Study on the Effect of Repetitive Peripheral Magnetic Stimulation Combined with Conventional Rehabilitation Measures on Shoulder Dysfunction in Early Stroke

Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.

Exploring Factors in the Systematic Use of Outcome Measures: A Multi-Disciplinary Rehabilitation Team Perspective

Purpose: The implementation of routine outcome measurement was initiated as a quality improvement initiative in a unit delivering intensive functional rehabilitation for people with lower limb amputation. Two years post-implementation, completion rates remained low which raised the need to gain an indepth understanding of the factors that might impact the systematic use of Outcome Measures (OMs). Method: A qualitative exploratory study embedded in the ongoing quality improvement initiative was designed. Data were gathered through a focus group with members of a multidisciplinary rehabilitation team. A deductive content analysis was performed using Consolidated Framework for Implementation Research (CFIR) as a guide to explore factors that impact routine outcome measurement. Results: Respondents perceived OMs as valid and offering clear advantages in clinical practice. At the organizational level, lack of fit with clinical practice, loss of project leaders and lack of clear management directives had negative repercussions on the use of OMs. Conclusion: Our results suggest that a dedicated project leader throughout the implementation process and effective communication may contribute to bypassing barriers associated to practice changes leading to a more systematic use of OMs among clinicians.

Measuring 3D face deformations from RGB images of expression rehabilitation exercises

Background The accurate(quantitative)analysis of 3D face deformation is a problem of increasing interest in many applications.In particular,defining a 3D model of the face deformation into a 2D target image to capture local and asymmetric deformations remains a challenge in existing literature.A measure of such local deformations may be a relevant index for monitoring the rehabilitation exercises of patients suffering from Par-kinson’s or Alzheimer’s disease or those recovering from a stroke.Methods In this paper,a complete framework that allows the construction of a 3D morphable shape model(3DMM)of the face is presented for fitting to a target RGB image.The model has the specific characteristic of being based on localized components of deformation.The fitting transformation is performed from 3D to 2D and guided by the correspondence between landmarks detected in the target image and those manually annotated on the average 3DMM.The fitting also has the distinction of being performed in two steps to disentangle face deformations related to the identity of the target subject from those induced by facial actions.Results The method was experimentally validated using the MICC-3D dataset,which includes 11 subjects.Each subject was imaged in one neutral pose and while performing 18 facial actions that deform the face in localized and asymmetric ways.For each acquisition,3DMM was fit to an RGB frame whereby,from the apex facial action and the neutral frame,the extent of the deformation was computed.The results indicate that the proposed approach can accurately capture face deformation,even localized and asymmetric deformations.Conclusion The proposed framework demonstrated that it is possible to measure deformations of a reconstructed 3D face model to monitor facial actions performed in response to a set of targets.Interestingly,these results were obtained using only RGB targets,without the need for 3D scans captured with costly devices.This paves the way for the use of the proposed tool in remote medical rehabilitation monitoring.

The Need and Its Influence Factors for Community-based Rehabilitation Services for Disabled Persons in One District in Beijing

Purpose To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. Method One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Results Of the interviewees, 57A% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost （P〈0.05）, knowledge about rehabilitation medicine （P〈0.05）; and the belief in the therapeutic benefit of the community-based rehabilitation service （P〈0.05）. Conclusion A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.

Monitoring recovery by physical therapists using the FIM scale during rehabilitation programs: An inter-rater and intra-rater reproducibility study

Our aim was to evaluate the reproducibility of the Functional Independence Measure (FIM) scale when assessed by physical therapists in the routine setting of a Rehabilitation Hospital. We included a consecutive series of patients with spinal cord or cerebral lesions. Each of the 50 selected patients was evaluated by two of the 5 experienced physical therapists participating in the study. The degree of inter-rater and intrarater agreement was measured by a weighted k statistic, k for perfect agreement, and k for the agreement with tolerance. The weighted k index for inter-rater agreement on the FIM score was in the almost perfect range (k 0.87;95% CI = 0.79 - 0.95), but a 20-point tolerance was necessary to reach a k value of 0.81 (95% CI = 0.66 - 0.95). Agreement was substantial or almost perfect for most subscales, but the k index with 1-point tolerance reached the almost perfect rating for comprehension only. For intra-rater agreement, weighted k index was in the almost perfect range for the FIM score and for all subscales;kappa index reached the almost perfect range with a 4-point tolerance for FIM score and with 1-point of tolerance for all subscales except interpersonal relations. FIM is useful to monitor patient improvement during rehabilitation treatment, mostly when assessed by the same physical therapist.

Functional outcomes after home-based rehabilitation for heroin-induced spongiform leukoencephalopathy

A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments. Activities of daily living were measured using the Functional Independence Measure at discharge and at 6, 12, and 24 months after discharge. His neurological symptoms gradually disappeared with rehabilitative treatment, and the functional scale scores increased from 55 on admission to 105 at 24 months after discharge. These results suggest that home-based rehabilitation was effective in ameliorating the pathology and improving activities of daily living in this patient with heroin-induced spongiform leukoencephalopathy.

Assessment of Persistence Symptoms in Recovered COVID-19 Patients by Yorkshire Rehabilitation Scale (C19‐YRS): A Cross-Sectional Study from Qassim Region, Saudi Arabia

Background: Earlier back at the beginning of COVID-19, the acute phase of infection was variable from one patient to another causing different symptoms. However, many patients are still suffering from Post COVID-19 Syndrome. Hence, this study aimed to assess the persistence of symptoms in patients who recovered from COVID-19 in the Qassim Region, Saudi Arabia. Methodology: A descriptive cross-sectional study of 413 confirmed PCR test-positive covid-19 patients enrolled in this study from the Ministry of Health Electronic Surveillance System (HESN). The Yorkshire Rehabilitation Scale (C19-YRS) checklist was used to record patients’ symptoms, functioning, and disability. Data were analyzed by the SPSS program. Functional and patient-reported outcome measures were correlated with certain items from C19-YRS, the severity of symptoms. Its distribution-based methods were used for responsiveness over time. The scaling and targeting assumptions were satisfied, and internal consistency was high (Cronbach’s α = 0.843). Results: After 4 weeks of infection, 50% of patients reported persistent symptoms such as laryngeal complications, 43.8% Swallowing changes, 31.3% fatigue, 18.8% pain, 18.8% loss of appetite, 12.5% breathlessness, and 6.3% depression, Moreover, 18.8% of patients experienced reduced mobility. At the beginning of the COVID-19 infection, fever was the most common complaint 332 (80.4%), followed by 267 (64.6%) fatigue, and loss of smell 230 (55.7%). The severity of the breathlessness symptoms was exaggerated during the patients’ walking or climbing stairs. Patients who were admitted to an intensive care unit (n = 5) were significantly elderly (P Conclusion: The study examined the severity of post covid syndrome by patients’ responsiveness to the scale items in C19-YRS. The majority of COVID-19 symptoms were still present but significantly reduced after 4 weeks of infection. Follow-up and long-term management of physical and psychological symptoms of hospitalized and non-hospitalized patients are very important.

Rehabilitation Soils with Date Palm Mulching Treatments

Kuwait is located in hyper arid desert environment. This geographical location and irrational human activities accelerate the expansion of land degradation problem. In order to rehabilitate the degraded areas it is necessary to use soil and water resources in sustainable manner. Owing to these reasons it is essential to use appropriate methods based on the scientific diagnostics of the problem. It is compulsory to identify, specify and test different efficient, cost-effective and environment friendly sound sustainable sand control measures such as, semi-circular bunds, square micro catchment and checker board palm leaves to rehabilitate degraded lands in Liyah refilled quarries. To evaluate the impact of rehabilitation method through mulching with date palm leaves soil samples were collected （control and rehabilitation sites with square micro catchment） prior to the implementation plan and post completion of the project （three years）. In this study will be highlighted on detail the results of using square micro catchment and with short brief descriptions on other water harvesting techniques. The results showed an improvement of physical soil properties after the application of these techniques. Soil fertility increased through increasing the quantity of fine and very fine sand. The soil moisture at the surface soil increased from 0.085% to 1.62% after the treatment. The untreated soil has high bulk density about 2 g/cm3 and low porosity about 27%. However, after the soil was ploughed and mulched the bulk density decreased to 0.03 g/cm3. And porosity improved 98%. This study conserved the irrigation water through reducing the proportion of soil evaporation, in addition to the creation of optimum condition for plant growth. The aim of this study was to analyze the effect of using organic mulch date palm leaves with water harvesting techniques on the physical and biological properties of degraded soil in Liyah area.

“互联网+”延续性康复训练综合干预模式的构建及在抑郁症患者中的实证研究

目的:探讨“互联网+”延续性康复训练综合干预模式的构建对抑郁症患者干预效果。方法:采用随机对照试验研究,以2022年6月至2023年6月选取符合诊断抑郁症患者110例,随机分为试验组和等待对照组,等待对照组采用药物治疗、每月复查和电话随访,试验组在等待对照组的基础上采用“互联网+”药物自我管理训练、舞动训练和社交技能训练。采用汉密顿抑郁量表(HAMD)、抑郁自评量表(SDS)、社交技能评定目录(SSC)社会适应功能评估量表(SAFE)比较干预前及干预2、4、6月后两组患者抑郁程度、社交能力和社会适应的差异。采用重复测量方差分析对不同时间点两组患者进行干预效果比较。结果:干预前两组HAMD、SDS、SSC、SAFE评分比较,差异无统计学意义(P>0.05);干预后组间与时间对HAMD、SDS、SSC、SAFE评分有交互作用(F=4.400,13.085,23.841,41.777;P<0.001),组间对HAMD、SDS、SSC、SAFE评分主效应显著(F=4040.373,3522.972,16452.039,151.544;P<0.001),时间对HAMD、SDS、SSC、SAFE评分主效应显著(F=69.345,100.620,69.874,221.385;P<0.001)。简单效应分析显示,试验组、等待对照组组内前后HAMD、SDS、SSC、SAFE评分比较,差异有统计学意义(t=-4.142,-6.313,-7.811,-18.903;P<0.008)。结论:“互联网+”延续性康复训练综合干预模式能减轻抑郁症患者抑郁程度,增强患者的社交能力,提高患者的社会适应水平。

灌区现代化发展实施路径与保障措施

灌区是保障国家粮食安全的重要基础。基于相对完备的工程设施和良好的灌溉排水条件,灌区粮食生产能力明显高于全国平均水平,成为我国粮食生产的“主力军”和粮食安全的“压舱石”。确保国家粮食安全、实现农业现代化、推进乡村全面振兴和推进中国式现代化等国家战略的深入实施,对灌区高质量发展提出了更多、更新、更高要求。相较之下,灌区发展仍存在基础设施建设滞后、运行管理短板明显、创新驱动能力不足等问题,灌区现代化建设与改造需求日益迫切,系统研究、全面推进灌区现代化建设与改造迫在眉睫。基于保障国家粮食安全、支撑服务农业现代化、保障国家水安全、发展农业经营新模式、实现灌区高质量发展等需求,提出树立现代化灌区建设管理理念、提升灌区规划设计建设标准、加快配套完善工程基础设施、改革完善运行管理体制机制、加强科技创新与新技术应用等灌区现代化建设与改造实施路径,并提出做好顶层设计、完善政策供给、加强示范引导、强化跟踪指导等保障措施。

烧伤后关节功能障碍的康复措施应用进展

烧伤是常见的意外事故损伤,可导致烧伤周围关节、烧伤周边组织、周边皮肤发生功能性损伤。其中关节功能损伤会形成不同程度的功能障碍,使患者日常生活受限,如关节活动范围缩小、关节平衡力下降等。近年来的研究显示烧伤后关节功能损伤采用积极的康复措施对关节功能改善有重要意义,因此临床开展各种类型的康复措施,以期帮助患者改善烧伤后关节功能障碍。本文现对近年来临床应用的康复措施进行总结,旨在提升烧伤后关节功能恢复水平。

脑卒中患者康复动机的研究进展

从脑卒中患者康复动机概念、测量工具、影响因素(包括社会人口学因素、疾病因素、社会心理因素、康复服务因素)和干预措施方面综述研究进展,以期为开展脑卒中患者康复动机的相关研究提供参考。

3D打印偏颌测量仪的研制及在偏颌患者康复期的应用效果

目的:研制3D打印偏颌测量仪,初步探索其在偏颌患者康复期的应用效果。方法:选择2021年7月—2022年12月上海交通大学医学院附属第九人民医院收治的偏颌患者20例,通过数字随机表法分为试验组(n=10)和对照组(n=10)。试验组在围术期及康复期均使用3D偏颌测量仪,对照组在围术期及康复期均使用常规测量方法。比较2组在疼痛、语言清晰度、咀嚼功能、相关生活质量方面的差异。采用SPSS 24.0软件包对数据进行统计学分析。结果:术后1、3、6个月,试验组疼痛VAS评分显著低于对照组(P<0.001),咬合力评分和语言清晰度显著高于对照组(P<0.001);试验组术后1、3、6个月的正颌健康相关生活质量问卷(OQLQ)评分显著高于对照组(P<0.05)。结论:3D打印偏颌测量仪能个体化、可视化地帮助医护患三方准确测量患者的偏颌程度,解决了传统测量方法的烦琐性和主观性等问题;可改善患者的疼痛及语言清晰度,减少并发症发生,减轻临床工作量,增强患者对康复训练的信心和行为,美化患者外观,促进功能恢复,提高生活质量,值得在临床上推广使用。

肌少症性吞咽障碍康复护理研究进展

从肌少症性吞咽障碍现状、诊断、影响因素、康复护理措施4个方面综述肌少症性吞咽障碍国内外研究进展,为其深入研究提供借鉴。

重型颅脑损伤患者术后肢体运动功能恢复的相关影响因素及康复措施

目的分析重型颅脑损伤(SCI)患者术后肢体运动功能恢复的相关影响因素及康复措施。方法回顾性选取2021年3月至2023年3月该院神经外科收治的86例SCI患者的临床资料。所有患者均接受标准去骨瓣减压术治疗及术后肢体运动功能康复训练。经单因素、logistic回归分析找出影响SCI患者术后肢体运动功能恢复的危险因素,并分析康复训练对患者肢体功能改善的应用价值。结果经单因素分析,两组年龄、格拉斯哥昏迷(GCS)评分、运动功能区损伤、脑疝、康复治疗介入时间、意识障碍时间比较,差异均有统计学意义(P<0.05);经logistic回归分析得出,年龄≥50岁、GCS评分3~5分、运动功能区损伤、脑疝、意识障碍时间>10 d均为SCI患者术后发生肢体运动功能障碍的危险因素(P<0.05),康复治疗介入时间≤30 d为SCI患者术后发生肢体运动功能障碍的保护因素(P<0.05)。干预后,8例患者肢体运动功能恢复正常,明显肢体运动功能障碍患者较干预前降低,差异有统计学意义(P<0.05),干预前后,轻度、中度、重度肢体功能障碍患者比较,差异均无统计学意义(P>0.05)。结论年龄≥50岁、GCS评分3~5分、运动功能区损伤、脑疝、意识障碍时间>10 d均为SCI患者术后发生肢体运动功能障碍的危险因素,术后应尽早采取康复措施,有利于术后肢体运动功能恢复。

康复机器人辅助治疗对脑性瘫痪运动功能影响的系统评价及Meta分析

目的:系统评价康复机器人辅助治疗对脑性瘫痪患者运动功能和平衡功能以及基本日常生活能力的影响。方法:使用计算机全面检索各大中外文数据库,纳入康复机器人辅助治疗脑性瘫痪的随机对照试验,对符合纳入标准的文献进行数据提取,采用Cochrane系统评价员手册5.0版进行质量评价,采用Revman 5.4统计软件进行Meta分析。结果:共纳入12项随机对照试验,合计797例患者。Meta分析结果显示,与传统康复治疗方法相比,康复机器人辅助治疗能显著提高脑性瘫痪的平衡功能(SMD=0.67,95%CI0.16~1.18,P=0.010),并能显著提高脑瘫患者粗大运动功能测试量表-D区评分(SMD=0.70,95%CI 0.28~1.12,P=0.001)和E区评分(SMD=0.50,95%CI 0.26~0.75,P<0.0001),以及基本日常生活能力(MD=8.77,95%CI 2.64~14.89,P=0.005)。结论:康复机器人辅助治疗同传统的康复治疗方法相比,能显著提高脑性瘫痪患者的平衡性评分、运动功能评分及基本日常生活能力。

Item-Level Analysis of the Revised Occupational Therapy Fieldwork Performance Evaluation Applied in Practice

Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.

半月板损伤患者的运动恐惧现状及相关危险因素分析

目的探究半月板损伤患者的运动恐惧现状,并分析其相关危险因素.方法选择福建省立医院收治的108例半月板损伤患者为研究对象,采用坦帕运动恐惧量表评估运动恐惧症水平,采用视觉模拟评分法评估疼痛强度,使用磁共振成像(MRI)评估患者半月板的损伤程度.经单因素分析、多因素Logistic回归分析研究半月板损伤患者运动恐惧心理的危险因素.结果65例半月板损伤患者出现运动恐惧心理,患者疼痛程度高、损伤程度Ⅲ度是造成半月板损伤患者运动恐惧的危险因素(P﹤0.05).结论半月板损伤患者存在运动恐惧症这一问题值得关注,半月板损伤患者受疼痛强度、损伤程度等因素影响,易出现运动恐惧心理,在临床治疗中需要密切监测患者的运动恐惧心理及其危险因素,并将其纳入半月板损伤患者的康复计划中,提升患者的运动依从性,以最大限度地促进患者康复.

中药熏蒸疼痛干预结合路径式康复措施对微创治疗腰椎间盘突出症术后患者VAS评分与康复效果的影响

目的分析中药熏蒸疼痛干预结合路径式康复措施对微创治疗腰椎间盘突出症术后患者视觉模拟评分法(VAS)评分与康复效果的影响。方法选取2022年6月至2023年9月接受脊柱内镜下髓核摘除术的腰椎间盘突出症126例,随机分为对照组(n=63)、观察组(n=63),在常规干预基础上,对照组采用中药熏蒸疼痛干预,观察组采用中药熏蒸疼痛干预结合路径式康复措施。比较2组腰痛VAS评分、腰椎功能、健康状况调查简表(SF-36)评分及不良反应发生率。结果干预后,观察组腰痛VAS评分、Oswestry功能障碍指数评分低于对照组,日本骨科协会评分及不同维度SF-36评分高于对照组(P<0.05,P<0.01)。观察组不良反应发生率低于对照组(P<0.05)。结论微创治疗腰椎间盘突出症术后患者应用中药熏蒸疼痛干预结合路径式康复措施,可行性良好,能有效减轻腰痛症状,提升腰椎功能及生活质量。

系统性阶梯式康复干预措施对硬膜外血肿术后患者的影响

目的:探讨系统性阶梯式康复干预措施对硬膜外血肿术后患者的影响。方法:选取2021年6月—2023年1月南华大学附属第二医院收治的112例硬膜外血肿术后患者。根据随机数表法将其分为试验组和参照组,各56例。参照组采用常规康复护理措施,试验组在对照组基础上给予系统性阶梯式康复干预措施。比较两组恢复情况,干预前后的神经功能及日常生活能力,预后情况及干预满意度,并发症。结果:试验组术后引流时间、抗生素应用时间和住院时间均短于参照组,差异有统计学意义(P<0.05)。干预后,两组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分降低,Barthel指数升高,试验组NIHSS评分低于参照组,Barthel指数高于参照组,差异有统计学意义(P<0.05)。试验组格拉斯哥预后评分量表(Glasgow outcome scale,GOS)评分和干预满意度评分均高于参照组,差异有统计学意义(P<0.05)。试验组并发症发生率低于参照组,差异有统计学意义(P<0.05)。结论:系统性阶梯式康复干预措施可促进硬膜外血肿术后患者康复,缩短引流时间和住院时间,改善神经功能和日常生活能力,减少并发症。