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Spinal cord injury is a catastrophic injury causing lifelong severe disabilities, and poses a great burden to the individuals, families and society. In order to promote the standardization in treatment of traumatic spinal cord injury, the consensus on the evaluation, treatment and rehabilitation of traumatic spinal cord injury was suggested by experts, who came from authoritative multicenter in China. The expert consensus, which formed a standardization process from the first aid clinical treatment to rehabilitation of spinal cord injury, shall give a better practical guide for clinic and rehabilitation physicians.
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@#Objective To investigate the long-term outcome of old stroke patients after rehabilitation. Methods 25 old hospitalized patients with first attack of stroke in recovery were followed up with Mini-mental Status Examination (MMSE), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Brunnstrom stages of hemiplegia, modified Ashworth scale (MAS), range of motion (ROM) in hemiplegic ankle, manual muscle test (MMT) of quadriceps femoris, Berg balance scale (BBS), modified Barthel index (BI) and the Zarit burden interview (ZBI) for caregiver before rehabilitation, discharge, 6 and 12 months after discharge. Results The Brunnstrom stages of lower limbs, MAS of upper limbs improved (P<0.05) after 3-month rehabilitation in hospital, as well as the scores of BBS, BI and ZBI. As 6 and 12 months in home, the limb function remained stable, while the scores of BBS, MMSE, BI, SAS, and ZBI improved, but SDS fluctuated (P<0.05). Conclusion It is important to offer the long-term rehabilitation or consultation service when advocating old stroke patients early return to family or community, including psychological support and intervention.
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@#Objective To understand the causes of injury and levels of disability of patients with traumatic spinal cord injury and explore the related factors with the levels of disability. Methods Literature review and experts panel advice were used to collect the related factors. The questionnaire "Survey on Related Factors of Disability Levels of Patients with Ttraumatic Spinal Cord Injury" was designed for the data collection, including the causes of injury, being conscious or not, protection of the injured areas, tools for transportation, the time getting first aid, levels of emergency hospitals and the time of first spinal surgery. From October 2010 to March 2011, 260 inpatients with traumatic spinal cord injury were surveyed by the well-trained researchers. Results 107 patients(41.2%) were caused by traffic accidents, 69 (26.5%) were caused by falls, 60 (23.1%) by crash, 6 (2.3%)by sports injury, and 18 (6.9%) by other reasons. The results of the extent and the levels were that complete paraplegia take up 41.15%, complete tetraplegia take up 25.38%, incomplete tetraplegia take up 18.08%, incomplete paraplegia take up 15.39%. There were significant differences in the causes of injury between the different extent and levels of injury (P<0.05). There were significant differences in levels of injury between the different extent of injury (P<0.05). Significant differences were existed in the levels of injury among being conscious or not, protection of injured areas during transportation and the secondary transportation (P<0.05). Whereas, no significant difference was observed among protection in the injury site, tools for transportation, the time getting first aid, the levels of emergency hospitals and the first time of spinal surgery between the different extent of injury(P>0.05). Conclusion Not only the causes of injury, but also the protection of injured areas, high frequency of secondary transportation are responsible for the extent of injury and levels of injury in individuals with traumatic spinal cord injury in China.
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@#ObjectiveTo explore the state of intelligence and adaptive behavior of children with cerebral palsy and the correlation between them.Methods169 children with cerebral palsy were evaluated with Wechsler Intelligence Scale for Children (Chinese version) and the Infants-Junior Middle School Students' Social-Life Abilities Scale for the intelligence and the adaptive behavior.ResultsThe average scores of verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full intelligence quotient(FIQ) of the patients were lower than the normal children and the average scores of PIQ and FIQ were less than 70; the PIQ deficiency was significant more than the VIQ deficiency(P<0.001). 93 cases had mental deficiency, including 43(46.23%) for mild, 36(38.71%) for moderate, 13(13.98%) for severe, 1(1.08%) for extreme severe. There were 113(66.86%) for the deficiency of full social-life abilities, 104(61.54%) for Self-Help, 147(86.98%) for Locomotion, 133 (78.70%) for Occupation, 73 (43.20%) for Communication, 115(68.05%) for Socialization, 90 (53.25%) Self-Direction. The damage of Locomotion was the most serious, while the damage of Communication was the least serious. The outcomes of Wechsler Intelligence Scale was significantly correlated with the Infants-Junior Middle School Students' Social-Life Abilities Scale(P<0.001).ConclusionThe cerebral palsy causes not only intelligent damage, but also intelligence deficiency in most patients and the major level of the intelligent deficiency is mild to moderate. The damage of the performance intelligence has more influence on the full scale intelligence in the children with cerebral palsy. Most of the children with cerebral palsy have inconsistent deficiency of different aspects of the adaptive behavior.
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@#Objective To investigate the status of the establishment and service of the rehabilitation departments in comprehensive hospitals in China mainland.Methods A questionnaire survey was conducted in 240 comprehensive hospitals with different grades distributed in the capital city of 31 provinces, autonomous regions, and municipality cities in China mainland in a stratified sampling way. The contents investigated are the settings of rehabilitation departments, the performances of the rehabilitation services, the staffing of the rehabilitation workers and the problems faced in rehabilitation. Then, statistical analysis were done between the developed eastern regions and economically less developed middle-western regions, as well as different grades of comprehensive hospitals. Results In total, 216 valid questionnaires were collected (72 tertiary hospitals, 72 secondary hospitals and 72 primary hospitals), and there are no statistically difference between eastern regions and middle-western regions(P=0.61). About 69% of the hospitals surveyed have built up the rehabilitation departments, and there are no statistically difference between different regions (P=0.30). As far as the performance of the rehabilitation services are concerned, 97.2% of them have carried out rehabilitation service, 60% of them can satisfy the demands of the patients, and there are no difference between the different grades and between the eastern and middle-western regions(P>0.05). In addition, 76.4% of them have rehabilitation doctors, 68.4% have physiotherapists(PT), 52.3% have traditional Chinese medicine doctors, 50.5% have occupational therapists(OT), 36.9% have speech therapists(ST), 17.8% have psychologists, and only 2.3% have social workers. The staff status on PT, OT and ST of the hospitals in eastern regions are significantly better than that in middle-western regions(P<0.01), and the staff status on rehabilitation doctors, PT, OT, ST and psychologists in the tertiary hospitals are significantly better than that in the secondary hospitals and primary hospitals(P<0.01). Finally, the first five problems the rehabilitation department faced are following: short of professional workers(63.9%), lack of training areas(51%), lack of modern rehabilitation service management system (50.5%), out-of-date equipments(49.5%) and low fees of rehabilitation treatment(49.1%). Conclusion Many problems exists in the rehabilitation departments of comprehensive hospitals, such as the development of rehabilitation departments, the professional workers, the quality and width of the service, the efficient use of rehabilitation resources, rehabilitation management and profession permission, the relative policies and regulations, personnel training and so on. Therefore, the government should enhance to put the supported policies into practice, and reinforce investment to the comprehensive hospitals, in particular, enhance the support of the comprehensive hospitals in middle-western regions, as well as the primary hospitals and the secondary hospitals, all of which will play a much more efficient role in rehabilitation for the disabled in the comprehensive hospitals.
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@#The earthquake always results in a great number of the injured and disabled patients.So timely and effective psychological rehabilitation interventions are very helpful,especially for those survivors to relieve their psychological traumatic response caused by the earthquake,and renew their healthy psychological situation.The present article analyzes the chief psychological symptoms and influencing factors of the injured and disabled patients after the earthquake,and further provides some principles and strategies for the psychological rehabilitation,such as how to cope with the early stress response(anxiety,depression,self-abasement,and so on),or how to deal with the social phobia.
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@#The relaxation therapy is a common method in the psychological rehabilitation in the injured and disabled patients,which can release the negative emotions,improve the quality of sleep,decrease the pain of the injured and disabled parts of the body and build up the confidence of life of the patients after the earthquake.After the long-term practice of the psychological rehabilitation in the injured and disabled patients and the experience of the psychological rehabilitation in the injured and disabled patients after the 5·12 Earthquake,the author thinks during the relaxation training psychotherapy of the injured and disabled patients after the earthquake,the choice of technique and procedure of the relaxation therapy should depend on the specific situation of the patients.The author introduces a idiographic method of the relaxation therapy and some suggestions of the implied treatment after the relaxation which is suitable for the injured and disabled patients.
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@#ObjectiveTo explore the effect of marriage on the life satisfaction and mood of the spinal cord injury couple survived after Tangshan earthquake.Methods40 SCI patients (20 married and 20 unmarried) who were survived after Tangshan earthquake were investigated with 20 from married family (10 male and 10 female) and 20 from unmarried family (10 male and 10 female). The contents of investigation included life satisfaction, quality of life, anxiety and depression.Results The married group had significantly more satisfied with their life and less anxiety than the unmarried group. But there were no differences in evaluation of life quality and depression between two groups.Conclusion The marriage can improve the life satisfaction and psychological health of the SCI patients survived after Tangshan earthquake.
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@#ObjectiveTo investigate the living condition of patients with spinal cord injury (SCI) after Tangshan earthquake.MethodsA questionnaire was designed for the investigation with 41 items including resident environment, income, mood, etc. The faculty of surveillance was composed of trained professionals. 1261 SCI patients living in Tangshan at present, 420 of which live in the sanatoriums and others live in the common families. The patients of four sanatoriums were chosen randomly from fourteen sanatoriums to be investigated in detail, and patients in the common families in two communities, one from city, another from countryside, were also chosen. This investigation was performed in 2003.The results are compared with that of 1988' survey.ResultsGreat improvements in the living condition of SCI patients in Tangshan were shown by the comparison of these two surveys, they were mainly in: the progress in the housing environments (100% SCI patients now live in the specially designed reconstructed houses); better medical services provided (the ratio of wheelchair available from 38.1% to 100%); the majority of the patients in acceptance stage of their disability; the increase of income (21.1% takes up various occupation) with a vigorous spare time; decrease in the common complications with SCI patients; although uremia was still the first death cause of the SCI patients, the percentage was decreased apparently; cardiovascular accident had a higher percentage in the death cause(the second leading cause), implies that the death cause of the SCI survivors had approached the normal person.ConclusionThe improvements reflect the social progress in China. However, still there are some problems to be remained for further solution: the ratio of employment is low; the insurance of living and medical rehabilitation needs further improvement.
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Objective To investigate the intelligence level and its structure of children with cerebral palsy, and to discuss the effect of degree on them. Methods The intelligence function of 45 children with cerebral palsy was tested by means of Wechsler Intelligence Scale for Children-Chinese Revised ~WISC-CR). The total IQ, verbal IQ, performance IQ and Bannatyne four factors were analyzed and compared among the children grouped on the basis of severity of their dysfunction. Results For children with cerebral palsy, the total IQ ~70.02?(19.50)) was lower than that of the normal children, the ratio of mental deficiency was 55.6%; their verbal IQ was higher than performance IQ ~79.80?18.88 vs 64.24?19.28),P
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@# In order to analyze the situations of 156 spinal cord injury patients after rehabilitation andreturn to family and society, an investigation was carried out. The results indicated that 156 patients werein good situations. However, there are still some problems in re--entering hospitals, nursing, economicsituations,renovation of no--barriers facilities,control of excrement and urine, and participation of familyand social life. It is urgent to pay attention to their rehabilitation.