ABSTRACT
Objective:To explore the suggestion and key points of implementing community rehabilitation centered on peer education for patients with chronic obstructive pulmonary disease (COPD). Methods:From June, 2016 to June, 2017, 19 doctors, 15 nurses and 27 patients with COPD were selected for semi-structured interviews with the phenomenological research method, and the data were analyzed using the 7-step analysis method of Colaizzi. Results:The points were as follows: establishment and orientation of group leader education, hospital-community-family interaction mode, collective and individual intervention mode and effect and interaction monitoring. Conclusion:There is still lack of unified standards and teaching materials for the application of peer education in the rehabilitation of COPD patients. COPD community rehabilitation implementation strategies with peer education as the core are formulated to provide further reference for the rehabilitation of COPD patients.
ABSTRACT
<p><b>BACKGROUND</b>Restoration of both normal movement of the pelvis and centre of mass is a primary goal of walking rehabilitation in post-stroke patients because these movements are essential components of effective gait. The aim of this study is to quantitatively analyze the effect of ankle-foot orthosis on walking ability, and to investigate the correlation between improvements in trunk motion and walking capacity.</p><p><b>METHODS</b>Walking speed, centre of mass displacement, and pelvic movements were examined in 20 post-stroke hemiparetic patients with and without ankle-foot orthosis using three-dimensional motion analysis.</p><p><b>RESULTS</b>Using ankle-foot orthosis improved walking speed, pelvic rotation and tilt, and lateral and vertical displacements of the centre of mass (P < 0.01). Moreover, the gait asymmetry index was significantly decreased (P < 0.01), and the Functional Ambulation Categories score improved significantly when patients used an ankle-foot orthosis (P < 0.05). There was significant correlation between improvements in the walking capacity and the displacement of the centre of mass in both vertical and lateral directions (P < 0.01).</p><p><b>CONCLUSIONS</b>Using ankle-foot orthosis improves the walking capacity by improving the stability and concordant of the trunk in hemiplegic patients. The improvement in the walking capacity from using an ankle-foot orthosis may be attributed to its prevention of foot drop and compensation for the instability of the ankle joint.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ankle , Physiology , Ankle Joint , Physiology , Foot Orthoses , Gait , Physiology , Stroke , Walking , PhysiologyABSTRACT
Objective To investigate the effect of local injection of Botulinum toxin type A(BTXA) on spasticity and function of the affected upper limb in stroke patients.Methods A total of 32 stroke patients were re- cruited and randomly divided into two groups:a BTXA group and a control group.All the patients had spasticity of upper limb muscles,which scored grade 2 to 3 with the Modified Ashworth Scale(MAS) ,and decreased elbow joint range of motion.The 16 patients in the BTXA group received BTXA injection in the biceps brachii muscles and flexor muscles of forearm on 10～15 points,while those in the control group did not.All the patients in both groups were treated with rehabilitation training techniques.The MAS,Fugl-Meyer upper limb function assessment and Barthel In- dex were employed to evaluate the changes of muscle tone,upper limb function and activity of living (ADL)perform- ance of the patients before injection and at 1st,2nd,6th 12th weeks after injection.Results The therapeutic effect between the BTXA group anti control group was significantly different in terms of biceps muscle tone,the scores of Fugl-Meyer upper limb function assessment and Barthel Index.Compared with preinjection,muscle tone was de- creased significantly and ADL performance was improved after injection in BTXA group.The effects of BTXA lasted more than 12 weeks.Conclusion Intramuscular muhipoint injection of BTXA was useful in reducing muscle spas- ticity,and was helpful for increasing motor ability of the affected upper limb and ADL performance of the stroke pa- tients.