Integrated medical rehabilitation delivery in China

Currently, China has a growing need for rehabilitative care;however, rehabilitative care has been underdeveloped for decades. Since the end of 2010, pilot programs in 46 cities (districts) of 14 provinces have been initiated by the Ministry of Health in China to establish formal arrangements for facilitating the delivery of continuous medical rehabilitative care for local communities. After 2 years of pilot work, an evaluation was conducted by researchers. This paper reviews the current status of rehabilitative care in China and discusses the findings of the nationwide pilot program on the integrated rehabilitative service. Some key mechanisms and main issues were identified after analyzing the preliminary outcomes of some of the pilot programs.

The elderly problems and countermeasures of exploring rehabilitation medical services

with the rising proportion of our aging population, the prevalence of chronic diseases in the elderly has increased, but most of the elderly body aging, action inconvenience, self-care ability is poor, become the thorny problem for the treatment of chronic diseases.Medical rehabilitation is a effective way to improve the sick old man body health.But with an aging that meet the needs of the elderly health service system in the aspect of construction and rehabilitation medical resources configuration, there are still some problems to be solved. In this article, through analyzing problems existing in the old medical service recovery to further explore its countermeasures.

The application of integrated medical and nursing rehabilitation in the management of patients with chronic heart failure and diabetes

Background At present,patients with chronic heart failure complicated with diabetes are often treated with drugs in clinical practice.Most patients cannot adhere to regular and quantitative medication for a long time,and their poor compliance has adverse effects on their rehabilitation.The aim of this study was to explore the application effects of integrated medical and nursing rehabilitation in the management of patients with chronic heart failure and diabetes.Methods A total of 75 patients with chronic heart failure and diabetes,admitted to our center from May 2020 to May 2023,were randomly divided into Group A(n=38)and Group B(n=37)using a random number table.Group A received integrated rehabilitation management,while Group B received conventional rehabilitation management.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),fasting blood glucose(FBG),2-hour postprandial blood glucose(2h PG),glycated hemoglobin(Hb Alc),and self-care ability were compared between the two groups before and after intervention.Results After intervention,the LVEDD and LVESD in both groups were lower than before,while LVEF was higher than before(P<0.05).The LVEDD and LVESD in Group A were lower than in Group B after intervention,while LVEF was higher than in Group B(P<0.05).After intervention,the levels of FBG,2h PG,Hb Alc,and the scores of the European Heart Failure Self-care Behavior Scale(EHFSc B-9)in both groups decreased,with Group A being lower than Group B(P<0.05).Conclusions Integrated medical and nursing rehabilitation can effectively improve the cardiac function and blood glucose levels of patients with chronic heart failure and diabetes,control the patients’condition,and enhance their quality of life and self-care ability.[S Chin J Cardiol 2024;25(1):44-49]

Implementation of a Return to Work Strategy in Germany—Are There Changes in Work-Related Rehabilitation Measures and Employment Status in Chronic Conditions?

Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.

THE WAY WALKED WITH CHILDREN： MEDICAL TREATMENT AND REHABILITATION

Due to obstacles in expression and communication, as well as a societal lack of humanitarian spirit and deficiencies in system design, children with intellectual disabilities are confronted with various problems when seeking medical treatment. The dilemma of medical treatment seriously restricts the survival and development of disabled groups. By reviewing the way in which a mother accompanied her disabled child for 28 years together, this article analyzed the reasons for the dilemmas of medical treatment, and appealed to improve the living conditions of persons with intellectual disabilities to guarantee their rights for rehabilitation. In addition, by introducing the recreational and sports activities that parents＇ spontaneous organization created for children with intellectual disabilities, it put forward the proposal to prevent in advance the possible deterioration of conditions caused by social isolation, which is definitely a preferable remedy for persons with disabilities.

OCULO-ACUPUNCTURE TREATMENT OF CEREBRAL INFARCTION INDUCED HEMIPLEGIA

Objective: To observe the therapeutic effect of oculo acupuncture therapy in the treatment of cerebral infarction induced hemiplegia. Methods: 58 cases of stroke patients were randomly divided into treatment group (n=30) and control group (n=28). In treatment group, on the basis of medication plus rehabilitation treatment, patients voluntarily accepted oculo acupuncture therapy (acupuncture of Upper Jiao Area and Lower Jiao Area). In control group, patients only accepted medication and rehabilitation treatment. The therapeutic effect was evaluated with Brunstrom’s 6 stages Assessing Method. Results: After 24 sessions of treatment, the ratios of the diseased limbs reaching stage VI and more in functional activity in the patients of treatment group increased from 16.7% (upper limb) and 20.0% (lower limb) before treatment to 70.0% and 90.0% respectively; while in control group, those ratios of the upper and lower limbs increased from 10.7% and 28.6% before treatment to 39.2% and 60.7% separately. There was a significant difference between two groups in the therapeutic effect (P<0.05). Conclusion: Oculo acupuncture plus medication is superior to simple medication treatment in improving functional activity of the hemiplegic limbs.