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Objective:To investigate the improvement of the inhibition ability and brain activity characteristics in female methamphetamine addicts by rehabilitation exercise training. Method:Fifty-two females were methamphetamine addicts in abstinence were randomly divided into the inter-vention group and control group.All groups were completed the stop signal task and the desire for speed ques-tionnaire both before and after the intervention.Reaction times,the scores of the desire for speed question-naire and the amplitude of P3 were recorded and analyzed. Result:Compared with the control group,the stop signal response time was significantly decreased(P=0.003),the induced P3 amplitude was significantly increased(P=0.031),and the score of craving was signifi-cantly decreased in the intervention group(P=0.012)after rehabilitation exercise training. Conclusion:Rehabilitation exercise training for female methamphetamine addicts in the period of educational correction can effectively improve their inhibition ability and promote the reduction of amphetamine craving.
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ObjectiveTo investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels, functional states, and quality of life for people with mild and moderate disabilities in community settings, to ascertain the health benefits of their engagement in such fitness sports activities, anchoring in the WHO "Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and the guidelines tailored for people with disabilities, using the theoretical framework and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsAligning with the WHO guidelines for people with disabilities and the ICF, a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities, featuring activities like fitness training (aerobic and resistance exercises), skill exercises (such as balance and coordination), as well as sports and recreational games (ball and games, etc.). A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen, with types of disabilities including physical, speech, intellectual, and mental. Professional rehabilitation fitness instructors implemented and supervised the program. The activities were of low to moderate intensity, 30 to 50 minutes per session, five times a month for six months. The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire (IPAQ), and their overall functioning was evaluated with WHODAS 2.0. The health-related quality of life was measured with WHOQOL-BREF. The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning, activity involvement, and quality of life. ResultsAfter the fitness activities, participation levels significantly increased in IPAQ domains of work-related, transport-related, domestic and gardening activity, and leisure time (|t| > 3.391, P < 0.001). The scores significantly decreased in the domains of cognition, activity, self-care, getting along, life activities and participation; and overall scores also decreased in WHODAS 2.0 (t > 6.639, P < 0.001). The scores significantly increased in the four dimensions of WHOQOL-BREF (|t| > 7.486, P < 0.001). ConclusionAfter participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity, individuals with mild to moderate disabilities have improved in physical activity and engagement levels, and the overall functioning and quality of life.
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OBJECTIVE:Clinically,chronic ankle instability has symptoms such as muscle weakness,loss of control and repeated sprains.These symptoms can be effectively improved by means of exercise intervention.Here,we conducted a comprehensive quantitative evaluation of the effects of exercise intervention on chronic ankle instability at home and abroad through Meta-analysis,and examined the moderating effects of different exercise interventions on chronic ankle instability in terms of effect size and exercise dose. METHODS:CNKI,WanFang,Web of Science,EBSCO-SPORTD and PubMed were searched and screened for relevant literature regarding randomized controlled trials of an exercise intervention program against chronic ankle instability.Included literature was analyzed by using Review Manager 5.3 and Stata-SE 15. RESULTS:A total of 52 documents were included with 1 880 patients with chronic ankle instability.Meta-analysis showed that exercise intervention could improve the functional score of patients with chronic ankle instability to a large amount.Neuromuscular control training,a 12-week intervention cycle,and two weekly interventions of>60 minutes are the best protocol for improving instability symptoms in patients with chronic ankle instability.Exercise intervention could improve the dynamic balance of patients with chronic ankle instability to reach the medium equivalent stress.The best exercise program to improve the dynamic balance ability is a combination of neuromuscular control training and hip strength training,with an exercise dose of 30-60 minutes,two or three times per week,for 8 weeks in total. CONCLUSION:Different exercise forms have a good effect on improving the unstable symptoms and dynamic balance ability of patients with chronic ankle instability,among which neuromuscular control training has a more comprehensive effect on improving chronic ankle instability.It is recommended that a multifunctional combination of training forms be used as a means of rehabilitation rather than a single form of exercise.
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Objective To evaluate the impact of customized rehabilitation exercise plans based on the results of cardiopulmonary exercise test(CPET)on cardiac function and prognosis in patients with chronic heart failure(CHF).Methods A total of 52 CHF patients admitted to Chengde Central Hospital from February 2020 to September 2021 were selected as the study subjects,and the patients were divided into observation group and control group according to the principle of randomized controlled study,with 26 cases in each group.The control group received rehabilitation treatment excluding exercise.The observation group was given routine rehabilitation treatment and high-intensity rehabilitation exercise plans based on CPET guidance.Above anaerobic threshold Δ50%power was exercise intensity,exercise time was 30 minutes/day,4 days/week,and intervention period was 12 weeks.Before and 12 weeks after intervention,CPET functional indicators,serum brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and 6-minute walking distance(6MWD)were measured.The Minnesota CHF quality of life questionnaire(LiHFe)was used to evaluate patient's quality of life,readmission rate and cardiogenic mortality within 1 year of follow-up,and univariate and multivariate Logistic regression analysis was used to analyze factors affecting readmission of CHF patients.Results ① Cardiopulmonary function indicators:there was no statistically significant difference in the anaerobic threshold,peak oxygen uptake,and peak oxygen pulse of CPET functional indicators before and after intervention in the control group,after intervention,the CPET functional indicators in the observation group were significantly higher than those before intervention,and the above indexes in the observation group were significantly higher than those of the control group[anaerobic threshold(mL·min-1·kg-1):10.77±1.40 vs.9.59±1.11,anaerobic threshold(%ped):78.95±11.39 vs.70.09±6.48,peak oxygen uptake(mL·min-1·kg-1):15.63±1.36 vs.14.27±1.72,peak oxygen uptake(%ped):72.42±6.91 vs.63.41±7.31,peak oxygen pulse(mL/order):11.38±1.29 vs.9.05±1.64,peak oxygen pulse(%ped):90.23±10.16 vs.80.53±6.73,all P<0.05].②Serum indicators,cardiac function indicators,exercise ability indicators,and quality of life evaluation:there was no statistically significant difference in serum indicators BNP,cardiac function indicators LVEDD,LVEF,exercise ability indicators 6MWD,and quality of life LiHFe scores between the two groups before intervention.After intervention,BNP and LiHFe scores were significantly reduced compared with before intervention,while LVEF and 6MWD were both increased compared with before intervention,and the changes of the above indexes in the observation group were more significant than those in the control group[BNP(ng/L):313.25±77.91 vs.445.89±110.67,LVEF:0.41±0.08 vs.0.37±0.06,6MWD(m):495.62±91.35 vs.416.04±65.29,LiHFe score:23.27±6.02 vs.29.50±4.61,all P<0.05].③ Prognostic follow-up:the readmission rate within 1 year in the observation group was significantly lower than that in the control group(23.08%vs.53.85%),and there was no statistically significant difference in the mortality rate of cardiogenic diseases between the two groups.④Logistic univariate analysis showed that hyperlipidemia,New York Heart Association(NYHA)grading,BNP,and rehabilitation exercise were factors that affect the prognosis of CHF patients[odds ratio(OR)and 95%confidence interval(95%CI)were 0.098(0.019-0.494),0.069(0.016-0.294),1.018(1.007-1.029),and 3.889(1.178-12.841),respectively,all P<0.05].Multivariate analysis showed that after adjusting for other factors,hyperlipidemia,NYHA grading,and BNP were risk factors affecting the prognosis of CHF patients(OR and 95%CI were 0.068(0.007-0.687),0.048(0.005-0.415),1.016(1.002-1.030),respectively,with P<0.05],the use of rehabilitation exercise therapy was a protective factor affecting the prognosis of CHF patients[OR and 95%CI were 11.179(1.135-10.124),P<0.05].Receiver operator characteristic curve(ROC curve)analysis showed that hyperlipidemia,NYHA grading,BNP,rehabilitation exercise therapy,and combined testing all had predictive value for the patient's prognosis(all P<0.05),and the prediction value of joint detection was the highest,with the area under the ROC curve(AUC)=0.984 and P = 0.000.Conclusion Developing a high-intensity individualized cardiac exercise rehabilitation plan under the guidance of CPET can help improve the cardiopulmonary function,cardiac function,and quality of life of CHF patients,which is of great benefit for improving the long-term prognosis of CHF patients and has high safety.
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Objective:To explore the application effect of multimodal quantitative rehabilitation exercise in patients with ankylosing spondylitis and to provide reference for patients′ rehabilitation exercise.Methods:The quasi-experimental study method was used to select 78 patients with ankylosing spondylitis admitted to Rheumatology and Immunology Department of First Affiliated Hospital of Xinjiang Medical University from February 2021 to February 2022 as the research objects. The 39 patients admitted from February 2021 to August 2021 as the control group, and 39 patients admitted from September 2021 to February 2022 as the experimental group. The control group adopted conventional rehabilitation exercise program, and the experimental group adopted multimodal quantitative rehabilitation exercise program. The Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis function index, inflammatory factors after 6 months of intervention were compared between the two groups.Results:The Bath ankylosing spondylitis disease activity index in the experimental group after 6 months of intervention was (2.35 ± 0.81) points, and that in the control group was (3.47 ± 1.04) points, with a statistically significant difference ( t = 4.02, P<0.05). The Bath ankylosing spondylitis disease activity index in the two groups were analyzed by repeated measurement variance. The differences of time effect, inter group effect and interaction effect were statistically significant ( Fgroup = 11.27, Ftime = 62.05, Finteraction = 5.47, all P<0.05). The Bath ankylosing spondylitis function index in the experimental group after 6 months of intervention was (2.11 ± 0.32) points, and that in the control group was (3.07 ± 0.58) points, with a statistically significant difference ( t = 4.03, P<0.05). The Bath ankylosing spondylitis function index in the two groups were analyzed by repeated measurement variance. The differences in time effect, inter group effect and interaction effect were statistically significant ( Fgroup = 21.44, Ftime = 42.25, Finteraction = 16.67, all P<0.05). After 6 months of intervention, C-reactive protein, interleukin-6, transforming growth factor β, tumor necrosis factor-α were (43.15 ± 2.21) mg/L, (3.28 ± 0.85) mg/L, (41.67 ± 9.04) ng/L, (176.63 ± 20.15) ng/L respectively in the experimental group, and (50.12 ± 1.67) mg/L, (5.27 ± 0.68) mg/L, (48.65 ± 8.96) ng/L, (194.56 ± 19.45) ng/L respectively in the control group. There was a statistically significant difference in the content of inflammatory factors between the two groups ( t values were 2.05-4.45, all P<0.05). Conclusions:Multimodal quantitative rehabilitation exercise can improve the physiological function of ankylosing spondylitis patients′spine, reduce the disease activity of patients, and promote the rehabilitation of patients.
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ABSTRACT Background: Taekwondo athletes with lateral chronic ankle instability (LCAI) may experience difficulties with proprioception and ankle muscle strength. After surgery, a conventional rehabilitation exercise program can be ineffective, as it may not restore proprioception or muscle strength and, thus, result in minimal improvement. Objective: This study aimed to assess the effects of an ARE program following MBO on the proprioception, isokinetic strength, and endurance of ankle. Methods: Thirty athletes diagnosed with LCAI underwent MBO. They were divided into the ARE group (n=15) and the control group (CON, n=15). The ARE group performed early ARE exercises six times per week for 4 weeks. The parameters applied to test ankle muscle strength were angular speed of 30°/sec and 180°/sec (inversion: Inv. and eversion: Eve., respectively). Proprioception was measured as being able to sense a joint position of 15° of Inv. and 5° of Eve. Results: Significant differences were observed between the ARE and CON groups in ankle strength 30°/sec (Inv.: p<0.001, Eve.: p<0.001), 180°/sec (Inv.: p<0.001, Eve.: p<0.001), and proprioception at 15° (Inv.: p<0.001) and 5° (Eve.: p<0.001). Conclusions: We recorded significant short-term effects from early ARE in Taekwondo athletes with LCAI after MBO. The results provide reference data for the sports rehabilitator or ATC in evaluating the rehabilitation phase and informing patients about expectations after MBO in terms of performance status and the timing of return to sports. Level of evidence III; Therapeutic studies-Investigation of treatment outcomes - Case-control Study.
RESUMEN Introducción: Los atletas de Tae Kwon Do con inestabilidad lateral crónica del tobillo (ILCT) pueden presentar dificultades con la propiocepción y la fuerza muscular del tobillo. Después de la cirugía, un programa convencional de ejercicios de rehabilitación puede ser ineficaz porque la propiocepción o la fuerza muscular pueden no restablecerse y, por tanto, dar lugar a una mejora mínima. Objetivos: Este estudio tuvo como objetivo evaluar los efectos de un programa de ERA después de TBM sobre la propiocepción, la fuerza isocinética y la resistencia del tobillo. Métodos: Treinta atletas diagnosticados con ILCT fueron sometidos a TBM. Se dividieron en grupo ERA (n=15) y grupo de control CON (n = 15). El grupo de ERA realizó ejercicios ERA precoces seis veces por semana durante 4 semanas. Los parámetros aplicados para probar la fuerza muscular del tobillo fueron la velocidad angular de 30°/s y 180°/s (inversión: Inv y eversión: Eve, respectivamente). La propiocepción se midió por la capacidad de sentir la posición articular de 15° de Inv y 5° de Eve. Resultados: Se observaron diferencias significativas entre los grupos ERA y CON en la fuerza del tobillo a 30°/s (Inv: p < 0,001, Eve: p < 0,001), 180°/s (Inv: p < 0,001, Eve: p < 0,001), y la propiocepción a 15° (Inv: p < 0,001) y 5° (Eve: p < 0,001). Conclusiones: Registramos efectos significativos a corto plazo con ERA precoz en atletas de Tae Kwon Do con ILCT después de TBM. Los resultados proporcionan datos de referencia para el rehabilitador deportivo o ATC (Certified athletic trainer) a la hora de evaluar la fase de rehabilitación e informar a los pacientes sobre las expectativas después de la TBM en cuanto a las condiciones de desempeño y el momento de retorno al deporte. Nivel de evidencia III; Estudios terapéuticos - Investigación de los resultados del tratamiento - Estudio de caso-control
RESUMO Introdução: Os atletas de taekwondo com instabilidade lateral crônica do tornozelo (ILCT) podem apresentar dificuldades com propriocepção e força muscular do tornozelo. Depois da cirurgia, um programa de exercícios de reabilitação convencional pode ser ineficaz, porque a propriocepção ou a força muscular podem não se restaurar e, portanto, resultar em melhora mínima. Objetivos: Este estudo teve como objetivo avaliar os efeitos de um programa de ERA depois de TBM sobre a propriocepção, força isocinética e resistência do tornozelo. Métodos: Trinta atletas com diagnóstico de ILCT foram submetidos à TBM. Eles foram divididos em grupo ERA (n=15) e grupo controle CON (n = 15). O grupo ERA realizou exercícios ERA precoces seis vezes por semana durante 4 semanas. Os parâmetros aplicados para testar a força muscular do tornozelo foram velocidade angular de 30°/s e 180°/s (inversão: Inv e eversão: Eve, respectivamente). A propriocepção foi medida pela capacidade de sentir a posição articular de 15° de Inv e 5° de Eve Resultados: Foram observadas diferenças significativas entre os grupos ERA e CON na força do tornozelo 30°/s (Inv: p < 0,001, Eve: p < 0,001), 180°/s (Inv: p < 0,001, Eve: p < 0,001), e propriocepção a 15° (Inv: p < 0,001) e 5° (Eve: p < 0,001). Conclusões: Registramos efeitos de curto prazo significativos com ERA precoce em atletas de taekwondo com ILCT depois da TBM. Os resultados fornecem dados de referência para o reabilitador esportivo ou ATC (Certified athletic trainer) na avaliação da fase de reabilitação e informar os pacientes sobre as expectativas depois da TBM em termos de condições de desempenho e momento de retorno ao esporte. Nível de evidência III; Estudos terapêuticos - Investigação dos resultados do tratamento - Estudo de caso-controle.
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Introducción. El entrenamiento físico puede mejorar la capacidad de ejercicio, la disnea y la calidad de vida (CV) en pacientes con enfermedades respiratorias crónicas (ERC). En este contexto, el uso de oxígeno suplementario a través de una cánula nasal de alto flujo (CNAF) podría ser un dispositivo que permita tolerar mayores niveles de actividad con menos síntomas de esfuerzo físico, optimizando en última instancia la capacidad de ejercicio y la CV. Objetivo. Este protocolo pretende conducir una revisión sistemática para evaluar el efecto terapéutico de la CNAF durante el ejercicio físico en pacientes con ERC. Fuente de búsqueda. Se realizarán búsquedas en el Registro Cochrane Central de Ensayos Controlados (CENTRAL), PUBMED, Embase, Lilacs, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov y literatura gris. Criterios de elegibilidad. Examinaremos los ECA de acuerdo con los criterios de elegibilidad para su inclusión en nuestra revisión. Dos revisores examinarán de forma independiente cada estudio para la elegibilidad, la extracción de datos y la evaluación del riesgo de sesgo. Se combinarán los resultados mediante un metanálisis y se aplicará el sistema GRADE para evaluar la certeza de las pruebas para cada resultado. La medida de resultado primaria será la capacidad de ejercicio, y las medidas de resultado secundarias serán la calidad de vida, la disnea, la funcionalidad, la comodidad, las complicaciones y adherencia. Se realizarán metaanálisis para determinar la diferencia de medias (DM) o la DM estandarizada para los datos continuos y la razón de riesgo para los datos dicotómicos. Se realizarán análisis de subgrupos según los tipos y la gravedad de la enfermedad, las condiciones de ejercicio físico y el estado de los dispositivos de oxigenoterapia. Ética y difusión. Como los investigadores no accederán a información que pueda conducir a la identificación de un participante individual, no fue necesario a obtener aprobación ética. Número de registro de PROSPERO: CRD42022336263.
Background. Physical training can improve exercise capacity, dyspnoea, and quality of life (QoL) in patients with chronic respiratory diseases (CRDs). It has been suggested that using supplemental oxygen through a high-flow nasal cannula (HFNC) could lead to higher levels of activity to be tolerated with fewer symptoms of physical exertion, ultimately optimizing exercise capacity and QoL. Objective. To conduct a systematic review to assess the therapeutic effect of HFNC during physical exercise in patients with CRDs. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and grey literature. Eligibility criteria. We will examine RCTs according to the eligibility criteria for inclusion in our review. Two reviewers will independently examine each study for eligibility, data extraction, and risk of bias assessment. We will combine the results using meta-analysis and apply the GRADE system to assess the certainty of the evidence for each outcome. The primary outcome will be exercise capacity, and secondary outcomes will be QoL, dyspnoea, functionality, comfort, complications, and adherence. We will perform meta-analyses to determine the mean difference (MD) or standardized MD for continuous data and the risk ratio for dichotomous data. Subgroup analyses will be performed according to types and severity of disease, physical exercise conditions, and condition of oxygen therapy devices. Ethics and Dissemination. As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived. Prospero registration number: CRD42022336263.
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ABSTRACT Introduction: Iatrogenic stroke is a cerebrovascular clinical event. It quickly leads to localized or diffuse brain dysfunction. After the onset, the patient develops motor dysfunction. Objective: To study the effect of evidence-based physical exercise on the physical function and daily life ability of stroke patients with hemiplegia. Results: The performance of the exercise group was better than that of the control group. The difference between the two groups was statistically significant. Conclusion: Systematic evidence-based exercise and effective rehabilitation methods can alleviate the motor dysfunction of stroke patients with hemiplegia. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução: O acidente vascular cerebral iatrogênico é um evento clínico que, em pouco tempo, leva à disfunção cerebral localizada ou difusa, fazendo com que o paciente desenvolva disfunções motoras. Objetivo: Estudar o efeito de atividade física baseada em evidências sobre a função física de pacientes de AVC com hemiplegia sobre sua capacidade de executar suas atividades da vida diária. Método: 160 pacientes com AVC iatrogênico foram selecionados e separados aleatoriamente em grupos. O grupo Exercício recebeu treino reabilitativo, além de terapia medicamentosa convencional básica, enquanto o grupo Controle recebeu apenas terapia medicamentosa. Em seguida, os efeitos da reabilitação foram avaliados. Resultados: A performance do grupo Exercício foi melhor que a do grupo Controle. A diferença entre os dois grupos foi estatisticamente significativa. Conclusão: Atividade física sistemática e baseada em evidências e métodos de reabilitação eficientes podem aliviar a disfunção motora de pacientes de AVC com hemiplegia. Nível de evidência II; Estudos terapêuticos - investigação do resultado de tratamentos.
RESUMEN Introducción: El accidente vascular cerebral iatrogénico es un evento clínico que, en poco tiempo, ocasiona disfunción cerebral localizada o difusa, haciendo que el paciente desarrolle disfunciones motoras. Objetivo: Estudiar el efecto de actividad física basada en evidencias sobre la función física de pacientes de ACV con hemiplejia sobre su capacidad de ejecutar sus actividades de vida diaria. Método: Fueron seleccionados y separados aleatoriamente en grupos 160 pacientes con ACV iatrogénico. El grupo Ejercicio recibió entrenamiento de rehabilitación, además de terapia medicamentosa convencional básica, mientras que el grupo Control recibió solo terapia medicamentosa. A continuación, los efectos de la rehabilitación fueron evaluados. Resultados: El rendimiento del grupo Ejercicio fue mejor que la del grupo Control. La diferencia entre los dos grupos fue estadísticamente significativa. Conclusión: Actividad física sistemática y basada en evidencias y métodos de rehabilitación eficientes pueden aliviar la disfunción motora de pacientes de ACV con hemiplejia. Nivel de evidencia II; Estudios terapéuticos - investigación del resultado de tratamientos.
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Objective:To explore the different types and characteristics of rehabilitation exercise compliance of patients with first stroke at 2 weeks of onset, and analyze its influencing factors, so as to provide reference for the formulation of targeted health education.Methods:A cross-sectional investigation was conducted in Neurology Department of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to June, 2021. 276 patients with first-episode stroke were investigated by the Questionnaire of Exercise Adherence at 2 weeks of the onset. The potential profile analysis was conducted to explore characteristics classification of the rehabilitation exercise compliance. And the chi-square test was used to compare demographic differences among different categories and ordered multi classification Logistic regression was used to explore the influencing factors of rehabilitation exercise compliance.Results:The patients were divided into 109 cases with high rehabilitation exercise compliance (39.5%), 114 cases with moderate rehabilitation exercise compliance (41.3%), and 53 cases with low rehabilitation exercise compliance (19.2%). There were statistically significant differences in education level, consciousness level at admission, complications and limb muscle strength among the three types of patients ( χ2 values were 6.17-31.50, all P<0.05). Ordered multi classification Logistic regression showed that the patient′s education level, the patient′s consciousness level at admission, whether there were complications and limb muscle strength would affect the rehabilitation exercise compliance of stroke patients ( P<0.05). Conclusions:There are three potential categories of rehabilitation exercise compliance in patients with first stroke. Patients with illiteracy, drowsiness, complications and poor limb muscle strength have poor rehabilitation exercise compliance.
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Objective:To explore the mediating effect of self-efficacy and fatigue between depression and cognitive function in patients with spinal cord injury.Methods:General information questionnaire, Hamilton Depression Scale, Montreal Cognitive Scale, Rehabilitation Exercise Self-Efficacy Scale, Fatigue Revised Scale were used to investigate 256 cases of spinal cord injury patients from December 2018 to August 2020. The deviation-corrected percentile Bootstrap method was used to test the chain mediating effect of rehabilitation exercise self-efficacy and fatigue on depression and cognitive function.Results:Correlation analysis showed that depression was negatively correlated with cognitive function ( r=-0.146, P<0.01), self-efficacy of rehabilitation exercise ( r=-0.115, P<0.01), and positively correlated with fatigue ( r=0.317, P<0.01), self-efficacy of rehabilitation exercise was positively correlated with cognitive function ( r=0.903, P<0.01), and negatively correlated with fatigue ( r=-0.889, P<0.01), and fatigue was negatively correlated with cognitive function ( r=-0.217, P<0.01). The mediation model test showed that depression had a significant direct effect on cognitive function, with an effect value of -0.141 and an effect size of 50.20%. Self-efficacy of rehabilitation exercise and fatigue had a significant mediating effect between depression and cognitive function. The effect value was -0.096, -0.026, the effect size was 34.1%, 9.3%, and the chain mediation effect of rehabilitation exercise self-efficacy-fatigue was also significant, the effect value was -0.018, and the effect size was 6.4%. Conclusions:Depression in patients with spinal cord injury not only directly affects cognitive function, but also indirectly affects cognitive function through the mediating effects of self-efficacy of rehabilitation exercise and fatigue, and the chain-type mediating effect of rehabilitation exercise self-efficacy and fatigue.
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Introdução: A doença pulmonar obstrutiva crônica (DPOC) possui alta prevalência e gera altos custos aos sistemas de saúde. A reabilitação pulmonar (RP) é uma intervenção não-farmacológica que gera benefícios clínicos para os pacientes e economia de gastos para o sistema de saúde devido a redução do número de exacerbações da doença e internações hospitalares. Embora fortemente recomendada, a RP tem sido subutilizada havendo um baixo índice de indicações. Objetivo: Identificar as barreiras e os facilitadores para o encaminhamento de pacientes com DPOC à RP e à prática de atividade física. Métodos: Estudo qualitativo, realizado com médicos atuantes na atenção primária à saúde (APS) e uso de entrevistas semiestruturadas. As entrevistas foram gravadas e transcritas literalmente e submetidas a análise de conteúdo. Itens (trechos) identificados nos discursos e relacionados ao encaminhamento de pacientes com DPOC à RP e à prática de atividade física foram classificados como barreiras ou facilitadores. Tal classificação se baseou entre os quatorze domínios da Theoretical Domains Framework (TDF) e suas definições para identificar determinantes de comportamento entre os participantes relevantes para a mudança na prática clínica. Resultados: Setecentos e cinquenta e seis itens foram identificados nos discursos de vinte e um participantes e classificados como sendo barreiras (n= 279, 37%) ou facilitadores (n= 477, 63%) relacionados principalmente aos domínios da TDF de "Conhecimento" (n= 245, 32%), "Contexto e recursos ambientais" (n= 124, 16%) e "Papel e identidade social/profissional" (n= 107, 14%). Conclusão: As principais barreiras identificadas foram relacionadas aos programas de RP devido ao conhecimento restrito dos profissionais médicos sobre programas de RP, a disponibilidade reduzida de locais que oferecem estes programas e as dificuldades de acesso dos pacientes à RP. Os principais facilitadores identificados foram relacionados a orientação e o conhecimento pelos médicos sobre os benefícios da atividade física e a presença dos grupos de exercícios fornecidos na APS.
Introduction: Chronic obstructive pulmonary disease (COPD) has a high prevalence and entails high costs to health systems. Pulmonary rehabilitation (PR) is a non-pharmacological intervention that generates clinical benefits for patients and cost savings for the health system due to a reduced number of exacerbations and hospitalizations. Although strongly recommended, PR has been underutilized, with a low rate of indications. Objective: To identify barriers and facilitators for referring patients with COPD to PR and physical activity. Method: Qualitative study was carried out with medical staff working in primary health care using semi-structured interviews. The interviews were recorded, transcribed literally and underwent content analysis. Items (text excerpts) identified in the speeches and related to the referral of patients with COPD to PR and physical activity were classified according to as barriers or facilitators, and among the fourteen domains of the Theoretical Domains Framework (TDF) and its definitions; aiming to identify the determinants of behaviour which were relevant to change in clinical practice. Results: Seven hundred and fifty-six items were identified in the speeches of twenty-one participants and classified as barriers (n= 279, 37%) or facilitators (n= 477, 63%) mainly related to the TDF domains of "Knowledge" (n= 245, 32%), "Context and environmental resources" (n=124, 16%) and "Role and social/professional identity" (n= 107, 14%). Conclusion: The main barriers identified were related to referring patients PR due to lack of knowledge by medical staff about PR programs, the limited number of programs available, and the restricted access to PR program locations. The main facilitators were related to physical activity, mainly the medical staff's knowledge on physical activity benefits and availability of exercise group activities delivered at primary health care centres.
Subject(s)
Pulmonary Disease, Chronic Obstructive , Primary Health Care , Rehabilitation , Exercise , Prevalence , Health ResourcesABSTRACT
Objective:To explore the effects of perceived stress and self-efficacy on patients′ compliance with rehabilitation exercise after total hip replacement (THR).Methods:Perceived Stress Scale, General Self-Efficacy Scale, Harris Hip Function Score Scale and Rehabilitation Exercise Compliance Scale for patients after total hip arthroplasty were used to investigate 118 cases THR patients in the Second Affiliated Hospital of Inner Mongolia Medical University from August 2019 to November 2019.Results:Self-efficacy had a direct positive predictive effect on rehabilitation compliance of patients after THR ( r value was 0.215, P<0.05), and perceived pressure had a direct negative predictive effect ( r value was -0.665, P<0.05). Conclusion:In the nursing intervention for patients after total hip arthroplasty, in addition to improving the patient's compliance with rehabilitation exercise, the relevant nursing staff also need to pay attention to the relief of patient's perceived pressure and the improvement of self-efficacy.
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Objective:To observe the effect of early rehabilitation exercise on blood pressure of elderly patients with septic shock.Methods:A single-center, prospective, randomized controlled study was conducted in elderly patients with septic shock who were hospitalized in the department of critical care medicine of Huangshan Shoukang Hospital (High-tech Zone Central Hospital of Huangshan) from December 2018 to November 2020. According to the principle of simple random, all patients were divided into control group and intervention group. Both groups were treated with lower limb barometry to prevent deep vein thrombosis, 3 times a day, 30 minutes each time. After comprehensive treatment in the intensive care unit (ICU), the severity of patients was gradually improved, the hemodynamics was relatively stable, and the norepinephrine was reduced to 0.5 μg·kg -1·min -1. The control group continued to receive lower limb barometric treatment without rehabilitation training, while the intervention group began rehabilitation training when the dose of norepinephrine was reduced to 0.5 μg·kg -1·min -1. The duration of norepinephrine use, the length of ICU stay, and the occurrence of adverse events during rehabilitation training in intervention group was recorded. Results:Seventy-two patients were included in the final analysis, 35 in intervention group and 37 in control group. There was no significant difference in gender, age, Oxford acute severity of illness score (OASIS), acute physiology and chronic health evaluationⅡ (APACHEⅡ), mean arterial pressure (MAP) of 3 times and underlying diseases between two groups. Compared with control group, the length of ICU stay and duration of dose of norepinephrine ≤0.5 μg·kg -1·min -1 in intervention group were significantly shorter [length of ICU stay (hours): 193.0 (145.5, 312.0) vs. 242.5 (180.0, 483.5), P < 0.05; duration of dose of norepinephrine ≤0.5 μg·kg -1·min -1 (hours): 120.0 (72.0, 144.0) vs. 144.5 (120.0, 192.0), Z = 2.976, P = 0.003]. In intervention group, 35 patients did not show acute myocardial infarction, arrhythmia, syncope, central venous catheter detachment, and gastric tube detachment during the rehabilitation period, except 1 patient suffered from naked hematuria due to urinary catheter traction, which disappeared the next day after symptomatic treatment. Conclusion:The early rehabilitation exercise was beneficial to the recovery of autonomic blood pressure in elderly patients with septic shock, shorten the time of norepinephrine use and ICU stay.
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@#Objective To investigate the effects of rehabilitation exercise on exercise tolerance and cardiovascular risk factors in patients with non-acute coronary syndrome (non-ACS) after interventional therapy. Methods A total of 102 patients with coronary heart disease and non-ACS in our hospital from December 2018 to June 2019 were selected and randomly divided into a control group (n=51, 30 males and 21 females with an average age of 56.1±4.8 years) and a trial group (n=51, 34 males and 17 females with an average age of 55.1±4.9 years). The control group received routine treatment, while the trial group received regular supervised rehabilitation exercise on the basis of routine treatment. Patients were followed up for 6 months to compare the differences in cardiovascular risk factors (blood pressure, blood lipid, fasting blood glucose), 6-minute walking distance (6MWD), adverse lifestyle changes and treatment compliance between the two groups after treatment. Results The difference of 6MWD between the two groups was statistically significant (P<0.05). In the trial group, 6MWD increased after intervention compared with that before intervention, and the difference was statistically significant (P<0.05). Comparison of total cholesterol (TC), high density liptein cholesterol (HDL-C), low density liptein cholesterol (LDL-C) and fasting blood glucose in the trial group before and after intervention showed statistically significant differences (P<0.05). The differences in TC, HDL-C and LDL-C in the control group before and after intervention were statistically significant (P<0.05). It was statistically significant in dietary compliance rate, smoking cessation rate and alcohol cessation rate between the two groups (P<0.05); the differences in the dietary compliance and drug compliance of the trial group before and after intervention were statistically significant (P<0.05). Conclusion Regular supervised rehabilitation exercise can significantly improve the exercise tolerance and cardiovascular risk factors of non-ACS patients after coronary intervention treatment, so as to improve the quality of life and long-term prognosis of non-ACS patients, which is worthy of clinical application.
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Objective:To systematically review and develop the categories in the fields of recreational physical activities and rehabilitation exercise for the children and youth with disabilities based on the theory and method of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). Methods:The literatures about physical activities and rehabilitation exercise for children and youth with disabilities were retrieved with subject retrieval method, from the database of CNKl, Wanfang Data, PubMed and Web of Science, until December 31st, 2020. The authors, countries, published time, published journals, research objectives, object of the study and their ages, data collection tool, and the key findings were extracted. Results:A total of 1920 literatures were returned, and 26 of them were enrolled, which were published in eleven countries, and mainly from the journals of medicine, public health, exercise and rehabilitation for people with disabilities, and mainly published after 2010. The researches mainly used questionnaire survey, experimentation and measurement methods. There were three typical recreational physical activities: physical fitness activities, skills activities and sports activities, mainly including physical activities in daily life, recreational and leisure activities, sports activities, school physical education courses and rehabilitation training, etc. According to the framework of ICF-CY, physical activities might promote functional recovery for children and youth with disabilities, in b body functions, including bl mental function; b2 sensory function and pain; b4 cardiovascular, blood, the function of the immune system and respiratory system; b5 digestion, metabolism and function of the endocrine system; and b7 nerve musculoskeletal function related to movement; and d activities and participation, including d2 the general tasks and requirements; d4 activity; d5 self-care; d6 family life; d7 interpersonal communication and interpersonal relationship; d8 main area of life and d9 community, social and civic life. The evidences showed benefits of improvement in the fields of gross motor function, muscle strength, balance coordination, walking, running, dexterity and functioning of hand, cardio-respiratory fitness, body composition, and pain relief. Further more, there were gains at improvement of the quality of life, well-being, social support and self-efficacy, taking an active part in all kinds of leisure activities and physical activity, increasing the range of activities, etc. The environmental and personal factors might affect the participation and performance in physical activities for children and youth, including e1 products and technologies, e2 natural environment and man-made changes to the environment, e3 support and interpersonal relationships, e4 attitude, e5 service system and policy, including physical and built environment, assistive technology, activity facilities, transportation, physical accessibility and availability of community leisure and recreational activities, athletic ability, orientation of family activities, family environment, etc. Conclusion:The physical activities may promote the recovery of body function, and activities and participation for children and youth with disabilities. The environmental and personal factors may affect the participation and performance in physical activities.
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Objective:To review the categories of physical activities and rehabilitation exercise for aging people based on the theory and method of the International Classification of Functioning, Disability, and Health (ICF). Methods:From the framework and coding of ICF, physical activities, rehabilitation exercise and functional improvement for the aging people were reviewed. Results:There were three typical physical activities: physical fitness, skills and sports, mainly including regular exercises, cognitive amusements, leisure sports activities, recreational sports activities, rehabilitation exercises, etc. Physical activities promoted the functioning of the aging people, including mental function (b1), pain and sensory dysfunction (b2), cardiovascular, blood, the function of the immune system and respiratory system (b4), digestion, metabolism and function of the endocrine system (b5), nerve musculoskeletal function related to movement (b7), the function of skin and related structures (b8), activity (d4), and community, social and civic life (d9), etc., especially body mass index, cardiovascular, physical fitness (muscular strength and endurance, aerobic endurance), balance, flexibility, upper and lower extremities strength, sleep, metabolic capability, cognitive function and anti-aging ability. There were more gains at individual levels, including promotion of subjective happiness, quality of life, reducing depression, risk of sarcopenia, dementia and falling, etc. The environmental and personal factors related to activity and participation in physical activities included the products and technologies (e1), natural environment and man-made changes to the environment (e3), support and interpersonal relationships (e3), attitude, service system and policy (e5), such as urban environment, building environment, street pavement behavior, weather, caregivers, accompany of family and friends, etc. Conclusion:The physical activities and rehabilitation exercise the aged joined include physical fitness activities, skills activities, and sports activities. The physical activities had effects on the rehabilitation of the aged including the function of the body(mental function, pain and sensory dysfunction, cardiovascular, blood, the function of the immune system and respiratory system, digestion, metabolism, and function of the endocrine system, nerve musculoskeletal function related to movement, the function of skin and related structures) and the participation in activities (activities, community, society and civic life). The function of the body works for the health of the aged to promote physical health, mental health, functional health, social adjustment and social well-being.
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Objective:To explore the effect of negative oxygen ion combined with rehabilitation exercise intervention on lung function and quality of life of elderly patients undergoing thoracoscopic lobectomy.Methods:Totally 196 elderly patients treated with thoracoscopic lobectomy in Shanghai Pulmonary Hospital from February 2018 to July 2020 were prospectively selected as study subjects. The 196 patients were divided into 2 groups by random number table method: control group ( n=98) and observation group ( n=98). The control group was given rehabilitation exercise intervention, and the observation group was given negative oxygen ion intervention on the basis of the control group. After 3 months of intervention, the lung function and quality of life were compared between the two groups. Results:There was no significant difference in the lung function and quality of life before intervention between the two groups ( P>0.05). After intervention, the vital capacity (VC), forced expiratory volume in the first second (FEV 1), forced vital capacity (FVC) and FEV 1/FVC of the observation group were (3.82 ± 0.83) L, (2.53 ± 0.34) L, (3.71 ± 1.22) L, (68.79 ± 10.48)%, which were higher than (3.15 ± 0.68) L, (1.61 ± 0.28) L, (3.07 ± 1.12) L, (55.56 ± 10.08)% of the control group, and the differences were statistically significant ( t values were 3.826-20.678, P<0.01). After intervention, the physiological function, physiological function, physical pain, energy, social function, general health status, emotional function, mental health and total score of the observation group were (70.34 ± 4.45) points, (86.53 ± 6.51) points,(83.64 ± 7.35) points, (84.38 ± 5.50) points, (82.87 ± 6.14) points, (79.51 ± 6.22) points, (81.38 ± 6.75) points, (75.41 ± 5.62) points, (80.51 ± 15.26) points, which were higher than (61.32 ± 4.06) points, (76.92 ± 6.41) points, (74.30 ± 5.80) points, (74.15 ± 6.07) points, (75.34 ± 5.12) points, (70.30 ± 5.48) points, (73.50 ± 5.26) points, (61.32 ± 4.18) points, (70.89 ± 12.34) points of the control group, and the differences were statistically significant ( t values were 4.853-19.915, P<0.01). Conclusion:The negative oxygen ion combined with rehabilitation exercise intervention has a significant effect and can effectively improve the lung function and quality of life of elderly patients undergoing thoracoscopic lobectomy.
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Objective To assess the intervention effect of upper limb rehabilitation exercise video on life quality in patients after modified radical mastectomy. Methods A total of 160 breast cancer patients received modified radical mastectomy were from Shanghai Jiading District Maternal and Child Health Hospital from June 2017 to June 2019.They were randomly divided into control group and observation group with 80 cases in each group.The patients in the control group were trained with routine upper limb rehabilitation exercise, and the patients in the observation group were given video training for upper limb rehabilitation exercise.Quality of life (QOL), anxiety scale and depression scale were used for corresponding evaluations.Satisfaction and compliance scales were also used for evaluation. Results Before intervention, there was no significant difference in each index between the two groups (P>0.05).After intervention, the quality of life in the observation group was better than that in the control group, including life status (21.43±4.83), functional status (19.69±4.72), emotional status (19.83±4.36), social/family status (19.59±3.62) and additional attention (24.73±3.27).There was no statistically significant difference in these parameters before and after intervention in the control group (P>0.05).The scores of anxiety (36.37±5.64) and depression (37.28±4.47) in the observation group were lower than those in the control group, and the differences were statistically significant.The nursing satisfaction of patients in the observation group was much higher than that in the control group (91.25% vs 77.50%), and the proportion of compliance was higher than that in the control group (97.50% vs 68.75%). Conclusion In breast cancer patients received radical mastectomy, video-guided rehabilitation training can improve the quality of life and nursing satisfaction, compliance of rehabilitation, and condition of anxiety and depression.
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Acute-on-chronic liver failure (ACLF) is a syndrome of acute liver failure complicated by other organ failure on the basis of chronic liver disease. Liver transplantation is the only effective treatment for ACLF. There is still discussion space on the optimal operation timing of ACLF, how to reduce postoperative infection rate, improvement of nutrition and body function. Transplantation Immunology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association and Enhanced Recovery of Liver Transplantation Group of Enhanced Recovery after Surgery Committee of Chinese Research Hospital Society organized relevant experts to discuss the perioperative management of ACLF liver transplantation from the operation timing, organ protection, nutritional support, infection prevention and control, rehabilitation exercise and regulation of the internal environment, etc. And the expert consensus was developed for the reference of clinicians.
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Objective:To solve the movement mode adapting to individual differences for the trajectory planning of lower limb rehabilitation robots. Methods:After summarizing the six movement modes of the lower limb rehabilitation robot, according to the multi-rigid body theory of the human body, the exoskeleton of the lower limb rehabilitation robot was simplified into a two-bar linkage mechanism, the inverse kinematics analysis of the motion mode was performed, and the motion pattern solving system was designed based on C#. Results:The motion mode joint angle value calculated based on the C# motion mode solving system was transmitted to the upper computer, and the six motion modes were successfully applied to the lower limb rehabilitation robot. Through the inversion kinematics analysis of the motor model, the C#-designed motion mode solving system could solve the motorized joint angle values that adapted to individual of different leg lengths with lower extremity motor dysfunction. Through physical prototype experiments, the lower limb rehabilitation robot could drive the human body model for rehabilitation training according to the planned exercise mode. The actual joint angle curve and the theoretical joint angle curve were basically coincident, the joint angle error was small. Conclusion:The individual difference motion pattern solution is valid and feasible.