Most patients with end-stage renal disease choose maintenance hemodialysis to prolong survival. The clinical application of exercise therapy has a definite effect on maintenance hemodialysis patients, and can effectively improve their quality of life and promote rehabilitation. Individualized exercise therapy under the guidance of medical professionals has positive effects on patients’ physical and mental rehabilitation. This paper mainly summarizes the status of exercise, factors affecting exercise, exercise therapy, exercise and rehabilitation of maintenance hemodialysis patients, and reviews the impact of exercise therapy on the physical and mental health of maintenance hemodialysis patients, in order to provide some references for clinical intervention and prognosis studies.
ObjectiveTo carry out an investigation on the life quality of amputees in the “5·12” Wenchuan earthquake before and after rehabilitation of one year (short term), three year (intermediate term) and five year (long term) and find out the best program of recovery. MethodsIn September 2008, 52 patients who were treated in the higher-level hospital and came back to the Second People’s Hospital of Mianzhu City for rehabilitation were divided into two groups: group A and B with 26 patients in each. Phased rehabilitation program was adopted for group A while traditional program was chosen for patients in group B. “The Personal Information Table of Amputees of Deyang City” and The Life Quality Measurement Table of World Health Organization were chosen as the research tools before the program and one year, three years and five years after the program. ResultScores of the life quality of both groups showed a general rising tendency, while group A was higher than group B in each single phase, especially in the longterm one. For positive feeling, group A got a score of 193.0±12.3 and group B got 126.0±11.2; for ability to work, group A had a score of 62.0±5.2 and group B had 41.0±2.3; for life satisfaction, group A achieved 150.0±2.1 and group B achieved 101.0±6.2; for ability of action, the score of group A was 17.0±2.6 and group B was 11.0±5.2. The differences were statistically significant (P ＜ 0.05) . ConclusionCompared with conventional rehabilitation program, phased rehabilitation program can better enhance and consolidate the amputees’ quality of life and promote their returning to family and society, which can make up for the deficiency of the existing rehabilitation programs and is worth popularization and application.
Aphasia is one of the common disabling lesions and sequelae in stroke patients. In post-stroke aphasia patients, impairments of non-verbal cognitive domain often occur, which seriously affect daily social contact and quality of life. Cognitive neuropsychological rehabilitation is a neuropsychological rehabilitation based on the development of cognitive neuropsychological theory. It is currently applied in the field of rehabilitation of brain cognitive function, opening up a new way for evaluation and treatment of post-stroke aphasia. This paper introduces the general features of the application of cognitive neuropsychological rehabilitation, expounds the evaluation model and treatment principles of cognitive neuropsychological rehabilitation, and discusses its application in the evaluation and treatment of post-stroke aphasia, so as to provide ideas for the linguistic and non-linguistic cognitive rehabilitation of post-stroke aphasia.
ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
Objective To explore the common rehabilitation techniques involved in early rehabilitation, early rehabilitation period, and the access conditions of medical institutions for early rehabilitation on the basis of the early rehabilitation data of Chengdu, investigation on some domestic rehabilitation institutions, and expert consultation opinions, to provide a scientific basis for the early rehabilitation of relevant medical institutions. Methods We extracted the data of 130 medical insurance designated institutions in Chengdu for the whole year of 2014 (from January 1st to December 31st), and used the investigation method to study eight common types of clinical rehabilitation diseases (except stroke); went out to investigate the data of eight common types of clinical rehabilitation diseases (except burns) of five hospitals; using expert consultation method, collected 15 experts’ opinions on the early treatment of common clinical rehabilitation, intervention time, rehabilitation costs and so on. Results Common techniques for early rehabilitation included: rehabilitation assessment, acupuncture/electroacupuncture treatment, low-intermediate frequency pulse electrotherapy, pneumatic limb blood circulation promotion treatment, joint loosening training, other massage training, aerobic training, exercise therapy, and occupational therapy. In addition, each disease type also corresponded to special rehabilitation techniques. The early rehabilitation period was 13–14 days for persistent vegetative state (hypoxic ischemic encephalopathy), 11–18 days for fractures, 12–14 days for joint and soft tissue injury, 31–47 days for spinal cord injury, 11–18 days for brain injury, 14–19 days for burn (chemical, electric shock), 10–12 days for hand injury, 9–20 days for peripheral nerve injury, and 13–21 days for stroke. The access conditions for early rehabilitation included: general hospitals above the second level, with independent rehabilitation treatment rooms and rehabilitation wards, with early rehabilitation equipment, qualified full-time rehabilitation physicians and therapists. Conclusions In the common technical aspects of early rehabilitation, each disease has a common technology and also corresponds to special rehabilitation techniques. The early rehabilitation period for most diseases is 2–3 weeks. In order to ensure the quality and safety of early rehabilitation, it is recommended to include the hospital level and professional rehabilitation talent qualifications into the access conditions for early rehabilitation.
This paper, focusing on vascular cognitive impairment, summarizes the current situation of cognitive impairment rehabilitation at home and abroad, and makes a comprehensive and systematic introduction and review on the concept, assessment, and treatment of cognitive impairment, and so on. This paper raises people’s awareness of cognitive impairment and guides people to make appropriate choices about assessment and treatment methods according to different conditions, in order to improve the diagnosis rate of cognitive impairment, and to comprehensively adopt various rehabilitation treatment methods to improve cognitive rehabilitation efficacy. At the same time, it points out the weak points and future development trend of cognitive impairment rehabilitation in order to help the future work.
Rehabilitation engineering is an important branch of rehabilitation medicine. Relying on combination of medical and engineering research projects to carry out the cultivation of rehabilitation medicine-engineering interdisciplinary postgraduates of medical engineering is an important way to train high-quality composite innovative talents. This article introduces the medicine-engineering interdisciplinary innovative training model of rehabilitation engineering medical workers piloted by the Department of Rehabilitation Medicine of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Research Institute of Rehabilitation Engineering and Technology of University of Shanghai for Science and Technology. By clarifying the objectives of medicine-engineering interdisciplinary postgraduates training, strengthening the construction of mentor teams, establishing multi-disciplinary postgraduates courses, improving teaching arrangements and apprenticeship plans, and encouraging the exchange of postgraduates with different research backgrounds, this training mode cultivates postgraduates to be guided by clinical problems in rehabilitation medicine to expand scientific research and research ideas, pomotes the transformation of research achievements and their application in clinical practice, and cultivates compound-type rehabilitation engineering research talents with post competence. The purpose is to provide a reference for the training of future composite rehabilitation engineering research talents.
ObjectiveTo explore the differences of rehabilitation clinical characteristics between youth stroke patients and middle and old age stroke patients, to provide references for secondary prevention and personalized rehabilitation treatment for youth stroke.MethodsFrom May 2016 to October 2019, stroke inpatient in the Department of Rehabilitation Medicine of Huashan Hospital of Fudan University were included. Patients were divided into youth group and middle and old age group according to their age. The clinical characteristics of the two groups during the rehabilitation period were analyzed.ResultsA total of 271 patients were included, including 70 in the youth group and 201 in the middle and old age group. The proportion of patients with hypertension (85.07% vs. 71.43%), diabetes (34.83% vs. 17.14%) and infection (20.90% vs. 8.57%) in the middle and old age group were higher than those in the youth group (P<0.05). The proportion of patients with hemorrhagic stroke (71.43% vs. 32.84%), history of stroke surgery (54.29% vs. 13.43%), epilepsy secondary to stroke (31.43% vs. 4.48%) and overweight/obesity (57.14% vs. 42.79%) in the youth group were higher than those in the middle and old age group (P<0.05). There was no significant difference in the proportion of gender, cognitive impairment, and thinness between the two groups (P>0.05). Among patients whose disease course was within 1 month at the time of admission, there was no significant difference in Brunnstrom stage of upper limbs-hands-lower limbs between the two groups (P>0.05). The scores of Berg Balance Scale (Z=−2.493, P=0.013) and Barthel Index (Z=−2.527, P=0.012) in the youth group were higher than those in the middle and old age group. Among patients whose disease course was between 1 month and 3 months at the time of admission, there was no significant difference in Brunnstrom stage of upper limbs-hands-lower limbs and Barthel Index between the two groups (P>0.05). The scores of Berg Balance Scale in the youth group were higher than those in the middle and old age group (Z=−2.004, P=0.045). Among patients whose disease course was more than 3 months at the time of admission, there was no significant difference in the scores of Berg Balance Scale, Barthel Index, and Brunnstrom stage of upper limbs-hands-lower limbs between the two groups (P>0.05).ConclusionsFor youth stroke patients, weight control is very important, and it is necessary to pay close attention to whether there are seizures. In the case of patients with stable vital signs in the early stage of the disease, more active rehabilitation treatment can be given.
Objective To investigate the amputation-related pain and quality of life (QoL) between the amputees with transfemoral amputation (TFA) and transtibial amputation (TTA) 10 years after the Wenchuan earthquake, and compare the effects of two different amputation level on the long-term functional rehabilitation of amputees. Methods A total of 305 amputees from Center of Comprehensive Service of Disabled of Deyang for the disabled 10 years after the Wenchuan earthquake were selected for cross-sectional study from February to June 2018. Through face-to-face interview, the basic information of amputees was collected and the evaluation of Prosthetic Evaluation Questionnaire (PEQ) was completed. The amputees were divided into TFA group and TTA group according to the amputation level. Results A total of 53 amputees were included, including 27 in the TFA group and 26 in the TTA group. The PEQ scores showed that the prevalences of phantom limb sensation (96.3% vs. 65.4%; χ2=6.372, P=0.012) and phantom limb pain (92.6% vs. 69.2%; P=0.039) in the TFA group were significantly higher than those in the TTA group. There was no significant difference with regard to the intensity of amputation-related pain between the victims with TFA and TTA (P>0.05). However, the TFA group were more bothered by phantom limb sensation than the TTA group (52.9±24.1 vs. 35.9±26.7; t=2.108, P=0.042), there was no significant difference in other indexes (P>0.05). There was no significant difference in QoL between the TFA and TTA groups (P>0.05). Conclusions The phantom limb sensation, phantom limb pain, residual limb pain, non-amputated limb pain and back pain are still prevalent among the victims with TFA and TTA 10 years after the Wenchuan earthquake. The higher amputation level is associated with increased prevalence of phantom limb sensation and phantom limb pain, as well as more bothersomeness of phantom limb sensation. The amputation level appeares to have no impact on the long-term QoL.
ObjectiveTo systematically review the efficacy of five types of rehabilitation exercises, including Baduanjin, aquatic exercise, Taijiquan, somatosensory exercise and whole body vibration training for the intervention of motor function in stroke patients. MethodsWeb of Science, PubMed, EMbase, The Cochrane Library, CNKI, CBM, CSJD and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of rehabilitation exercise interventions for motor function in stroke patients from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using R and ADDIS software. ResultsA total of 50 RCTs involving 1 838 patients were included. The results of the meta-analysis showed that all five types of rehabilitation exercises were superior to conventional rehabilitation group in terms of balance in stroke patients (P<0.05), with the best ranking occupied by Baduanjin. In terms of lower limb strength, only the aquatic exercise was superior to conventional rehabilitation (P<0.05). In terms of walking function, somatic training and aquatic exercise were superior to conventional rehabilitation (P<0.05), with somatic exercises ranking first. ConclusionCurrent evidence shows that Baduanjin has an advantage in improving the balance, somatosensory interactive game exercise has an advantage in improving the walking capability and aquatic exercise has an advantage in improving the lower limb strength of stroke patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.