Objective To observe the effects of extracorporeal shock wave therapy (ESWT) combined with kinesio taping (KT) on chronic non-specific low back pain (CNLBP). Methods CNLBP patients who visited the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Nantong University between January 2021 and January 2022 were selected. The included patients were divided into ESWT group, KT group, and combined treatment group using a random number table method. All patients received conventional rehabilitation. The ESWT group was treated with ESWT, the KT group was given KT therapy, and the combined treatment group were treated with ESWT and KT with the same treatment frequency as before. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), MOS 36-item Short form Health Survey (SF-36) and Self-rating Anxiety Scale (SAS) were used to evaluate pain severity, lumbar spine function, quality of life, and anxiety status in all groups before and 4 weeks after treatment, respectively. Results A total of 85 patients were included. Among them, there were 29 cases in the ESWT group, 28 cases in the KT group, and 28 cases in the combined treatment group. There was no adverse event in any group. The intra-group comparison results showed that the VAS, ODI, and SAS scores of the three groups after 4 weeks of treatment were lower than those before treatment (P<0.05), while the SF-36 scores in all dimensions were higher than those before treatment (P<0.05). Before treatment, there was no statistically significant difference in VAS, ODI, SAS, or SF-36 scores among the three groups (P>0.05). After 4 weeks of treatment, there were statistically significant differences in VAS, ODI, SAS, and SF-36 scores among the three groups (P<0.05). The results of multiple comparisons between groups showed that the VAS scores of the ESWT group and the combination therapy group were lower than those of the KT group (P<0.05); the ODI scores of the combination therapy group were lower than those of the ESWT group and the KT group (P<0.05); the SAS scores of the combination therapy group were lower than those of the KT group (P<0.05); the SF-36 scores of each dimension were compared in pairs among the three groups, and the differences were statistically significant (P<0.05); there was no statistically significant difference in pairwise comparison of other indicators between groups (P>0.05). Conclusion ESWT combined with KT can more effectively improve the pain and lumbar spine function of patients with CNLBP, and improve the quality of life of patients.
ObjectiveTo observe the effects of upper limb rehabilitation robot-assisted training combined with mirror therapy on unilateral spatial neglect (USN) in stroke patients.MethodsA total of 40 patients with USN admitted to the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Nantong University from January 2017 to December 2018 were selected and randomly divided into the trial group and the control group, with 20 cases in each group. The trial group used upper limb rehabilitation robot-assisted training combined with mirror therapy and USN comprehensive rehabilitation treatment. The control group patients only received USN comprehensive rehabilitation treatment. All patients continued treatment for 4 weeks. Before treatment and after 4 weeks of treatment, the modified Barthel index (MBI) was used to assess the activities of daily living, the Fugl-Meyer assessment (FMA) was used to assess motor function, and the Catherine-Bergego scale was used to assess the degree of USN.ResultsThere was no statistically significant difference in general information between the two groups of patients (P>0.05). There was no significant difference in MBI, FMA or USN degree scores between the two groups before treatment (P>0.05). After 4 weeks of treatment, the MBI, FMA and USN degree scores of the two groups were improved compared with those before treatment (P<0.05). The improvements in MBI, FMA and USN degree scores of the trial group were 14.75±1.97, 17.05±3.93 and 5.25±2.29, respectively, and those of the control group were 9.75±4.44, 8.30±2.06 and 3.10±0.72, respectively, and the differences were statistically significant (P<0.05).ConclusionsUpper limb rehabilitation robot-assisted training combined with mirror therapy can effectively improve the spatial neglect of USN patients, and improve the ability of daily living and motor functions.
Objective To report the clinical characteristics and treatment analysis of 3 cases of congenital ulnar collateral flexor contracture of the forearm and take a reference for clinic. Methods A total of 3 patients with congenital ulnar collateral flexor contracture of the forearm were admitted between February 2019 and August 2021. Two patients were male and 1 was female, and their ages were 16, 20, and 16 years, respectively. The disease durations were 8, 20, and 15 years, respectively. They all presented with flexion deformity of the proximal and distal interphalangeal joints of the middle, ring, and little fingers in the neutral or extended wrist position, and the deformity worsened in the extended wrist position. The total action motion (TAM) scores of 3 patients were 1 and the gradings were poor. The Carroll’s hand function evaluation scores were 48, 55, and 57, and the grip strength indexes were 72.8, 78.4, and 30.5. Preoperative CT of case 2 showed a bony protrusion of the flexor digitorum profundus tendon at the proximal end of the ulna; and MRI of case 3 showed that the ulnar flexor digitorum profundus presented as a uniform cord. After diagnosis, all patients were treated with operation to release the denatured tendon, and functional exercise was started early after operation. Results The incisions of 3 patients healed by first intention. Three patients were followed up for 12, 35, and 12 months, respectively. The hand function and the movement range of the joints significantly improved, but the grip strength did not significantly improve. At last follow-up, TAM scores were 3, 4, and 4, respectively, among which 2 cases were excellent and 1 case was good. Carroll’s hand function evaluation scores were 95, 90, and 94, and the grip strength indexes were 73.5, 81.3, and 34.2, respectively. ConclusionCongenital ulnar collateral flexor contracture is a rare clinical disease that should be distinguished from ischemic muscle contracture. The location of the contracture should be identified and appropriate surgical timing should be selected for surgical release. Active postoperative rehabilitation and functional exercise can achieve good hand function.
ObjectiveTo investigate the effect of virtual scene simulation training combined with midium frequency impulse electrotherapy on upper limb function and daily living ability of hemiplegia patients.MethodsFrom March to October 2019, 50 hemiplegic patients were recruited and randomly assigned to the trial group and the control group, with 25 patients in each group. The control group was given routine rehabilitation training, while the trial group was given virtual scene simulation training and medium frequency impulse electrotherapy on the basis of routine rehabilitation training. The Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Simple Test for Evaluating Hand Function (STEF), and Modified Barthel Index (MBI) were used to assess patients’ upper limb function and daily living ability before treatment and after 8 weeks of treatment.ResultsBefore treatment, the FMA-UE, STEF, and MBI scores of the trial group vs. the control group were 22.88±5.18 vs. 23.44±6.26, 40.12±4.82 vs. 41.44±4.54, and 51.40±7.29 vs. 48.60±7.00, respectively, and none of the between-group differences was statistically significant (P>0.05); after 8 weeks of treatment, the FMA-UE, STEF, and MBI scores of the two groups were 39.48±6.35 vs. 33.52±6.53, 59.08±7.54 vs. 52.52±5.83, and 71.00±8.78 vs. 62.40±9.37, respectively, and all of the between-group differences were statistically significant (P<0.05). After 8 weeks of treatment, the FMA-UE, STEF and MBI scores of the two groups of patients were significantly improved compared with those before treatment (P<0.05), and the improvement of each score of the trial group was significantlybetter than that of the control group (P<0.05). No stroke recurrence, electric burn, or other adverse reactions occurred in the two groups after treatment. ConclusionVirtual scene simulation training combined with midium frequency impulse electrotherapy can effectively improve the upper limb function of patients with hemiplegia and improve their quality of life.
Lumbar disc herniation (LDH) is one of the most important causes of back and leg pain, which seriously affects the quality of life of patients. As the first-line treatment for LDH, non-operative treatment can relieve 80% to 90% of symptoms among the patients with LDH. This guideline followed Guidelines for the Formulation/Revision of Clinical Treatment Guidelines in China (2022 edition) and WHO handbook for guideline development (2014 edition) to set up guideline working group. This guideline identified fourteen clinical questions through the literature review and clinical experts’ consensus. We drafted the recommendations after systematically searching and evaluating the evidence; delphi method was adopted for expert consensus on the preliminary recommendations, finally, 19 recommendations were made to guide non-operative treatments for LDH. This guideline can provide guidance for the clinical practice of Chinese and western orthopedics practitioners.