Objective To explore the effect of early rehabilitation treatment on complications and prognosis of elderly patients with sever pneumonia undergoing mechanical ventilation. Methods The patients who meeting the inclusion criteria were randomly divided into an early rehabilitation group and a control group, with 35 cases in each group. On basis of same routine treatment, the early rehabilitation group was treated with early rehabilitation. The early rehabilitation methods included exercise therapy, electrical stimulation therapy, swallowing therapy, cough training and wheelchair-bed transfer training, etc. The patients received individual training methods according to their conditions. The difference of two groups were observed in the rates of ICU-acquired weakness (ICU-AW), ventilator-associate pneumonia (VAP), the incidence of delirium, the mechanical ventilation time, ICU-hospital time, total hospital time, 30-day hospital mortality, extubation fail rate and tracheotomy rate. Results Compare with the control group, the incidence of ICU-AW (14.28% vs. 37.14%), VAP (8.57% vs. 28.57%), and delirium (40.00% vs. 65.71%) in the early rehabilitation group were significantly reduced (all P<0.05). The duration of delirium [(3.50±1.31) dvs. (6.40±1.47) d], the ventilation time [(6.32±2.19) d vs. (9.40±4.43) d], ICU hospitalization time [(10.80±3.64) d vs. (15.31±3.85) d] and total hospitalization time [(22.52±7.56) d vs. (30.22±11.54) d] of the early rehabilitation group were significantly lower than the control group (all P<0.001). The tracheotomy rate and 30-day hospital mortality of the early rehabilitation group were significantly lower than the control group (25.71%vs. 51.42% and 28.57% vs. 54.28%, both P<0.05). There was no significant difference in extubation fail rate (5.71%vs. 11.42%, P>0.05). In the early rehabilitation group, there were no complications such as pipe prolapse, limb injury or serious arrhythmia. Conclusion Early rehabilitation can reduce the incidence of ICU-AW, VAP, delirium in elderly patients with severe pneumonia, help to shorten the mechanical ventilation time, ICU hospitalization time and total hospitalization time, reduce extubation failure rate and tracheotomy rate, so it is safe and effective, and worthy of being popularized and applied.
Osteoporosis (OP) is one of the most serious health problems, causing a huge economic burden to patients, families and society. OP rehabilitation treatment plays an important role in pain-relieving, reducing the risk of fracture, improving the ability of daily activities, and promoting the healing of osteoporosis fractures, and has been increasingly valued and recommended by domestic and foreign guidelines. This guideline was updated based on the Chinese expert consensus on rehabilitation intervention for primary osteoporosis 2019 editions, and was initiated by Chinese Society of Physical Medicine and Rehabilitation professor HE Chengqi, Chairman of the Chinese Medical Association Physical Medicine and Rehabilitation Branch. This guideline development was guided by domestic and international guideline development methods and principles, and selected through clinical issue screening and deconstruction, and two rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the grading of recommendations assessment, development and evaluation (GRADE) was used based on the best available evidence. The ICF is a theoretical framework based on the best available evidence, and uses the GRADE method to grade the quality of evidence and recommendations, and reports them according to the Reporting Items for Practice Guidelines in Healthcare (RIGHT), taking into account patients’ preferences and values and the needs of Chinese clinical practice, resulting in 22 recommendations in 7 aspects of rehabilitation assessment, physical agents therapy, occupational therapy, rehabilitation brace, cognitive behavior and psychological therapy, traditional Chinese medicine therapy and health education to systematically standardize the rehabilitation of osteoporosis.
The comprehensive rehabilitative treatment was used in 58 cases(194 finger)for functional impairment after eplantation. After the treatment the overall increase of flexion-extension range of motion was 30 to 130 degrees respectively. From the assessment of 10 items of daily activities, the patients could accomplish three-fourth of them. the average time taken for the treatment was 3 months with an excellent-good rate about 87.4%. Through the early comprehensive rehabilititive treatment patients could achieve better results.
目的：探讨5·12汶川地震致脊髓损伤患者神经源膀胱的康复治疗方法。方法：通过对35例脊髓损伤患者神经源膀胱康复治疗的总结回顾，观察采用制定饮水计划，间歇性导尿，药物治疗，膀胱功能训练，手术治疗等方法治疗神经源膀胱的疗效。结果：经过综合治疗，35例患者的神经源膀胱都得到了不同程度的改善。结论：地震致脊髓损伤发生率高，而神经源膀胱是其重大并发症之一，危害患者生命，重建脊髓损伤后患者的膀胱功能对于提高截瘫患者的生活质量，降低死亡率具有十分重要的意义。
Objective To investigate the rehabilitation treatment methods for distal tibiofibular syndesmosis injury triad after the second surgery. Methods We reported the postsurgical rehabilitation treatment for a 16-year-old male who received second surgery for internal fixation screw rupture on August 20th 2014, due to weight bearing too early after his first surgery in March 2014 for distal tibiofibular syndesmosis diastasis combined with lateral malleolus fracture, ligamenta talofibulare anterius and deltoid ligament rupture. The patient was treated in the Rehabilitation Center of National Sports Training Center on September 25th, 2014. By analyzing the rehabilitation assessment results, a secondary ankle impingement syndrome was detected and following modified treatments were implemented. Results At the end of the first course of treatment, right ankle muscle strength, range of motion and Y balance tests were all weaker than the left. At the end of the second course of treatment, all data were better than the first course. At the end of the third course, all data were close to normal value except the right leg forward squat. Conclusions Through comprehensive rehabilitation, assessment feedback and further treatment improvement, complex cases like distal tibiofibular syndesmosis injury triad after second injury can be well handled. However, more cases should be collected and investigated.
Pilon fracture is one of the most common and complex fractures in clinic. It has many postoperative complications, such as limitation of motion, pain, swelling, and decreased muscle strength. Complications will seriously affect patients’ ankle function. If the accelerated rehabilitation support can be obtained, patients can obtain a good functional recovery in the later stage. At present, there are few reports on enhanced rehabilitation related to Pilon fractures. This article introduces the rehabilitation treatment protocol for perioperative accelerated rehabilitation of Pilon fractures, mainly including rehabilitation evaluation, preoperative rehabilitation and postoperative rehabilitation treatment, aiming to provide some reference for standardizing the rehabilitation treatment of Pilon fractures in the perioperative period.
With the continuous development of critical care medicine, the survival rate of critical ill patients continues to increase. However, the residual dysfunction will have a far-reaching impact on the burden on patients, families, and health-care systems, and will significantly increase the demand of the follow-up rehabilitation treatment. Critical illness rehabilitation intervenes patients who are still in the intensive care unit (ICU). It can prevent complications, functional deterioration and dysfunction, improve functional activity and quality of life, shorten the time of mechanical ventilation, the length of ICU stay and hospital stay, and also reduce medical expenses. Experts at home and abroad believe that early rehabilitation of critical ill patients is safe and effective. So rehabilitation should be involved in critical ill patients as early as possible. However, the promotion of this model is still limited by the setting of safety parameters, the ICU culture, the lack of critical rehabilitation professionals, and the physiological and mental cognitive status of patients. Rehabilitation treatment in ICU is constantly being practiced at home and abroad.
High-voltage electric burns is refractory with high rate of amputation (46%) in early stage and unfavorable functional recovery in later stage. Little breakthrough has so far been made in this respect. From Jan. 1985 to Jan. 1996, ninety-six cases with high-voltage burns were treated in our department. Seventy-one cases of various tissue flap grafting were applied to treat early electric burns, among which sixty-four cases were successful. The amputation rate was reduced to 30%. Postoperatively, a long-term rehabilitation training at home was carried out. Most of them achieved a good appearance of the wounded sites and limbs and satisfactory ability to work or self-care. It was suggested that early thorough debridement of necrosis tissue, careful reservation of living tissue, appropriate choice of tissue flap and postoperative rehabilitation training were of great importance to achieve a good prognosis.