Efficacy of task-oriented training for rehabilitation of stroke patients with hemiplegia in community / 中华全科医师杂志

Objective:To evaluate the efficacy of task-oriented training for rehabilitation of stroke patients with hemiplegia in the community.Methods:Eighty stroke patients with hemiplegia receiving rehabilitation in Shanghai Babsongyuan Subdistrict Community Health Service Center from January 2017 to December 2019 were enrolled in the study. According to the rehabilitation methods, the patients were divided into the observation group (42 cases) and the control group (38 cases). Both groups were given routine Bobath technique and motor relearning method for 3 months; on this basis the observation group was given additional task-oriented training. The Brunnstrum stage was used to evaluate the limb function, Bobath balance scale was used to evaluate the sitting and standing balance function, and modified Barthel Index (MBI) was used to evaluate the activities of daily living.Results:The Brunnstrum stage of upper limbs, hands and lower limbs, Bobath sitting and standing balance function classification and MBI score of the two groups were significantly improved after treatment (the observation group: Uc=5.037, 4.567, 5.228, 2.538, 6.508, t=36.215, P<0.05; the control group: Uc=2.483, 2.311, 2.335, 2.200, 4.102, t=29.260, P<0.05). While the Brunnstrum stage of upper limb, hand and lower limb, Bobath sitting and standing balance function grade of observation group were significantly better than those of control group, MBI score was significantly higher than that of control group ( Uc=2.592, 2.243, 2.897, 2.018, 2.825, t=8.375, P<0.05). Conclusion:Bobath technique and motor relearning method combined with task-oriented training can significantly enhance the recovery of limb motor function and the improvement of activities of daily living of stroke patients.

Demands and Determinants of Community Rehabilitation Services for Older Adults / 中国康复理论与实践

Objective:To investigate the current status of community rehabilitation services for the older adults and the related factors based on the framework of Anderson Health Model and World Health Organization Community-based Rehabilitation Guideline. Methods:Data from 2016 China Longitudinal Aging Social Survey were analyzed with multiple response to explore the needs of community rehabilitation services, analyzed with Logistic regression to explore the related factors. Results:The older adults needed somehow community rehabilitation services (11.07%). However, the ratio of actual utilization of rehabilitation services (0.94%) and the meeting of needs (6.75%) were very low. The demand of community rehabilitation services related with education among the propensity factors (OR = 1.299); income (OR = 1.245), pensions (OR = 1.337), financial support from children (OR = 1.236), community's health support services (OR > 1.547) and community participation (OR = 1.640) among the enabling factors; disability (OR = 2.336) and suffering some chronic diseases (diabetes, cerebrovascular diseases, cervical and lumbar diseases, and Alzheimer's disease, etc.) among the demand factors. Conclusion:There are structural differences between the demand and supply of community rehabilitation services for the older adults. Education, economic conditions, community's health support services, community participation and health status are the factors related with the needs of community rehabilitation services, in the framework of Community-based Rehabilitation Guideline.

Efficacy of community rehabilitation combined with drug therapy on patients with schizophrenia in rural communities / 四川精神卫生

ObjectiveTo study the efficacy of community rehabilitation combined with drug therapy on rehabilitation of patients with schizophrenia in rural communities， and to provide references for community rehabilitation of patients with schizophrenia in rural areas of our country. MethodA total of 81 patients in rural communities of three towns in Lanzhou new area who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） were randomly divided into study group （n=39） and control group （n=42）. Both groups received general drug treatment. On this basis， the study group received community rehabilitation intervention for 6 months. Before and after intervention， Positive and Negative Syndrome Scale （PANSS）， Activity of Daily Living Scale （ADL）， Social Disability Screening Schedule （SDSS） and Schizophrenia Quality of Life Scale （SQLS） were used to assess the psychotic symptoms， social function and quality of life in two groups. ResultsAfter intervention， the PANSS total score ［（55.54±14.75） vs. （63.52±13.95）， t=-2.504， P=0.014］， negative symptom factor score ［（15.64±4.50） vs. （18.38±5.13）， t=-2.547， P=0.013］ and general psychopathological factor score ［（25.67±7.39） vs. （30.35±6.60）， t=-3.015， P=0.003］ of the study group were lower than those of the control group. The SDSS score ［（8.21±3.78） vs. （10.21±4.67）， t=-2.118， P=0.037］ and SQLS score ［（18.97±6.23） vs. （22.43±8.04）， t=2.150， P=0.035］ of the study group were lower than those of the control group. ConclusionCommunity rehabilitation combined with drug therapy may help alleviate psychotic symptoms， improve social function and improve quality of life in patients with schizophrenia in rural communities.

Chinese Medicine Involving Triple Rehabilitation Therapy for Knee Osteoarthritis in 696 Outpatients: A Multi-Center, Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To determine the effects of Chinese medicine (CM) involving triple rehabilitation therapy on the progression of knee osteoarthritis (KOA).@*METHODS@#A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally, using a cluster randomization design. Health education combined with CM involving triple rehabilitation therapy for KOA (electro-acupuncture, Chinese medicinal herb fumigating-washing, and traditional exercises) was administered in the treatment group while conventional rehabilitation therapy (physical factor therapy, joint movement training, and muscle strength training) was administered in the control group. Patients with a visual analog scale (VAS) scores ≽4 were treated with dispersible meloxicam tablets (7.5 mg, once daily). The Lequesne index scores, VAS scores, range of motion (ROM), lower limb muscle strength, knee joint circumference, quantitative scores of KOA symptoms, and the short-form 36 item health survey questionnaire (SF-36) scores were measured for each patient at 5 checkpoints (before treatment, at the 2nd week and the 4th week during the 4-week treatment period, at 1 month and 3 months after end of treatment), and adverse reactions were observed also.@*RESULTS@#A total of 696 patients completed the entire process, with 351 in the treatment group and 345 in the control group. At all treatment checkpoints, the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores, effective rate and improvement rate of the total Lequesne index scores, VAS scores, lower limb muscle strength, knee circumference, quantitative scores of KOA symptoms, and SF-36 scores as well (P<0.05 or P<0.01). No adverse reactions were encountered in this study.@*CONCLUSIONS@#CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling, improve lower limb muscle strength, promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA. It is suitable for patients with early or mid-stage KOA. (Registration No. ChiCTR-TRC-12002538).

Comprehensive physiotherapy management in covid-19 ­ a narrative review / Tratamento fisioterápico na covid-19 - uma revisão narrativa

The 2019 novel coronavirus officially named as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization, has spread to more than 180 countries. The ongoing global pandemic of severe acute respiratory syndrome coronavirus, which causes COVID-19, spread to the United Kingdom (UK) in January 2020. Transmission within the UK was confirmed in February, leading to an epidemic with a rapid increase in cases in March. As on April 25- 2020, there have been 148,377 confirmed cases of COVID-19 in the UK and 20,319 people with confirmed infection have died. Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy and community rehabilitation of COVID-19 patients has recently been identified as an essential therapeutic tool and has become a crucial evidence-based component in the management of these patients. This comprehensive narrative review aims to describe recent progress in the application of physiotherapy management in COVID 19 patients. Assessment and evidence- based treatment of these patients should include prevention, reduction of adverse consequences in immobilization, and long-term impairment sequelae. A variety of techniques and modalities of early physiotherapy in intensive care unit are suggested by clinical research. They should be applied according to the stage of the disease, comorbidities, and patient's level of cooperation.

O novo coronavírus de 2019 oficialmente nomeado como pandemia da doença por coronavírus 2019 (COVID-19) pela Organização Mundial de Saúde, se espalhou para mais de 180 países. A pandemia global em curso da síndrome respiratória aguda grave causada pela COVID-19, se espalhou para o Reino Unido em janeiro de 2020. A transmissão no Reino Unido foi confirmada em fevereiro, levando a um rápido aumento de casos em março. Em 25 de abril de 2020, houve 148.377 casos confirmados de COVID-19 no Reino Unido e 20.319 pessoas, com infecção confirmada, morreram. A sobrevivência de pacientes críticos está frequentemente associada ao comprometimento funcional significativo e redução da qualidade de vida relacionada à saúde. A fisioterapia precoce e a reabilitação comunitária de pacientes com COVID-19 foram recentemente identificadas como uma ferramenta terapêutica essencial e tornaram-se um componente crucial baseado em evidências no tratamento desses pacientes. Esta revisão abrangente tem como objetivo descrever o progresso recente na aplicação do manejo da fisioterapia em pacientes com COVID-19. A avaliação e o tratamento baseado em evidências desses pacientes devem incluir a prevenção, a redução de consequências adversas da imobilização e as sequelas de comprometimento a longo prazo. Uma variedade de técnicas e modalidades de fisioterapia precoce em unidade de terapia intensiva são sugeridas por pesquisas clínicas. Eles devem ser aplicados de acordo com o estágio da doença, com as comorbidades e com o nível de cooperação do paciente.

Effects of the livelihood activity of BasicNeeds model on rehabilitation for patients with mental disorders in community / 中华行为医学与脑科学杂志

Objective@#To explore the rehabilitation effect of participating in the subsistence activity in the basicneeds model on the community patients with mental disorders.@*Methods@#A total of 70 patients with mental disorders were enrolled in the Basicneeds Mental Health Development Research Program from June 1st, 2015 to December 1st, 2015 were enrolled. They were divided into research group (n=35) and control group (n=35). The research group received subsistence activity intervention in the basicneeds model for 12 months on the basis of the original drug therapy, whereas the control group only received conventional drug therapy. The World Health Organization Disability Assessment Scale Ⅱ (WHO-DAS Ⅱ) and Gross Assessment of Functioning (GAF) were adopted for assessment.@*Results@#The total WHO-DAS Ⅱ score, getting along with others, and communal participation in research group ((57.40±23.59), (7.43±4.15) and (9.97±4.99) were significantly lower than those in control group (74.17±22.14), (11.03±5.12) and (14.09±4.43). The D-value of GAF score before and after intervention in research group(11.37±6.19) was higher than that in control group (3.20±5.38). Multivariate Logistic regression analysis indicated that high family annual income (β=3.412, OR=30.325, 95%CI=1.634-562.883) and WHO-DAS Ⅱ score (β=-0.068, OR=0.934, 95%CI=0.884-0.987) were the influence factors of the social functional recovery.@*Conclusion@#Under the premise of drug therapy, the subsistence activity in the basicneeds model can outstandingly improve the social functions of patients with mental disorders and reduce the disability degree.

Application of the Cerebral Palsy Rehabilitation System in the Digital Community on the Thumb Adduction Deformity / 现代生物医学进展

Objective:To explore the effect of digital rehabilitation system on the recovery of infants with cerebral palsy.Methods:Twenty-one children with cerebral palsy were treated with residual cerebral palsy in Putuo District,and 21 children with cerebral palsy were followed up.The patients were divided into two groups (n =21).The control group was treated by routine OT training by the parents,and the treatment group was treated with the digital rehabilitation system.Three months later,the efficacy was evaluated and compared.Results:After 3 months of treatment,the total effective rate (effective rate and effective rate) of the two groups was 90.5％ and 81％,respectively,and the treatment group was significantly higher than the control group (P ＜0.05).The PROM of the two groups was improved (P ＜0.01),and the PROM in the treatment group was significantly higher than that in the control group (P ＜0.05).FMFM was significantly higher than that before treatment (P ＜0.01),and FMFM was significantly higher in the treatment group than in the control group (P ＜0.01).Conclusion:Family (community) digital rehabilitation system can effectively improve the rehabilitation of children with cerebral palsy.

Effect of community care and family members′participation on rehabilitation of patients with cerebral infarction / 现代临床护理

Objective To study the effect of community nursing and family members′participation on rehabilitation of patients with cerebral infarction. Methods Forty-two patients with cerebral infarction discharged from our hospital was chosen to take community rehabilitation training. The scores by modified Barthel index (MBI) and functional comprehensive assessment (FCA) before intervention were compared to those after intervention at the time points of pre-intervention and 1 month , three months after intervention. Results The scores by modified Barthel index (MBI) and functional comprehensive assessment (FCA) before intervention were significantly higher than those before intervention (P<0.01). The scores by MBI 1 month after intervention were significantly higher than those three months after intervention (P<0.01), indicating the longer the rehabilitation training, the better the effect. Conclusion The community rehabilitation care to patients with cerebral infarction sequelae can improve the quality of rehabilitation training and finally their quality of life.

Effects of pulmonary rehabilitation on patients with stable chronic obstructive pulmonary disease / 中华物理医学与康复杂志

Objective To observe the effects of puhnonary rehabilitation on the symptoms and quality of life of persons with chronic obstructive pulmonary disease (COPD).Methods COPD patients were recruited from a hospital and community health centers and given pulmonary rehabilitation in the community.The rehabilitation program included health education and nutrition guidance,medication,breathing exercises,and physical exercise.Each patient was followed up every 4 weeks by telephone.The outcome measures included pulmonary function (FEV1％,FEV1/FVC％),St George's questionnaire (SGRQ),the Medical Research Council scale (MRC),Borg scoring,evaluation of anxiety and depression,the six-minute walk test (6MWT),and an evaluation of nutritional status.All of the patients were observed for one year.Results A total of 85 patients completed the program and were included in the final statistical analysis.There was no difference in FEV1 ％ before and after rehabilitation.Six-minute walking distance improved significantly in statistical terms but the average increase was only from (416.1 ±99.84)m to (437.51 ±116.17)m.The SGRQ scores decreased by an average of 4.8 points after a year of rehabilitation,with significant improvements among the moderately and severely impaired.Incidents of COPD exacerbation also decreased significantly.Patients with a low body mass index had the greatest SGRQ score improvments.Few patients showed depression or anxiety in this research population.Conclusions Pulmonary rehabilitation in the community can improve exercise tolerance and the quality of life for persons with COPD,reducing incidents of acute exacerbation.Patients may benefit from such pulmonary rehabilitation regardless of disease severity.The compliance was good despite the infrequent monitoring.Pulmonary rehabilitation in the community is worthy of more widespread use.

Construction and Application of Space Resource Course Based on Network Platform of World University Town: Case Study of Community Rehabilitation Course / 中国康复理论与实践

@#Educational informationization is the focus of education and teaching reform. World University Town provided a very good platform for information and network teaching. This paper, taking the community rehabilitation course as an example, introduced the function ofWorld University Town in course construction and described the concepts, ideas, procedures and application effect.

Problems and Recommendations of Community Exercise Rehabilitation for Cardiovascular Disease / 中国康复理论与实践

@# Community rehabilitation of cardiovascular disease is of great significance. Exercise therapy of cardiovascular disease in communities is necessary and feasible. At present, the main problems China faced to carry out community exercise therapy of cardiovascular disease include: cardiovascular patients with a weak sense of community exercise therapy, lack of professional rehabilitation personnel, inadequate community-based exercise therapy practice and lack of community rehabilitation funding. To solve above problems, we should strengthen the community exercise therapy practice of cardiovascular disease, and promote the cooperation between community rehabilitation and hospital rehabilitation. In all, comprehensive efforts should be made in order to solve the problems.

The Role of Administrative Rehabilitation Physicians after the Great East Japan Earthquake: Support for the frail Elderly and Persons with Disabilities and Community Rehabilitation Support / The Japanese Journal of Rehabilitation Medicine

In this paper, we report the various actions and administrative steps taken by the Miyagi Prefectural Rehabilitation Support Center (MPRSC) to aid the disabled, following the Great East (Eastern) Japan Earthquake. Among various problems we encountered, it was alarming that the shelters set up for victims were not always accessible for disabled persons. These non accessible shelters had various barriers. Also, we noticed that many disabled people had lost their technical aids, i.e. canes, wheel chairs, orthoses and prostheses, etc. After the administrative vacuum caused by the disaster, we were able to restart community services for the disabled through reestablishment of local support center activities under MPRSC direction. During this process, we received much support from across the nation and from various specialist groups related to rehabilitation services. We now realize the need for the Disaster Acute Rehabilitation Team (DART) and the undergoing change in needs for the disabled people since the disaster. Finally, we comment on the importance of building a guideline of rehabilitation services, especially in case of a disaster, and having an everyday working intimate network established among the local administration office, medical associations and the other related parties.

Influence of comprehensive nursing intervention on quality of life and activity of daily living in community patients with convalescent stroke / 中国实用护理杂志

Objective To study on the influence of comprehensive nursing intervention on extremities function and quality of life (QOL) in community patients with convalescent stroke.Methods A total of 200 community patients with convalescent stroke were selected and randomized into the experimental group and the control group,100 cases each.Patients in the control group were given conventional treatment and following.While patients in the experimental group were given comprehensive nursing intervention besides the treatment mentioned above.Then the therapeutic effects were evaluated by filling out brief Fugl-Meyer assessment(FMA) scale and ADL rating scale(FIM).Life satisfaction index A(LSIA) and quality of life index (QLI) were selected to evaluate QOL.Results After treatment,the scores of LSIA and QLI of the control group showed no difference,but these scores of the experimental group were significantly improved,and was better than those of the control group.In addition,both FMA and FIM in these two groups improved obviously compared to those before treatment and the effect of the experimental group was superior to that of the control group.Conclusions The comprehensive nursing intervention can significantly improve extremities function and ADL and QOL of community patients with convalescent stroke.It is economical,simple and suitable to community families with any education background.

Caracterización psicosocial de la población consumidora de Spa, en proceso de rehabilitación vinculada a la comunidad terapéutica FFARO del departamento del Quindío / Psychosocial characterization of the spa consuming population, in the process of rehabilitation linked to the FFARO therapeutic community of the department of Quindío

El presente trabajo identifica las características de la población consumidora de SPA, en proceso de rehabilitación vinculada a la comunidad terapéutica FFARO del departamento de Quindío Colombia. Se realizó una investigación cuantitativa ­ descriptiva, consultando las entrevistas pedagógicas realizadas en la comunidad. A partir de los datos obtenidos, se encontró que la edad promedio es de 18.1 años; además, que la sustancia con mayor prevalencia de consumo es la marihuana con un 92% seguido de sustancias como el sacol con un 52%, el 48% para el cigarrillo, el alcohol en un 28%, y el bazuco con un 24%; En cuanto al género el 76% son hombres y el 24% mujeres.

The present of this study is to identify psychosocial characteristics of the consumer population of SPA, in rehabilitation related to the therapeutic community FFARO Colombia Quindío department. We performed a quantitative research - descriptive, educational consulting interviews conducted in the community. From the data, he found that the average age is 18.1 years. Moreover, the substance with the highest prevalence of marihuana consumption is 98%, followed with a substance such as a 52% Sacol, the cigarette with a 48% alcohol by 28% and a 24% bazuco.

Investigation in needs of health education of TCM health preservation and rehabilitation in community patients with chronic disease / 中国实用护理杂志

Objective To understand the needs of health education of TCM health preservation and re-habilitation in community patients with chronic disease in order to instruct nurses to carry out health education pur-posively. Methods A questionnaire survey was carried out in 320 patients with coronary heart disease, hyper-tension, chronic liver disease, diabetes mellitus, chronic obstructive pulmonary disease(COPD) and other chronic diseases. The investigation contents included cognition of TCM health preservation and rehabilitation, knowledge needs and demand patterns and the results underwent analysis. Results In 320 patients, 11% of patients understood the TCM health preservation and rehabilitation-related knowledge, 43% understood part of it, 46% knew nothing about it. All patients showed different degree of needs for TCM .health preservatiou and reha-bilitatiou and different demand patterns,and the total demand for various educational content was above 90%. Needs for disease prevention, health seasons, TCM dietetic therapy occupied the first three. Health care workers o-ne- to-one education was the most popular form of health education. 75% of the patients hoped that the family members were given health education at the same free. Conclusions Patients with chronic disease possess de-ficient but greater needs for knowledge about TCM health preservation and rehabilitalion. The awareness and ca-pability of serf-care, health preservation and rehabilitation and prevention-tirst should be improved.

Effect of Community Rehabilitation on Stroke Patients during Convalescence / 中国康复理论与实践

@#Objective To observe the effect of community rehabilitation on the motor function and activities of daily living(ADL)of stroke patients.Methods 155 stroke patients were randomly divided into the exercises group(n=76)and control group(n=79)and evaluated with simple Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI)and Functional Comprehensive Assessment(FCA)before treatment and 1 and 3 months after treatment.Results The evaluations of FMA,MBI and FCA were not different between two groups before treatment.One month later,the scores of MBI and FCA of the exercises group improved significantly(P<0.01),but simple FMA not improved even to 3 months after treatment(P>0.05).In the control group,the simple FMA score not improved(P>0.05),the scores of MBI and FCA had a declined tendency with disease course prolong.Conclusion The effect of community rehabilitation on the motor function of stroke patients during convalescence is not significant,but community rehabilitation may improve ADL and the quality of life.

Psychological rehabilitation on 57 schizophrenic patients / 中国康复理论与实践

@#ObjectiveTo standardize the service for mental disability in community, and evaluate scientifically the effect of rehabilitation measures and social factors on the prognosis of disease.MethodsIn the communities selected by cluster sampling method, family-social rehabilitation service was established. The observe groups or specified observers were selected by the community committee, and the maintenance treatment and rehabilitation evaluation were made by psychiatrists.ResultsAfter community rehabilitation treatment, schizophrenia could be compliant with maintenance treatment, which led to satisfactory social function evaluation and rehabilitation result.Conclusion Community rehabilitation treatment could increase the compliance with medical treatment and decrease the occurrence of relapse.

Efficacy of the Rehabilitation Strategy for Inpatients with Schizophrenia / 中国心理卫生杂志

Objective:To explore efficacy of the rehabilitative strategy in hospitalized schizophrenics.Method:Sixty-four schizophrenic patients were randomly divided into the intervention group and the control group.Both groups received the anti-psychotics therapy, but the teamwork education,medication management skills training module, symptom management skills training module were only given to the intervention group for ten weeks. And a one-year follow-up was carried out after their discharge from hospital. All subjects were evaluated with the Positive and Negative Syndrome Scale (PANSS), Nurses` Observation Scale for Inpatient Evaluation-30 (NOSIE-30), Insight and the Attitude to Treatment Scale, Social Disability Screening Schedule (SDSS), Morning Side Scale. We also recorded the relapse rate, reemployment rate, and re-hospitalization rate. Result:The clinical outcome of the intervention group was significantly superior to the control group on overall improvement according to PANSS (31.17?3.13 vs 52.34?13.02,7.34?1.08 vs 12.36?4.28,7.76?2.13 vs 13.26?4.50,16.13?1.82 vs 32.17?9.82 ),increase of active factor score of NOSIE-30 (-18.3?3.2 vs 14.4?6.7),and the reduction of inactive factor score of NOSIE-30(9.4?6.2 vs -22.3?7.4).The relapse rate(9.4% vs 54.8%),re-hospitalization rate(3.2% vs 42%),reemployment rate(37.5% vs 9.6%)were also better in the intervention group.Conclusion:The effect of rehabilitative strategy for schizophrenic patients not only improves the symptom, but also their social function.