Feasibility of a Home-based Exercise Program after Abdominally Based Autologous Breast Surgery Reconstruction：An Observational Study / The Japanese Journal of Rehabilitation Medicine

Objective：We aimed to evaluate the feasibility of our rehabilitation program for abdominally based rehabilitation following autologous breast reconstruction, and investigate the changes in physical function and health-related quality of life in the early postoperative period.Methods：Fifteen patients who underwent breast reconstruction between September 2020 and October 2021 were included in this prospective, observational case series.The program composed of prehabilitation and postoperative home-based exercise until 12 weeks post-surgery. Adherence to home exercise program was surveyed using a self-reported workout check list. At postoperative 4th, 8th, 12th, and 24th weeks, a physio-/occupational therapist assessed the following objectives：i) Range of motion, muscle strength, and disability of upper extremity and trunk, ii) Quality of life using EQ-5D questionnaire, and iii) Patients' daily activities.Results：No adverse events were observed, and all patients completed the program. Overall adherence to daily exercise was 71.1％．Physical function of the upper extremities recovered in 8th postoperative week；however, truncal function, quality of life, and daily activities in 12th postoperative week remained lower than those observed preoperatively. Nevertheless, the program appeared useful for many patients, although some reported difficulty in continuing the exercise after returning to work.Conclusion：Rehabilitation programs directed by physio/occupational therapists may play a potentially advantageous role in facilitating a return to baseline function and quality of life during the early postoperative period.

Feasibility of a Home-based Exercise Program after Abdominally Based Autologous Breast Surgery Reconstruction：An Observational Study / The Japanese Journal of Rehabilitation Medicine

Objective：We aimed to evaluate the feasibility of our rehabilitation program for abdominally based rehabilitation following autologous breast reconstruction, and investigate the changes in physical function and health-related quality of life in the early postoperative period.Methods：Fifteen patients who underwent breast reconstruction between September 2020 and October 2021 were included in this prospective, observational case series.The program composed of prehabilitation and postoperative home-based exercise until 12 weeks post-surgery. Adherence to home exercise program was surveyed using a self-reported workout check list. At postoperative 4th, 8th, 12th, and 24th weeks, a physio-/occupational therapist assessed the following objectives：i) Range of motion, muscle strength, and disability of upper extremity and trunk, ii) Quality of life using EQ-5D questionnaire, and iii) Patients' daily activities.Results：No adverse events were observed, and all patients completed the program. Overall adherence to daily exercise was 71.1％．Physical function of the upper extremities recovered in 8th postoperative week；however, truncal function, quality of life, and daily activities in 12th postoperative week remained lower than those observed preoperatively. Nevertheless, the program appeared useful for many patients, although some reported difficulty in continuing the exercise after returning to work.Conclusion：Rehabilitation programs directed by physio/occupational therapists may play a potentially advantageous role in facilitating a return to baseline function and quality of life during the early postoperative period.

Índice de eficiencia miocárdica en cardiópatas posterior a un programa de rehabilitación cardiaca / Myocardial efficiency index in patients with heart disease after a cardiac rehabilitation program

Resumen Objetivo: El índice de eficiencia miocárdica (IEM) correlaciona el consumo miocárdico de oxígeno (MVO2) con el consumo máximo de oxígeno, el cual proporciona información sobre la eficiencia cardiovascular (EfCV). En deportistas, el IEM mejora posterior a un microciclo de entrenamiento, en el paciente con enfermedad cardiovascular sometido a un programa de rehabilitación cardiaca y prevención secundaria PRHCyPS, el comportamiento del IEM podría resultar un estimador relacionado con mejoría derivado de un periodo de entrenamiento. El objetivo del estudio fue determinar el comportamiento del IEM posterior a un PRCyPS en pacientes con cardiopatías y riesgo cardiovascular alto (RCVA). Métodos: Estudio de cohorte ambilectivo, descriptivo, analítico, no aleatorizado. Se seleccionaron pacientes con cardiopatías de etiología mixta con RCVA ingresados a un PRCyPS durante 4-6 semanas. A todos los pacientes se les realizó una prueba de ejercicio máximo en banda antes y después del PRCyPS. Se determinaron umbrales de consumo de oxígeno (VO2) pico, equivalentes metabólicos-carga, doble producto e IEM. Se estableció un punto de corte del IEM mediante una curva ROC con un valor de 7.37 con un área bajo la curva de 0.68 (IC 95%: 0.61-0.76; p < 0.001), sensibilidad 0.60 y 1-especificidad de 0.35. Resultados: Se incluyeron 193 pacientes con una media de edad de 62.3 años, en su mayoría del sexo masculino (66.2%). Se observaron porcentajes de cambio en el IEM -27.1% (p < 0.001), MET 43.1% (p < 0.001), doble producto 5.7% (p < 0.01) y MVO2: 8.3% (p < 0.01) al término del PRCyPS. Conclusiones: Se observó un cambio significativo en el IEM posterior a un PRCyPS, lo cual se asoció a una mejoría en la EfCV, sugiriendo que este pueda considerarse como un parámetro clínico que evaluar en los programas de rehabilitación cardiaca.

Abstract Objective: The myocardial efficiency index (MEI) correlates the Myocardial Oxygen Consumption (MVO2) with the Maximum Oxygen Consumption (VO2max), this index provides information about the cardiovascular efficiency (CVEf). In athletes, the MEI improves after a micro-cycle training, however in patients with cardiovascular disease undergoing Cardiac Rehabilitation Program (CRP), IEM behavior could be a good estimator related to the improvement training period. The objective of this study was to determine the myocardial efficiency index behavior in patients with heart disease and high cardiovascular risk (HCVR) after a CRP. Methods: Ambilective, descriptive, analytical, non-randomized cohort study was conducted. Patients with heart disease of mixed etiology and HCVR admitted to a CRP for 4-6 weeks were selected. All patients performed a maximal exercise test in band before and after the CPR. Thresholds of VO2 peak, METs-load, Double product (DP) and MEI were determined. A cut-off point for the MEI was established using a ROC curve with a value of 7.37, area under the curve: 0.68 (95% CI 0.61 - 0.76, p < 0.001), sensitivity 0.60 and 1-specificity 0.35. Results: 193 patients with a mean age of 62.3 years were included, predominantly men (66.2%). Percentages changes in the MEI-27.1% (p < 0.001),METs-43.1% (p < 0.001),DP 5.7% (p < 0.01), and MVO2: 8.3% (p < 0.01) were observed at the end of CRP. Conclusions: Significant change in the MEI were observed after CRP associated to CVEf improvement, suggesting that this parameter could be considered as a good clinical tool in the CRP care programs.

Effect of Acute Rehabilitation Treatment for Patients with Severe COVID-19 / The Japanese Journal of Rehabilitation Medicine

Patients with severe coronavirus disease 2019 (COVID-19) have poor prognosis, with many cases being difficult to treat and many reports of neurological complications in patients who have been in the intensive care unit for a long time. Rehabilitation of patients with severe COVID-19 is important；however, no rehabilitation program has shown effectiveness. Thus, this study aimed to investigate the effects of a rehabilitation program developed and used at our hospital for patients with severe COVID-19. We enrolled 28 patients with severe COVID-19 (age 61［23-88］years；female/male, 9/19, body mass index, 25.0［18.0-33.6］kg/m2). We assessed the medical research council scoring (MRC) of the patients at the time of entry and exit from the ordinary ward using Wilcoxon signed-rank tests. MRC was significantly improved after exiting the ordinary ward compared with that on entering the ordinary ward (43 vs. 50 points；P＜.001). Moreover, Barthel index improved significantly after exiting the ordinary (32.5 vs. 77.5 points, P＜.001). Therefore, our acute rehabilitation treatment for patients with severe COVID-19 may be effective in improving their muscle strength and daily living.

Efecto del Programa de Rehabilitación Cardiaca del Hospital San Vicente Paúl sobre parámetros bioquímicos, antropométricos y funcionales en pacientes con cardiopatía isquémica del 1º de enero del 2014 al 31 de diciembre del 2015 / Effect of the Cardiac Rehabilitation Program of the Hospital San Vicente Paúl on biochemical, anthropometric and functional parameters in patients with ischemic heart disease from January 1, 2014 to December 31, 2015

Resumen Introducción y objetivos: Los programas de rehabilitación cardiaca (RHC) son considerados como los más eficaces entre las intervenciones de prevención secundaria. El cual su función es mejorar la sobrevida como así también, la calidad de vida de estos enfermos. El objetivo fundamental de este trabajo es analizar el impacto de un Programa de Rehabilitación Cardiaca en pacientes portadores de cardiopatía isquémica con respecto a parámetros bioquímicos, antropométricos y funcionales. Pacientes y métodos: Fue un estudio observacional retrospectivo, unicéntrico, con seguimiento de 3 años. Se incluyo un total de 228 pacientes. Con criterios de inclusión: >18 años, con EAC y al menos una comorbilidad de riesgo cardiovascular que completaran el PRC. Se excluyó enfermedad valvular sin cardiopatía isquémica preexistente, infarto agudo al miocardio reciente, ángor inestable, obstrucción del tracto de salida del ventrículo izquierdo, y los que no cumplieron el PRC. Resultados: De los 228 pacientes que se incluyeron el PRC del HSVP el 70,7% eran hombres y el 29,3% eran mujeres con diagnóstico de cardiopatía isquémica. El promedio de edad era de 60.2 +- 11.4 años en total entre hombres y mujeres. El peso de los pacientes masculinos previo al ingreso del PRC fue de 77,7 kg +-13,2 kg, y las mujeres 69,7 kg +- 13,1 kg. Al final del fue de 75,5 kg +-13,1 kg y el de las mujeres era de 68,3 +- 13,1 kg. En la caminata de 6 minutos el promedio de mujeres al inicio fue de 390,0 mts y el de los hombres de 386,6, y la segunda vez posterior a la rehabilitación en hombres fue de 595,8 +- 107,2 y el de las mujeres fue de 549+-102,4. Los niveles de PCR de los hombres al inicio del programa fue de 1,2 +-2,4 mg/dL y el de las mujeres fue de 1,5 +- 1,9 mg/dL al finalizar los hombres tuvieron un promedio de 1,8+-3,0 Conclusiones: Los PRC dependen de la participación de profesionales de la salud que trabajen en equipo para alcanzar resultados finales, los cuales están basados no solo en el ejercicio sino también en el cambio de estilo de vida del paciente, por lo tanto, necesita de servicios asociados como fisioterapia, nutrición, psicología.

Abstract Effect of the Cardiac Rehabilitation Program of the Hospital San Vicente Paúl on biochemical, anthropometric and functional parameters in patients with ischemic heart disease from January 1, 2014 to December 31, 2015 Introduction and objectives: Cardiac Rehabilitation Programs, are considered the most effective programs among secondary prevention interventions. The function is to improve survival as well as the quality of life of these patients. The main objective of this work is to analyze the impact of Cardiac Rehabilitation Program in patients with ischemic heart disease with the respect biochemical, anthropometric and functional parameters. Patients and method: A observational, retrospective single-center, study with a 3-year-follow up. A total of 228 patients were included, witch 70.7% were men with an average of 60.2+-11.4 years. The inclusion criteria were: > 18 years with CAD and at least one cardiovascular risk comorbidity and completed the Cardiac Rehabilitation Program. Valvular disease without pre-existing ischemic heart disease, recent acute myocardial infarction, unstable angina, left ventricular outflow tract obstruction, and those who did not went to the Program. Results: The 228 patients who were included in the HSVP CRP, 70.7% were men and 29.3% were women with a diagnosis of ischemic heart disease. The average age was 60.2 + - 11.4 years in total between men and women. The weight of male patients prior to admission to the CRP was 77.7 kg + -13.2 kg, and women 69.7 kg + -13.1 kg. At the end of the program, the weight of the men was 75.5 kg + -13.1 kg and that of the women was 68.3 + - 13.1 kg. The total waist circumference at the start of the program was 100.1 ± 11.4 cm. In women the average was 98.4 + - 12.7cm, that of men was 101.1 + - 10.8 cm. At the end of the program, the total average of men and women was 96.7 + - 11.0, the average of women at the end of the program was 96.2 + - 12.6 cm and of men was 96. 9 + - 10. In the 6-minute walk, the average of women at the beginning was 390.0 meters and that of men was 386.6, and the second time after rehabilitation in men was 595.8 + - 107.2 and the of women it was 549 + -102.4. In men, the previous total cholesterol was 154.8 + -39.7 mg / dL and that of women was 162.0 + -40.2 mg / dL and at the end of the program the value of men was 161 .6 + -46.0 mg / dL and 170.8 + -41.8 mg / dL for women. The CRP levels of the men at the beginning of the program was 1.2 + -2.4 mg / dL and that of the women was 1.5 + - 1.9 mg / dL at the end of the program, the men had an average of 1.8 + -3.0. Conclusion: The Cardiac Rehabilitation Program depends on the partipation of health professionals care who work as a team to achieve final results, witch are based not only on exercise but also on the change in the patient's lifestyle, therefore, they need associated services such as physiotherapy, nutrition, psychology.

Concretizing occupational justice principles in Philippine community-based drug rehabilitation practice settings

Background@#The substance addiction and rehabilitation situation in the Philippines is a complex health and social crisis that has plagued individuals, groups, and communities in the past decades. While pluralistic and critical approaches to address the drug demand reduction issue are available, hegemonic practices continue to eclipse evidenceinformed approaches underpinned by resiliency and occupational justice perspectives. @*Methodology@#This case study utilized a qualitative and interpretive approach to describe the practice processes of localized community-based drug rehabilitation programs in selected Filipino communities and to propose concrete practice processes to improve the development and implementation of the local community-based drug rehabilitation. Two independent focus group discussions were conducted. Participants were health care professionals, community workers, and citizens who have an affinity to the substance addiction rehabilitation setting. Framed by the Participatory Occupational Justice Framework, specifically the practice process “engage collaboratively with partners,” qualitative data extracted from the focus group discussions were thematically analyzed. @*Results@#Three themes emerged: (1) Changing perspective: starting from the community; (2) Better together: collaboration and coordination in substance addiction and rehabilitation; and (3) “Juan for All, All for Juan”: contextualized strategies in substance addiction and rehabilitation. The findings in the case study reaffirm the value of shifting from an individualistic (symptom-eradication) to populational (social and systemic interventions) perspectives in developing community-based drug rehabilitation programs. @*Conclusion@#To reify occupational justice and resiliency approaches, proposed strategies include understanding drug use from critical and occupational perspectives, enacting social modeling and mentorship, promoting inter-agency and inter-professional collaborative practices, and infusing culturally appropriate strategies in the development and implementation of local community-based drug rehabilitation programs.

WeChat-based education and rehabilitation program in unprotected left main coronary artery disease patients after coronary artery bypass grafting: an effective approach in reducing anxiety, depression, loss to follow-up, and improving quality of life

This study aimed to investigate the effect of WeChat-based education and rehabilitation program (WERP) on anxiety, depression, health-related quality of life (HRQoL), major adverse cardiac/cerebrovascular events (MACCE)-free survival, and loss to follow-up rate in unprotected left main coronary artery disease (ULMCAD) patients after coronary artery bypass grafting (CABG). In this randomized controlled study, 140 ULMCAD patients who underwent CABG were randomly assigned to WERP group (n=70) or control care (CC) group (n=70). During the 12-month intervention period, anxiety and depression (using hospital anxiety and depression scale (HADS)) and HRQoL (using 12-Item Short-Form Health Survey (SF-12)) were assessed longitudinally. During the total 36-month follow-up period (12-month intervention and 24-month non-intervention periods), MACCE and loss to follow-up were recorded. During the intervention period, HADS-anxiety score at month 9 (M9) (P=0.047) and month 12 (M12) (P=0.034), anxiety rate at M12 (P=0.028), and HADS-D score at M12 (P=0.048) were all reduced in WERP group compared with CC group. As for HRQoL, SF-12 physical component summary score at M9 (P=0.020) and M12 (P=0.010) and SF-12 mental component summary score at M9 (P=0.040) and M12 (P=0.028) were all increased in WERP group compared with CC group. During the total follow-up period, WERP group displayed a trend of longer MACCE-free survival than that in CC group but without statistical significance (P=0.195). Additionally, loss to follow-up rate was attenuated in WERP group compared with CC group (P=0.033). WERP serves as an effective approach in optimizing mental health care and promoting life quality in ULMCAD patients after CABG.

Psychosocial rehabilitation program for Schizophrenia disorder patients: Measuring disease impacts and intervention outcomes

OBJECTIVES@#This study purposed to measure the effectiveness of the Psychosocial Rehabilitation (PSR) Program, which was a combination of occupational therapy and psychoeducation in managing patients diagnosed with schizophrenia who were recovering in a mental health facility as well as identify gaps and problems in its implementation.@*METHODOLOGY@#An experimental design was used followed by a qualitative study to further analyze the impacts of the psychosocial rehabilitation program.@*RESULTS@#Pre-and-post-test measures showed that clinical global improvement, psychiatric symptoms and socio-occupational functioning of the patients improved while quality of life and enjoyment did not change. Performance and satisfaction of experimental group participants related to the occupational therapy program also increased. Insights and meaningful realizations were observed in those who had undergone the psychosocial rehabilitation program (PSR).@*CONCLUSION@#Implications for treatment and recommendations for the psychosocial program were made to address challenges in implementing the psychosocial rehabilitation program.

Clinical Application of AR System in Early Rehabilitation Program After Stroke: 2 Case Study

PURPOSE: To investigate the effect of an augmented reality (AR) system on muscle strength and function level of the paretic lower limb and the balance ability in the early rehabilitation program of acute stroke patients. METHODS: The participants (30 or fewer days after stroke) were randomly assigned to receive intervention with an early rehabilitation program using an AR system (n=1) or an early rehabilitation program consisting of functional electrical stimulation and tilt table use (n=1). Patients in both subjects received interventions 4-5 times a week for 3 weeks. RESULTS: In the paretic limb muscle strength, AR subject was increased from 15 to 39.6 Nm and Control subject was increased from 5 to 30.2 Nm. The paretic limb function of AR subject motor function was increased from 8 to 28 score and Control subject motor function was increased from 6 to 14 score. But sensory function was very little difference between the two subjects (AR subject: from 4 to 10 score, Control subject: from 3 to 10 score). In the balance ability, AR subject had more difference after intervention than control subject (AR subject: 33 score, Control subject: 22 score). CONCLUSION: The early rehabilitation program using the AR system showed a slightly higher improvement in the motor function of the paretic lower limb and balance ability measurement than the general early rehabilitation program. The AR system, which can provide more active, task-oriented, and motivational environment, may provide a meaningful environment for the initial rehabilitation process after stroke.

Advance in Rehabilitation after Lumber Disc Surgery (review) / 中国康复理论与实践

Lumbar disc herniation is an important cause of chronic low back pain, for which surgery has a great effect. However, there remain some residual symptoms, such as pain, disability, etc. It's effective for postoperative rehabilitation to relieve pain, and improve the disability and psychological status. However, the optimal rehabilitation program is controversial. So it's necessary to consider various aspects including time, site, frequency, intensity and pattern for an optimal rehabilitation choice, which needs further study. Psychological factors shall be concerned by medical workers as well.

Profiling "voluntary surrenders" of Oplan Tokhang in Marikina City, Philippines: An emic view

BACKGROUND: This study was undertaken in response to the lack of contextualized and grounded description of surrendered drug offenders (e.g voluntary surrenderers) provided to the media and to the public by the law enforcement agencies on the Oplan TokGang campaign of the Duterte administration.OBJECTIVE: This paper sought to provide a profile of "voluntary surrenderers" of Oplan TokHang in four selected barangays in Marikina City. Specifically, it aimed to describe their socio-demographic characteristics, drug use behaviors, underlying reasons for initial and continued drug use, severity of use, and the nature and reasons behind their participation in the Oplan TokHhang campaign, respectively.METHODOLOGY: A total of 56 participants was surveyed and descriptive statistics was used in the presentation and analysis of data. These were triangulated by direct observation, local studies and international studies, data from national agencies, and news reports.RESULTS: Most of the voluntary surrenderers in the study were drug users rather than user-pushers and were predominantly single, male, high school educated, and were observed to be in their most productive years, yet, unemployed. They abused methamphetamine (shabu) and marijuana and started to take drug in their mid-adolescent years. Although users for one to two years, more than the majority of them were mild users, taking drugs on a weekly basis that were sourced from their friends and from drug pushers. Exposed to drug-using friends and relatives, most were initiated to drugs because of peer influence, personal and family problems. They continued to use drugs because they were not able to resolve these personal and social relations issues. Being jobless, most sustained their drug-taking behavior by committing petty crimes, such as selling household goods, drug-pushing, and theft. Afraid to be killed and wanting to be rehabilitated, they participated in the TokHang campaign for safety and for self-change.CONCLUSION: Voluntary surrenderers in the study were not as violent and dangerous as generally reported by media and law enforcers. As mild users, they were not those types that were considered as "beyond redemption" but were rather capable of self-change. These primary data were reflective of national reports that 90 percent of surrenderers were mild users. Policy-wise, the study suggests that government should, through the Oplan TokHang campaign, shift more focus in providing community-based treatment and rehabilitation program that is responsive, sustainable, protective, and rights-respecting of voluntary surrenderers.

Profiling “Voluntary Surrenderers” of Oplan Tokhang in Marikina City, Philippines: An emic view

@#<p><strong>Background:</strong> This study was undertaken in response to the lack of contextualized and grounded description of surrendered drug offenders (e.g voluntary surrrenderers) provided to the media and to the public by the law enforcement agencies on the Oplan TokHang campaign of the Duterte administration.</p><p><strong>Objective:</strong> This paper sought to provide a profile of “voluntary surrenderers†of Oplan TokHang in 4 selected barangays in Marikina City. Specifically, it aimed to describe their socio-demographic characteristics, drug use behaviors, underlying reasons for initial and continued drug use, severity of use, and the nature and reasons behind their participation to the Oplan TokHang campaign, respectively.</p><p><strong>Methodology:</strong> A total of 56 participants were surveyed and descriptive statistics was used in the presentation and analysis of data. These were triangulated by direct observation, local studies and international studies, data from national agencies and news reports.</p><p><strong>Results:</strong> Most of the voluntary surrenderers in the study were drug users rather than user-pushers and were predominantly single, male, high school educated and were observed to be in their most productive years yet unemployed. They abused shabu and marijuana and started to take drug in their mid-adolescent years. Although users for 1 to 2 years, more than majority of them were mild users, taking drugs on a weekly basis that were sourced from their friends and from drug pushers. Exposed to drug- using friends and relatives, most were initiated to drugs because of peer influence, personal and family problems. They continued to use drugs because<br />they were not able to resolve these personal and social relations issues. Being jobless, most sustained their drugtaking behavior by committing petty crimes such as selling household goods, drug-pushing and theft. Afraid to be killed and wanting to be rehabilitated, they participated in the TokHang campaign for safety and for self-change.</p><p><strong>Conclusion:</strong> Voluntary surrenderers in the study were not as violent and dangerous as generally reported by media and by law enforcers. As mild users, they were not those types that were considered as “beyond redemption†but were rather capable of self-change. These primary data were reflective of national reports that 90 percent of surrenderers were mild users. Policy-wise, the study suggests that government should, through the Oplan TokHang campaign, shift more focus in providing community-based treatment and rehabilitation program that is responsive, sustainable, protective, and rights-respecting of voluntary surrenderers.</p>

Study on the effect of modern communication tools on the rehabilitation plan of discharged patients with pulmonary heart disease / 中国实用护理杂志

Objective To explore the modern communication tools urged by effect of patients with cor pulmonale discharge rehabilitation program. Methods A retrospective analysis was carried out from February 2014 to October 2016 in 46 cases of patients who suffered heart disease from lung disorders, they were given implementation of rehabilitation nursing through modern communication tools after discharge by the nursing staff. Another 46 cases of cor pulmonale patients were selected as the control group from January 2012 to January 2014, who were given routine rehabilitation treatment after discharge. The treatment effect, lung function and satisfaction degree were compared between the two groups after rehabilitation. SF-36 scale was adopted to assess the patients quality of life. Results The total efficiency was 97.83%(45/46) in the observation group, higher than that of the control group , 86.96%(40/46), the difference was statistically significant (χ2=3.8655,P<0.05). The indexes of pulmonary function of tidal volume, vital capacity, vital capacity, forced expiratory volume in one second of the observation group was (837.47±211.35), (3689.56 ± 174.63), (3788.43 ± 735.34), (1761.24 ± 510.35) ml, the control group were (678.34 ± 184.56), (3089.35 ± 215.35), (2916.36 ± 457.35), (1394.24 ± 394.34) ml, there were significant differences between two groups (t=3.8464-14.6825, P<0.01). The SF-36 scale physiological function, physiological function, mental health, emotional function, body pain, vitality, social function, general health scores of the control group were 77.46 ± 3.46, 74.32 ± 4.25, 72.13 ± 3.46, 77.46 ± 3.67, 75.78 ± 2.74, 79.53 ± 2.15, 80.46 ± 3.15, 78.94 ± 3.47, while they were 87.43 ± 5.23, 88.43 ± 3.47, 85.36 ± 2.36, 89.65 ± 5.36, 88.53 ± 3.48, 90.43 ± 4.36, 90.43 ± 2.35, 89.64 ± 3.27 in the observation group, there was significant difference between two groups (t=10.7831-21.4244, P<0.01). The satisfaction rate of the observation group was 97.83%(45/46), which was significantly higher than that of the control group 82.61% (38/46), and the difference was statistically significant (χ2=6.0348, P<0.05). Conclusions Rehabilitation treatment by the nursing staff through modern communication tools has a very good effect on pulmonary heart disease patients. It can help the pulmonary function of patients recover well, improve the quality of life and satisfaction degree significantly , which should be popularized in clinic.

Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer’s disease and cognitive impairment without dementia

Abstract Background Non-pharmalogical interventions represent an important complement to standard pharmalogical treatment in dementia. Objective This study aims to evaluate the effects of a multidisciplinary rehabilitation program on cognitive ability, quality of life and depression symptoms in patients with Alzheimer’s disease (AD) and cognitive impairment without dementia (CIND). Methods Ninety-seven older adults were recruited to the present study. Of these, 70 patients had mild AD and were allocated into experimental (n = 54) or control (n = 16) groups. Two additional active comparison groups were constituted with patients with moderate AD (n = 13) or with CIND (n = 14) who also received the intervention. The multidisciplinary rehabilitation program lasted for 12 weeks and was composed by sessions of memory training, recreational activities, verbal expression and writing, physical therapy and physical training, delivered in two weekly 6-hour sessions. Results As compared to controls, mild AD patients who received the intervention had improvements in cognition (p = 0.021) and quality of life (p = 0.003), along with a reduction in depressive symptoms (p < 0.001). As compared to baseline, CIND patients displayed at the end of the intervention improvements in cognition (p = 0.005) and depressive symptoms (p = 0.011). No such benefits were found among patients with moderate AD.Discussion: This multidisciplinary rehabilitation program was beneficial for patients with mild AD and CIND. However, patients with moderate dementia did not benefit from the intervention.

Efeitos de um programa de exercício físico em pacientes com doença arterial obstrutiva periférica / Effects of physical exercise program in patients with obstructive peripheral arterial disease

O objetivo do estudo foi estratificar os fatores de risco cardiovasculares (FR) e avaliar os efeitos de um programa de exercício físico (PEF) por três meses em pacientes diagnosticados com doença arterial obstrutiva periférica (DAOP) através do teste de caminhada de 6 minutos (TC6), utilizando como parâmetro a distância total percorrida (DTP), tempo inicial da dor (TID), tempo final da dor (TFD) e tempo total da dor (TTD). O estudo foi composto por 12 voluntários, encaminhados para o programa de Reabilitação Física. Para estratificar os FR houve aplicação de questionário contendo pergunta objetivas com opção de sim ou não sobre tabagismo, diabetes mellitus, etilismo, hipertensão arterial, sedentarismo, hereditariedade, dislipidemia e obesidade, adotou-se o índice de massa corpórea. O TC6 foi realizado em um corredor de 22 metros e o paciente foi orientado a informar aos avaliadores o momento de início da dor (TID) e somente parar quando a dor tornar-se insuportável para continuar a caminhada. O TFD foi estabelecido quando o paciente retornou ao TC6. Ao final do teste foi calculada a DTP que o paciente atingiu. O teste de ANOVA foi utilizado para comparar as condições pré e pós-reabilitação, tendo nível de significância quando p<0,05. Observou-se que todos os pacientes mostraram-se sedentários, 58,3% são dislipidêmicos, 50% são tabagistas, hipertensos e apresentam hereditariedade. Houve diferença significativa na DTP (327,7±83,3 vs 431,7±90,5), TID (01:52±0:36 vs 02:59±0:41) e TTD (01:55±0:14 vs 00:45±0:36) pré e pós-reabilitação. O PEF para pacientes com DAOP se mostrou eficaz na DTP, TID, TTD.

Impact of New Family Rehabilitation Program on Sleep Status and Quality of Life in Insomnia Patients After Meridian-collateral Stroke / 广州中医药大学学报

Objective To investigate the sleep status, quality of life, activities of daily living and the serum levels of interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) in insomnia patients after meridian-collateral stroke treated by the new family rehabilitation program, a combined therapy including traditional family rehabilitalion, acupoint massage and ear point application. Methods A total of 80 cases of insomnia patients after meridian-collateral stroke were enrolled. Subjects were evenly divided into treatment group ( treated with new family rehabilitation program) and control group ( treated with traditional hospital health education and family rehabilitation). Clinical effects of the two groups were evaluated with the Pittsburgh Sleep Quality Index (PSQI), the brief version of WHO Quality of Life Assessment (WHOQOL-BREF) and activities of daily living ( ADL) . The serum levels of IL-1β and TNF-α were monitored before and after therapy and measured by enzyme-linked immunosorbent assay ( ELISA). Results ( 1) After treatment for 28 days, the scores of total PSQI, sleep time, sleep efficiency and sleep disorder incidence in the treatment group were significantly lower than those in the control group ( P<0.01) . ( 2) The scores of physiological, psychological, social relation, environmental dimensions of WHOQOL-BREF in the treatment group were significantly higher than those in the control group ( P<0.01) . ( 3) ADL scores were significantly higher in the treatment group than those in the control group (P<0.01) . (4) Serum levels of IL-1βand TNF-αwere increased in the treatment group as compared with those in the control group (P<0.01). Conclusion Compared with the traditional hospital health education, the new family rehabilitation program can effectively improve the quality of sleep, quality of life, as well as the activities of daily living. And the mechanism may be associated with the up-regulation of the serum levels of IL-1βand TNF-α, which are relevant to the sleep status.

Rehabilitación neuropsicológica en un caso de TDAH con predominio impulsivo / Neuropsychological rehabilitation in a case of ADHD with impulsive predominance

En Trastorno por déficit de atención e hiperactividad (TDAH) el síntoma central desde la neuropsicología es el deficiente desarrollo de la organización de su conducta, específicamente de las formas de actividad consciente e intencionalmente orientada. Los niños presentan dificultades en la organización y autorregulación de la conducta y un comportamiento inapropiado respecto a lo que se espera para su edad y desarrollo intelectual, aunque el niño es capaz de formar un propósito para su actividad, no logra mantenerse en ella, es incapaz de planear y seguir una secuencia de acciones para alcanzar el objetivo que se había planteado, los estímulos auditivos y visuales externos lo distraen con facilidad desviándolo de su propósito. El objetivo de este artículo es mostrar un programa de intervención Neuropsicológica en un caso de un niño con TDH de predominio impulsivo fundamentado en la identificación de la falla en el mecanismo de regulación y control que afecta la función reguladora del lenguaje para lograr una actividad voluntaria y organizada, se muestran los resultados de la valoración pre, el programa de intervención, la valoración pos y un análisis comparativo. La discusión se establece a partir de la importancia de la función reguladora del Lenguaje para la organización de la actividad voluntaria...

In the Attention Deficit Hyperactivity Disorder (ADHD), the central symptoms from the neuropsychology aspect, is the poor development of the organization of the behavior, specifically for conscious and intentionally targeted activities. Children have difficulties in self-regulation and organization of their behavior as well as an inappropriate conduct in respect to what is expected for their age and intellectual development. Although the child is capable of developing a purpose for their activity, the child is unable to plan and follow a sequence of actions, and maintain the focus to achieve the objective established. External visual and/or acoustic stimulus can easily distract and deflect them from their activities. The aim of this paper is to show a Neuropsychological intervention program for a case of a child with ADHD with impulsive predominance, based on the identification of the fault in the regulation and control’s mechanism that affects the language regulatory function to achieve an organized and voluntary activity. This paper shows the results of the pre-assessment, intervention program, the post assessment and the comparative analyzes. The discussion is set as regards as the importance of the language regulatory function in organizing a voluntary activity...

Effect of pulmonary rehabilitation program on patients with COPD: a meta analysis / 中国实用护理杂志

Objective To systematically evaluate the type and magnitude of effectiveness of pulmonary rehabilitation program on patients diagnosed with chronic obstructive pulmonary disease (COPD) in none-acute phases.Methods Two investigators independently searched three databases including Cochrane library,Pub Med and CNKI to collect randomized controlled trials about Pulmonary Rehabilitation Program on COPD Patients.A total of 17 trials were included.The quality of these RCTs was evaluated by two investigators and the combination of study results was conducted using RevMan 5.0.2 software.Results Pulmonary Rehabilitation Program could improve COPD patients' exercise tolerance,quality of life,lung function and blood oxygen level.It was also beneficial to patients' discomforts including dyspnea and fatigue.Conclusions The meta-analysis had identified a significant effect of pulmonary rehabilitation program on COPD patients,so nurses are suggested to integrate effective programs into clinical practice.

Evaluación clínica de los pacientes con enfermedad pulmonar obstructiva crónica en los programas de rehabilitación respiratoria / Clinical evaluation of patients with chronic obstructive pulmonary disease in pulmonary rehabilitation programs

Patients with Chronic Obstructive Pulmonary Disease (COPD) are the largest tributaries of the pulmonary rehabilitation programs. This chapter discusses the necessary evaluation required for patients with COPD, before entering the pulmonary rehabilitation program. Scientific evidence exists regarding the benefits of these programs. The assessment method recommend is: general evaluation, lung function, exercise tolerance (6-minute walk test, incremental walking test), dyspnea (scale of Borg, modified Medical Research Council scale) and health-related quality of life (Saint George's questionnaire). Also, BODE index, psychological and nutritional assessment and a cardiovascular evaluation to rule out cardiac pathology that contraindicates rehabilitation, should be carried out. Following the evaluation, the patient will be into a pulmonary rehabilitation program, the team should consist of a multidisciplinary and include: 1) education of patients and their families, 2) muscle testing and training of: lower extremities, upper extremities and respiratory muscles, and 4) psychosocial support. The pulmonary rehabilitation program provides significant benefits to patients with COPD in terms of reducing dyspnea, improve exercise capacity and quality of life (quality evidence A, strong recommendation). Physical space is required for the evaluation of patients and a training room. It is recommended that pulmonary rehabilitation program must be personalized and centred on the needs of the patient and has a duration of 6 to 12 weeks. Programs effectiveness is independent of where they are carried out and it depends primarily on its structure. It is important to work out a strategy study and control program for evaluating its success.

Los pacientes con Enfermedad Pulmonar Obstructiva crónica (EPOC) son los mayores tributarios de los programas de rehabilitación respiratoria. En este capitulo se analiza la evaluación que requieren los pacientes con EPOC antes de ingresar al programa de rehabilitación respiratoria y la evidencia científica que existe en cuanto a sus beneficios. El método de evaluación recomendado es: una evaluación general, la función pulmonar, la tolerancia al ejercicio (prueba de caminata de 6 minutos, prueba de caminata incremental), la disnea (escala de Borg, escala del Medical Research Council modificada) y los relacionados con la calidad de vida con el cuestionario de Saint George. Además, evaluación del índice BODE, evaluación psicológica y nutricional y una evaluación cardiovascular para descartar patología cardiaca que contraindique la rehabilitación. Efectuada la evaluación, se ingresa al paciente a un programa de rehabilitación respiratoria, el cual debe constar de un equipo multidisciplinario y debe incluir: 1) Educación de los pacientes y su familia; 2) Evaluación y entrenamiento muscular de extremidades inferiores, superiores y músculos respiratorios; 3) Soporte nutricional, y 4) Apoyo psicosocial. El programa de rehabilitación pulmonar proporciona importantes beneficios a los pacientes con EPOC en términos de reducción de la disnea, mejoría en la capacidad de ejercicio y en la calidad de vida (calidad de la evidencia A, recomendación fuerte). Se debe contar con espacio físico para la evaluación de los pacientes y con una sala de entrenamiento. Se recomienda que el programa de rehabilitación respiratoria debe ser personalizado y centrado en las necesidades del paciente y debe tener una duración de 6 a 12 semanas. La efectividad del programa es independiente del lugar donde se lleva a cabo y depende principalmente de su estructura. Es importante elaborar un estudio de estrategia y programa de control para evaluar su éxito.

A atenção fonoaudiólogica e a linguagem escrita de pessoas com baixa visão: estudo exploratório / Speech and language pathology therapy and the reading and writing of a person with visual disabilitie: exploratory study

Os objetivos deste trabalho foram: conhecer como as pessoas com baixa visão (visão subnormal) adquirida utilizavam a linguagem escrita no cotidiano e recomendar a atenção fonoaudiológica nesse processo. Foi realizado estudo descritivo exploratório para a construção do instrumento de coleta de dados. A amostra foi constituída por pessoas com baixa visão que freqüentaram o Programa de Reabilitação de Adolescentes e Adultos do Cepre/FCM/Unicamp em 2008. Aplicou-se questionário por entrevista, onde foram investigadas as variáveis: características pessoais, uso de recursos de tecnologia assistiva na leitura e escrita, razões das atividades de leitura e escrita e frequência do uso após a perda visual. A amostra foi composta por 08 pessoas com baixa visão com média de idade de 47 anos e predominância do sexo masculino (75,0 por cento). Os resultados indicaram que a maioria (62,5 por cento) relatou utilizar auxílios ópticos nas atividades de leitura. Todos informaram utilizar auxílios não ópticos na leitura. Os sujeitos declararam utilizar a leitura para obter informações sobre assuntos que os interessavam e a escrita para se comunicarem com as outras pessoas. Verificou-se que a maioria (75,0 por cento), relatou não utilizar a leitura e nem a escrita com a mesma freqüência que usava antes da perda visual e os motivos alegados foram a dificuldade para enxergar e o cansaço visual. A redução do uso da linguagem escrita no cotidiano por sujeitos com baixa visão adquirida compromete a autonomia e independência, fato este que demonstra necessidade de ênfase no trabalho com a linguagem escrita que poderá ser maximizado por meio da atenção fonoaudiológica.

The aim of this study was to: understand how people with acquired low vision (subnormal vision) used written language in daily living and to recommend speech and language pathology therapy during the process. A descriptive/exploratory study was conducted in order to build a data collection instrument. The sample was composed of subjects with low vision who attended Cepre / FCM / Unicamp in 2008. A questionnaire was applied during an interview, during which time the following variables were investigated: personal characteristics, use of assistive technology in reading and writing, reasons for performing reading and writing activities and the frequency of reading and writing after having acquired the visual loss. The sample was made up of 8 subjects with acquired low vision. The mean age was 47 years, of which 75,0 percent were males. Most of the subjects (62,5 percent) declared they used optical aids to read. All reported they used non-optical aids to read. The results showed that the subjects reported that they used to read to get information on topics of interest and they write to communicate with other people. The majority (75,0 percent) reported they didn't read and write with the same frequency as before the emergence of the ophthalmic problem and the reason given was difficulty in seeing and eyestrain. The reduction of reading and writing for individuals with low vision justifies the need for greater emphasis on working with reading and writing during rehabilitation, and this can be enhanced by speech and language pathology therapy.