ObjectivesTo systematically review the efficacy of home-based telerehabilitation (HTR) for stroke survivors.MethodsPubMed, EMbase, Web of Science, Joanna Briggs Institute Library, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on HTR for stroke survivors from inception to January 1st, 2019. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 793 patients were included. The results of meta-analysis showed that: after 1 to 2 years of treatment, BI scores (MD=20.22, 95%CI 17.10 to 23.35, P<0.000 01) in HTR group were higher than those in the traditional rehabilitation group. However, there were no statistical differences between two groups in ARAT scores (SMD=0.16, 95%CI ?0.14 to 0.45, P=0.30) after 1 to 2 months of treatment, as well as MBI scores (SMD=0.98, 95%CI ?0.33 to 2.29, P=0.14) and FMA scores (SMD=0.57, 95%CI ?0.08 to 1.23, P=0.09) after 3 months of treatment, and CSI scores (MD=?1.48, 95%CI ?3.90 to 0.94, P=0.23) and BBS scores (MD=1.33, 95%CI ?1.15 to 3.81, P=0.29) after 6 months of treatment. The results of descriptive analysis indicated that there was no statistically significant difference in quality of life between the two groups at 6 months after intervention. However, the HTR group was superior to the traditional rehabilitation group after 2 years of treatment.ConclusionsCurrent evidence shows that, compared with traditional rehabilitation, long-term intervention (1-2 years) with HTR can improve the ability to perform activities of daily living and quality of life of stroke survivors. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
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.
Chronic kidney diseases (CKD) with long duration and a variety of complications have caused great physical and psychological problems for patients, and the overall quality of life of patients is low. Taijiquan, as a traditional Chinese techniques project, is beneficial to improving cardiopulmonary function, enhancing lower limb muscle strength, and reducing cardiovascular and cerebrovascular risks. We summarized the latest progress in clinical research concerning taijiquan as exercise rehabilitation for patients with CKD, aiming to promote the clinical application of taijiquan and other traditional exercises in the rehabilitation process of CKD patients and improve the overall quality of life of CKD patients.
The theoretical system of motor re-learning is one of the important technical systems in the field of neurological rehabilitation. It is helpful to improve the curative effect of rehabilitation by deeply understanding this theory system and applying it flexibly to patients with neural system impairment. In this paper, the principles of neurorehabilitation based on motor re-learning (including active training, repetitive reinforcement; task-specific practice, goal-orientated training; rich environment, increasing difficulty; emphasis on feedback and early intervention) are interpreted with available evidence of mechanism and clinical application studies, in order to provide some ideas and directions for the future clinical research of neurological rehabilitation.
Implantable cardioverter defibrillator (ICD) is the most effective measure to prevent sudden cardiac death. However, ICD patients frequently have problems such as decline of exercise tolerance and quality of life, anxiety and depression after operation, which require cardiac rehabilitation (CR). A considerable amount of studies have proved that CR is an effective secondary prevention measure for patients with cardiovascular disease. Its safety and effectiveness have been supported by evidence-based medicine research, which can prevent the recurrence of cardiovascular events, reduce the readmisson rate, and promote healthy behavior and active lifestyle formation of patients, so as to improve the quality of life of patients. This review mainly summarized the necessity, safety, exercise program and economic benefits of CR in ICD patients.
Objective To explore the experience and needs of orthopedic inpatients for pre-hospital examinations led by nurses, provide a reference for optimizing the pre-hospital examination procedures and improve the pre-hospital examination experience of patient. Methods Using the method of phenomenology, semi-structured in-depth interviews were conducted on 35 patients who attended the Department of Orthopedics of the Second Affiliated Hospital of Army Medical University from July to August 2018 and had undergone pre-hospital examinations. Colaizzi’s seven-step method was used to encode, analyze, organize, summarize, and refine topics. Results Patients’ experience and needs for pre-hospital examinations led by nurses could be divided into three major sections: attitudes and emotions, individualized pre-rehabilitation needs and pre-hospital examination feelings. Attitudes and emotions included high treatment expectations, feelings of loss, and some patients’ understanding of pre-hospital examinations. Individualized pre-rehabilitation needs included pre-rehabilitation needs with cardiopulmonary diseases, pre-rehabilitation needs with sleep dysfunction, nutritional conditioning needs, and medication safety needs. Patients’ feelings during pre-hospital examinations mainly included complicated procedures and staff attitudes that need to be improved. Conclusion Some links in the pre-hospital inspection process urgently need to be optimized. In pre-hospital examinations, it is necessary to focus on patient expectation management and predictive communication, improve multidisciplinary cooperation, formulate personalized pre-rehabilitation plans, optimize examination procedures, strengthen humanistic care, and improve patient experience.
Since the outbreak of coronavirus disease 2019 (COVID-19), there have been numerous studies confirming that physiotherapy is an essential part of the comprehensive treatment during hospitalization and can facilitate recovery in COVID-19 patients. However, physiotherapy protocols for COVID-19 patients in intensive care units are still lacking. This article reviews the literature and incorporates practical experience around recommendations for the safe protection during physiotherapy, recommendations for evaluation criteria and intervention of physiotherapy, and future work for COVID-19 patients, so as to provide a standardized recommendation for physiotherapists working in intensive care units.
ObjectiveTo investigate the morbidity of postoperative pulmonary complications (PPCs) in patients after transcatheter tricuspid valve replacement (TTVR). MethodsA prospective cohort study enrolled 19 patients who were diagnosed with severe or greater tricuspid regurgitation in West China Hospital from October 11, 2020 to March 1, 2021, and would receive TTVR using LuX-valve for valve replacement. The patients were divided into a PPCs group and a non-PPCs group according to the presence of PPCs. The incidence of PPCs after tricuspid valve intervention between the two groups was compared. ResultsOf 19 patients diagnosed with severe or greater tricuspid regurgitation registered in the database, 17 met the inclusion criteria, including 15 females and 2 males, with a mean age of 68.4±8.0 years. PPCs occurred in 9 of 17 (52.9%) patients. At discharge, compared with the non-PPCs group, the PPCs group had a longer postoperative hospital stay [11.0 (10.0, 17.0) d vs. 7.5 (7.0, 8.0) d, P=0.01], longer ICU stay [72.0 (45.5, 95.0) h vs. 20.5 (16.0, 22.8) h, P<0.01], and more hospital cost [74.3 (65.9, 98.3) thousand yuan vs. 52.6 (44.2, 57.4) thousand yuan, P<0.01]. At 30 days of follow-up, the PPCs group was found that the rate of New York Heart Association cardiac function≥class Ⅲ (66.7% vs. 12.5%, P<0.01) was higher, the six-minute walk distance (170.2±169.3 m vs. 377.9±80.5 m, P<0.01) was shorter and Kansas City Cardiomyopathy Questionnaire heart failure score (40.9±31.2 vs. 80.4±5.8, P<0.01) was less than those of the non-PPCs group. ConclusionPPCs are common in the patients undergoing TTVR and severely affect patients' cardiac function, exercise function and quality-of-life recovery. Proactive preoperative intervention as well as early postoperative rehabilitation management should be provided to those at high risk of PPCs.
ObjectiveTo summarize the early postoperative pain management strategies for anterior cruciate ligament reconstruction (ACLR), and to select a reasonable and effective pain management plan to promote functional rehabilitation after ACLR. MethodsThe literature about the early postoperative pain management strategies of ACLR both domestically and internationally in recent years was extensiverly reviewed, and the effects of improving postoperative pain were reviewed. ResultsCurrently, physical therapy and oral medication have advantages such as economy and simplicity, but the effect of improving postoperative pain is not satisfactory, often requires a combination of intravenous injection or intravenous pump, which is also a common way to relieve pain. However, in order to meet the analgesic needs of patients, the amount of analgesic drugs used is often large, which increases the incidence of various adverse reactions. Local infiltration analgesia (LIA), including periarticular or intra-articular injection of drugs, can significantly improve the early postoperative pain of ACLR, and achieve similar postoperative effectiveness as nerve block. LIA can be used as an analgesic technique instead of nerve block, and avoid the corresponding weakness of innervated muscles caused by nerve block, which increases the risk of postoperative falls. Many studies have confirmed that LIA can alleviate postoperative early pain in ACLR, especially the analgesic effects of periarticular injection are more satisfactory. It can also avoid the risk of cartilage damage caused by intra-articular injection. However, the postoperative analgesic effect and timeliness still need to be improved. It is possible to consider combining multimodal mixed drug LIA (combined with intra-articular and periarticular) with other pain intervention methods to exert a synergistic effect, in order to avoid the side effects and risks brought by single drugs or single administration route. LIA is expected to become one of the most common methods for relieving postoperative early pain in ACLR. ConclusionEarly pain after arthroscopic ACLR still affects the further functional activities of patients, and all kinds of analgesic methods can achieve certain effectiveness, but there is no unified standard at present, and the advantages and disadvantages of various analgesic methods need further research.
Objective
To investigate the effect of aerobic combined with resistance training on exercise capacity and quality of life in patients with severe or very severe chronic obstructive pulmonary disease (COPD).
Methods
Thirty patients with severe or very severe COPD were randomly divided into the control group (n=15) and the exercise group (n=15) from January 2011 to January 2013. The control group was given health education and routine drug treatment. The exercise group was given muscle relaxation and 6-week aerobic combined resistance exercise training on the basis of the control group. Pulmonary function, 6-minute walk test (6MWT), 30-second sit-to-stand (30-STS), 30-second arm curl test (30-ACT), Medical Research Council Dyspnea Scale (MRC), COPD Assessment Test (CAT), Beck Anxiety and Depression Scale were performed before and after intervention in both groups.
Results
After intervention, compared with those in the control group, the 6MWT, 30-STS and 30-ACT in the exercise group increased significantly [(518.44±84.62) vs. (412.93±82.53) m, (24.53±3.98) vs. (16.87±3.91) times, (26.07±3.41) vs. (17.93±3.39) times, P<0.05], while the CAT score, Beck anxiety and depression scores decreased significantly (4.87±3.68vs. 26.10±10.18, 2.47±1.81 vs. 11.50±4.89, 2.27±2.49 vs. 12.20±6.35, P<0.05), and MRC score also decreased significantly [1.0 (1.0, 2.0)vs. 2.0 (2.0, 4.0), P<0.05]. There was no statistical difference in pulmonary function between the two groups before or after intervention (P>0.05).
Conclusion
Exercise-based pulmonary rehabilitation can significantly improve the treatment outcomes in Chinese patients with severe or very severe COPD.
