Baoxing airborne medical team of West China Hospital participated in the medical rescue in 2013 “4?20”Lushan earthquake. The medical team excellently fulfilled their rescue task for 1 week in the earthquake-struck areas where there was power and communication failure and lack of water and food supply. We found some experiences and problems in airbornemedical team assembly and member selection, which may provide quotable experiences for future disaster assistance and rescue teams.
Stroke is a kind of cerebrovascular disease with high incidence and disability rate. Motor dysfunction and cognitive dysfunction are common dysfunctions of stroke. Rehabilitation treatment can effectively reduce the disability rate of stroke and improve the quality of life. The short-term hospitalization and ambulatory rehabilitation treatment cannot meet the rehabilitation needs of stroke patients. Cloud rehabilitation is one of the ways to solve this problem. This article introduces the definition and application of cloud rehabilitation and artificial intelligence (including assisted rehabilitation assessment and assisted rehabilitation treatment), and summarizes the current problems in the development of stroke cloud rehabilitation in China, so as to promote the construction of remote rehabilitation based on artificial intelligence in China and provide some references for the selection of rehabilitation programs for patients with stroke.
Post-stroke cognitive dysfunction is a common complication of stroke, and active rehabilitation therapy can effectively promote the recovery of patients. As a new treatment method, telecognitive rehabilitation is used in rehabilitation treatment of cognitive disorders. Its main technologies include computer-assisted cognitive rehabilitation, virtual reality technology, and artificial intelligence technology. It can use the Internet platform to provide homogeneous treatment, make patients more convenient for cognitive rehabilitation treatment, help to ensure the continuity of rehabilitation treatment, and save medical costs. This article describes the definition of cognitive telerehabilitation, the development and application of cognitive telerehabilitation technology, and summarizes the existing problems. The purpose is to provide a reference for the clinical application of cognitive telerehabilitation in China and future research directions.
Objective To investigate the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital. Methods Using the Barthel Index, the Modified Rivermead Mobility Index, the Zung Self-rating Depression Scale, and a self-designed rehabilitation exercise questionnaire, we conducted a cross-sectional investigation on the daily living ability, mobility, depression, and self-rehabilitation exercise of 207 stroke patients six months after discharge, who were discharged from the Rehabilitation Department of West China Hospital of Sichuan University between April 2017 and July 2019. The rehabilitation status of young and middle-aged (≥20 and <60 years old) stroke patients and elderly (≥60 years old) stroke patients were compared. Results There were 91 elderly patients and 116 young and middle-aged patients. Six months after discharge, the incidences of dysfunction in daily living ability (97.8% vs. 90.5%; χ2=4.598, P=0.032) and depression (51.2% vs. 36.2%; χ2=4.043, P=0.044) were higher in the elderly patients than those in the young and middle-aged patients, and the mobility score (26.38±9.77 vs. 29.47±10.60; t=2.154, P=0.032) and the proportion of patients taking self-rehabilitation exercise (93.4% vs. 100.0%; χ2=5.708, P=0.017) were lower in the elderly patients than those in the young and middle-aged patients. Conclusions In the process of continued rehabilitation nursing, different rehabilitation nursing measures should be implemented according to different ages, focusing on elderly stroke patients, and strengthening the supervision and promotion of rehabilitation training of daily living ability and mobility, psychological nursing and self-rehabilitation exercise compliance of elderly patients.
As a kind of disease with high incidence rate, high mortality, high recurrence rate and high disability rate, stroke has become one of the most serious disease burdens in China. Rapid diagnosis and treatment of stroke can effectively improve the outcome of patients and reduce the psychological and economic burden of patients’ families and society. In recent years, with the rapid development of artificial intelligence technology,this technology can effectively improve daily diagnosis and treatment efficiency. This paper focuses on the application of artificial intelligence technology to the diagnosis, treatment and outcome prediction of stroke, aiming to provide ideas for further guiding precision medicine.
Objective To explore the consistency between the iKcare® grading system and Brunnstrom staging in evaluating upper and lower limb motor function in stroke patients. Methods From May 2018 to May 2020, stroke patients who met the standards in 34 medical institutions in China were recruited. The iKcare® grading system and Brunnstrom staging were used to evaluate the motor function of the upper and lower limbs of the subjects, respectively. The Kappa consistency test was used to evaluate the consistency between the two evaluation methods. Results A total of 340 eligible subjects were included, including 230 males and 110 females, with an average age of (61.44±12.77) years old, and an average course of disease of (62.96±42.53) days. The results showed that the Kappa evaluated for upper limb staging was 0.597 (P<0.001), and the Kappa evaluated for lower limb staging was 0.514 (P<0.001). Conclusions The evaluation results of iKcare® grading and Brunnstrom staging have moderate consistency. The iKcare® grading system can be used as an assessment tool for remote rehabilitation of motor function in stroke patients, but there is still room for improvement.
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.
ObjectiveTo explore the application and effect of peer education combined with group psychological intervention in patients with spinal cord injury.Methodspatients with spinal cord injury admitted to the Rehabilitation Medicine Center of West China Hospital, Sichuan University from April to June 2019 were selected. According to the random number table method, the patients were randomly divided into the control group and the experimental group. The patients in the control group received routine psychological nursing intervention; while those in the experimental group were given routine psychological nursing intervention, supplemented by peer education and group psychological intervention. Before and 1 month after the intervention, the self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), the Short Form-36 (SF-36), and the compliance of rehabilitation treatment were compared between the two groups.ResultA total of 51 patients with spinal cord injury were admitted and 40 were eventually included, with 20 in each group. Before the intervention, there was no statistically significant difference between the two groups in SAS, SDS, SF-36 or rehabilitation treatment compliance (P>0.05). After the intervention, SAS [(28.60±3.30) points], SDS [(33.35±2.32) points], SF-36 [(86.60±4.56) points], and the rehabilitation treatment compliance [(83.28±5.07) %] in the experimental group were significantly improved compared with those in the control group [(34.75±6.17) points, (45.90±3.81) points, (80.90±5.19) points, (75.61±5.94) %; t=−3.932, −12.580, −3.694, 4.397, P<0.001]. After the intervention, SAS and SDS of the experimental group decreased compared with those before the intervention (P<0.05); while SF-36 and rehabilitation treatment compliance were higher than those before the intervention (P<0.05). Compared with those before the intervention, the SAS, SDS, SF-36 and rehabilitation treatment compliance of the control group after the intervention were not statistically significant (P>0.05).ConclusionGroup psychological intervention combined with peer education can effectively promote the psychological rehabilitation of patients with spinal cord injury and improve the curative effect and patients' quality of life.
ObjectiveTo explore the application and effect of integration of doctors-nurses-therapists continuous nursing management in patients with spinal cord injury.MethodsThe patients with spinal cord injury from June to December 2018 in the Department of Rehabilitation Medicine of West China Hospital of Sichuan University were selected. A set of numbers was generated by a computer. And the patients were randomly divided into the trial group and the control group. Patients in the control group were given routine discharge continuous nursing management, and patients in the trial group adopted the integration of doctors-nurses-therapists continuous nursing management to implement post-discharge guidance. The activity of daily living (ADL), quality of life or psychological status of the two groups were compared at discharge and 3 months after discharge. The compliance, satisfaction and readmission rates between the two groups were also compared 3 months after discharge.ResultsA total of 60 patients were included, with 30 cases in each group. There was no significant difference in the scores of ADL, quality of life or Huaxi Xinqing index between the two groups (P>0.05). Three months after discharge, the score of ADL (71.65±1.87 vs. 62.70±2.29), quality of life (302.90±2.71 vs. 292.95±3.39), compliance rate of medication on time (86.67% vs. 63.33%), compliance rate of exercise on time (86.67% vs. 60.00%), compliance rate of follow-up visit on time (90.00% vs. 63.33%), compliance rate of reasonable diet (83.33% vs. 60.00%), and satisfaction (90.45±1.82 vs. 79.55±1.39) of patients in the trial group were higher than those in the control group (P<0.05). There was significant difference in Huaxi Xinqing index between the trial group and the control group (14.57±1.36 vs. 21.60±1.88, P<0.001). The readmission rate of the trial group was lower than that of the control group (6.67% vs. 26.67%), but the difference was not statistically significant (P>0.05). Three months after discharge, the ADL and quality of life in both groups were significantly different from those at discharge (P<0.001); the score of Huaxi Xinqing index in the control group was higher than that at discharge (t=-17.971, P<0.001), which in the trial group was also higher than that at discharge, but the difference was not statistically significant (t=-1.352, P=0.187).ConclusionThe integration of doctors-nurses-therapists continuous nursing management can effectively improve the ADL, quality of life and compliance of discharged patients with spinal cord injury, improve the mental state of patients, and improve patient satisfaction, which is helpful for the rehabilitation of patients with spinal cord injury outside the hospital.
Stroke is a common and frequently-occurring disease, which seriously endangers human health. Rehabilitation treatment can effectively reduce the disability rate of stroke and improve the quality of life. The tertiary rehabilitation treatment system for stroke can effectively improve the motor function of stroke patients and improve the quality of life. This paper focuses on the choices and methods of physical therapy and occupational therapy at all levels of the hospitals and in different periods of the disease. It also aims to summarize the tertiary rehabilitation strategy for motor dysfunction in stroke patients, to provide references for all levels of hospitals and communities, achieve standardization and unification of rehabilitation treatment, as well as the rehabilitation efficacy of homogeneity.