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Objective:To study the application value of nursing management based on self-efficacy theory in the early functional exercise of the affected limb after permanent pacemaker implantation.Methods:This study was a randomized controlled trial. A total of 90 patients who underwent permanent pacemaker implantation in Wuxi Second People′s Hospital (the Affiliated Central Hospital of Jiangnan University) from May 2019 to March 2021 were enrolled. They were divided into observation group and control group with 45 patients each according to random number table. The control group received routine nursing intervention, and the observation group received supplemental management interventions based on self-efficacy theory. The rate of post-operative rehabilitation up to the standard, the scores of the Shoulder Pain and Disability Index (SPADI), Chronic Disease Self-Efficacy Scale (CDSES) and Quality of Life Instrument for Patients with Pacemaker (QLIPP) were compared.Results:The rate of observation group's post-operative rehabilitation up to the standard was 93.33% (42/45), which was higher than that of the control group 77.78% (35/45). The difference was statistically significant ( χ2 =4.41, P<0.05). The pain index of the observation group was (20.27 ± 4.13), (5.25 ± 2.64)points at 1 and 2 weeks after operation, which was significantly lower than (27.06 ± 5.30), (9.35 ± 4.22) points of the control group ( t=6.78, 5.53, both P<0.05). The dysfunction index of the observation group was (15.06 ± 5.96), (7.21 ± 3.68) points, which was significantly lower than (17.75 ± 6.04), (9.03 ± 4.06) points of the control group ( t=2.13, 2.23, both P<0.05). After 2 weeks of operation, the total score of CDSES in the observation group was (4.73 ± 1.68) points, which was higher than (3.67 ± 1.49) points in the control group, and the difference was statistically significant ( t=3.17, P<0.05). The total score of QLIPP in the observation group was (92.78 ± 6.26), (124.40 ± 4.91) points at 2 weeks and 1 month after operation, which was significantly higher than (83.50 ± 7.91), (112.42 ± 5.04) points in the control group ( t=6.17, 9.51, both P<0.05). Conclusions:The application of nursing care based on self-efficacy theory in the patients of early functional exercise of the affected limb after permanent pacemaker implantation can improve rehabilitation compliance, self-efficacy of patients, the function of the affected shoulder joint and the patient′s quality of life.
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Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.
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Wolf-Hirschhorn syndrome is a chromosomal aberration caused by a deletion of the distal short arm of chromosome 4, characterized by distinct craniofacial features, failure to thrive, psychomotor developmental retardation, epilepsy, and feeding disorders. We report a case of patient with Wolf-Hirschhorn syndrome who underwent interventional rehabilitation commencing from the neonatal period in the neonatal intensive care unit. The patient was born at gestational age of 38 weeks 0 days, weighing 1583 g, with an Apgar score of 4/9, and was diagnosed with partial monosomy of the short arm of chromosome 4. Postnatal inspiratory stridor exacerbation was noted for which high-flow nasal cannula therapy was initiated. Rehabilitation commenced on the 18th day after the infant's birth, to promote sensorimotor development. Initially, the trunk was in a low muscle tension and unstable state. Therefore, we first prescribed rest followed by sensorimotor rehabilitation. When the infant's clinical condition stabilized, we performed prone and anti-gravity hugging exercises to improve the low trunk tension. Breastfeeding evaluation began 56 days after birth, when the respiratory condition improved. We practiced feeding the infant orally, in collaboration with doctors and nurses, to reduce bending and stabilize the posture when raising the mandible. The infant was gradually able to feed orally and gained weight. Thereafter, he was discharged 141 days after birth. This report concluded that rehabilitation intervention from the neonatal period, in collaboration with the multidisciplinary team and patient's family, contributed to initiation of oral feeding, improvement of sensorimotor development, and smooth transition to home care.
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A 3D printing based wrist orthosis device was developed. After collecting the contour information of the carpal and metacarpophalangeal joints of the patients with a 3D scanner, the wrist orthotics were designed to meet the individual needs of the patients according to the relevant requirements of biomechanics. Choose TPU (thermoplastic polyurethanes) materials for preparation of 3D printing. It can functionally assist the smart brace after stroke patients with hemiplegia early rehabilitation training, the use of orthoses carry MPU6050 inertial sensor, magnetometer, time module device such as a sensor and monitor its movements and record the training time, ensure safe efficient rehabilitation training, help patients return to a normal life as soon as possible.
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Humans , Orthotic Devices , Printing, Three-Dimensional , Stroke , Wrist , Wrist JointABSTRACT
Objective:To explore the application effect of micro-classes combined with flipped classrooms based on short videos and images in "early rehabilitation nursing of stroke patients with hemiplegia".Methods:A total of 70 nursing students who were interns in our department from June 2019 to April 2021 were selected as the research objects, among which, 35 nursing students who entered the department from June 2019 to March 2020 were selected as the control group, using traditional teaching, and 35 nursing students who entered the department from July 2020 to April 2021 were selected as the research group, adopting the micro-classes combined with flipped classrooms teaching based on short videos and images. After the teaching, the test scores of the two groups of students, the students' satisfaction with the teaching methods, their critical thinking ability and the students' autonomous learning ability were evaluated. SPSS 17.0 was used for independent-sample t test and paired-sample t test. Results:After the teaching, the theoretical scores and clinical practice assessment scores of the research group were better than those of the control group, and the difference was statistically significant ( P<0.05); the students in the research group were more satisfied with the teaching method than those in the control group. After the teaching, the scores of 7 dimensions of critical thinking ability of the students in the research group were higher than those of the students in the control group; the scores and total scores of 4 dimensions of the self-learning ability evaluation were higher in the research group than those in the control group. Conclusion:Micro-classes combined with flipped classrooms teaching based on short videos and images can improve the teaching effect of "early rehabilitation nursing for patients with stroke and hemiplegia".
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Objective:To explore the clinical effect of bench treadmill training on functional recovery for patients with severely burnt on lower limbs. Methods:From October, 2016 to December, 2017, 30 patients with severe lower limb burn were divided into control group (n = 15) and observation group (n = 15). The control group accepted routine comprehensive rehabilitation, while the observation group accepted the bench treadmill training in addition. They were assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Numerical Rating scale (NRS) of pain, Berg Balance Scale (BBS) and 6-minute walking test (6MWT) before and after six weeks of treatement. Results:The scores of SAS, SDS and NRS decreased in both groups (t > 3.636, P < 0.01), and they were less in the observation group than in the control group (t > 2.319, P < 0.05). The score of BBS and distance of 6MWT increased in the observation group compared with those in the control group (t > 2.541, P < 0.05). Conclusion:Early training with bench treadmill may promote the functional recovery for patients with severe lower limbs burns.
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Objective@#To analyze the nursing methods and effects of early rehabilitation and health management for hypertensive patients with cerebral infarction and hemiplegia.@*Methods@#Totally 86 patients with hypertension and cerebral infarction with hemiplegia were randomized to a random number table, with 43 patients in each group. The control group received routine nursing, and the observation group underwent early rehabilitation health management care, and the recovery of the two groups was compared.@*Results@#After treatment, the patient medical research committee score (MRC) in the observation group was (50.25±3.37) points, higher than the control group (40.28±3.38) points, and the Fugl-Meyer score (upper limb) of the observation was (65.44 ± 1.08) points, which was higher than that of the control group (53.38 ±1.22) points, and the Fugl-Meyer score (lower limb) was (28.15±1.13) points, significantly higher than the control group (26.52±1.17) points, the living activity ability Barthel index (88.65±4.73) was significantly higher than the control group (80.27 ±4.69)( t values were 6.571-48.536, P < 0.01). After nursing, the scores of memory and thinking, emotion, communication, mobility, daily living ability, hand function, strength and participation in the quality of life in the observation group were (74.58 ±3.27) points, (75.87 ±4.06) points, (72.31 ±5.08) points, (72.13 ±5.06) points, (69.75 ±4.41) points, (78.56 ±5.13) points, (64.17±3.50) points and (68.95±5.03) points. The scores of the observation group were significantly higher than those of the control group, which were (69.27 ±3.66) points, (66.35 ±4.17) points, (63.59±5.41) points, (58.95±4.22) points, (59.67±4.30) points, (63.49±5.07) points, (59.74±3.15) points, (54.09±5.10) points (t values were 6.144-13.701, P < 0.05).@*Conclusion@#Early rehabilitation health management and nursing for hypertensive patients with cerebral infarction and hemiplegia is helpful to improve the limb motor function and life activity ability of patients, and can significantly improve the quality of life of patients, which is worthy of promotion.
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Objective@#To investigate the nursing effect of clinical treatment combined with early rehabilitation nursing intervention in patients with heart failure.@*Methods@#A total of 60 cases of patients with heart failure from January 2018 to May 2018 in Beijing Anzhen Hosipital, Capital Medical University were admitted. They were divided into control group (30 cases) and observation group (30 cases) by random digits table method. All patients in 2 groups were treated with clinical treatment, while those in control group were treated with conventional nursing and observation group combined with early rehabilitation nursing intervention. Echocardiogram, 6 min walking test (6MWT), body composition analyzer (measuring extracellular moisture ratio) and body mass index (BMI) was used to evaluate the changes of all indexes before and after nursing care in 2 groups.@*Results@#Using the receiver operating characteristic curve(ROC) of extracellular moisture ratio to predict heart failure, the area under the curve (AUC) of patients with heart failure was predicted to be 0.737(P<0.01). Analysis of the correlation between the decrease of extracellular moisture ratio after treatment and the increase of walking distance after 6 minutes of treatment showed a positive correlation. With the decrease of extracellular water ratio after treatment, the 6MWT distance increased continuously after treatment (r=0.164, P=0.032). In the observation group, the 6 minute walking distance, extracellular water ratio, the added value of BMI, added value of 6 minute walking distance after treatment, after treatment of extracellular water reducing ratio, and BMI lower values were (438.76±89.16) m, (0.380±0.021)%, (24.74±3.13) kg/m2, (129.20±18.62) m, 0.010±0.006, (2.71±0.89) kg/m2, respectively. The control group were (356.40±85.28) m, (0.384±0.014)%, (25.93±2.68) kg/m2, (60.25±8.43) m, 0.009±0.008, (1.37±0.85) kg/m2. The differences between the two groups were statistically significant (t=1.726-15.739, P<0.05).@*Conclusions@#The extracellular moisture ratio indicates the degree of heart failure. Clinical treatment combined with early rehabilitation nursing intervention is superior to conventional nursing in patients with heart failure, which can significantly increase the patient′s 6MWT and reduce the patient′s BMI, which is worth popularizing and applying.
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Introducción: La curación de las secuelas dentofaciales de la tortícolis congénita, una vez establecidas, solo puede lograrse mediante cirugías. La identificación temprana de los pacientes aquejados de esta dolencia y un tratamiento precoz es imprescindible, pues de ello dependerá la evolución a largo plazo de los mismos. Objetivo: Identificar los factores que pueden tener utilidad desde la perspectiva de la prevención primordial de la tortícolis congénita. Métodos: Se realizó una investigación observacional, longitudinal y prospectiva en pacientes con diagnóstico de tortícolis muscular congénita atendidos en el Policlínico de Especialidades del Hospital Infantil Sur de Santiago de Cuba, en el periodo de septiembre de 2016 a septiembre de 2018. La muestra fue de 20 pacientes con dicho diagnóstico. Las variables fueron agrupadas en clínicas e imagenológicas. Resultados: Predominaron los pacientes del sexo masculino, 14 casos (70 por ciento). El diagnóstico de la mayoría de los casos fue precoz, 3 (15 por ciento) en la etapa neonatal y 14 (70 por ciento) entre los 29 días y 6 meses. Las complicaciones más temidas tales como la asimetría facial, la deformidad plagiocefálica, la distopia orbitaria y auricular aparecieron sobre todo asociadas a un diagnóstico y tratamiento tardío. La tomografía axial computarizada solo superó a las radiografías para descubrir complicaciones neurológicas. Conclusiones: La atención a temprana edad es la mejor opción terapéutica para evitar complicaciones en niños con tortícolis muscular congénita(AU)
Introduction: Once established, dentofacial sequels of congenital torticollis can only be healed by surgery. Early identification of sufferers and timely treatment are indispensable to achieve a favorable long-term evolution. Objective: Identify potentially useful factors from the perspective of fundamental prevention of congenital torticollis. Methods: An observational longitudinal prospective study was conducted of patients diagnosed with congenital muscular torticollis attending the Secondary Care Polyclinic at the South Children's Hospital in Santiago de Cuba from September 2016 to September 2018. The sample was 20 patients diagnosed with the disease. The variables analyzed were grouped into clinical and imaging. Results: There was a predominance of male patients with 14 cases (70 percent). Diagnosis of most cases was performed early: 3 (15 percent) at the neonatal stage and 14 (70 percent) between 29 days and 6 months. The most feared complications, such as facial asymmetry, plagiocephalic deformity, and orbital and auricular dystopia, were mainly found to be associated to late diagnosis and treatment. Computed axial tomography only surpassed radiography in spotting neurological complications. Conclusions: Early care is the best therapeutic option to prevent complications in children with congenital muscular torticollis(AU)
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Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Congenital Abnormalities , Torticollis/complications , Torticollis/diagnostic imaging , Prospective Studies , Observational StudyABSTRACT
INTRODUÇÃO: A fraqueza muscular adquirida em internações prolongadas é comum em cerca de 50 -80% dos pacientes onde apresentam evidências eletrofisiológicas de disfunção neuromuscular. A mobilização e a reabilitação precoce têm demonstrado melhorar os resultados funcionais e a qualidade de vida e neste contexto, a estimulação elétrica neuromuscular (NMS) tem positivas evidências auxiliando na preservação da síntese proteica e na prevenção de atrofia muscular durante o período de imobilização. OBJETIVO: Analisar os benefícios proporcionados pela eletroestimulação em pacientes internados na unidade de terapia intensiva. METODOLOGIA: Para realizar esta revisão, foi realizada uma busca nas seguintes bases de dados: SciELO, Medline, Lilacs, PEDro, PubMed e Cochrane, no período de junho a dezembro de 2018. Foram encontrados 106 artigos e 99 excluídos por não estarem de acordo com nossos descritores. No final, 7 artigos se enquadram nos critérios para a análise final. Os estudos foram selecionados primeiro pelo título, resumos e metodologias. Os critérios de inclusão dos estudos foram: comparador (es): parâmetros da EENM utilizados, força muscular e tempo de terapia por sessão, indivíduos maiores de 18 anos, homens e mulheres, necessitando de ventilação mecânica invasiva por mais de 24 horas. Estudos: Ensaios clínicos, coorte transversal, coorte longitudinal com esse tema. Não foram selecionados estudos de caso, artigos de revisão sistemática, resumos de congressos sobre o assunto, estudos fora do intervalo de tempo escolhido e outras técnicas de mobilização precoce. RESULTADOS: O número total de participantes incluídos nos estudos foi de 594 adultos, 323 em grupos experimentais e 271 em grupos controle, e todos os estudos investigaram os efeitos da NMS em pacientes críticos. Os estudos foram em adultos com diversos diagnósticos, houve grande variabilidade entre os protocolos NMS, número e tempo de sessão realizada. CONCLUSÃO: O NMS tem resultados significativos no aumento da força muscular, melhora a independência funcional, encurta o tempo de internação hospitalar, o tempo do uso de ventilação mecânica invasiva e níveis mais baixos de sedação. No entanto, ainda há necessidade de mais estudos com uma metodologia mais bem descrita para realmente investigar com mais precisão sobre o efeito isolado de NMS em pacientes críticos.
INTRODUCTION: Acquired muscle weakness in prolonged hospitalizations is common in approximately 50 -80% of hospitalized patients where all present electrophysiological evidence of neuromuscular dysfunction. Mobilization and early rehabilitation have been shown to improve functional results and quality of life and in this context, neuromuscular electrical stimulation (NMS) has positive evidences aiding in the preservation of protein synthesis and in the prevention of muscle atrophy during the immobilization period. OBJECTIVE: To analyze the benefits of electrostimulation in patients in the intensive care unit. METHODOLOGY: To carry out this review a search was performed in the following databases: SciELO, Medline, Lilacs, PEDro, PubMed and Cochrane, in the period from June to December 2018. 106 articles were found and 99 were excluded because they were not in accordance with our descriptors. In the end, 7 articles fit the criteria for the final analysis. The studies were selected first by the title, abstracts and methodologies. The criteria for inclusion of the studies were: comparator (es): NMS parameters used, muscle strength and therapy time per session, individuals over 18 years old, male and female, requiring invasive mechanical ventilation for more than 24 hours. Studies: Clinical trials, cross-sectional cohort, longitudinal cohort with this theme. No case studies, Systematic review articles, congress summaries on the subject, studies outside the chosen time interval, and other early mobilization techniques were selected. RESULTS: The total number of participants included in the studies was 594 adults, 323 in experimental groups and 271 in control groups, and all studies investigated the effects of NMS in critical patients. The studies were in adults with diverse diagnoses, there was great variability between the NMS protocols, number and time of session performed. CONCLUSION: The NMS has significant results in the increase of muscle strength, Improves functional independence, shortens hospital admission time, shortens time for invasive mechanical ventilation and lower levels of sedation. However, there is still a need for further studies with a better described methodology to actually investigate more accurately about the isolated effect of NMS in critical patients.
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Transcutaneous Electric Nerve Stimulation , Critical Care , Early AmbulationABSTRACT
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.
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Humans , Electric Stimulation , Extremities , Lower Extremity , Muscle Strength , Rehabilitation , Sensation , StrokeABSTRACT
Objective:To compare the expectation and perception of rehabilitation services for patients with work injury with or without early intervention. Methods:From August, 2017 to February, 2018, 350 inpatients with work injury accepted early intervention and non-early intervention were investigated with the modified ServQual scale. Results:There was no significant difference in the expectation between the inpatients accepted early intervention and non-early intervention (t < 1.904, P > 0.05). In both groups, expectation was the highest in assurance and responsiveness dimension, and the lowest in reliability dimension. The perception was higher in the early intervention group than in the non-early intervention group. In both groups, perception was the highest in tangibility, and the lowest in empathy. Conclusion:Early intervention of rehabilitation may improve the perception of services.
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Objective@#To investigate the effect of progressive early rehabilitation training in patients with severe acute pancreatitis.@*Methods@#A total of 67 patients with severe acute pancreatitis requiring mechanical ventilation who were treated in the intensive care department of Shanghai first people's hospital from May 2015 to May 2018 were selected. According to the order of admission, they were divided into the control group (n=32) and the intervention group (n=35). On the basis of this nursing, the intervention group was jointly evaluated by the ICU rehabilitation team and adopted the progressive early rehabilitation nursing mode according to the different degrees of patients' conditions. The intervention effects of the two groups were compared.@*Results@#The success rate of one-time weaning, mechanical ventilation time and ICU hospitalization time in the intervention group were 97.14% (34/35), (4.62±1.98) d, (8.76±1.02) d, and 78.12% (25/30), (9.01±2.15) d, and (14.01±2.87) d, respectively, in the control group. The difference between the two groups was statistically significant (χ2 = 3.986, t=-5.012, -8.260, P < 0.05 or 0.01). The incidence of delirium, Barthel index (BI) scale score and grip strength score were 2.86% (1/35), 47.54±4.32, (34.05±10.68) kg, in the intervention group, 12.50% (4/32), 41.68±3.18, and (26.79±8.97) kg, in the control group, respectively. The difference between the two groups was statistically significant (χ2=4.024, t=7.651, 3.194, P < 0.05 or 0.01).@*Conclusions@#Progressive early rehabilitation training and nursing has a great influence on the prognosis of patients with severe acute pancreatitis, which can effectively improve the prognosis of patients, accelerate the recovery of patients, shorten the length of hospital stay and the duration of use of ventilator, reduce the incidence of delirium, help patients to restore muscle strength, and improve the Barthel index score of patients, which is worthy of promotion and application.
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Objective To investigate the effect of progressive early rehabilitation training in patients with severe acute pancreatitis. Methods A total of 67 patients with severe acute pancreatitis requiring mechanical ventilation who were treated in the intensive care department of Shanghai first people′s hospital from May 2015 to May 2018 were selected. According to the order of admission, they were divided into the control group (n=32) and the intervention group (n=35). On the basis of this nursing, the intervention group was jointly evaluated by the ICU rehabilitation team and adopted the progressive early rehabilitation nursing mode according to the different degrees of patients′ conditions. The intervention effects of the two groups were compared. Results The success rate of one- time weaning, mechanical ventilation time and ICU hospitalization time in the intervention group were 97.14% (34/35),(4.62 ± 1.98) d,(8.76 ± 1.02) d, and 78.12% (25/30),( 9.01 ± 2.15) d, and(14.01 ± 2.87) d, respectively, in the control group. The difference between the two groups was statistically significant (χ2=3.986, t=-5.012,-8.260, P<0.05 or 0.01). The incidence of delirium, Barthel index (BI) scale score and grip strength score were 2.86% (1/35), 47.54 ± 4.32,(34.05 ± 10.68) kg,in the intervention group, 12.50% (4/32), 41.68 ± 3.18, and(26.79 ± 8.97)kg, in the control group, respectively. The difference between the two groups was statistically significant (χ2=4.024, t=7.651, 3.194, P < 0.05 or 0.01). Conclusions Progressive early rehabilitation training and nursing has a great influence on the prognosis of patients with severe acute pancreatitis, which can effectively improve the prognosis of patients, accelerate the recovery of patients, shorten the length of hospital stay and the duration of use of ventilator, reduce the incidence of delirium, help patients to restore muscle strength, and improve the Barthel index score of patients, which is worthy of promotion and application.
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@#Cardiac rehabilitation can safely and effectively improve the quality of patient's life and reduce readmission rate and mortality after cardiac surgery. Early cardiac rehabilitation after cardiac surgery is an indispensable part of cardiac rehabilitation. It can speed up the recovery of patient's exercise endurance, prevention of postoperative complications, shorten the time of returning to the family, increase the confidence of sustained rehabilitation, and lay foundation and set rehabilitation targets for the later stage of cardiac rehabilitation. This paper reviews the development history of early cardiac rehabilitation after cardiac surgery, and summarizes the current status, problems and outlook of rehabilitation management in China.
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Methods: A retrospective analysis was made in the data of 83 patients with unilateral osteonecrosis of the femoral head between March 2014 and May 2017. Forty-eight patients were treated with THA via PA (PA group) and 35 patients were treated with THA via DAA (DAA group). There was no significant difference in gender, age, body mass index, stage of osteonecrosis of the femoral head, and disease duration between 2 groups ( P>0.05). The length of incision, operation time, total amount of bleeding, the time of first postoperative walking with crutch, the time of first postoperative walking without crutch, the Harris scores, and the visual analogue scale (VAS) scores of 2 group were recorded and compared.
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Objective To investigate the effect of early rehabilitation physiotherapy on muscle quality and function in critical patients. Methods A prospective randomized controlled study was performed. Adult critically ill patients admitted to intensive care unit (ICU) of Anhui Provincial Hospital from October 1st, 2016 to August 31st, 2017 who had been hospitalized for more than 7 days and had acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ ) > 8 were enrolled, and they were divided into treatment group and control group according to random number table method. All patients were given routine treatment, and on this basis, the treatment group was given rehabilitation therapy within 24 hours after admission, including limb active / passive activities, respiratory muscle function training and transcutaneous electrical nerve stimulation, etc. Bedside ultrasound was used to measure the area and cross sectional thickness of left rectus femoris muscle and the cross sectional thickness of middle thigh muscle of patients at 1, 4 and 7 days after treatment; at the same time, the muscle strength of sober patients was evaluated by medical research council (MRC) muscle strength evaluation method, and the mechanical ventilation time, ICU hospitalization time and ICU expenses were recorded. Results Forty patients were enrolled in this study, with 20 in each group. Compared with the control group, the difference of left rectus femoris muscle area between 1 day and 4 days, 4 days and 7 days, 1 day and 7 days (cm2: 0.19±0.02 vs. 0.31±0.19, 0.02±0.01 vs. 0.08±0.05, 0.04±0.02 vs. 0.38±0.23), and the difference in left rectus femoris thickness (cm: 0.01±0.01 vs. 0.14±0.13, 0.03±0.03 vs. 0.16±0.14) and the difference in middle thigh muscle thickness (cm: 0.02±0.02 vs. 0.11±0.09, 0.03±0.02 vs. 0.16±0.12) between 1 day and 4 days, 1 day and 7 days in the treatment group were significantly reduced (all P <0.01). The MRC strength score in the treatment group was significantly higher than that of the control group at 7 days (52.06±3.52 vs. 47.94±3.96, P < 0.05). The mechanical ventilation time in the treatment group (n = 15) and the control group (n = 13) were (138.5±34.5) hours and (185.0±40.9) hours, respectively, and the difference between two groups were statistical significance (P < 0.05). Compared with the control group, the incidence rate of ICU acquired muscle weakness (ICUAW) in the treatment group was significantly decreased [5.0% (1/20) vs. 40.0% (8/20), P < 0.05], the length of ICU stay was significantly shortened (days: 17.67±4.91 vs. 22.06±5.94, P < 0.05), and the ICU expenses were significantly reduced (ten thousand yuan: 7.53±2.09 vs. 9.55±1.73, P < 0.05). Conclusion Early rehabilitation physiotherapy can improve the muscle quality and function in critical patients, and decrease the length of ICU stay.
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Objective To investigate the effect of early combined functional exercise on lower limb rehabilitation of vessel bridge taken in coronary artery bypass surgery. Methods From January to October 2017,90 patients undergoing coronary artery bypass surgery were randomly divided into control group and experimental group by coin toss, with 45 patients in each group. The control group was given routine nursing care, and the experimental group was given early combined functional exercise (foot dorsiflexion, ring rotation exercise and straight leg raising exercise) on the basis of routine nursing care. The difference of correlation index between two groups was compared. Results In the experimental group, the number of swelling in the thigh, crus and ankle were 20, 25 and 35 respectively; the control group was 32, 35, 43, the difference was statistically significant(χ2=6.55, 5.00, 8.38, P<0.05). The remission of limb swelling in the experimental group was also better than that in the control group(P<0.01). The incidence of limb wound complications: 6 cases in the experimental group, 18 cases in the control group(χ2=11.79,P<0.01));limb muscle strength grade Lovett:experimental group 0 case with grade 3,19 cases with grade 4,26 cases with grade 5,control group 9 cases with grade 3,26 cases with grade 4,10 cases with grade 5, there were significant differences between two groups (χ2=17.20, P<0.05). The limb comfort score,postoperative bed time,postoperative hospital stay was(7.11±1.15)points,(5.28±1.07)d, (11.04±2.01)d in the experimental group and(5.18±1.13)points,(6.97±1.21)d,(12.67±1.59)d in the control group,the differences were significant(t=-8.02,6.97,4.23,P<0.01). Conclusions To carry out early functional exercise can not only take angiogenesis effectively reduce limb swelling rate after coronary artery bypass grafting,relieve the severity of limb swelling,but also can reduce the incidence of incision complications,promote the recovery of limb muscle strength,shorten the postoperative recovery time and postoperative hospitalization time,is worthy of promotion and use in clinical nursing work.
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@#Objective To explore the effect of early pressure therapy during sensory training on functional recovery after island skin flap repairing vitia of thumb ventral. Methods From January, 2016 to July, 2017, 63 patients accepted island skin flap repairing vitia of thumb ventral were divided into control group (n=31) and observation group (n=32) according to the order of hosptalization. The control group accepted routine sensory training, while the observation group accepted early pressure therapy in addition. Their swelling, scars and sensory function were observed after treatment. Results The swelling and scars were milder, and the sensory function was better in the observation group than in the control group (P<0.05).Conclusion Combination with early pressure therapy during sensory training may promote the recovery of sensory function and fadeaway of swelling, and alleviate the formation of scar.
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Objective To observe the treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia,and to explore its possible mechanism.Methods One hundred cases of acute cerebral infarction hemiplegia in our hospital from January 2013 to June 2016 were selected and divided into the rehabilitation training group (50 cases) and control group (50 cases).The control group was given the routine medication therapy and the rehabilitation training group was given early rehabilitation training on the basis of conventional medication therapy.The functional independence assessment (FIM),Fugl-Meyer assessment (FMA) and modified Barthel index (MBI) were used to evaluate the therapeutic effect of early rehabilitation training.The level of stromal cell-derived factor-1α (SDF-1α) in peripheral blood was measured by enzyme linked immunosorbent assay,and the level of CD34+KDR+ in peripheral blood was measured by flow cytometry.Results There was no statistically significant difference in the FIM total score,FIM sports function score,FMA score,MBI score,SDF-1α and CD34+KDR+ levels before treatment between the rehabilitation training group and the control group (P>0.05).After treatment,the FIM total score,FIM sports function score,FMA score,MBI score and SDF-1α and CD34+KDR+ levels of the rehabilitation training group were higher than those of the control group,the differences were statistically significant (P<0.05).Conclusion The effect of early rehabilitation training on acute cerebral infarction patients with hemiplegic is remarkable.The mechanism may be related to promoting the expression of SDF-1α and CD34+KDR+ in peripheral blood.