By reviewing and analyzing the domestic and international rehabilitation medicine education, we try to forecast the development of rehabilitation medicine of Sichuan, and moreover, to summarize and analyze the problems and difficulties of rehabilitation medicine education in this province. Then, we put forward the development countermeasures of Sichuan rehabilitation medicine education from the aspect of talent training object and mode, in order to gradually establish and improve a rehabilitation medicine education system that can adapt to the training requirements of modern medicine, to cultivate talents of rehabilitation medicine suitable for national construction needs at every level, and to improve the overall quality of Sichuan rehabilitation medicine education and build a medical rehabilitation highland in West China.
ObjectiveTo investigate the effects of early rehabilitation on function of patients undergoing complex lower limb amputation caused by injuring in "4·20" Lushan earthquake.
MethodsFrom April 20th to June 30th, 2013, we carried out comprehensive rehabilitation intervention for two patients who had undergone complex lower limb amputation, including physical treatment, exercise treatment, psychological treatment, wound dressing, rehabilitation program, and multiple rehabilitation nursing care.
ResultsThrough early comprehensive rehabilitation intervention, patients' pain was relieved, and their muscle strength, activities of daily living (ADL), and balance function had been improved greatly, achieving the goal of installing artificial limb.
ConclusionEarly rehabilitation intervention treatment is effective in relieving pain in patients undergoing lower extremities amputation, and improving their muscle strength, ability of ADL and balance function, which can make the patients return to society much better and faster.
ObjectiveTo explore the risk factors of stroke-associated pneumonia in stroke inpatients at rehabilitation stage.MethodsA retrospective survey was conducted to collect the general clinical data of 271 patients with stroke who were hospitalized for the first time between January 2017 and December 2018. They were divided into two groups according to the presence or absence of pneumonia. The general clinical data of the two groups were observed and analyzed, including sex, age, length of stay, course of disease, Brunnstrom Stage, Barthel Index, scores of Kubota’s Water Drinking Test, indwelling gastric tube, cognitive impairment, aphasia, hypertension history, diabetes history, history of smoking and drinking, albumin content, and hemoglobin content. Statistically significant factors were screened out from single factor analysis, and then multivariate logistic regression analysis was conducted.ResultsThere were significant differences in age, length of stay, Barthel Index, Brunnstrom Stage (upper limb, hand and lower limb), scores of Kubota’s Water Drinking Test, indwelling gastric tube, albumin content, hemoglobin content, cognitive impairment, and aphasia between the two groups (P<0.05). Multivariate logistic regression analysis showed that indwelling gastric tube [odds ratio=52.463, 95% confidence interval (4.154, 662.658), P=0.002] was an independent risk factor for pneumonia.ConclusionsIndwelling gastric tube is an independent risk factor for pneumonia. In view of the risk factor, taking active and effective preventive measures can help prevent pneumonia.
Stroke can lead to dysfunction of movement, sensation, cognition and other functions, eventually affect the quality of life of patients. Many patients suffer from severe and persistent upper limb dysfunction. Upper limb rehabilitation has always been a focus in clinical practice and scientific research of rehabilitation field. As an emerging technology, virtual reality (VR) provides simulated environments for patients to enhance their participation and experience, and has been more and more widely used in stroke rehabilitation. This paper reviews the application and research progress of VR in upper limb rehabilitation after stroke, discusses the current evidences based on both the independent application of VR and the application of VR combined with other rehabilitation interventions, and indicates that VR can play a positive role in promoting the upper limb strength and coordination of stroke patients and enhancing their motivation to participant in rehabilitation. In the future, more high-quality studies are needed to further confirm the efficacy and optimal parameter settings.
ObjectivesTo systematically review the safety and efficacy of autologous bone marrow mesenchymal stem cells (BMSCs) transplantation for spinal cord injury (SCI) patients.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) and clinical controlled trials (CCTs) of autologous BMSCs transplantation for SCI patients from inception to June 8th, 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 16 studies involving 954 SCI patients were included. The results of meta-analysis showed that: BMSCs could significantly increase the patients’ ASIA motor score (MD=6.91, 95%CI 3.95 to 9.87, P<0.000 01), ASIA light-tough score (MD=11.79, 95%CI 6.66 to 16.39,P<0.000 01), ASIA pain score (MD=8.76, 95%CI 4.11 to 13.40,P=0.000 2), Barthel index score (MD=8.47, 95%CI 7.32 to 9.61, P<0.000 01). It could also improve the ASIA grade (OR=3.75, 95%CI 2.35 to 5.99,P<0.01), and decrease the bladder urine residue (MD=–23.32, 95%CI –46.27 to –0.37,P=0.05). The complications mainly included headache, low-grade fever, and so forth. No serious adverse event and abnormal tissue formation occurred.ConclusionAutologous BMSCs transplantation is a safe and effective therapy for SCI. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
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.
Objective To investigate the injury types, dysfunction situation and rehabilitation deamnd of the Lushan earthquake victims. Methods The rehabilitation demand of 208 Lushan earthquake victims in the West China Hospital of Sichuan University were investigated using a questionnaire. Results Bone fractures accounted for the largest proportion of injury types, followed by combined injuries, soft tissue injuries, pulmonary contusion, and amputation. Most victims suffered from the motor dysfunction, balance disorder and restrictions in activities of daily living. More than 80% of victims had pain. A few victims had paresthesia and respiratory disorder. Most victims needed rehabilitation assistant devices and hospitalization treatment. Conclusion The injury types and dysfunction situation of Lushan earthquake victims are associated with the demand of rehabilitation assistant device. The tailored rehabilitation regimen can be made in combination with victim’s rehabilitation demand. The early intervention of rehabilitation medicine is extremely beneficial to the recovery of earthquake victims.
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.
Since its discovery in early 2020, the coronavirus disease 2019 (COVID-19) has spread rapidly around the world and is now a global challenge. As early respiratory rehabilitation can improve the patient’s respiratory function and quality of life, it deserves proper attention. Aimed to provide reference for the clinical rehabilitation, this paper summarizes the rehabilitation goals, rehabilitation treatments, nutrition therapy and psychotherapy for different types of COVID-19, on the basis of brief describing the etiological, pathological mechanism, clinical features and medical treatment.
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.
