This study aimed to determine the effectiveness of comprehensive rehabilitation for patients with aneurysmal subarachnoid hemorrhage (aSAH) and to explore the factors influencing the prognosis of rehabilitation. This ...This study aimed to determine the effectiveness of comprehensive rehabilitation for patients with aneurysmal subarachnoid hemorrhage (aSAH) and to explore the factors influencing the prognosis of rehabilitation. This was a retrospective study. Twenty-five patients with aSAH were treated with physical therapy, occupational therapy, speech therapy, cognitive therapy, music therapy, Chinese acupuncture, hyperbaric oxygen, and transcranial magnetic stimulation. The general data of all patients were collected, and the functional scores at admission were compared with those at discharge. The Mini Mental State Examination, Fugl-Meyer Assessment Scale (FMAS) for motor and balance assessment, Holden Functional Ambulation Classification (FAC), modified Rankin Scale, National Institute of Health Stroke Scale, Modified Barthel Index for activities of daily living (ADL), and Glasgow Outcome Scale were significantly improved among 25 patients with aSAH after 1 month of comprehensive rehabilitation training. Hydrocephalus was an independent factor of the ability to perform ADLs (odds ratio, 0.29;95% confidence interval, 2.03. 3.15;p = 0.000). The improvement of ADLs in aSAH patients was not related to sex, surgical method, aneurysm location, age, or smoking status. Comprehensive and professional rehabilitation is effective for the cognition, movement, walking, ADLs, and functional prognosis of patients with aSAH, while early hydrocephalus may be a risk factor for poor ADLs.展开更多
Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describ...Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.展开更多
Global cerebral ischemia/hypoxia may occur due to various causes such as cardiac arrest,shock,and asphyxiation.Even though the patient’s life may be saved after cardiopulmonary resuscitation,cerebral ischemia– reper...Global cerebral ischemia/hypoxia may occur due to various causes such as cardiac arrest,shock,and asphyxiation.Even though the patient’s life may be saved after cardiopulmonary resuscitation,cerebral ischemia– reperfusion injury is likely to occur and often results in neurological dysfunction.Apart from motor and speech impediments,patients with such injury may also suffer from impaired higher-level cognitive functions such as learning and memory,placing a heavy burden on families and society.Brain areas associated with the limbic system include the hippocampus,corpus striatum,and amygdala,which are linked with cognitive function.Those brain regions are easily damaged by hypoxia,and since they are connected with the dopaminergic pathway,global cerebral ischemia–reperfusion can damage the dopaminergic pathway as well and affect the projection of dopaminergic neurons in the limbic system.This review article examines the feasibility of using dopamine,a neurotransmitter heavily involved in cognitive function,in experimental research and clinical treatment of global cerebral ischemia–reperfusion injury.Specifically,we examine the effects of dopamine on post-injury cognition and neuronal plasticity,with the ultimate goal of identifying a new tool for clinical treatment.展开更多
文摘This study aimed to determine the effectiveness of comprehensive rehabilitation for patients with aneurysmal subarachnoid hemorrhage (aSAH) and to explore the factors influencing the prognosis of rehabilitation. This was a retrospective study. Twenty-five patients with aSAH were treated with physical therapy, occupational therapy, speech therapy, cognitive therapy, music therapy, Chinese acupuncture, hyperbaric oxygen, and transcranial magnetic stimulation. The general data of all patients were collected, and the functional scores at admission were compared with those at discharge. The Mini Mental State Examination, Fugl-Meyer Assessment Scale (FMAS) for motor and balance assessment, Holden Functional Ambulation Classification (FAC), modified Rankin Scale, National Institute of Health Stroke Scale, Modified Barthel Index for activities of daily living (ADL), and Glasgow Outcome Scale were significantly improved among 25 patients with aSAH after 1 month of comprehensive rehabilitation training. Hydrocephalus was an independent factor of the ability to perform ADLs (odds ratio, 0.29;95% confidence interval, 2.03. 3.15;p = 0.000). The improvement of ADLs in aSAH patients was not related to sex, surgical method, aneurysm location, age, or smoking status. Comprehensive and professional rehabilitation is effective for the cognition, movement, walking, ADLs, and functional prognosis of patients with aSAH, while early hydrocephalus may be a risk factor for poor ADLs.
文摘Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.
基金This study was supported by the National Natural Science Foundation of China(grant number:81100982)Central Public-Interest Scientific Institution Basal Research Fund(grant number:2018CZ-5).
文摘Global cerebral ischemia/hypoxia may occur due to various causes such as cardiac arrest,shock,and asphyxiation.Even though the patient’s life may be saved after cardiopulmonary resuscitation,cerebral ischemia– reperfusion injury is likely to occur and often results in neurological dysfunction.Apart from motor and speech impediments,patients with such injury may also suffer from impaired higher-level cognitive functions such as learning and memory,placing a heavy burden on families and society.Brain areas associated with the limbic system include the hippocampus,corpus striatum,and amygdala,which are linked with cognitive function.Those brain regions are easily damaged by hypoxia,and since they are connected with the dopaminergic pathway,global cerebral ischemia–reperfusion can damage the dopaminergic pathway as well and affect the projection of dopaminergic neurons in the limbic system.This review article examines the feasibility of using dopamine,a neurotransmitter heavily involved in cognitive function,in experimental research and clinical treatment of global cerebral ischemia–reperfusion injury.Specifically,we examine the effects of dopamine on post-injury cognition and neuronal plasticity,with the ultimate goal of identifying a new tool for clinical treatment.
