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 explore whether the effect of cloud rehabilitation system on motor dysfunction and activities of daily living (ADL) of stroke patients is not inferior to hemiplegia manual treatment. Methods This study adopted a multicenter randomized controlled trial design. A total of 118 stroke patients were enrolled from 5 hospitals in China between April 2018 and April 2019, and they were randomly divided into a trial group and a control group, with 59 patients in each group. The trial group adopted hemiplegia manual treatment (≥30 min per time, once a day) and cloud rehabilitation training (30 min per time, once a day), and the control group adopted hemiplegia manual treatment alone (≥30 min per time, twice a day). All patients received continuous treatment for 2 weeks, and followed up for 2 weeks after that. The Brunnstrom stage (BRS), IK exercise stage, and Modified Barthel Index (MBI) were used to evaluate the motor function and ADL before and 4 weeks after treatment. Results There was no significant difference in gender, age, course, hemiplegia side, source (inpatient/outpatient) or hospital grade between the two groups (P>0.05), which were comparable. Compared with those before treatment, there were significant improvements in the BRS (upper and lower extremities), IK exercise stages (upper and lower extremities), and MBI scores in both groups 4 weeks after treatment (P<0.05). The four-week improvements in motor function indicators (BRS and IK) of the trial group were not inferior to those of the control group (P<0.05), and there was no significant difference in MBI score between the two groups 4 weeks after treatment (F=1.498, P>0.05). Conclusion The cloud rehabilitation system is not inferior to hemiplegia manual treatment in improving the limb motor function or ADL of patients .
ObjectiveTo explore the effect of a new rehabilitation intervention model based on International Classification of Functioning, Disability and Healthy (ICF) concept in perioperative treatment on patients with adolescent idiopathic scoliosis (AIS).MethodsFrom June 2017 to January 2019, AIS patients with Cobb angle below 80° were randomly divided into experimental group and control group by the method of randomized block design. The patients in the control group received routine perioperative rehabilitation intervention, while the patients in the experimental group received rehabilitation mode intervention based on ICF concept. The therapeutic effect of the two groups including functional and activity dimensions was observed.ResultsA total of 40 patients were included, with 20 in each group. Two patients withdrew the control group. On the fourth day after surgery, the total score of Modified Barthel Index (50.55±8.87 vs. 18.99±5.63; t=13.264, P<0.001) and Scoliosis Research Society-22 (SRS-22) (3.68±0.13 vs. 3.27±0.11; t=10.355, P<0.001) in the experimental group were all better than those in the control group. In the SRS-22 scores, statistically significant differences in comparison of function (2.79±0.29 vs. 1.90±0.48; t=6.884, P<0.001), and self image (3.91±0.27 vs. 3.38±0.32; t=5.539, P<0.001) between the two groups were found. There was no statistically significant difference in pain indicators and muscle strength between the two groups in the two postoperative evaluations (P>0.05). ConclusionsThe treatment based on the concept of ICF can improve the daily living ability in the short term with the safe and acceptable premise. The concept of stimulating patient autonomy, improving patient independence, and promoting social treatment, may improve the overall state of the patients.