The rehabilitation experience of 20 patients with tracheostomy after lung transplantation was reported, and the key points of rehabilitation nursing included sequential oxygen therapy, airway clearance, diaphragm pacing, respiratory training, swallowing training, speech training, exercise training, and gastrointestinal function rehabilitation. Tracheostomy is conducive to airway management and offline extubation in patients assisted by long-term breathing, and promotes patient recovery and discharge through multidisciplinary collaborative rehabilitation nursing integrated case management.
Objective To investigate the knowledge level about pulmonary rehabilitation in respiratory physicians in Shanghai. Methods A self-designed questionnaire about pulmonary rehabilitation was sent to respiratory physicians in 18 tertiary-care referral hospitals of Shanghai from June to September 2011. Results A total of 237 valid questionnaires were collected. Accuracy rate of single-answer questions was(62.1±18.3)% , while correct rate of multiple-answer questions ( more than one answer) was ( 35.5±15.6) % . Neither working years nor doctor rank had correlation with accuracy of questionnaires. Conclusion The knowledge about pulmonary rehabilitation in respiratory physicians of Shanghai was poor. We need to strengthen the relevant training and continuing education.
Pneumoconiosis is an interstitial lung disease with pulmonary fibrosis as the main pathological change. Patients with pneumoconiosis can increase immunity, delay disease progression, reduce symptoms, and improve lung function through respiratory rehabilitation. With the development of the domestic medical stratification, grading, and referral system between various specialties and the promotion of “internet +” model, remote home respiratory rehabilitation has become an inevitable trend in the full-cycle management of chronic respiratory diseases. By searching Chinese and English literatures, this article summarizes the safety, efficacy and research progress of remote home respiratory rehabilitation for pneumoconiosis. The purpose is to provide ideas for patients with pneumoconiosis to receive home-based remote rehabilitation management.
ObjectiveTo investigate the impact of electrical impedance tomography (EIT) as a means of assessing and guiding pulmonary rehabilitation chest physiotherapy (CPT) in hospital-acquired pneumonia (HAP) patients on the time to symptom improvement, cost of hospitalisation, length of stay and patient satisfaction with pulmonary rehabilitation. MethodsNinety-six patients with HAP requiring pulmonary rehabilitation were included in the study and were divided into control group and experimental group using the random number table method. Patients in both groups underwent pulmonary rehabilitation CPT in addition to clinical treatment for HAP, twice daily for 20 minutes each time. EIT was added to experimental group as a means of assessment and guidance, with dynamic review prior to treatment and real-time adjustment of treatment based on the results. The primary outcome indicator was a comparison of the change in clinical pulmonary infection score (CPIS) after the start of treatment in both groups, and secondary outcome indicators were a comparison of the length of HAP hospitalisation, HAP-related cost, and patient satisfaction with pulmonary rehabilitation in both groups. ResultsDuring the study, 8 patients terminated airway clearance due to the aggravation of the disease, and 1 patient referral. Finally, 43 patients in the study control group and 44 patients in the experimental group were included. There was a significant difference in CPIS between the test group and the control group on 3rd and 7th day after starting airway clearance (P<0.05). Compared with the control group, there were significant differences in the length of HAP hospitalisation, HAP-related cost, and patient satisfaction with airway clearance in the test group (P<0.01). ConclusionThe use of EIT allows real-time visual monitoring of the distribution of lung ventilation in HAP patients, thus guiding individualized pulmonary rehabilitation treatment, which can shorten the time to symptom improvement, reduce the length and cost of HAP hospitalisation and significantly improve patient satisfaction and compliance with pulmonary rehabilitation.
ObjectiveTo analyze the symptom characteristics and influencing factors in order to provide reference for symptom management of patients with esophageal cancer after operation.MethodsA total of 216 esophageal cancer patients, including 180 males and 36 females with an average age of 63.7±8.3 years, who underwent surgical operation in our hospital from March to October 2018 were recruited and investigated with self-designed symptom questionnaire at 1 month after surgery.ResultsThe top five symptoms were acid reflux (48.6%), cough (42.6%), dysphagia (40.7%), hoarseness (12.0%), and diarrhea (11.6%). Women were more prone to acid reflux (OR=2.053), fatigue (OR=1.932), chest pain (OR=3.681), sleep disturbance (OR=2.419), abdominal pain (OR=3.882), nausea (OR=3.014) and vomiting (OR=2.505). Patients over 60 years were more prone to dysphagia (OR=2.274). Patients with lower thoracic esophageal cancer had a higher incidence of dysphagia compared with patients with carcinoma of esophagogastric junction (OR=0.326). Patients who had neoadjuvant chemotherapy were more likely to suffer acid reflux (OR=1.594). Open surgery (OR=3.681) and neoadjuvant radiotherapy (OR=2.495) were the risk factors of chest pain.ConclusionThere are many symptoms in patients with esophageal cancer after operation, and the occurrence of symptoms is closely related to gender, age, tumor location, surgical procedure and neoadjuvant chemoradiotherapy.
Pulmonary rehabilitation (PR) is a comprehensive intervention to the chronic respiratory diseases, that its benefits in chronic obstructive pulmonary disease (COPD) have been well established. Localization of PR in China is one of the key health strategies as there are nearly 100 million patients with COPD which causes huge disease burden. In addition, the evidence of PR for patients with other chronic respiratory diseases and post-thoracic surgery should be accumulated too. Now clinician, patients, and policy makers have few recognition of PR, which needs large-scaled standardized training and popularizing. This article starts with the definition of PR, reviews its population, implementation, settings, as well as the current situation of PR in our country in order to make clinicians, researchers, and policy makers have better understanding of PR and to make some suggestions on direction of the future research and clinical work.
cardiac rehabilitation has evolved over the past decades from a simple monitoring for the safe return to physical activities to a multidisciplinary approach that focuses on patient education, individually tailored exercise training, modification of the risk factors and the overall well-being of the cardiac patients. It has been proven to be an effective tool for the care of the patients with heart disease. Recent research in cardiac rehabilitation has demonstrated that tremendous benefits can be derived from the optimal use of cardiac rehabilitation in patients with various cardiac pathologies including ischemic heart disease, heart failure and post heart surgery. The benefits of cardiac rehabilitation include mortality reduction, symptom relief, reduction in smoking and improved exercise tolerance, risk factors modification and the overall psychosocial wellbeing. Unfortunately, cardiac rehabilitation remains considerably underutilized mainly because of referral problems and poor enrollment. The development of alternate approaches and the use of transtelephonic and other means of monitoring and surveillance will help expand the utilization of cardiac rehabilitation.
ObjectiveTo understand the obstacles in the practice of pulmonary rehabilitation between doctors and patients.MethodsMedical staff and patients with chronic obstructive pulmonary disease (COPD) in public hospitals in this region were randomly sampled, and a questionnaire survey was conducted on possible obstacles to the practice of pulmonary rehabilitation.ResultsTotal of 265 medical staff and 120 COPD patients were recruited in this survey. The obstacles of pulmonary rehabilitation practice of medical staff in clinical work are poor cooperation of patients and their families (84.2%), medical staff’s insufficient awareness of pulmonary rehabilitation (82.3%), and lack of practice and guidelines (78.9%), lack of objective conditions such as site, equipment and equipment (75.1%), lack of multidisciplinary teams (74.3%), pulmonary rehabilitation has fallen by the wayside (73.6%) etc. The main obstacles for COPD patients in pulmonary rehabilitation are lack of access to relevant knowledge (52.4%), insufficient knowledge (36.5%), inconvenient transportation, economic problems and other objective conditions (33.3%). After multiple correspondence analysis, there are differences in the degree of correlation between obstacle factors and groups with different characteristics.ConclusionsThere are many factors hindering the development of pulmonary rehabilitation and there are certain differences among different populations, but the lack of understanding of pulmonary rehabilitation between doctors and patients is the primary problem. It is necessary to improve the cognition of both doctors and patients on pulmonary rehabilitation, and then to solve the obstacles in the implementation of pulmonary rehabilitation.
Objective To systematically analyze the relevant research on the application of preoperative exercise training in the pre-rehabilitation of elderly hip fracture patients, identify the specific content, outcome indicators, and application effects of exercise intervention, in order to provide reference for medical staff to carry out relevant interventions. Methods Computer searches were conducted on domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, VIP, Cochrane Library, PubMed, Embase, Web of Science. The search period was from the establishment of the database to January 2024. The scoping review method was used to screen, summarize, and analyze the included studies. ResultsA total of 10 studies were included, including 3 randomized controlled trial, 1 quasi experimental study, 5 retrospective studies and 1 case report. Preoperative exercise preparation includes completing relevant examinations and providing sufficient pain relief. The types of exercise include adaptive training, resistance training, and aerobic exercise. Monitor the patient’s symptoms, signs, and adverse reactions throughout the exercise process. Outcome measures include physical activity and function, pain, average length of hospital stay, and perioperative complications. Conclusions Preoperative exercise training has a positive effect on elderly patients with hip fracture. Elderly patients with hip fracture should be well prepared for preoperative exercise, based on adaptive training, with resistance exercise as the main focus, while monitoring the patient’s physical signs and adverse events during exercise.
In order to stimulate the patients' active participation in the process of robot-assisted rehabilitation training of stroke patients, the rehabilitation robots should provide assistant torque to patients according to their rehabilitation needs. This paper proposed an assist-as-needed control strategy for wrist rehabilitation robots. Firstly, the ability evaluation rules were formulated and the patient's ability was evaluated according to the rules. Then the controller was designed. Based on the evaluation results, the controller can calculate the assistant torque needed by the patient to complete the rehabilitation training task and send commands to motor. Finally, the motor is controlled to output the commanded value, which assists the patient to complete the rehabilitation training task. The control strategy was implemented to the wrist function rehabilitation robot, which could achieve the training effect of assist-as-needed and could avoid the surge of assistance torque. In addition, therapists can adjust multiple parameters in the ability evaluation rules online to customize the difficulty of tasks for patients with different rehabilitation status. The method proposed in this paper does not rely on the information from force sensor, which reduces development costs and is easy to implement.