ObjectiveTo observe the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) applied at contralesional hemisphere Broca’s homologue on patients with global aphasia after left massive cerebral infarction. Methods Patients with global aphasia after left massive cerebral infarction in the Department of Neurorehabilitation of China Rehabilitation Research Center between August 2021 and December 2023 were selected. According to the random number table method, patients were randomly divided into a low-frequency rTMS group and a high-frequency rTMS group. rTMS targeted the mirror area within the right hemispheric Broca’s area. Patients’ language ability was assessed pre- and post-treatment by the Chinese version of the western aphasia battery (WAB). Results A total of 27 patients were included, with 14 in the low-frequency rTMS group and 13 in the high-frequency rTMS group. Before treatment, there was no statistically significant difference in the WAB test indicators between the two groups of patients (P>0.05). After treatment, WAB scores (spontaneous speech, auditory comprehension, naming, repetition, aphasia quotients) in both groups were significantly improved (P<0.05); compared to the low-frequency rTMS group, the high-frequency rTMS group exhibited significant improvement in spontaneous speech, auditory comprehension, repetition, naming and aphasia quotients (P<0.05). Conclusion The effect of high-frequency rTMS excitation to contralesional hemisphere is better than that of conventional low-frequency rTMS inhibition to contralesional hemisphere in improving the speech function of patients with global aphasia after left massive cerebral infarction.
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.
This paper briefly introduces the basic concepts, development history, basic principles, main treatment and evaluation technologies, development status, existing problems and development trends of aquatic therapeutic exercise, and summarizes the new progress of aquatic therapeutic exercise in basic medical research and evidence-based medical research through literature analysis. It aims to provide a reference for clinical treatment, scientific research and medical education for practitioners in rehabilitation medicine and related fields by systematically analyzing the scientific principles, technical systems, application fields and evidence-based foundation of aquatic therapeutic exercise, and improve the awareness rate and application rate of aquatic therapeutic exercise in the fields of rehabilitation medicine, sports medicine, geriatrics, etc., promote the standardized development of aquatic rehabilitation.
Stroke is one of the most health-threatening diseases in the world, with high incidence and high morbidity. Despite the development of stroke therapy and improved systems to recognize stroke symptoms and deliver care promptly, only a minority of patients with acute stroke receive thrombolytic therapy, and many of them remain with residual functional deficits. Thus, the need for effective stroke rehabilitation is likely to remain an essential part of the continuum of stroke care for the foreseeable future. This review summarizes and analyzes the results of literatures on stroke rehabilitation in recent years, briefly describes the rehabilitation techniques and progress in dyskinesia, speech barrier, dysphagia, emotional disorder and spasticity after stroke, to provide some references for the optimization of rehabilitation treatment.
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.
Objective To evaluate the impacts of pulmonary rehabilitation at different levels of exercise intensity on health status of patients with moderate to severe COPD. Methods Thirty-two COPD patients treated with pulmonary rehabilitation by ergometry exercise were randomly assigned to exercise intensity level either by anaerobic threshold （AT group; n=15） or by maximum tolerate [high intensity group（HI group）; n=17]. Nine COPD patients without exercise training served as control. Bicycle exercise training was conducted in two separate days each week for 12 weeks. Spirometry，cardiopulmonary exercise testing，the St George’s Respiratory Questionnaire （SGRQ） were accessed before and after the rehabilitation program. Results Exercise intensity （%Wmax） was significantly higher in HI group than AT group （69%±14% vs 52%±7%，Plt;0.01）. Significant improvement of SGRQ scores after rehabilitation were found both in AT group （－11.91±15.48 U） and HI group （－8.39±9.49 U）. However，no significant difference was found between the two groups in the degree of improvement （Z=－0.540，P=0.589）. Symptoms and impacts subscale scores of SGRQ were decreased significantly in HI group，but only symptoms scores decreased significantly in AT group. The control group did not show any significant improvement in SGRQ scores. No statistically significant correlation was found between improvement of peak oxygen consumption per predicted (VO2peak%pre) and SGRQ scores. Conclusion Both pulmonary rehabilitation strategies by anaerobic threshold and by maximum tolerate can improve health status of COPD patients significantly with no significant difference between each other.
ObjectiveTo observe the effect of Baduanjin on the motor function and balance function in patients within 6 months after stroke.Methods Between July 2018 and March 2019, a total of 40 stroke patients were randomly divided into the Baduanjin group and the control group. Twenty patients in the Baduanjin group received the treatment of Baduanjin training and conventional rehabilitation, while the other 20 patients in the control group were treated with conventional rehabilitation only. The duration of the treatment was 3 weeks; then the motor function, balance ability and the ability of daily life in the two groups were assessed by the Fugl-Meyer Assessment (FMA), the 6-minute Walking Test (6MWT), the Berg Balance Scale (BBS), the balance tester and the Barthel Index (BI) respectively before and after treatment.ResultsAfter the 3-week treatment, the motor function, balance ability and the ability of daily life assessed by FMA, 6MWT, BBS, the balance tester, and BI were improved significantly in both groups (P<0.05). The post-treatment scores of FMA, BI, BBS and 6MWT distance in the Baduanjin group were more than those in the control group [72.25±20.91 vs. 57.90±20.25, 89.75±12.08 vs. 77.75±15.68, 53.25±5.74 vs. 47.80±9.77, (251.03±79.43) vs. (186.92±100.09) m; P<0.05]. In the sit-to-stand balance test, compared with those in the control group, the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in standing stance in the Baduanjin group reduced significantly [(235.86±76.08) vs. (303.60±123.01) cm, (11.67±3.37) vs. (15.76±7.05) cm/s, (2.53±0.99) vs. (3.40±1.28) cm/cm2; P<0.05], and the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in sitting stance in the Baduanjin group also reduced significantly [(246.59±98.79) vs. (334.05±155.87) cm, (7.69±2.29) vs. (11.13±6.41) cm/s, (4.10±1.38) vs. (6.25±4.21) cm/cm2; P<0.05].ConclusionConventional rehabilitation with or without Baduanjin can improve the motor function, balance function and the ability of daily life in patients after stroke, but the effect of rehabilitation with Baduanjin is better than conventional rehabilitation.
Adolescent idiopathic scoliosis refers to a three-dimensional spinal deformity or structural change that occurs in adolescence. The rotation of the vertebral body is greater than or equal to 10°. In order to avoid affecting the physical and mental health of patients, appropriate intervention and treatment of adolescent idiopathic scoliosis should be carried out as soon as possible. Based on the summary of non-surgical treatment of adolescent idiopathic scoliosis at home and abroad, this paper systematically introduces the mainstream early non-surgical treatment of adolescent idiopathic scoliosis, including observation and follow-up, electrical stimulation therapy, Chinese traditional chiropractic techniques, massage and manual reduction, functional training and exercise therapy, traction therapy and brace therapy, in order to provide a reference for the possible treatment research direction of adolescent idiopathic scoliosis in the future.
Spinal cord injuries (SCI) seriously impair the quality of life, functional status, and social independence of the patients. Since the last century, a series of basic research on spinal cord injury has made us a deep understanding of its mechanisms and pathophysiology. But so far, how to repair damaged nerve functions after SCI is still a neurological problem. There are still controversies surrounding some treatment strategies for SCI, including the use of magnetic resonance imaging, type and timing of anticoagulant prevention, the timing of surgical intervention, the use of corticosteroids such as methylprednisolone sodium, as well as the type and timing of rehabilitation. For patients with SCI, early surgical intervention and neuroprotective therapy may be the best treatment. At the same time, rehabilitation and psychological intervention are equally important.
ObjectiveTo explore the effectiveness of lung ultrasound-guided pulmonary rehabilitation training in ICU patients on mechanical ventilation.MethodsPatients on mechanical ventilation admitted to the ICU of a tertiary A-level hospital in Hefei city from July 2022 to December 2023 were selected and randomly divided into a control group and an experimental group using a random number table method. The control group received conventional pulmonary rehabilitation training, while the experimental group underwent lung ultrasound-guided pulmonary rehabilitation training. The differences in lung ultrasound scores, oxygenation index, diaphragm function, weaning success rate, and mechanical ventilation time were compared between the two groups on the 1st, 3rd, 5th, and 7th days of intervention.ResultsThe study was completed with 48 cases in the experimental group and 46 cases in the control group. Repeated measures ANOVA showed statistically significant intergroup effects, time effects, and interaction effects on lung ultrasound scores, oxygenation index, diaphragm mobility, and diaphragm thickness variability rate (P<0.05). The weaning success rate was higher in the experimental group than in the control group, and the mechanical ventilation time was shorter, with statistically significant differences (P<0.05).ConclusionsThe lung ultrasound-guided pulmonary rehabilitation training program can effectively improve the pulmonary status, oxygenation, and diaphragm function of ICU patients on mechanical ventilation, increase the success rate of weaning, shorten the mechanical ventilation time, and accelerate patient recovery.