Establishment of undergraduate rehabilitation specialty in Chinese universities: current status and existing problems / 中华医学教育探索杂志

With the increasing demand for rehabilitation medical care, medical education has taken on the important mission of cultivating high-quality rehabilitation talents for "Healthy China", and it is necessary to make attempts to explore the reform of rehabilitation majors in line with social needs and develop a professional layout that fits better with social needs. After more than 20 years of development, a certain scale has been formed for the establishment of rehabilitation majors, but the analysis of related data has revealed the problems such as mismatch of professional disciplines, mixed attributes of professional institutions, and unstable quality of talent training. Based on the setting of rehabilitation majors in the catalogues of undergraduate majors in colleges and universities adjusted and promulgated in 1998, 2012, and 2020 and the addition of majors in different types of colleges and universities in each catalogue, this article summarizes the rules, trends, and characteristics of the development of rehabilitation majors in higher education institutions in China and discusses the current status and existing problems of such majors, so as to provide a theoretical reference for the optimization and adjustment of rehabilitation majors in China.

The value of standardized patient simulation combined with OSCE model in clinical undergraduate teaching / 中华医学教育探索杂志

Objective:To study the value of standardized patient simulation combined with objective structured clinical examination (OSCE) in clinical undergraduate teaching.Methods:A total of 114 medical undergraduates who were interned in our hospital from January 2018 to January 2020 were selected as the research objects. All the students were randomly divided into observation group ( n=57) and control group ( n=57). Other undergraduate students were recruited as standardized patients and trained; students in the observation group were given standardized patient simulation teaching, while patients in the control group were given traditional teaching methods; experienced teachers prepared test questions and developed unified scoring standards, and OSCE model was adopted to assess the two groups. The scores of theory, medical history, humanistic communication, rehabilitation thinking, practical skills and total scores of the two groups were recorded. The evaluation of standardized patient simulation by 57 undergraduates and the evaluation of OSCE model by 114 undergraduates in the observation group were recorded. SPSS 22.0 statistical software was used for t test. Results:After teaching, the scores of medical history, humanistic communication, rehabilitation thinking and practical skills in the observation group were significantly higher than those in the control group ( P<0.05), but there was no significant difference in theoretical scores between the two groups ( P>0.05). Before teaching, there was no significant difference in the total scores between the two groups ( P>0.05); after teaching, the total scores of the two groups were both improved, with significant differences ( P<0.05); compared with the control group, the total score of the observation group was improved higher, with significant differences ( P<0.05). All the undergraduates in the observation group thought that the standardized patient simulation teaching improved themselves, and 89.47% of the undergraduates thought that the standardized patient simulation was worth promoting in the teaching of rehabilitation and therapy. Most of the undergraduates believed that OSCE model could reflect the students' comprehensive ability better than the traditional written examination, and could improve their communication ability and practical operation ability, cultivate their high-quality rehabilitation thinking, and change their tendency to lay stress on theoretical study. And 91.23% of the undergraduates thought that OSCE model was worth promoting in the courses of rehabilitation therapy. Conclusions:Standardized patient simulation combined with OSCE model is conducive to improving the comprehensive performance of undergraduates, improving their communication ability and practical operation ability, and cultivating their high-quality rehabilitation thinking, which can be promoted in clinical undergraduate teaching.

Evaluation of the rehabilitation therapy outcome for pneumoconiosis patients in the rehabilitation station / 中国职业医学

ObjectiveTo explore the rehabilitation outcome of personalized pulmonary rehabilitation therapy in pneumoconiosis patients in the rehabilitation station. Methods A total of 42 pneumoconiosis patients were selected as the study subjects from seven pneumoconiosis rehabilitation stations in Xinjiang Uygur Autonomous Region using the judgment sampling method. Patients were treated with personalized rehabilitation therapy for three months, and the outcome was analyzed. Results The six-minute walking test distance, maximum inspiratory pressure, maximum expiratory pressure, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio of the pneumoconiosis patients were higher after rehabilitation therapy than those before therapy (all P<0.05). The score of Chronic Obstructive Pulmonary Disease Assessment Test of patients after therapy was lower than that in pre-treatment (P<0.05). There was no significant difference in respiratory difficulty, Borg scale, balance ability, depression symptoms, anxiety symptoms, nutritional status scores, body mass index, blood oxygen saturation, and heart rate before and after rehabilitation therapy (all P>0.05). Conclusion The individualized pulmonary rehabilitation therapy of pneumoconiosis patients at pneumoconiosis rehabilitation station can improve the respiratory muscle strength and lung function of patients, and improve their quality of life.

Application of WeChat combined with team-based learning in the teaching of rehabilitation therapy / 中华医学教育探索杂志

Objective:To investigate the application effect of WeChat combined with team-based learning (TBL) in the teaching of rehabilitation therapy.Methods:A total of 40 students majoring in rehabilitation therapy who studied in our department were selected and divided into control group and experimental group, with 20 students in each group. The students in the control group received lecture-based learning, and those in the experimental group received WeChat combined with TBL. At the end of training, department examination and satisfaction investigation were performed for all students. SPSS 26.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the experimental group had a significantly better score of department examination (74.3±4.9 vs. 62.4±5.2, P<0.001), which was reflected in the three aspects of case analysis (18.3±2.1 vs. 15.2±1.9, P<0.001), clinical practice (19.3±2.1 vs. 14.8±2.4, P<0.001), and doctor-patient communication (17.8±2.4 vs. 14.1±2.4, P<0.001). Compared with the control group, the experimental group had a significantly better total score of satisfaction investigation (79.6±4.8 vs. 71.2±3.5, P<0.001). Conclusion:The teaching method of WeChat combined with TBL can improve the teaching effect of rehabilitation therapy and help to enhance the abilities for case analysis, clinical practice, and doctor-patient communication among students.

Rehabilitation experience of patients after total knee arthroplasty:a qualitative meta-synthesis / 中华护理杂志

Objective To systematically evaluate the rehabilitation experience of patients after total knee arthroplasty,and to provide references for improving the effect of rehabilitation treatment and formulating related clinical nursing strategies.Methods We searched PubMed,Web of Science,the Cochrane Library,Embase,CINAHL,Scopus,ProQuest,CNKI,Wanfang database,VIP database and Chinese biomedical literature database.A qualitative study on the experiences,feelings,and needs of patients undergoing rehabilitation after total knee arthroplasty was retrieved from the database until April 2023.The quality of literature was evaluated using the Quality Evaluation Criteria of Evidence-Based Health Care Center(2016)of Joanna Briggs Institute in Australia,and the results were summarized and integrated by the aggregation integration method.Results A total of 25 studies were included;82 topics were summarized into 12 categories;4 integrated results were finally formed:rehabilitation treatment was faced with multiple difficulties,and patients lost confidence and needed professional guidance and supervision;unsatisfactory experience in rehabilitation;the perception of the benefits of rehabilitation therapy and the encouragement of medical staff,and firm faith in rehabilitation;seeking understanding and social support can promote the effect of rehabilitation therapy.Conclusion Healthcare professionals should pay attention to and reflect on the challenges and unsatisfactory experiences that patients may face during rehabilitation,and provide them with professional guidance and supervision,as well as personalized rehabilitation treatment.

Atención del Trastorno del Espectro Autista y epilepsia a través de Sistemas Aumentativos/Alternativos de Comunicación / Care of Autism Spectrum Disorder and Epilepsy through Augmentative/

El incremento de la prevalencia de los perfiles clínicos de personas con TEA y epilepsia en la etapa infantil ha aumentado en los últimos años, describiendo una problemática en su evaluación e intervención en las competencias lingüísticas. Esta población muestra graves alteraciones en el lenguaje expresivo que abarcan diferentes dimensiones de este como la fonología, la semántica, la morfosintaxis, la pragmática y la comprensión auditiva. Todo ello hace que estos usuarios muestren alteraciones significativas en su comunicación y expresión del lenguaje, lo que dificulta significativamente su autonomía y calidad de vida. Por ello, según la literatura científica, uno de los planes de intervención más efectivo que disponemos en la actualidad es el uso de los Sistemas Aumentativos y/o Alternativos de Comunicación (SAAC), los cuales han demostrado en esta población que permiten aumentar su capacidad comunicativa y resolver situaciones lingüísticas con éxito. Es por lo que los profesionales de la salud deben tener un plan de evaluación e intervención adecuado que permita solventar las necesidades comunicativas de las personas con TEA y epilepsia en la etapa infantil. Por ende, este trabajo tuvo el objetivo de reflexionar y proporcionar una revisión de la atención de la población infantil con TEA y epilepsia a través del uso de los SAACs. Para ello, se llevó a cabo una revisión narrativa de la literatura científica publicada hasta el momento, con la lectura de 51 artículos de investigación sobre la atención de la población infantil con TEA y epilepsia. Los resultados indicaron que el protocolo de evaluación para su implementación debe seguir una serie de pasos como son: Recogida de información, Valoración de la persona, Valoración del entorno cercano, Selección del vocabulario, Selección de los reforzadores, Análisis de los sistemas de comunicación, Toma de decisiones y Evaluación de la efectividad del sistema de comunicación. Asimismo, el uso de SAACs en este colectivo mejora de forma significativa la comunicación funcional en diferentes contextos y entornos. En conclusión, se debe llevar a cabo una atención multidisciplinar para mejorar las competencias lingüísticas de las personas con TEA y epilepsia.

The increasing prevalence of clinical profiles of individuals with ASD and epilepsy in childhood has grown in recent years, describing a challenge in their assessment and intervention in language competencies. This population exhibits severe impairments in expressive language that encompass various dimensions of language, such as phonology, semantics, morphosyntax, pragmatics, and auditory comprehension. All of this results in these individuals showing significant disruptions in their communication and language expression, significantly impacting their autonomy and quality of life. Therefore, according to scientific literature, one of the most effective intervention plans currently available is the use of Augmentative and Alternative Communication Systems (AAC), which have shown in this population to increase their communicative capacity and successfully address language-related situations. Hence, healthcare professionals should have an appropriate assessment and intervention plan to address the communication needs of children with ASD and epilepsy. Therefore, this work aimed to reflect on and provide a review of the care for children with ASD and epilepsy through the use of AACs. To achieve this, a narrative review of the scientific literature published up to now was conducted, with the reading of 51 research articles on the care of children with ASD and epilepsy. The results indicated that the assessment protocol for its implementation should follow a series of steps, including: Gathering information, Assessing the individual, Assessing the immediate environment, Selecting vocabulary, Choosing reinforcers, Analyzing communication systems, Making decisions, and Evaluating the effectiveness of the communication system. Furthermore, the use of AACs in this group significantly improves functional communication in various contexts and environments. In conclusion, a multidisciplinary approach should be taken to enhance the language competencies of individuals with ASD and epilepsy.

Theoretical construction and practical research on the curriculum system of children's rehabilitation specialty in rehabilitation therapy / 中华医学教育探索杂志

This article takes the setting of children's rehabilitation specialty in the rehabilitation therapy of Xiamen Medical College as an example, and expounds that in the process of cultivating talents in children's rehabilitation, theoretically, a training model of "2.5+0.5+1" has been built closely around the training goals of "solid foundation, wide caliber and strong skills", highlighting basic pediatric courses, core skills courses for children's rehabilitation therapy and special courses for children's rehabilitation. In practice, the training of "early clinical practice and early probation" for children's rehabilitation skills is stressed. The results show that students have greatly improved their professional knowledge and practical ability, and the effect of "early clinical practice and early probation" is obvious. Among the students who choose the direction of children's rehabilitation, 95% of the students want to engage in the career of children's rehabilitation and believe that the curriculum system will be of great help to their future employment.

Real Situation of Rehabilitation Therapy from the Viewpoint of Medical Service Fees / The Japanese Journal of Rehabilitation Medicine

Purpose：The older population in Japan is increasing faster than that in the rest of the world. As a result of the increasing number of elderly patients, rehabilitation treatment has become very important, resulting in rehabilitation-related medical expenses increasing, However, it is unclear which age groups are administered rehabilitation treatments. In this study, we investigated the age distribution of patients receiving rehabilitation treatment in Japan.Methods：We investigated the age distribution of patients receiving rehabilitation treatment using insurance data.Results：Rehabilitation fees for cardiovascular, cerebrovascular, and musculoskeletal diseases peaked in the early 80 years age group, whereas those of disuse syndrome, respiratory diseases, and cancer peaked in the late 80 years. Male patients with cardiovascular diseases were twice as common until 80 years of age. Regarding cerebrovascular diseases, the number of male patients peaked in the late 70s, and there were more male patients in the following age groups. More female patients in the late 80 years age group had disuse syndrome. Rehabilitation fees for musculoskeletal diseases had the highest number of units calculated, with 2.5 times as many female patients as male patients. As for respiratory diseases, more male patients were present in the late 80 years age group. Among patients with cancer, males were about twice as common as females.Conclusion：The peak age of patients receiving rehabilitation treatment was in the 80 years age group, and the number of patients increased every year.

Treatment of finger spasm after stroke with wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of wheat grain moxibustion combined with rehabilitation training and simple rehabilitation training on finger spasm after stroke.@*METHODS@#A total of 80 patients with finger spasm after stroke were randomly divided into an observation group and a control group, 40 cases in each group. The control group was given routine rehabilitation training, once a day, 30 min each time. The observation group was given wheat grain moxibustion at Shixuan (EX-UE 11) on the basis of the control group, 8~10 moxibustion cones at each point, once a day. Both groups were treated for 6 days as one course of treatment for 4 courses. The motor function of the affected hand (Fugl-Meyer assessment [FMA] score) and muscle tension (modified Ashworth scale [MAS] grading), surface EMG indexes (wrist dorsiflexor muscle and flexor carpal metacarpal muscle mean square [RMS] value), hand muscle strength (neurological deficit score [NDS]) and daily living ability (modified Barthel index [MBI] score) were compared between the two groups before and after treatment, and clinical efficacy was evaluated.@*RESULTS@#After treatment, FMA and MBI scores in the 2 groups were increased compared with before treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The RMS value of wrist dorsiflexor muscle and flexor carpal metacarpal muscle in relaxation and passive function testsand and NDS in the 2 groups were lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). MAS grading in the 2 groups was improved compared with before treatment (P<0.05), and that in the observation group was better than the control group (P<0.05). The total effective rate of the observation group was 92.5% (37/40), which was higher than that of the control group (80.0%, 32/40, P<0.05).@*CONCLUSION@#Wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training can improve the hand motor function and daily living ability of patients with finger spasm after stroke, improve the degree of spasm and the function of wrist dorsiflexor muscle and flexor carpal metacarpal muscle, the clinical effect is better than simple rehabilitation training.

Effects of acupuncture and rehabilitation therapy on lower limb motor function after stroke: an fNIRS study / 中国康复理论与实践

Objective To investigate the efficacy of acupuncture and rehabilitation therapy on lower limb motor function, and to explore a cortical mechanism using functional near infrared spectroscopy (fNIRS). Methods From December, 2020 to July, 2021, 24 stroke patients with lower limb motor dysfunction in our hospital were randomly divided into rehabilitation group (n = 12) and acupuncture-rehabilitation group (n = 12), and received routine rehabilitation training and acupuncture-rehabilitation intervention for four weeks, respectively. The control group included ten healthy subjects matched the patients. Before and after intervention, the lower limb motor function of the patients was assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), and all the subjects accepted fNIRS examination. The functional intensity and lateralization index (LI) of supplementary motor area (SMA), premotor cortex (PMC) and sensory motor cortex (SMC) were calculated based on oxygenated hemoglobin (HbO2). Results There was no significant difference in FMA-LE score between the rehabilitation group and the acupuncture-rehabilitation group before the intervention (P > 0.05). After four weeks of intervention, FMA-LE scores improved in both groups (t > 3.770, P 0.05). After intervention, the average functional connection increased in both groups (t > 2.178, P < 0.05), and the functional connection of the affected PMC of acupuncture-rehabilitation group increased (P < 0.05). The LI in SMC increased in the acupuncture-rehabilitation group (P < 0.05). There was a significant positive correlation between the change of functional connection of the affected PMC and the change of FMA-LE scores in the acupuncture-rehabilitation group (r = 0.579, P < 0.05). Conclusion Acupuncture with rehabilitation therapy can significantly improve the lower limb motor function and asymmetrical activation of SMC in stroke patients. The recovery of lower limb motor function may be related to the enhanced activation of affected PMC.

Application of six-minute walking test in cardiopulmonary function rehabilitation of occupational pneumoconiosis patients / 中国职业医学

As a simple, objective, effective, and repeatable functional testing method, six-minute walk test(6 MWT) was widely used in the physical assessment of patients with chronic cardiopulmonary diseases. The correct evaluation of cardiopulmonary function of patients with occupational pneumoconiosis(hereinafter referred to as pneumoconiosis) has important reference value for their cardiopulmonary rehabilitation. The application of 6 MWT in the cardiopulmonary function rehabilitation of pneumoconiosis patients mainly includes the following: it can accurately evaluate the maximum physical load of pneumoconiosis patients during exercise; comprehensively evaluate the cardiopulmonary function of pneumoconiosis patients, guide the formulation of personalized exercise prescription and improve the practicability of exercise prescription; evaluate the safety of exercise in pneumoconiosis patients; evaluate the effect of exercise rehabilitation; and pre-evaluate the cardiopulmonary function. As a supplement to cardiopulmonary exercise test, it can be used in disability identification of pneumoconiosis patients.The 6 MWT can provide a quantitative index for the assessment of cardiopulmonary function in pneumoconiosis patients, and it is worthy of wide application in the assessment of cardiopulmonary function, exercise ability and respiratory rehabilitation in such patients.

Effect of Acupuncture-rehabilitation Therapy on Neural Function and Expression of Forkhead Box P3 and Retinoic Acid-related Orphan Receptor γt in Mice with Cerebral Ischemia / 中国康复理论与实践

Objective To explore the effect of acupuncture-rehabilitation therapy on the expression of transcription factor forkheadbox P3 (Foxp3) and retinoic acid-related orphan receptor γt (RORγt) protein in cerebral ischemic mice. Methods Forty-five female C57BL/6 mice were randomly assigned to sham operation group, model group, acupuncture group, rehabilitation group, and acupuncture-rehabilitation group, with nine mice in each group. Subsequently, each group was divided into three days, seven days and 14 days subgroups. The permanent middle cerebral artery occlusion models were established by the suture method, except the sham operation group. The sham operation group and the model group received no treatment. The acupuncture group received scalp cluster acupuncture, the rehabilitation group received treadmill training, and the acupuncture-rehabilitation group received scalp cluster acupuncture combined with treadmill training. Three days, seven days and 14 days after modeling, the modified Neurological Severity Score (mNSS) was obtained, and the expression of Foxp3 and RORγt in brain tissue of ischemic side was analyzed by Western blotting. Results The mNSS in the sham operation group was 0, and was higher in the model group than in the sham operation group at each postoperative time point. Three days after operation, the mNSS decreased in the rehabilitation group and the acupuncture-rehabilitation group, compared to the model group (P < 0.05). Fourteen days after operation, the mNSS decreased in the acupuncture-rehabilitation group, compared to the model group and acupuncture group (P < 0.05). The expression of Foxp3 protein was significantly lower in the acupuncture-rehabilitation group than in other groups at all time points after surgery( P < 0.05). Three days after operation, the expression of RORγt was higher in the acupuncture-rehabilitation group than in other groups (P < 0.05). Seven days after operation, the expression of RORγt was higher in the acupuncture-rehabilitation group than in the acupuncture group and sham operation group (P < 0.05). Conclusion Acupuncture-rehabilitation therapy may improve the tissue injury of cerebral ischemia mice, and promote the recovery of neural function, possibly by regulating Foxp3 and RORγT expression to reduce the level of inflammation, and then exert neuroprotective effects.

Effect of Acupuncture-rehabilitation Therapy on Neural Function and Expression of Forkhead Box P3 and Retinoic Acid-related Orphan Receptor γt in Mice with Cerebral Ischemia / 中国康复理论与实践

Objective To explore the effect of acupuncture-rehabilitation therapy on the expression of transcription factor forkheadbox P3 (Foxp3) and retinoic acid-related orphan receptor γt (RORγt) protein in cerebral ischemic mice. Methods Forty-five female C57BL/6 mice were randomly assigned to sham operation group, model group, acupuncture group, rehabilitation group, and acupuncture-rehabilitation group, with nine mice in each group. Subsequently, each group was divided into three days, seven days and 14 days subgroups. The permanent middle cerebral artery occlusion models were established by the suture method, except the sham operation group. The sham operation group and the model group received no treatment. The acupuncture group received scalp cluster acupuncture, the rehabilitation group received treadmill training, and the acupuncture-rehabilitation group received scalp cluster acupuncture combined with treadmill training. Three days, seven days and 14 days after modeling, the modified Neurological Severity Score (mNSS) was obtained, and the expression of Foxp3 and RORγt in brain tissue of ischemic side was analyzed by Western blotting. Results The mNSS in the sham operation group was 0, and was higher in the model group than in the sham operation group at each postoperative time point. Three days after operation, the mNSS decreased in the rehabilitation group and the acupuncture-rehabilitation group, compared to the model group (P < 0.05). Fourteen days after operation, the mNSS decreased in the acupuncture-rehabilitation group, compared to the model group and acupuncture group (P < 0.05). The expression of Foxp3 protein was significantly lower in the acupuncture-rehabilitation group than in other groups at all time points after surgery( P < 0.05). Three days after operation, the expression of RORγt was higher in the acupuncture-rehabilitation group than in other groups (P < 0.05). Seven days after operation, the expression of RORγt was higher in the acupuncture-rehabilitation group than in the acupuncture group and sham operation group (P < 0.05). Conclusion Acupuncture-rehabilitation therapy may improve the tissue injury of cerebral ischemia mice, and promote the recovery of neural function, possibly by regulating Foxp3 and RORγT expression to reduce the level of inflammation, and then exert neuroprotective effects.

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

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

Construction and Effect of Partnership Model of Rehabilitation for Patients with COVID-2019 in Critical Wards Using International Health Classifications Framework / 中国康复理论与实践

Objective:To construct a teamwork model, Partnership Rehabilitation Therapy (PRT), for therapists in critical wards for patients with Corona Virus Disease 2019 (COVID-19), and observe its effect. Methods:PRT had been developed, in which one therapist (main) implementing therapy and another (assistant) monitoring and supporting in the treatment. Eleven COVID-19 patients from infectious critical ward were treated with PRT. The behavior safety of therapists was recorded during the treatment, and the patients were assessed with Borg Index, Cough Score, Miller Sputum Grading and World Health Organization Disability Assessment Schedule (WHODAS) 2.0 before and after treatment. Results:No physiotherapist was infected by COVID-19. Seven times of infection risks were recorded and avoided, and six times of treatment risks were corrected instantly. All the patients improved in Borg Index (P < 0.01), Cough Score (P < 0.05), Miller Sputum Grading (P = 0.02) and WHODAS 2.0 (P < 0.01) after a 1-week physical therapy. Conclusion:Based on the Family International Classifications, a teamwork model is established, which provides a safe and practicable way for rehabilitation for COVID-19 patients in critical wards.

Influence of acupuncture combined with rehabilitation therapy on limb motor function and serum cAMP and cGMP in patients with hemiplegia of cerebral ischemic stroke / 中国针灸

OBJECTIVE@#To evaluate the therapeutic effect of the combined treatment with balance acupuncture therapy and exercise re-learning rehabilitation therapy and the impact on serum cAMP and cGMP in the patients with hemiplegia of cerebral ischemic stroke.@*METHODS@#A total of 90 patients of hemiplegia of cerebral ischemic stroke were randomized into an observation group and a control group, 45 cases in each one. All of the patients in the two groups received health education, diet guidance, routine symptomatic treatment as well as exercise re-learning rehabilitation therapy. Additionally, in the observation group, balance acupuncture therapy was applied, in which, the acupoints on the aspect of the human body, on the governor vessel and bladder meridian were adopted in the morning and those on the aspect of the human body, on the conception vessel and kidney meridian were stimulated in the afternoon. In the control group, the regular acupuncture was given. In the two groups, both acupuncture and rehabilitation therapies were given 5 days a week, 2 week-treatment as one course and totally 2 courses were required. Separately, before and after treatment, the score of Fugl-Meyer assessment (FMA) and the score of Chinese stroke scale (CSS) were recorded, the levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) detected in serum and the clinical therapeutic effect were evaluated in the two groups.@*RESULTS@#After treatment, FMA score was increased in the patients of either of the groups as compared with that before treatment (<0.01) and CSS score decreased as compared with that before treatment (<0.01). After treatment, FMA score in the observation group was higher than that in the control group (<0.01) and CSS score was lower than the control group (<0.01). After treatment, the level of serum cAMP of the patients in either of the groups was increased as compared with that before treatment (<0.01) and that of cGMP decreased as compared with that before treatment (<0.01). After treatment, the level of cAMP in the observation group was higher than that in the control group (<0.01) and that of cGMP was lower than the control group (<0.01). The total effective rate was 93.3% (42/45) in the observation group, better than 73.3% (33/45) in the control group (<0.01).@*CONCLUSION@#The balance acupuncture therapy combined with exercise re-learning rehabilitation effectively improves the motor function of the affected limb, relieves injury and regulate the levels of serum cAMP and cGMP in the patients with hemiplegia of ischemic stroke.

Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury:A multicenter randomized controlled clinical trial / 吉林大学学报(医学版)

Objective:To discuss the curative effect of Chinese medicine synthesis rehabilitation in the treatment of neurogenic bladder dysfunction after incomplete spinal cord injury, and to provide the clinical evidences for its application.Methods:A total of 184patients meeting the inclusion criteria were randonly divided into trial group (n=89) and control group (n=95) with central area group method.The patients in two groups were given the intermittent catheterization and the urinary functional training.The patients in trial group were treated by the electricity needle (20min/time, one time a day, 6dper week) and the massage (20min/time, one time a day, 6d per week) .All patients in two groups were treated for 4courses (2 weeks for a course) .The residual urine volumes, the bladder securiey capacities, and the intravesical pressures of the patients in two groups were measured before and after treatment, and the curative effects were evaluated.Results:Compared with before treatment the residual urine volume of the patients in trial group was reduced significantly after treatment (P＜0.01) , the bladder security capacity was significantly increased (P＜0.01) , and there was no significant change in intravesical pressure (P＞0.05) ;the residual urine volume of the patients in control group was reduced significantly after treatment (P＜0.01) , there were no significant changes in the bladder security capacity and intravesical pressure (P＞0.05) .After treatment, the residual urine volume of the patients in trial group was significantly lower than that in control group (P＜0.01) , while there were no significant differences in the bladder security capacities and intravesical pressures between two groups (P＞0.05) .Conclusion:Chinese medicine synthesis rehabilitation may reduce the residual urine volume of the patients with neurogenic bladder urinary retention after incomplete spinal cord injury, and its curative effect is superior to modern rehabilitation of intermittent catheterization and urinary bladder function training.

Efficacy observative of proprioception training on rehabilitation therapy of knee joint function after minimally invasive surgery of patellar fracture / 中国综合临床

Objective To explore the clinical effect of proprioceptive training on knee joint function rehabilitation after minimally invasive surgery for patellar fracture.Methods Fifty-eight patients with minimally invasive Kirschner wire tension band internal fixation under arthroscopy in department of orthopedics,Peking Union Medical College Hospital of Chinese Academy of Medical Sciences from March 2016 to April 2018 were selected as research objects,and were divided into experimental group and conventional group according to digital lottery,Twenty-nine cases in each group.The conventional group received conventional rehabilitation therapy such as joint range of motion (ROM) training,joint mobilization technique,muscle strength training,weight-bearing standing and ambulation training,The experimental group added proprioception training on the basis of the conventional group.The affected knee active range of motion (AROM),Lysholm knee scoring scale (LKSS),Berg balance scale (BBS) score and modified Barthel index (MBI) score before treatment and after 2 months of treatment between the two groups were observed and compared.According to the LKSS scoring system,the effect of knee function rehabilitation was evaluated.Results After 2 months of treatment,the active range of motion of the knee joint in the experimental group ((120.3± 17.1) °) was better than that in the conventional group ((100.4± 17.5) °),with significant difference (t =4.380,P =0.000);the LYSHOLM knee joint function score in the experimental group ((93.2 ± 5.3) points) was higher than that in the conventional group ((80.6 ± 7.7) points),with significant difference (t=7.259,P=0.000);the score of BERG balance scale ((52.4±1.6) points vs.(43.7±2.8)points),the difference was significant (t =14.528,P =0.000);the score of improved BARTHEL index ((92.5± 3.1) points vs.(85.6± 2.2) points),the difference was significant (t =9.775,P=0.000).The excellent and good rate of knee joint function in the experimental group was 93.10％ (27/29),which was significantly higher than 72.41％ (21/29) in the conventional group.There was significant difference between the two groups (Z =-2.390,P =0.017).Conclusion The proprioceptive training has a remarkable effect on knee joint function rehabilitation after minimally invasive surgery for patellar fracture.It can significantly improve the range of motion,joint stability and motion control ability of the affected knee,and improve the daily living ability of the patients.

Effect of cognitive-behavioral therapy combined with family rehabilitation therapy on improving depression patients / 中国实用护理杂志

Objective@#To explore the effect of cognitive-behavioral therapy combined with family rehabilitation therapy on improving depression patients.@*Methods@#Totally 82 depressive patients admitted to our hospital from February 2016 to January 2017 were randomly divided into the control group and the observation group according to the random number table method, with 41 cases in each group. Patients in the control group were treated with family rehabilitation therapy, while the patients in the observation group were treated with cognitive behavioral therapy on the basis of family rehabilitation therapy. After 12 months of intervention, the patients in the observation group were treated with cognitive behavioral therapy. The treatment efficiency, psychological status, coping style and medication compliance of the two groups were compared.@*Results@#After intervention the scores of Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD) in the observation group were (31.08±4.83), (14.14±3.52) points respectively, which were significantly lower than (36.97±2.73), (16.68 ±2.14) points of the control group (t=-6.789,-3.948, P < 0.01). The effective rate of the observation group was 97.56% (40/41), which was significantly higher than 70.05% (32/41) of the control group, and the difference was statistically significant (χ2=5.581, P<0.05). The scores of "problem solving" and "help seeking" items in the observation group were (1.66±0.18) and (1.81±0.21) respectively, significantly higher than (1.39±0.11), (1.48±0.13) of the control group; "avoidance" and "self-blame" items were (1.33±0.12) and (1.47±0.14) respectively, significantly lower than (1.58±0.19), (1.48±0.13) in the control group, and the difference was statistically significant (t=-8.349-8.555, P < 0.05). After treatment, the compliance of the observation group was significantly better than that of the control group (χ2= 8.902, P < 0.05).@*Conclusion@#Cognitive behavioral therapy combined with family rehabilitation therapy for depression patients can effectively improve the bad mood of patients, improve their medication compliance, and achieve better clinical treatment results.

Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury: A multicenter randomized controlled clinical trial / 吉林大学学报(医学版)

Objective: To discuss the curative effect of Chinese medicine synthesis rehabilitation in the treatment of neurogenic bladder dysfunction after incomplete spinal cord injury, and to provide the clinical evidences for its application. Methods: A total of 184 patients meeting the inclusion criteria were randonly divided into trial group ( n=89) and control group (n=95) with central area group method. The patients in two groups were given the intermittent catheterization and the urinary functional training. The patients in trial group were treated by the electricity needle (20 min/time, one time a day, 6 d per week) and the massage (20 min/time, one time a day, 6 d per week). All patients in two groups were treated for 4 courses (2 weeks for a course). The residual urine volumes, the bladder securiey capacities, and the intravesical pressures of the patients in two groups were measured before and after treatment, and the curative effects were evaluated. Results: Compared with before treatment the residual urine volume of the patients in trial group was reduced significantly after treatment ( P0. 05); the residual urine volume of the patients in control group was reduced significantly after treatment ( P0. 05). After treatment, the residual urine volume of the patients in trial group was significantly lower than that in control group ( P0. 05). Conclusion: Chinese medicine synthesis rehabilitation may reduce the residual urine volume of the patients with neurogenic bladder urinary retention after incomplete spinal cord injury, and its curative effect is superior to modern rehabilitation of intermittent catheterization and urinary bladder function training.