医疗社会工作介入干预对老年痴呆患者日常生活能力和认知能力的影响

目的：探讨医疗社会工作介入干预对老年痴呆患者日常生活能力以及认知能力的影响。方法：将我院2015年4月～2016年8月收治的老年痴呆患者80例随机等分为对照组和观察组，对照组予以常规护理以及康复训练，观察组同时予以医疗社会工作介入干预。比较两组干预效果。结果：观察组干预后Barthel指数评分均高于对照组（P〈O．05），认知能力评分均低于对照组（P〈0．05）。结论：针对老年痴呆患者实施医疗社会工作介入干预，可以产生明显的效果，能够有效提升患者的日常生活能力以及认知能力水平，值得推广应用。

家属资源中心对慢性精神分裂症患者日常生活能力影响观察

目的:了解家属资源中心康复训练对慢性分裂症患者日常生活能力的影响。方法:对36例符合CCMD-3精神分裂症诊断标准,病程超过5年,2001年10月-2004年6月在我院住院,住院期间曾接受过职业康复训练3个月或以上,出院后参加家属资源中心活动、病情稳定的分裂症患者。使用阳性阴性症状量表(PANSS)、日常生活能力量表(ADL)为评定工具。结果:经过家属资源中心工作人员培训指导的患者日常社会生活能力明显提高,精神症状得到一定控制,待人接物,克服困难能力有一定提高,服药依从性有效地提高,独立生活自理能力明显提高,人际交往能力得到锻炼,社会功能基本接近正常,日常生活能力量表总分比出院时明显下降由16.88±3.57降低至14.66±2.03(P<0.05)。结论:家属资源中心的康复训练能有效地巩固经接受过职业康复的精神病患者面向环境挑战信心,增强社会适应能力,促进社会生活正常化。

早期康复治疗对脑卒中偏瘫患者肢体功能及日常生活能力的影响

目的:探讨早期康复治疗对脑卒中偏瘫患者肢体功能及日常生活能力的影响。方法:纳入我院88例2017年7月-2018年9月脑卒中偏瘫患者。随机数字表分组,对照组采取常规康复治疗,观察组则采取早期康复治疗。比较对照组、观察组效果;偏瘫肢体功能改善的时间、日常生活能力改善的时间;治疗前后患者偏瘫肢体功能评分、日常生活能力的评分;副反应。结果:观察组偏瘫肢体功能改善的时间、日常生活能力改善的时间、偏瘫肢体功能评分、日常生活能力的评分相比较常规康复治疗组更好,P<0.05。观察组副反应和常规康复治疗组无明显差异,P>0.05。结论:早期康复治疗脑卒中偏瘫的效果理想。

脑卒中康复过程中心理因素的探讨

探讨了脑卒中康复治疗与生物－ 心理－社会模式的关系，ＡＤＬ评估中的心理因素， 一对一治疗模式中的心理因素，康复心理的实施四个问题。

康复护理应用于脑卒中患者的效果观察

目的探讨康复护理应用于脑卒中患者的临床效果及意义。方法将120例脑卒中患者随机分为观察组和对照组各60例，对照组给予神经内科一般常规护理，观察组在常规护理的基础上实施康复护理干预。观察并比较两组患者ADL恢复情况。结果两组患者在治疗后ADL均有明显恢复，但观察组恢复效果更为明显，两组治疗后MBI评分比较（P〈0.05）有统计学意义。结论康复护理对改善脑卒中患者的ADL情况及减少并发症有重要意义。

Multi-dimensional frailty and its risk factors among older residents in long-term care facilities in Shanghai,China

Objectives:The integrated model of frailty shifted the physiologically-dominated view to an integrated and multidisciplinary view of frailty and adopted an integrated and holistic approach to the complex challenges facing frail older adults and their caregivers.There is an urgent need for researchers to identify multi-faceted frailty among older adults and to explore contributors to it.We assessed the level of frailty among older residents in long-term care(LTC)facilities in Shanghai,China and explored risk factors of multiple dimensions of frailty among older residents.Methods:It is a cross-sectional descriptive study.We interviewed 218 older residents from nine LTC facilities.We used Tilburg Frailty Indicator to assess older residents’physiological,psychological,and social frailty.The Geriatric Depression Scale,Mini-Mental state examination,Athens Insomnia Scale,and Activity of Daily Living(ADL)Scale were used to assess their depressive symptoms,cognitive function,sleep quality and ADL abilities,respectively.Results:Older residents have a moderate level of frailty in physiological,psychological and social domains.There is a high correlation among dimensions of frailty.Older residents’depressive symptoms have remained positively associated with their overall and each domain of frailty.Older residents’actual activity participation and exercise in LTC facilities are negatively associated with older residents’overall,physiological and social frailty.Conclusions:Frailty is a multi-dimensional concept and is prevalent among older residents in LTC facilities.It is important to take an integrated view on frailty and carry out appropriate and comprehensive interventions to prevent adverse outcomes and provide holistic care for frail older residents in LTC facilities.There is an urgent need to improve the quality and expand the number of activities offered within LTC facilities that would engage older residents in a person-centered way,despite their age,ADL abilities,frailty and functional limitations.

PREVENTION OF DISABILITY AND REHABILITATION──RESULTS FROM A COLLABORATIVE PROJECT IN CHINA

Eight different geographical districts in China varying in urban and rural characteristics from 6 provinces and 2 municipalities were selected as pilot areas of the project.The interventions included early detection and treatment of neuritis,self-care training,adapted footwear,surgery,comprehensive treatment of complicated ulcers,and prostheses.Main changes in eye,hand and foot impairments between baseline assessment and assessment at 2 years have been presented in this paper.

Effect of governor vessel-regulating needling combined with rehabilitation training on the activities of daily living of patients with cerebral infarction

Objective To observe the difference in efficacy between governor vessel- regulating needling and conventional acupuncture, and to summarize the clinical efficacy and application rules of governor vessel-regulating needling. Methods Ninety patients with cerebral infarction were randomly divided into 2 groups with 45 cases in each group. Governor vessel-regulating needling combined with rehabilitation training were applied in governor vessel- regulating needling group （observation group）, and conventional acupuncture combined with rehabilitation training were applied in conventional acupuncture group （control group）. Modified Barthel index （MBI）, FugI-Meyer assessment （FMA） and neurological deficit scale （NDS） were adopted to assess the treatment efficacy in the two groups before treatment, after treatment for 2 weeks, and after treatment for 4 weeks, respectively. Results After treatment for 2 weeks, MBI and FMA increased significantly in both groups when compared with the results before treatment （all P〈0.01）, NDS reduced significantly in both groups when compared with the results before treatment （both P〈0.01）, and there was no significant difference in MBI, FMA and NDS between two groups （all P〉0.05）; after treatment for 4 weeks, MBI and FMA in observation group were significantly higher than those in control group （both P〈0.05）, and NDS was significantly lower than that in control group （P〈0.05）. Conclusion Compared with conventional acupuncture, governor vessel- regulating needling can significantly improve the activities of daily living of patients with cerebral infarction.

Clinical Study on Acupuncture Effect for Spastic Paralysis Following Cerebrovascular Disease

Objective： To investigate the acupuncture effect for post-apoplectic spasticity. Methods： Modified Ashworth spasticity rating, Brunnstrom grades, Barthel ADL （Activity of Daily Living） indexes were employed to assess the spasticity, motor function and activities of daily living （ADL）, and thus observe the effect of combined scalp and body acupuncture for post-apoplectic hemiplegic patients. Results： Combined scalp and body acupuncture can obtain significantly better effects than body acupuncture alone in relieving spasticity and improving the patients＇ motor function and ADL （P〈0.01）. Conclusion： Combined scalp and body acupuncture has a distinct advantage in relieving spasticity and can improve the patients＇ motor function and ADL.

Therapeutic efficacy and mechanism of heat-sensitive moxibustion for vascular dementia

Objective:To observe the clinical efficacy of heat-sensitive moxibustion for vascular dementia and explore its mechanism.Methods:A total of 70 patients with vascular dementia were randomized into an observation group and a control group,with 35 cases in each group.The control group was treated with piracetam,and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment of the control group.The treatment lasted for 8 weeks.Before and after the treatment,the mini-mental state examination(MMSE),activity of daily living(ADL)and traditional Chinese medicine(TCM)symptom scores were assessed,and the levels of acetyl choline(Ach)and homocysteine(Hcy)were measured.The efficacy was evaluated after treatment.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the MMSE and ADL scores in the observation group decreased significantly,and were lower than those in the control group(all P<0.05);the TCM symptom score of the observation group decreased significantly(P<0.05),while that of the control group had no significant change(P>0.05);the plasma Ach level in the observation group increased significantly(P<0.05),and the Hcy level decreased significantly(P<0.05),which were statistically different from those in the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus piracetam is effective in treating vascular dementia.It can significantly improve dementia symptoms and ADL,which may be related to the correction of plasma Ach and Hcy levels.

Clinical Observation on Fu’s Subcutaneous Needling plus Electroacupuncture for Post-stroke Spastic Hemiplegia

Objective： To observe the clinical effect of Fu’s subcutaneous needling plus electroacupuncture on post-stroke spastic hemiplegia. Methods： A hundred and twenty patients with post-stroke spastic hemiplegia were divided into the treatment group and the control group randomly, 60 individuals in each group. Patients in the treatment group received Fu’s subcutaneous needling plus electroacupuncture treatments, while only elecroacupuncture treatment for those in the control group. Limbs spasticity, extremity motor function and activity of daily living （ADL） was respectively evaluated with Ashworth scale, simplified Fugl-Meyer motor function score and modified Barthel index （BI） before treatment and after 30-day treatment. Results： After treatment, Ashworth scale score, Fugl-Meyer motor function score and BI score in the treatment group were much higher than those in the control group （P0.05）. Fu’s subcutaneous needling plus electroacupuncture can release spastic hemiplegia, and it is better than the control group. Conclusion： Fu’s subcutaneous needling plus electroacupuncture can release post-stroke spastic hemiplegia effectively.

Effect of Acupuncture on Functional Reconstruction of the Wrist Following Cerebral Apoplexy

Objective： To observe the effect of needling different points on functional reconstruction of wrist following cerebral apoplexy. Methods： Forty apoplexy cases were randomly allocated into four groups, 10 in each. Cases in group A were treated by needling the extensor muscle motor points. Cases in group B were treated by needling alternating extensor-flexor muscle motor points. Cases in group C were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10） and Waiguan （TE 5）. Cases in group D were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10）, Waiguan （TE 5）, Chize （LU 5） and Neiguan （PC 6）. The motor functions of affected upper limbs were evaluated on the surface electromyography （SEMG）, Fugl-Meyer function scale and Barthel ADL （Activities of Daily Living） indexes. Results： Needling alternating extensor-flexor muscle motor points can significantly increase the peak value （MAX） of the upper limb SEMQ integrated electromyogram （IEMG）, Fugl-Meyer motor function value and Barthel ADL indexes. Conclusion： Needling different points may produce different effects on wrist function following cerebral apoplexy. Needling alternating extensor-flexor muscle motor points can obtain an exact treatment effect.

Therapeutic Efficacy Observation on Acupuncture plus Medication for Rheumatoid Arthritis

Objective： To observe the clinical efficacy of acupuncture plus medication for rheumatic arthritis （RA）. Methods： A total of 80 RA cases were randomized into an observation group and a control group, 40 in each group. Cases in the observation group received antirheumatic agents and acupuncture therapy, whereas cases in the control group received antirheumatic agents alone. The therapeutic efficacies were observed after 3 sessions of treatment. Results： After the treatment, patients in the observation group had significant improvement in their morning stiffness time, average grip of both hands, joint tenderness and joint swelling, showing statistical significances （P〈0.01）; symptoms of patients in the control group were also remarkably improved （P〈0.01, P〈0.05）. Compared with the control group, the improvements in joint tenderness and average grip of both hands in the observation group were more significant （P〈0.05）. After treatment, the Health Assessment Questionnaire （HAQ） points were significantly improved in both groups, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） in both groups were remarkably reduced （P〈0.01, P〈0.05）; however, compared with the control group, the CRP decrease in the observation group was more significant （P〈0.05）. Conclusion： Acupuncture plus antirheumatic agents can effectively increase the RA patients＇ activities of daily living （ADL） and thus improve their quality of life.