Impact of stage-specific limb function exercises guided by a selfmanagement education model on arteriovenous fistula maturation status

BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were presented and analyzed using the Wilcoxon rank sum test.RESULTS At the 8-wk postoperative mark,the observation group demonstrated significantly higher scores in AVF symptom recognition,symptom prevention,and self-management compared to the control group(P<0.05).However,the variance in symptom management scores between the observation and control groups lacked statistical signi-ficance(P>0.05).At 4 wk after the operation,the observation group displayed a superior vessel diameter and depth from the skin of the drainage vessels in comparison to the control group(P<0.05).While the observation group did manifest elevated blood flow rates in the drainage vessels relative to the control group,this distinction was not statistically significant(P>0.05).By the 8-wk postoperative interval,the observation group outperformed the control group with notable enhancements in blood flow rates,vessel diameter,and depth from the skin of drainage vessels(P<0.01).Seven days following the procedure,the observation group manifested significantly diminished limb swelling and an overall reduced complication rate in contrast to the control group(P<0.05).The evaluation of infection,thrombosis,embolism,arterial aneurysm stenosis,and incision bleeding showed no notable differences between the two groups(P>0.05).By the 4-wk postoperative juncture,complications between the observation and control groups were statistically indistinguishable(P>0.05).CONCLUSION Stage-specific limb function exercises,under the guidance of a self-management education model,amplify the capacity of AVF patients to discern and prevent symptoms.Additionally,they expedite AVF maturation and miti-gate postoperative limb edema,underscoring their efficacy as a valuable method for the care and upkeep of AVF in hemodialysis patients.

Effects of Video Combined with the Teach-Back Method on the Respiratory Function Exercise of Patients Undergoing Thoracotomy

Objective: To explore the effect of video combined with the teach-back method on respiratory function exercise in patients undergoing tumor thoracotomy. Methods: Eligible patients undergoing thoracotomy for tumor were selected from the thoracic surgery at a level-A tertiary hospital between August 2021 and December 2021 and included in the control group and the observation group (40 patients in each group). To prevent two groups of patients from interacting with each other, the thoracic surgery ward I was distinguished as the control group, which was adopted by the routine instruction. Based on routine instruction, the thoracic surgery ward II conducted respiratory function exercise instruction by video combined with the teach-back method to compare the two groups’ compliance with respiratory function exercise, complication rates, and patient satisfaction. Results: The patient compliance with respiratory function exercise in the observation group was significantly higher (P < 0.05) and the rate of pulmonary complications in the observation group was lower (P < 0.05) than that in the control group, while the observation group had a high level of satisfaction (P Conclusion: Taking video combined with the teach-back method, an effective health education method, can improve the compliance of the respiratory function exercise of patients undergoing thoracotomy for tumor and promote the recovery of pulmonary function to reduce the incidence of postoperative pulmonary complications so as to improve patient satisfaction.

Application effect of quality control circle in postoperative functional exercise compliance of breast neoplasms patients:a meta-analysis

Background:Good adherence to post-operative exercise is crucial for long-term exercise intervention programs aimed at improving compliance,motivation for functional exercise,and quality of life among breast cancer patients.This study aims to evaluate the application effect of quality control circles on postoperative functional exercise compliance in breast neoplasm patients.Methods:A comprehensive search was conducted in CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Web of Science and CINAHL databases from their establishment to May 06,2023.Manual search and backtracking of relevant literature were also conducted.The search terms included a combination of subject terms and free words.Meta-analysis was performed using RevMan 5.4 software on eligible literature.Results:Initially,517 papers were retrieved,and after removing duplicates 238 papers using NoteExpress software,279 titles and abstracts were reviewed.Subsequently,225 non-compliant papers were excluded,leaving 54 full texts to be read.After excluding 38 non-compliant papers,16 eligible papers were included for Meta-analysis.These papers comprised a total of 1,342 patients(679 in the test group and 663 in the control group).The heterogeneity test using a fixed effects model showed P=0.22 and I2=21%.The Meta-analysis results demonstrated that the implementation of quality control circles alongside usual care significantly improved compliance with postoperative functional exercise in breast cancer patients(odds ratio=6.68,95%confidence interval(4.97,8.98),P<0.00001).Conclusion:Quality control circles activities can effectively enhance compliance with post-operative functional exercise among breast cancer patients,aiding in the recovery of affected limb function,improvement of self-care ability,and early reintegration into society and normal life,thereby enhancing quality of life.It is important to continually accumulate experience in applying relevant quality control circles activities in clinical work and promptly enhance the level of care accordingly,as the functional exercise of breast cancer patients after surgery involves a long-term and gradual improvement process.

Application of Functional Exercise Nursing Plan Based on Evidence-based Nursing After Hip Replacement

Objective:To explore the effect of functional exercise nursing plan based on evidence-based nursing in patients after hip replacement.Methods:A total of 150 patients who underwent hip replacement in the orthopedic second ward of our hospital during the research period from January 2010 to January 2020 were selected as the research object.The random number expression method was applied to achieve grouping of patients.Among them,the control group received conventional rehabilitation treatment;the experimental group guided rehabilitation exercises according to the functional exercise nursing plan after hip replacement,and the rehabilitation conditions of the two groups were compared.Results:Compared with the patients in the control group,the bed time(7.45±2.10)days and average hospital stay(15.84±3.29)of the experimental group were relatively shorter.The incidence of complications in the experimental group and the control group was 6.67%and 16.00%,which are significantly different.The difference in Harris hip score before surgery was small,and the difference when discharge and after discharge was gradually increased,showing a better care effect in the experimental group.There was no significant difference in preoperative quality of life scores between the two groups before surgery(P>0.05).The life quality of the experimental group was significantly higher than that of the control group at discharge,1 month after discharge and 3 months after discharge,and showed most significantly after 3 months.Conclusion:The effect of functional exercise nursing plan based on evidence-based nursing in patients after hip replacement is remarkable,which can promote the recovery of patients,improve the quality of life,reduce the hospitalization time,reduce the incidence of postoperative complications,and has a positive significance in promoting clinical development in China.

Gait improvement after treadmill training in ischemic stroke survivors A critical review of functional MRI studies

Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.

Health Evaluation for Hypertensive Population Using Exercise Testing and Health-related Quality of Life Questionnaire

Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF and SP-16 questionnaire and exercise testing. 57 normotensive and 76 hypertensive subjects aged 35-65 year-old participated the health survey using this instrument. Based on the exercise testing results of the two groups, a discriminate function was established and used to investigate cardiovascular risk factors for hypertensive population. Results The results showed that persons with hypertension rated significantly lower scores on physical health (i.e. limitation in performing daily activities and problems with work or mobility) than did normotensives (P < 0.01). The discriminant score obtained from the exercise testing results was capable of reflecting the impacts of hypertension on CVFS. Conclusions The method presented in this paper provides a more powerful tool to estimate the effects of health interventions and medical therapy for hypertensive population than just self-rated HRQOL questionnaire.

A Retrospective Analysis of the Gluteal Muscles Contracture and Discussion of the Relative Problems

Summary: The operation methods, clinical classification, postoperative function exercise of gluteal muscles contracture were investigated. Clinically and retrospectively, treatment of 1280 patients with gluteal muscles contracture, being subjected to a 'Z-shaped' release lengthening operation and efficiency exercise, was clearly standardized. All the cases were followed up from 3 months to 2 years with the effective rate being 100 %, the cure rate being 98. 5 %, the recent complications being 5%, and the far complications being 0. 2 %. It was concluded that the clear diagnosis combined with standarized operation and efficiency functional exercise could greatly improve the therapeutic effects of gluteal muscles contracture.

Neural plasticity after spinal cord injury

Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have been studied, the mechanism and treatment to effectively improve neural plasticity changes remain controversial. The present study reviewed studies regarding plasticity of the central nervous system and methods for promoting plasticity to improve repair of injured central nerves. The results showed that synaptic reorganization, axonal sprouting, and neurogenesis are critical factors for neural circuit reconstruction. Directed functional exercise, neurotrophic factor and transplantation of nerve-derived and non-nerve-derived tissues and cells can effectively ameliorate functional disturbances caused by spinal cord injury and improve quality of life for patients.

Active Achilles tendon kinesitherapy accelerates Achilles tendon repair by promoting neurite regeneration

Active Achilles tendon kinesitherapy facilitates the functional recovery of a ruptured Achilles tendon However, protein expression during the healing process remains a controversial issue. New Zealand rabbits, aged 14 weeks, underwent tenotomy followed immediately byAchilles tendon microsurgery to repair the Achilles tendon rupture. The tendon was then immobilized or subjected to postoperative early motion treatment （kinesitherapy）. Mass spectrography results showed that after 14 days of motion treatment, 18 protein spots were differentially expressed, among which, 12 were up-regulated, consisting of gelsolin isoform b and neurite growth-related protein collapsing response mediator protein 2. Western blot analysis showed that gelsolin isoform b was up-regulated at days 7-21 of motion treatment. These findings suggest that active Achilles tendon kinesitherapy promotes the neurite regeneration of a ruptured Achilles tendon and gelsolin isoform b can be used as a biomarker for Achilles tendon healing after kinesitherapy.

Treatment of Severe Gluteal Muscle Contracture in Children

To investigate the efficacy of a combination therapy on gluteal muscle contracture, 286 definitely diagnosed patients were subjected to surgical treatment, and then functional exercises and physical therapy. The patients with severe symptoms were asked to have a set of specially-designed functional exercises. All the patients were followed up for 3 to 24 months by hospital visit, correspondence or telephone interview. The effective rate was 100%, and the curative rate was up to 94.6%. Few patients developed complications and relapse was rare. It is concluded that the combination therapy, including surgical removal of diseased tissues, functional exercises and physical therapy, is an effective approach for the treatment of severe juvenile gluteal muscle contracture.

Effect of feedback health education on postoperative rehabilitation of patients with lumbar disc herniation: a cluster randomised trials

Aims and objective:A theoretical model based on guided postoperative rehabilitation with feedback was developed for patients with lumbar intervertebral disc protrusion to explore the effects of feedback-based health education.Patients were assessed in terms of disease knowledge,general self-efficacy,medical behaviour,and the Oswestry disability index(ODI).During postoperative rehabilitation,nursing staff provided health education regarding lumbar intervertebral disc protrusion.Design:The CONSORT 2010 statement extension for cluster randomized trials checklist(Campbell et al.,2012)was used to guide reporting outcomes(File S1).Methods:The methods were based on previous research on the feedback method of health education.A cluster randomized controlled trial design was used.From March 2019 to January 2020,patients who underwent spinal surgery at a first-class tertiary hospital were enrolled,and 76 met the inclusion criteria for lumbar disc disease(lumbar disc herniation,LDH).Patients were divided into an experimental group and a control group,with 38 patients in each group.Feedback-based health education was conducted for the experimental group,and routine health education was provided for the control group.Disease knowledge,general self-efficacy,compliance behaviour,and ODI scores were compared between the two groups.The intervention effect was compared between groups by means of t tests.SPSS 23.0 was used for statistical analysis,and P<0.05 was considered statistically significant.The research was reported according to CONSORT statement.Results:1.Comparison of baseline data between the two groups before the intervention.Before the intervention,there was no statistically significant difference between the two groups in terms of general demographic data,disease-related data,disease knowledge,general self-efficacy,compliance behaviour,or ODI(P>0.05).2.Comparison of relevant indicators between the two groups of patients before and after the intervention.(1)One,four and 12 weeks after surgery,the disease knowledge,general self-efficacy and postoperative compliance behaviour of the experimental group were significantly higher than those of the control group(P<0.05).(2)At 1,4 and 12 weeks after surgery,the ODI of the experimental group was significantly lower than that of the control group(P<0.05).Conclusions:Feedback-based health education is conducive to improving disease knowledge,general self-efficacy and compliance behaviour and reducing ODI scores in patients with LDH.Relevance to clinical practice:This study provides nurses worldwide with a reference for health education during postoperative rehabilitation for lumbar disc herniation.

The Effect of an Acute Farmers Walk Exercise Bout on Muscle Damage and Recovery in Recreationally Trained Adults

Purpose The Farmer’s Walk(FW)may supplement resistance training through functional tasks like lifting and carrying weight over various distances.Minimal information exists concerning the intramuscular responses resulting from FW per-formance,possibly impacting its application in exercise prescription.Therefore,the purpose of the study was to investigate Creatine Kinase(CK)and myoglobin(Mb)responses following the Farmers Walk Condition(FWC)compared to a control protocol(NWC).Methods Fifteen participants(Mean±SEM;age:21.6±0.5 years;height:172.5±2.4 cm;body weight:81.8±4.0 kg)completed an initial session to measure body composition,lower body power,and strength.Participants then completed two counter-balanced exercise protocols consisting of a 20-m walk performed within 5 sets of 2 repetitions while either carrying weight(FWC;average wt:85.15±25.55 kg)or not(NWC)with collection of Visually Perceived Muscle Soreness(VPMS),Ratings of Perceived Exertion(RPE),and blood samples.VPMS,blood samples,and Countermovement Jump(CMJ)height were also collected during recovery from each exercise protocol with significance of P<0.05.Results Significant differences were observed between exercise protocols performed including participant RPE(P<0.01),CK(P=0.01),and overall,upper body,and lower body VPMS(P<0.05)post-FWC.No significant differences were noted for Mb or CMJ height.Conclusion Training variables implemented during the FWC may have indirectly minimized muscle damage and neuro-muscular inhibitions in performance.Although participants reported mild soreness,the negligible physiological damage suggests the FWC is a safe and appropriate functional movement exercise.