of hospitals and communities, achieve standardization and unification of rehabilitation treatment, as well as the rehabilitation efficacy of homogeneity.
Chronic kidney diseases (CKD) with long duration and a variety of complications have caused great physical and psychological problems for patients, and the overall quality of life of patients is low. Taijiquan, as a traditional Chinese techniques project, is beneficial to improving cardiopulmonary function, enhancing lower limb muscle strength, and reducing cardiovascular and cerebrovascular risks. We summarized the latest progress in clinical research concerning taijiquan as exercise rehabilitation for patients with CKD, aiming to promote the clinical application of taijiquan and other traditional exercises in the rehabilitation process of CKD patients and improve the overall quality of life of CKD patients.
According to a guideline on promoting the high-quality development of public hospitals issued by the General Office of the State Council and a guideline on accelerating the development of medical rehabilitation, a high-quality and efficient rehabilitation system should be established, and efforts should be made to promote the high-quality development of rehabilitation services in public hospitals. We propose an action guideline for promoting the high-quality development of rehabilitation services in public hospitals, which is based on a Delphi method questionnaire on the opinions of front-line clinical rehabilitation experts, and integrated with relevant literature and evidences. This guideline introduces 31 specific action plans from 7 dimensions, including standardization of basic rehabilitation settings, standardization of clinical rehabilitation techniques, improvement of the tertiary rehabilitation system, standardization of emergency rehabilitation, standardization of rehabilitation education, standardization of rehabilitation management, and promotion of scientific and technological innovation in rehabilitation medicine.
Sensorimotor disorder can be easily caused by stroke, and there are many targeted movement rehabilitation therapies. With the development of rehabilitation robot technology, robot-assisted therapy combined with mechanical perturbations has become a more effective motor rehabilitation therapy. In this paper, the definition of mechanical perturbation and its physiological mechanism in stroke rehabilitation are introduced, the research progress on mechanical perturbation in the field of stroke rehabilitation therapy is mainly discussed, the application of mechanical perturbation in motor control, postural response and sensory evaluation of stroke rehabilitation is summarized, and the future development direction of mechanical perturbation rehabilitation therapy is also prospected.
ObjectiveTo clarify the intervention guidance of return to sports WeChat applet and evaluate the rehabilitation effectiveness after anterior cruciate ligament (ACL) reconstruction. MethodsBetween September 2020 and September 2022, 80 patients who met the selection criteria and underwent ACL anatomical single bundle reconstruction were selected as the research objects. According to the double-blind random method, they were divided into the applet group and the regular group, with 40 cases in each group. Patients in the applet group were rehabilitated under the guidance of the return to sports WeChat applet, and the patients were asked to perform the test once a month after operation, including patients’ subjective scores [Tegner score, knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) score, American Hospital for Special Surgery (HSS) score], psychological assessment [ACL recovery sports injury scale (ACL-RSI) score], jumping test, balance test, bending angle test. Patients in the regular group were followed up by doctors and nurses regularly by telephone every month. All the patients were reexamined at 3, 6, 9, and 12 months after operation, and the range of motion of the knee joint with 6 degrees of freedom (flexion and extension angle, varus and valgus angle, internal and external rotation angle, anteroposterior displacement, superior and inferior displacement, and internal and external displacement) recorded by Opti_Knee three-dimensional knee joint motion measurement gait analysis system was observed. The anterior tibial translation difference (ATTD) was measured by Ligs knee measuring instrument when a forward thrust of 120 N was applied to the posterior part of the proximal tibia. Tegner score, IKDC score, KOOS score (including KOOS-Pain score, KOOS-Symptoms score, KOOS-Activities of daily living score, KOOS-Sport score, and KOOS-Quality of life score), HSS score, ACL-RSI score, jumping ability, balance ability, patients’ satisfaction with the rehabilitation process, and ACL healing grading according to ACL continuity and signal intensity shown by MRI. Results There were significant differences in various indicators between different time points after operation in the two groups (P<0.05). At 3 months after operation, except that the ACL-RSI score of the applet group was significantly higher than that of the regular group (P<0.05), there was no significant difference in the other indicators between the two groups (P>0.05). At 6 months after operation, the ACL-RSI score, IKDC score, Tegner score, KOOS scores of different items, HSS score, balance and jumping ability of the applet group were significantly higher than those of the regular group (P<0.05), and there was no significant difference in the other indicators between the two groups (P>0.05). At 9 months after operation, there was no significant difference in all indicators between the two groups (P>0.05). At 12 months after operation, 27 cases (67.5%) in the applet group and 21 cases (52.5%) in the regular group returned to sport, with a significant difference of the return to sports incidence between the two groups [RR(95%CI)=1.50 (1.00, 2.25), P=0.049]. In the applet group, 27 cases were very satisfied with the rehabilitation process, 10 cases were satisfied, 2 cases were basically satisfied, and 1 case was not satisfied, while 19, 13, 5, and 3 cases in the regular group, respectively. The satisfaction degree of the applet group was significantly better than that of the regular group (P=0.049). MRI examination of the two groups showed that the ACL was continuous without secondary rupture or necrosis. The ACL healing grade of the applet group was 31 cases of grade 1 and 9 cases of grade 2, and that of the regular group was 28 cases of grade 1 and 12 cases of grade 2, there was no significant difference in ACL healing grade between the two groups (P=0.449). ConclusionThe application of return to sports WeChat applet in the rehabilitation of patients after ACL reconstruction can significantly reduce the fear of return to sports and improve the rate of return to sports. The return to sports WeChat applet is convenient to operate, with high utilization rate and high patient compliance, which significantly improves the satisfaction.
Within 4 weeks after Lushan earthquake, 400 person-times were rescued in the West China Hospital of Sichuan University. There were 325 hospitalized victims, 238 surgeries including 202 orthopedic surgeries, 28 critical victims, and 1 severe victim. In order to avoid and reduce the complications, minimize disability, and recover in the early stage, a set of early rehabilitation nursing process was established by the department of rehabilitation of the West China Hospital since the 28th hour after the earthquake: set up the emergency teams for early rehabilitation nursing, and clarify the responsibilities of each team; select the technicians of early rehabilitation nursing, and perform scientific management; build the information platform for early rehabilitation nursing, and make information unobstructed; strengthen the cooperation with professional and social organizations. This nursing mode helps the victims get rehabilitation care and treatment timely and efficiently. Up to the 4 weeks after earthquake, 178 person-times recover, accounted for 44.5%; and the records of 69 victims in Wenjiang branch of the hospital show zero death after orthopedic surgery.
Objective To explore the effects of different intensity of inspiratory muscle training on pulmonary function, hospitalisation time and quality of life of critically ill patients. Methods A total of 42 patients were included in the intensive care ward, high dependency ward, and cardiac surgery ward of the Southern Theatre General Hospital from January 2023 to June 2023, and were randomly divided into 14 cases in the control group, 14 cases in the low-intensity inspiratory muscle training group, and 14 cases in the moderate-intensity inspiratory muscle training group; conventional treatment was used for the control group, and 20% of the maximum inspiratory pressure (MIP) was added as the starting threshold load for inspiratory muscle training for the patients of the low-intensity inspiratory muscle training group on the basis of conventional treatment. In the control group, conventional treatment was used; in the low-intensity inspiratory muscle training group, 20% of the maximum inspiratory pressure (MIP) was added to the conventional treatment as the starting threshold load for inspiratory muscle training; in the medium-intensity inspiratory muscle training group, 40% of the MIP was added to the conventional treatment as the starting threshold load for inspiratory muscle training; and the maximal inspiratory pressure, exertional lung capacity, diaphragm thickness and mobility, hospital stay and quality of life were evaluated after 6 weeks of training. Results A total of 40 patients completed the training, and the three groups showed statistically significant differences in MIP (P<0.05) and statistically significant differences in exertional lung capacity (P<0.05). There was no statistically significant difference in diaphragm thickness (P=0.566), and diaphragm mobility was lower in the control group than in the low-intensity inspiratory muscle training group (P=0.021), and there was also a difference between the low-intensity inspiratory muscle training group and the moderate-intensity inspiratory muscle training group (P=0.036); there was a difference in the length of stay in the care unit among the three groups (P=0.034), and there was no statistically different (P=0.149), and the duration of hospital stay was significantly shorter in the moderate intensity inspiratory muscle training group compared to the control group (P=0.016). Medium-intensity inspiratory muscle training can significantly improve patients' quality of life compared with the control group and low-intensity inspiratory muscle training group (P<0.05). Conclusions Both low-intensity inspiratory muscle training and moderate-intensity inspiratory muscle training can enhance the lung function of critically ill patients, improve their diaphragm mobility, and promote their pulmonary rehabilitation. Medium-intensity inspiratory muscle training was significantly better than low-intensity inspiratory muscle training in improving the lung function of patients. Moreover, moderate-intensity inspiratory muscle training may have positive significance in improving patients' quality of life and shortening their hospitalisation time.
ObjectiveTo clarify the effectiveness of preoperative pulmonary rehabilitation (PPR) and provide evidence for the application of PPR on lung cancer patients by meta-analysis.MethodsAccording to inclusion and exclusion criteria, literatures related to PPR on lung cancer patients were retrieved from major databases between the date of establishment of each database and January 2019, and then data required were extracted from the selected literatures. Meta-analysis was conducted by RevMan 5.0.ResultsTwelve randomized controlled trials were involved in meta-analysis, including 658 patients who were well-diagnosed and prepared for surgery, with 307 patients in the PPR group and 351 patients in the control group. The results of the meta-analysis showed that in the PPR group, the pulmonary function including forced vital capacity [MD=0.31, 95%CI (0.21, 0.42), P<0.01], forced expiratory volume in one second [MD=0.27, 95%CI (0.20, 0.34), P<0.01] and activity tolerance including 6-minute walk distance [MD=50.55, 95%CI (35.98, 65.13), P<0.01] were significantly better than the control group, and the postoperative complication rate was lower ［MD=0.28, 95%CI (0.18, 0.43), P<0.01］, postoperative hospital stay was shorter [MD=–2.09, 95%CI (–2.41, –1.77), P<0.01].ConclusionsA period of PPR on lung cancer patients can improve postoperative pulmonary function and activity tolerance, and reduce postoperative complications and hospital stay, which is beneficial to postoperative recovery.
Brain–computer interface (BCI) technology enable humans to interact with external devices by decoding their brain signals. Despite it has made some significant breakthroughs in recent years, there are still many obstacles in its applications and extensions. The current used BCI control signals are generally derived from the brain areas involved in primary sensory- or motor-related processing. However, these signals only reflect a limited range of limb movement intention. Therefore, additional sources of brain signals for controlling BCI systems need to be explored. Brain signals derived from the cognitive brain areas are more intuitive and effective. These signals can be used for expand the brain signal sources as a new approach. This paper reviewed the research status of cognitive BCI based on the single brain area and multiple hybrid brain areas, and summarized its applications in the rehabilitation medicine. It’s believed that cognitive BCI technologies would become a possible breakthrough for future BCI rehabilitation applications.
Objective To explore the choice of weight-bearing time and the clinical effect of different starting time of weight bearing after internal fixation of ankle fracture. Methods A total of 48 patients undergoing routine internal fixation for closed ankle fractures were selected. They were randomly divided into a tiral group and a control group, with 24 patients in each group. The patients in the tiral group started weight bearing one week after operation, while the ones in the control group did that four weeks after operation. The two groups were followed up for evaluation according to the modified Weber scale 2, 4, 8, and 12 weeks after operation, and the scale scores were presented as median (lower quartile, upper quartile). Results The fractures recovered well and no complications occurred. Two weeks after operation, the pain score [3.00 (2.00, 3.00) vs. 2.00 (1.00, 2.00)] and swelling score [3.00 (3.00, 4.00) vs. 2.00 (1.00, 2.00)] were significantly different between the trial group and the control group (P<0.05), but there was no significant difference in other indexes of the modified Weber scale between the two groups (P>0.05). Four weeks after operation, the swelling score was significantly different between the two groups [2.00 (2.00, 3.00) vs. 1.00 (0.00, 1.00), P<0.05], but there was no significant difference in other indexes of the modified Weber scale between the two groups (P>0.05). Eight and twelve weeks after operation, there was no significant difference in any of the modified Weber scale scores between the two groups (P>0.05). Conclusions It is feasible to start weight bearing one week after internal fixation of ankle fracture. Although swelling and pain will occur, it does not affect fracture healing or functional recovery.