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Objective:To explore the related factors affecting the functional outcome of adult spinal cord injury and to establish a predictive model. Methods:A retrospective analysis was made on the medical records of 110 adult spinal cord injured patients with paraplegia from September, 2016 to December, 2018. Quantitative indicators that affected functional outcome were systematically collected, including age, length of stay, number of other diagnostic, number of complications, number of comorbidities, number of operations, days from onset to rehabilitation intervention, and the total scores of Lower Extremity Motor Subscore (LEMS), light touch (LT), pin prick (PP) and modified Barthel Index (MBI) at admission (MBIa) and discharge (MBId), the change values and change rates of MBI were calculated. The correlation coefficients among variables were analyzed. Multivariate linear regression models were established for the MBI total score at discharge and change of MBI score from admission to discharge (MBIc). Results:MBId was significantly correlated with MBIa, the total score of LEMS at admission (LEMSa), the total score of PP at admission, the total score of LT at admission, the number of days from onset to rehabilitation intervention, the number of operations and the number of comorbidities. The fitted regression equation was: MBId = 28.24 + 0.52 × MBIa + 0.24 × LEMSa - 1.23 × number of comorbidities (R2 = 0.64, P < 0.001). The MBIc was significantly correlated with MBIa, the days from onset to rehabilitation intervention and the length of stay. The fitted regression equation was: MBIc = 18.44 - 0.29 × MBIa + 0.06 × length of stay (R2 = 0.29, P < 0.001). Conclusion:The spinal cord injured patients with better functional status, higher motor score and less comorbidity at admission, and longer hospitalization have better functional recovery.
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Objective The aim of the longitudinal was to explore the level of posttraumatic growth (PTG) and the effect on rehabilitation outcome in patients who received renal transplant. Methods A questionnaire survey was carried out in patients after renal transplant in one month (T1) and six months (T2) in China during hospitalization. PTG was measured by the Posttraumatic Growth Inventory (PTGI), depression by the Patient Health Questionaire (PHQ-9), anxiety by the Generalised Anxiety Disorder Questionaire (GAD-7). Totally 180 patients were recruited, and 160 completed the follow-up measure. Data were analyzed using IBM SPSS 20.0. Results There were 88.3% (158/180) patients reported positive PTG in T1, and 94.3% (151/160) in T2. The mean score of posttraumatic growth at T1 and T2 had no significant difference (T1:77.96 ± 16.36,T2:79.54 ± 17.58;t=-1.302,P=0.195). PTG was not significant to the recovery of physical symptoms (χ2Creatinine=0.504,P=0.841,χ2recover=0.609,P=0.777, χ2complication=6.131,P=0.150), while it affected the incidence of anxiety (χ2=7.541, P=0.021), but not related with the incidence of depression (χ2=3.926,P=0.130). Conclusions There is no difference in the level of PTG in time. PTG has no obvious effect on body health recovery for patients with renal transplantation after six months, while for the mental health, PTG has no effect on depression symptoms, but can reduce the occurrence of anxiety symptoms.
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OBJECTIVE: To evaluate effects of caregiver's education program on their satisfaction, as well as patient functional recovery, performed in addition to daily conventional rehabilitation treatment. METHODS: Three hundred eleven subjects diagnosed with first-onset stroke and transferred to the Department of Physical Medicine and Rehabilitation of Inha University Hospital were surveyed. In 2015, caregivers attended an education program for acute and subacute stroke patients. Patients who received an additional rehabilitation therapy were assigned to the experimental group (n=81), whereas the control group (n=100) consisted of transfer cases in 2014 with only conventional treatment. The experimental group was classified by severity using the Korean version of the National Institutes of Health Stroke Scale (K-NIHSS), which was administered to all 181 subjects, in addition to, the Korean version of the Mini Mental Status Examination (K-MMSE), a Modified Barthel Index (K-MBI), and the Berg Balance Scale (K-BBS). Caregiver satisfaction and burden before and after education programs were assessed using the Canadian Occupational Performance Measure (COPM), as well as family burden and caregiver burnout scales. RESULTS: No significant intergroup difference was observed between initial K-NIHSS, K-MMSE, K-BBS, K-MBI scores, and times from admission to transfer. Those with moderate or severe strokes under the experimental condition showed a more significant improvement than the control group as determined by the K-NIHSS and K-BBS, as well as tendential K-MMSE and K-MBI score increases. Satisfaction was significantly greater for family members and formal caregivers of patients with strokes of moderate severity in the experimental group. CONCLUSION: The caregiver's education program for stroke subjects had a positive outcome on patients' functional improvement and caregiver satisfaction. The authors believe that the additional rehabilitation therapy with the education program aids patients to achieve functional improvements for an optimal return to social life.
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Humans , Caregivers , Education , Physical and Rehabilitation Medicine , Rehabilitation , Stroke , Treatment Outcome , Weights and MeasuresABSTRACT
@#Objective To investigate the factors related to outcome (recovery of motor, activities of daily living, and balance) of stroke patients. Methods 67 stroke patients with hemiplegia were evaluated with the Ueda Classfication of upper and lower limbs function, Functional Independence Measure (FIM), Berg balance scale (BBS) before and after treatment. The scores of all the assessment were as the dependent variable respectively, and regression analyzed with the factors possiblely related to the outcome. Results The positive factors for lower limbs function included rehabilitation intervention, time of rehabilitation, and hypercholesterolemia; while the negative factors were body mass index (BMI), and damage of superficial sensibility. The positive factors for upper limbs function were rehabilitation intervention and time of rehabilitation; while the negative factors were BMI, dysphagia, damage of superficial sensibility, and frequency of attack. The positive factors for hand function were rehabilitation interventions and interval from diagnosis to rehabilitation, while the negative factors were the muscle tension, incontinence, and frequency of attack. The positive factors for FIM were the rehabilitation intervention, while the negative factors were BMI, incontinence, hypercholesterolemia, gender and residence status. The positive factors for BBS were the rehabilitation intervention, while the negative factors were BMI, frequency of attack, and hyperglycemia. Conclusion Rehabilitation promotes the recovery of stroke patients, but the BMI may block it.
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Objective To evaluate the short-term effect of pelvic floor muscle rehabilitation training under the guidance of doctors on children with neuropathic acontractile sphincter incontinence ( NASI ).Methods Sixty eighty children[aged 4 - 12 ( mean, 7 ) years]with NASI were selected.All children were randomly divided into multiple guidance group and single guidance group.Pelvic floor muscle rrehabilitation training was successfully accomplished in all children.Three-day urinary diary, 7-day fecal diary, the ICI-Q-SF score and urodynamic evaluations were completed before and after the treatment.Three months later, follow-up was carried out.The results were compared between the groups.Results After treatment,TOV, LT, TFI and ICI-Q-SF of multiple guidance group were significantly lower than those of single guidance group[(29±8) vs (34±12), (19±10) vs (25 ±12), (1.9±1.1) vs (2.5 ±1.3), (9±5) vs ( 12 ± 6 ), P ＜ 0.05], however, PMUC of multiple guidance group was significantly higher than those of single guidance group[(5.6 ± 2.0 ) vs (4.7 ± 1.7 ), P ＜ 0.05].The effective rate of multiple guidance group after treatment and at follow-up were respectively 79.4% and 70.6% , significantly higher than those of single guidance group ( 64.7% and 50.0%, P ＜ 0.05 ).Conclusion Pelvic floor muscle rehabilitation training under the guidance of doctors has satisfactory therapeutic efficacy on the children with NASI.
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@# To study the related factors for the outcome of stroke would help to improve the approaches of the treatment, promote the quality of life of patients.
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@#Objective To investigate the effect of Doctor-patient Interaction Model on hemiplegia after acute stroke.Methods 200 cases with mderate to severe hemiplegia were divided into treatment group and the control group with each 100 cases according to whether their family supporting rehabilitation.Cases in treatment group received interaction model rehabilitation.They were assessed with National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Barthel Index(BI)10 d,1 month,3 months,6 months,12 months after rehabilitation,and the Geriatric Depression Scale(GDS)1 year after rehabilitation.Results The scores in all the assessment of the cases in the treatment group improve mostly 3 month after rehabilitation(P<0.01),while the BI improved 6-12 month after rehabilitation(P<0.01).The incidence of depression reduced 18% compared with that of the control group(P<0.01).Conclusion Doctor-patient interaction can improve the outcome of patients with moderate to severe hemiplegia.
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The incidence of traumatic brain injury (TBI) has increased with the advanced technology of society. A careful evaluation of associated problems, initial severity, and complications is important for the acute management and rehabilitation of patients with TBI. To predict the rehabilitation potentials of patients with TBI, we have retrospectively investigated the causes, types of injury, associated problems, and complications in 186 patients and also assessed the rehabilitation outcomes by measuring the functional gains according to the types of brain injury and the initial severities evaluated by the Glasgow coma scale in 82 patients. The functional gains were measured by differences of the Mini-mental status examination, PULSES profile, and Barthel index of pre- and post-rehabilitation states. The incidence of TBI was highest in the 3rd decade men and the most common cause was a traffic accident (120 cases, 64.5%). The types of brain injury were a diffuse axonal injury, 87 cases (46.8%); epidural hematoma, 21 cases (11.3 %); subarachnoid hemorrhage, 25 cases (13.4%); subdural hematoma, 28 cases (15.1%); and intracerebral hematoma, 25 cases (12.9%). Common associated problems were fractures and injuries of nervous system. The 7th cranial nerve and the peroneal nerve were the most common injuries for cranial and peripheral nerves, respectively. Common complications were pulmonary and skin disorders. Total hospital stay and the duration for rehabilitation were not significantly different by the types of injury. Functional gain tended to be higher in the intracerebral hematoma compared to the other types of brain injury. The functional gain was statistically higher in patients with initial severity of moderate degree according to the Glasgow coma scale. In conclusion the moderate traumatic brain injured patients seem to have a higher potential for the good functional outcome.