Effects of PRECEDE-PROCEED Model on Behavior of Patients after Total Hip Arthroplasty / 中国康复理论与实践

Objective:To explore the effect of PRECEDE-PROCEED model on health behavior and quality of life of patients after total hip arthroplasty. Methods:From February to December, 2018, 103 patients who underwent primary total hip arthroplasty were divided into control group (n = 51) and intervention group (n = 52). The control group received routine perioperative guidance, while the intervention group received PRECEDE-PROCEED model in addition, in accordance to the nine links of the model, multi-dimensional intervention measures should be formulated with tendency factors, contributing factors and strengthening factors as the core. They were followed up for six months after discharge, and were assessed with Health Promoting Life style Profile II (HPLP II) and the MOS Item Short From Health Survey (SF-36) one, three and six months after discharge, respectively. Results:There was no significant difference in the scores of HPLP II and SF-36 between two groups at discharge (P > 0.05). The scores of HPLP II and SF-36 were higher than in the intervention group than in the control group one, three and six months after discharge (t > 2.307, P < 0.05). Conclusion:PRECEDE- PROCEED model could change the undesirable life behavior after operation, and improve the health behavior and quality of life of patients with total hip arthroplasty.

Clinical Effect of Telerehabilitation after Total Knee Arthroplasty: a Meta-analysis / 中国康复理论与实践

Objective:To evaluate the outcome of telerehabilitation in pain control and function recovery after total knee arthroplasty. Methods:CNKI, Wanfang Data (WF), CBM, VIP, PubMed, Web of Science, Medline, Springer Link, and Cochrane Library were searched on the effects of telerehabilitation on the patients after total knee arthroplasty, and the literatures of random control trials (RCT) study in English and Chinese in the above databases from 2000 to 2018 were collected. Literature screening, quality evaluation, data extraction and data analysis were carried out by 2 researchers. The indexes of outcome in the RCT studies included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), extension and flexion range, the Timed Up and Go Test (TUGT), Visual Analogue Scale (VAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results:A total of 6 RCT studies were included, with a total of 601 cases, 301 in the intervention group and 300 in the control group. There was difference in extension range (MD = 0.30, 95%CI: 0.20 to 0.40, P < 0.001), TUGT scores (MD = -5.17, 95%CI: -9.79 to -0.55, P = 0.03), VAS scores (MD = -0.43, 95%CI: -0.85 to -0.01, P = 0.04) and KOOS scores (MD = -1.10, 95%CI: -1.63 to 0.57, P < 0.0001) between two groups. There was no significant difference in WOMAC scores (MD = -0.32, 95%CI: -2.30 to 1.65, P = 0.75), flexion range (MD = 0.68, 95%CI: -2.28 to 3.63, P = 0.65), and muscle strength (MD = 13.77, 95%CI: -3.89 to 31.43, P = 0.13) (P > 0.05) between two groups. Conclusion:Telerehabilitation is effective to improve extension range, ambulation, pain and quality of life, while it is uncertainly effective in flexion range, knee function and muscle strength.

Evaluation of individualized medication under the guidance of genetic testing in the management of hypertension patients in rural areas / 中华疾病控制杂志

Objective This study combined genotyping with family doctors' contracting model to assess the application of precision medicine in rural patients with essential hypertension. Methods In this study, 209 hypertensive patients from 3 villages in Lujiang County, Hefei City, Anhui Province were selected as subjects and randomly divided into experimental group(n=105) and control group(n=104). The medication regimen of observation group was guided by genetic testing for gene sensitivity to antihypertensive drugs, and the control group was implemented routine pharmacy. All the patients were managed by family doctors. Adverse drug reaction rate, treatment compliance, blood pressure, body mass index (BMI), fasting blood glucose (FBG), cholesterol (TC), and triglycerides (TG) of the two groups were analyzed, respectively, during the 6-month intervention. Results After 6-month of intervention, the medication compliance of the experimental group were significantly higher than that of the control group, and the blood pressure and adverse drug reaction rate were significantly lower than that of the control group. After 3 months of intervention, there was no significant decrease in BMI, FBG, TC and TG in the two groups. After 6 months of intervention, the FBG, TC and TG of the experimental group were significantly decreased,while only the FBG value of the control group was significantly decreased. There were no significant changes in body mass index (BMI) values in both groups. Conclusions Individualized medication guided by genotyping can improve the treatment compliance, reduce the adverse drug reaction rate, and improve the treatment efficiency of patients with essential hypertension.