Objective To compare the early rehabilitation effects of total hip arthroplasty (THA) with direct anterior approach (DAA) versus posterior approach (PA). Methods A retrospective analysis was made in the data of 83 patients with unilateral osteonecrosis of the femoral head between March 2014 and May 2017. Forty-eight patients were treated with THA via PA (PA group) and 35 patients were treated with THA via DAA (DAA group). There was no significant difference in gender, age, body mass index, stage of osteonecrosis of the femoral head, and disease duration between 2 groups (P>0.05). The length of incision, operation time, total amount of bleeding, the time of first postoperative walking with crutch, the time of first postoperative walking without crutch, the Harris scores, and the visual analogue scale (VAS) scores of 2 group were recorded and compared. Results All incisions healed primarily and no infection, dislocation, or fracture occurred. All patients were followed up 30.2 months on average (range, 6-44 months). The numbness symptom caused by the lateral femoral cutaneous nerve injury occurred in 2 patients of DAA group and released after symptomatic treatment. The length of incision, total amount of bleeding, the time of first postoperative walking with crutch, and the time of first postoperative walking without crutch of DAA group were significantly superior to those of PA group (P<0.05). The Harris scores of DAA group were significantly higher than those of PA group at 2 weeks and 1 month after operation (P<0.05), while no significant difference was found between 2 groups before operation and at 3 months and 6 months after operation (P>0.05). The VAS scores of DAA group were significantly lower than those of PA group at 1 day, 4 days, 1 week, and 2 weeks after operation (P<0.05), while no significant difference was found between 2 groups before operation (P>0.05). Conclusion DAA is meaningful to enhanced recovery after THA. But it should be chosen carefully because of the disadvantages, such as long learning curve, limited indications, and requirements of specific instruments.
Cardiac rehabilitation can safely and effectively improve the quality of patient's life and reduce readmission rate and mortality after cardiac surgery. Early cardiac rehabilitation after cardiac surgery is an indispensable part of cardiac rehabilitation. It can speed up the recovery of patient's exercise endurance, prevention of postoperative complications, shorten the time of returning to the family, increase the confidence of sustained rehabilitation, and lay foundation and set rehabilitation targets for the later stage of cardiac rehabilitation. This paper reviews the development history of early cardiac rehabilitation after cardiac surgery, and summarizes the current status, problems and outlook of rehabilitation management in China.
Objective To explore the effect of self-designed early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology in the outpatient treatment of patients with early frozen shoulder. Methods One hundred and eighty-two consecutive patients who attended the outpatient clinic of the Department of Rehabilitation Medicine of the First Affiliated Hospital of Xinjiang Medical University and were diagnosed with frozen shoulder between January 2018 and May 2021 were selected and randomly divided into the trial group and the control group, with 91 patients in each group. Patients in the trial group received early rehabilitation procedures for frozen shoulder, and patients in the control group received conventional physiotherapy. The Visual Analogue Scale (VAS) (including VAS score for resting pain and VAS score for active motion), active range of motion of the shoulder joint (external rotation, forward flexion, and abduction), Shoulder Pain and Dysfunction Index (SPADI) (including pain subscale score, dysfunction subscale score, and total score) were compared between the two groups before treatment (Week 0) and 4 and 8 weeks after the start of treatment (Week 4 and 8). Results A total of 143 patients (74 in the trial group and 69 in the control group) completed the study. There was no significant difference in any assessment index between the two groups in Week 0 (P>0.05). The results of the within-group comparison after treatment showed that the VAS score for resting pain (F=44.359, P<0.001), VAS score for active motion (F=158.458, P<0.001), anterior shoulder flexion (F=123.334, P<0.001), abduction mobility (F=117.539, P<0.001), total SPADI score (F=133.814, P<0.001), SPADI pain subscale score (F=74.093, P<0.001), and SPADI dysfunction subscale score (F=145.336, P<0.001) in Week 4 and 8 were better than those in Week 0, and the assessments in Week 8 were better than those in Week 4 in each group (P<0.05); in the control group, there was no statistically significant difference in the external rotation mobility of the shoulder in Week 4 compared with that in Week 0 (P=0.599), and the external rotation in Week 8 improved significantly compared with that in Week 0 (P<0.001), whereas the external rotation of the shoulder in Week 4 and 8 in the trial group improved significantly compared with that in Week 0 (P<0.001). The results of the between-group comparison after treatment showed that the two groups had statistically significant differences in resting shoulder pain VAS score (F=93.712, P<0.001), active motion VAS score (F=103.565, P<0.001), external shoulder rotation (F=13.388, P<0.001), anterior shoulder flexion (F=66.375, P<0.001), abduction mobility (F=110.253, P<0.001), total SPADI score (F=7.917, P=0.006), and SPADI pain subscale score (F=39.091, P<0.001); the SPADI dysfunction subscale score was lower in the trial group than that in the control group in Week 4 (P=0.002), but by Week 8 there was no statistically significant difference between the two groups (P=0.352). Conclusion The early rehabilitation program for frozen shoulder incorporating high-frequency ultrasound technology is more effective than conventional physiotherapy in the intervention of patients with early frozen shoulder, and may provide a referenceable example for the combined application of high-frequency ultrasound technology and physiotherapy.