Objective To evaluate the clinical significance of operative indication in patients with lung cancer accompanied by lung dysfunction using cardiopulmonary exercise test (CPET). Methods Before operation, using CPET with step program, work rate(W%), maximal oxygen uptake(VO2%P), maximal oxygen uptake per kilogram(VO2/kg) and other indexes were tested in the end of load exercise in 195 patients with lung cancer accompanied by lung dysfunction. Chi-square test and logistic regression analysis were performed for the abnormal rate of indexes mentioned above in patients with or without postoperative respiratory failure. Results After pneumonectomy, W%,VO2%P, VO2/kg, metabolic equivalent (MET), minute ventilation(VE) and respiratory frequency(BF) in patients with postoperative respiratory failure were lower than those in patients with non-postoperative respiratory failure (Plt;0.05 or 0.01). Logistic regression analysis showed that VElt;30 L/min and (BFlt;30) times/min were more related to the morbidity of postoperative respiratory failure than other indexes. As for the patients with lung dysfunction treated by lobectomy, this indexes didn’t show any significant difference between patients with or without postoperative respiratory failure. However, this indexes decreased in patients with postoperative respiratory failure whose ratio of forced expiratory volume in one second to forced vital capacity (FEV1%) were lower than 60%(Plt;0.05 or 0.01). Logistic regression analysis showed that VO2%Plt;60% related to the morbidity of postoperative respiratory failure. Conclusion CPET is useful to evaluate the operative indication in patients with lung cancer accompanied by lung dysfunction. VO2%Plt;60% should be selected as a evaluating index.
Pneumoconiosis is an interstitial lung disease with pulmonary fibrosis as the main pathological change. Patients with pneumoconiosis can increase immunity, delay disease progression, reduce symptoms, and improve lung function through respiratory rehabilitation. With the development of the domestic medical stratification, grading, and referral system between various specialties and the promotion of “internet +” model, remote home respiratory rehabilitation has become an inevitable trend in the full-cycle management of chronic respiratory diseases. By searching Chinese and English literatures, this article summarizes the safety, efficacy and research progress of remote home respiratory rehabilitation for pneumoconiosis. The purpose is to provide ideas for patients with pneumoconiosis to receive home-based remote rehabilitation management.
Objective To evaluate the effects of different ways of exercise training on elderly patients with chronic obstructive pulmonary disease ( COPD) , which focuse on the changes of cardiopulmonary exercise function and COPD symptoms. Methods 54 cases of elderly patients with stable COPD were randomly allocated to a control ( 15 cases) , a lower-limb ( 20 cases) , or a upper-Limb and lower-Limb combined exercise group ( 19 cases) . All patients received conventional medical therapy.Meanwhile, the exercise groups received training for 16 weeks. The improvements of resting spirometry,cardiopulmonary exercise test ( CPET) , and dyspnea ( Borg scale rating) were evaluated before and after the training scheme. Results There was no significant difference in resting spirometry after exercise training( P gt;0. 05) . Exercise tolerance and Borg scale were improved in both exercise groups significantly than baseline ( P gt;0. 05) and the control group ( P gt;0. 05) . VE@ 50% Vo2max was improved significantly in the combined group( 4. 81 ±0. 70 vs. 2. 49 ±1. 15, P lt; 0. 001) . Breathing reserve ( BR) was elevated in bothexercise groups than the control ( P lt; 0. 01) , and the improvement in the combined group was more significant ( 9. 79 ±1. 57 vs. - 1. 36 ±2. 82, P lt; 0. 001) . Gas exchange response ( VD /VT ) was slightly improved after rehabilitation in the combined group( P lt;0. 05) . Borg scale after rehabilitation was correlatedwith FEV1% pred, BR, and Vo2 /kg after rehabilitation[ Borg = 9. 516 - 0. 174 ×FEV1% pred - 0. 156 × (Vo2 /kg) - 0. 023 ×BR] . Conclusions Upper-limb combined with lower-limb exercise training can markedly improve the level of aerobic capacity and ventilation in elderly patients with stable COPD, and then improve the exercise tolerance.
Objective To systematically review the association between Chinese eye exercises and myopia onset in children and adolescents to provide a theoretical basis for clinical prevention of myopia. Methods The PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched from inception to March 2022 to collect observational studies about the association between Chinese eye exercises and myopia onset in children and adolescents. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 28 studies were included, including 217 112 subjects. The results of meta-analysis showed that doing eye exercises, doing eye exercises ≥2 times per day, doing eye exercises regularly or consistently, doing eye exercises seriously and doing eye exercises correctly and normatively were the protective factors of myopia onset in children and adolescents. Conclusion Current evidence shows that doing eye exercises, doing eye exercises ≥2 times per day, doing eye exercises regularly or consistently, doing eye exercises seriously, doing eye exercises correctly and normatively can prevent myopia onset in children and adolescents. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Stroke has a high disability rate, with patients often experiencing varying degrees of motor function impairment. Some patients also have concurrent cardiovascular diseases, leading to varying degrees of cardiopulmonary dysfunction. Formulating exercise prescriptions tailored to stroke patients, selecting appropriate assessment methods, and determining suitable exercise intensity are significant clinical concerns. However, there is a lack of definitive conclusions on how to formulate precise exercise prescriptions based on the assessment of cardiopulmonary and motor functions. This paper reviews the determination of post-stroke exercise loads and current research on stroke and cardiopulmonary fitness, aiming to provide a basis for the precise formulation of exercise prescriptions for stroke patients.
Objective To explore the effect of deep muscle stimulation (DMS) combined with exercise therapy on morphological changes of the trapezius muscle assessed by musculoskeletal ultrasound and the function for patients with neck and shoulder myofascial pain syndrome (MPS). Methods One hundred and twenty patients with neck and shoulder MPS admitted to the First People’s Hospital of Shuangliu District, Chengdu between August 2021 and December 2022 were randomly selected and divided into 4 groups. There were 30 cases in each group. Group A received modulated middle frequency electrotherapy, group B received modulated middle frequency electrotherapy combined with DMS, group C received modulated middle frequency electrotherapy combined with exercise therapy, and group D received modulated middle frequency electrotherapy, DMS combined with exercise therapy. Before treatment and after 4 weeks of treatment, shear wave elastography was used to detect the shear wave velocity (SWV) of the four groups, high frequency ultrasound was used to detect the muscle thickness of the trapezius muscle. The Visual Analogue Scale (VAS) scores, Neck Disability Index (NDI), modified Barthel Index (MBI), Instrumental Activities of Daily Living Scale (IADL), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Self-rating Anxiety Scale (SAS), and Self-rating Anxiety Scale (SDS) were also assessed to compare the therapeutic effects among the four groups of patients under different intervention methods. Results Before treatment, there was no significant difference in trapezius muscle SWV, trapezius muscle thickness, VAS, NDI, MBI, IADL, WHOQOL-BREF, SAS or SDS among the four groups (P>0.05). After 4 weeks of treatment, there were significant differences in trapezius muscle SWV, VAS, NDI, WHOQOL-BREF in the physiological domain and psychological domain, SAS and SDS among the four groups (P<0.05), and the improvements of trapezius muscle SWV, WHOQOL-BREF in the physiological domain and psychological domain, and SDS in group D were more obvious than those in other groups (P<0.05). After 4 weeks of treatment, there was no significant difference in MBI, IADL, or WHOQOL-BREF in the society domain and environmental domain among the four groups (P>0.05). Conclusion DMS combined with exercise therapy can significantly improve trapezius muscle elasticity, psychological state and quality of life of patients with neck and shoulder MPS.
Objective To systematically analyze the relevant research on the application of preoperative exercise training in the pre-rehabilitation of elderly hip fracture patients, identify the specific content, outcome indicators, and application effects of exercise intervention, in order to provide reference for medical staff to carry out relevant interventions. Methods Computer searches were conducted on domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, VIP, Cochrane Library, PubMed, Embase, Web of Science. The search period was from the establishment of the database to January 2024. The scoping review method was used to screen, summarize, and analyze the included studies. ResultsA total of 10 studies were included, including 3 randomized controlled trial, 1 quasi experimental study, 5 retrospective studies and 1 case report. Preoperative exercise preparation includes completing relevant examinations and providing sufficient pain relief. The types of exercise include adaptive training, resistance training, and aerobic exercise. Monitor the patient’s symptoms, signs, and adverse reactions throughout the exercise process. Outcome measures include physical activity and function, pain, average length of hospital stay, and perioperative complications. Conclusions Preoperative exercise training has a positive effect on elderly patients with hip fracture. Elderly patients with hip fracture should be well prepared for preoperative exercise, based on adaptive training, with resistance exercise as the main focus, while monitoring the patient’s physical signs and adverse events during exercise.
Objective To compare the early and mid-term results between Fontan operation and anatomic correction for congenitally corrected transposition of the great arteries (ccTGA). Methods The clinical data of 53 patients with ccTGA who underwent anatomic correction and Fontan operation from January 2009 to September 2021 in our hospital were reviewed, including 41 males and 12 females with a mean age of 55.02 (3-168) months. They were divided into an anatomic correction group (16 patients) and a Fontan operation group (37 patients) according to the operation. The hospitalization mortality, survival rate, postoperative complications, and free rate from re-intervention between the two groups were compared. Another 180 healthy children were recruited as a control group, and 14 children were matched with the propensity score matching method as a Fontan control group. The results of cardiopulmonary exercise testing (CPET) between the Fontan operation group and the Fontan control group were compared. Results There were 2 (12.5%) early deaths and 3 (18.8%) early re-intervention in the anatomic correction group, while 1 death and 2 re-intervention in the Fontan operation group. In addition, there were 9 patients (56.3%) in the anatomic correction group and 6 (16.2%) patients in the Fontan operation group suffering from arrhythmia after operation, respectively. Compared with the anatomic correction group, cardiopulmonary bypass time, aortic cross-clamping time, intubation time and ICU stay were significantly shortened in the Fontan operation group (P<0.05). CPET results showed that, percent predicted max VO2 in the Fontan operation group was lower than that in the Fontan control group (0.84±0.11 vs. 0.99±0.12, P＜0.05). The patients were followed up for 0.5-126.0 months. Two patients were lost in the Fontan operation group. There was no death and 1 re-intervention in the anatomic correction group, while no death or re-intervention in the Fontan operation group. The 1-year, 5-year and 10-year transplant-free survival rate of the anatomic correction group and the Fontan operation group was 87.5%, 87.5%, 87.5% and 97.3%, 97.3%, 97.3%, respectively (P＞0.05). The 48 patients were classified as grade Ⅰ-Ⅱ in cardiac function in the last follow-up. Conclusion There is no statistical difference in the transplant-free survival rate between the anatomic correction and the Fontan operation group. The postoperative complications in the Fontan operation group are decreased than those in the anatomic correction group. The Fontan operation is also a good choice, even though the patients with ccTGA meet the condition of the procedure of anatomic correction.
Objective To explore the effect of early weight-bearing exercise on the recovery of elderly patients with intertrochanteric fractures after internal fixation. Methods The clinical data of 50 patients with unstable intertrochanteric fractures (AO 31-A2 or A3) who underwent proximal femoral nail treatment between February and August 2015 were collected. Among them, 25 patients underwent early weight-bearing exercise after surgery (the observation group), and 25 patients underwent routine recovery after surgery (the control group). Demographic data of patients, modified Barthel Index, and EuroQOL Five Dimensions Questionnaire (EQ-5D) scores were collected, and mortality was assessed by telephone follow-up one year after surgery. Results In the observation group, the modified Barthel Index before injury, within 48 hours , 6 weeks , 12 weeks, and 1 year after surgery was 49.56±2.00, 26.40±3.11, 44.04±3.92, 47.92±3.13, and 48.76±3.07, respectively; in the control group, the modified Barthel Index at the above mentioned time points was 49.92±0.40, 26.52±3.34, 40.92±2.62, 45.44±2.36, and 49.16±1.75, respectively. The difference between the observation group and the control group at 6 and 12 weeks after surgery was a statistically significant (P<0.05), and the observation group was better than the control group; there was no statistical difference between the two groups in the modified Barthel Index before surgery, within 48 hours after surgery or one year after surgery (P>0.05). None of the patients died within the first one year after surgery. Conclusion The early weight-bearing exercise after hip fracture in the elderly has a positive effect on the recovery of the patients.
Objectives To analyze the effect of sling exercise therapy on the walking ability of children with spastic hemiplegia and cerebral palsy, and to provide a scientific basis for clinical treatment. Methods Children with spastic hemiplegia and cerebral palsy who were treated in the Department of Rehabilitation of Children’s Hospital of Shanghai from July 2018 to July 2019 were selected as the research subjects. The children were divided into conventional treatment group and sling exercise therapy group by random number table method. The routine treatment group was given routine rehabilitation training, and the sling exercise therapy group was given combined sling exercise therapy on the basis of routine treatment. The Gross Motor Function Measure (GMFM)-88-item E functional area score, Clinical Spasticity Index (CSI) and Berg Balance Scale (BBS) score were compared between the two groups. Results A total of 36 children were included, with 18 cases in each group. There was no significant difference in gender, age and hemiplegia side between the two groups (P>0.05). All children completed the trial without adverse reactions. Before treatment, there was no significant difference in BBS, CSI and GMFM-88 E functional area scores between the two groups (P>0.05). After 3 months of treatment, the above scores of the two groups were improved compared with those before treatment (P<0.05). The improvement of the above scores in the sling exercise therapy group after treatment was better than that in the conventional treatment group. The difference of BBS, CSI, and GMFM-88 E functional area scores in the sling exercise therapy group before and after treatment was 8.94±4.15, 2.44±0.71, and 7.28±3.23, respectively, the difference of the above scores before and after treatment in the conventional treatment group was 4.50±4.15, 1.83±0.79, and 2.89±1.64, respectively, and the differences were statistically significant (P<0.05). Conclusion Combined use of sling exercise therapy can better improve the walking ability of children with spastic hemiplegia and cerebral palsy, which is worthy of clinical promotion and application.