Dynamic interaction nursing intervention on functional rehabilitation and self-care ability of patients after aneurysm surgery

BACKGROUND Nursing practices based on the dynamic interaction model have been shown to be superior to generic nursing practices.However,whether this model is effective in patients recovering from intracranial aneurysm surgery is not well studied.AIM To investigate the effect of nursing based on a dynamic interaction model on functional rehabilitation of patients after aneurysm surgery.METHODS A total of 86 cases in our hospital with intracranial aneurysm from April 2019 to April 2021,were selected and divided into the study group and the control group,with 43 patients in each group.The control group received routine nursing,and the research group received nursing intervention based on a dynamic interaction model.The daily living ability(activities of daily living,ADL),cognitive function(Simple Intelligent Mental State Scale,MMSE),quality of life(Generic Quality of Life Inventory-74,GQOL-74),self-care ability(Exercise of Self-Care Agency scale),incidence of complications,and nursing satisfaction were recorded before and after intervention.RESULTS Before intervention,ADL(52.09±6.44),MMSE(18.03±4.11),and GQOL-74(53.68±4.34)scores in the study group were not significantly different from those in the control group(ADL:50.97±7.32,MMSE:17.59±3.82,GQOL-74:55.06±3.98)(P>0.05).After intervention,ADL(86.12±5.07),MMSE(26.64±2.66),and GQOL-74(83.13±5.67)scores in the study group were higher than those in the control group(ADL:79.81±6.35,MMSE:24.51±3.00,and GQOL-74:77.96±6.27)(P<0.05).Before intervention,self-concept(17.46±4.44),self-care skills(25.22±4.20),self-care knowledge(22.35±4.74),and self-care responsibility(15.06±3.29)scores in the study group was similar to those in the control group(self-concept:16.89±5.53,self-care skills:24.59±4.46,self-care knowledge:21.80±3.61,and self-care responsibility:14.83±3.11)(P>0.05).After the intervention,self-concept(26.01±3.18),self-care skills(37.68±6.05),self-care knowledge(45.56±5.83),and self-care responsibility(22.01±3.77)scores in the study group were higher than those in the control group(self-concept:22.97±3.46,self-care skills:33.02±5.65,selfcare skills knowledge:36.81±5.54,and self-care responsibility:17.97±3.56 points)(P<0.05).The incidence of complications in the study group(4.65%)was lower than that in the control group(18.60%)(P<0.05).Nursing satisfaction in the study group(95.35%)was higher than that in the control group(81.40%)(P<0.05).CONCLUSION Nursing intervention based on a dynamic interaction model can improve postoperative cognitive function,daily living ability,self-care ability,quality of life,and patient satisfaction,while reducing the risk of complications.

Evaluating the clinical application and effect of acupuncture therapy in anal function rehabilitation after low-tension rectal cancer surgery

BACKGROUND According to the indexes of serum and anal function,acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.AIM To explore the clinical application and evaluate the effect of acupuncture therapy for anal function rehabilitation after low-tension rectal cancer surgery.METHODS From the anorectal surgery cases,we selected 120 patients who underwent colorectal cancer surgery between January 2020 and December 2022 and randomly divided them into a control group(n=60),observation group(n=60),and control group after surgery for lifestyle intervention(including smoking cessation and exercise),dietary factor adjustment,anal movement,and oral loperamide treatment.The serum levels of motilin,5-hydroxytryptamine,and vasoactive intestinal peptide(VIP),Wexner score for anal incontinence,and incidence of complications were compared between groups.RESULTS After treatment,the VIP and 5-hydroxytryptamine levels in the observation group were lower than those in the control group(P<0.05).The motilin level was higher than that in the control group(P<0.05).Postoperative anal incontinence was better in the observation group than in the control group(P<0.05).The incidence of complications in the observation group was 6.67%,which was significantly lower than that in the control group(21.67%;P<0.05).CONCLUSION Acupuncture therapy has a positive effect on the rehabilitation of anal function after low-tension rectal cancer surgery;it can effectively help to improve the serum indices of patients,avoid the occurrence of anal incontinence,and reduce the incidence of complications.Popularizing and applying it will be valuable.

Obstetric Brachial Plexus Palsy of Newborns and Infants: Functional Outcomes after Rehabilitation by Their Own Parents

Introduction: Obstetric palsy of the brachial plexus (OPBP) is a paralytic lesion common to obstetric trauma, whose clinical presentation varies according to the severity and extent of the root lesions at birth. Early and appropriate rehabilitation is necessary in order to improve the functional prognosis of the injured limb. Under special conditions, parents could carry out this physiotherapy themselves. Objective: The aim of this work was to assess limb functional recovery in newborns and infants with OPBP after rehabilitation by their parents. Patients and Methods: We conducted a prospective study at the NCRDP in Yaoundé over a period of 18 months. We included all patients aged 0 to 2 years with OPBP, isolated or associated with other lesions and followed at least two (02) years at the NCRDP. Results: We recruited 69 cases. The hospital frequency of OPBP was estimated at 1.02%. The age at first consultation was [0 - 28 d] in 50.8% of cases. The sex ratio was 0.68. The right side was reached in 54.4% of cases. The Erb’s palsy predominated in 79.7% of cases. The risk factors for OPBP were vaginal delivery, cephalic presentation, shoulder dystocia and macrosomia. Physiotherapy was performed as prescribed in 94.9% of cases allowing excellent and good functional recovery in 76.81% of cases. Conclusion: In the care of their children’s OPBP rehabilitation by sensitized, actively involved and supervised parents would be a good alternative to professional physiotherapy in all situations where the latter would not be possible.

Evaluating rehabilitation interventionsin Parkinson's disease with functional MRI:a promising neuroprotective strategy

Parkinson＇s disease （PD） is a progressive neurodegenerative disorder affecting approximately 10 million people world- wide （Planetta et al., 2014; Zigmond and Smeyne, 2014）. The principal clinical features of PD are bradykinesia, rigidity, tremor at rest and postural instability （Planetta et al., 2014）. It is known that both PD itself and the use of anti-parkinson drugs are associated with several non-motor symptoms such as cognitive impairment, neuropsychiatric disturbances and sleep, autonomic, and sensory disorders （Park and Stacy, 2009; Foster et al., 2014）. The histopathological hallmark of PD is the reduction of dopaminergic cells in the substantia nigra pars compacta, causing dopamine deficiency in spe- cific nuclei of the basal ganglia such as the dorsal striatum （Fearnley and Lees, 1991; Planetta et al., 2014）. The disrup- tion of the dopaminergic system has long been regarded as the major cause of PD; however, it has been shown that a widespread involvement of several non-dopaminergic path- ways also contribute to the clinical manifestations of PD （Park et al., 2014）.

Results of Chronic Neck Pain Rehabilitation at Cotonou

Background: Neck pain is a real public health problem. Its treatment uses different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of the cervical spine, muscle strength and functional capacity of the patient. Anova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. The neck pain, at least of moderate intensity (97.26%), was present since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.

Real-time and wearable functional electrical stimulation system for volitional hand motor function control using the electromyography bridge method

Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method.Through a series of novel design concepts,including the integration of a detecting circuit and an analog-to-digital converter,a miniaturized functional electrical stimulation circuit technique,a low-power super-regeneration chip for wireless receiving,and two wearable armbands,a prototype system has been established with reduced size,power,and overall cost.Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects,the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy.Test results showed that wrist flexion/extension,hand grasp,and finger extension could be reproduced with high accuracy and low latency.This system can build a bridge of information transmission between healthy limbs and paralyzed limbs,effectively improve voluntary participation of hemiplegic patients,and elevate efficiency of rehabilitation training.

A case to be made: theoretical and empirical arguments for the need to consider fatigue in post-stroke motor rehabilitation

Motor rehabilitation after hemiparetic stroke is essential to soften physical disability（Furlan,2014）.Nevertheless,current interventions are mostly designed for well recovered individuals and often exclude stroke survivors with rather limited motor ability（Sterr and Conforto,2012）.Given that,and further advancing our research agenda in this arena（Sterr et al.,2002;Sterr and Freivogel,2003,2004;Sterr,2004;Sterr et al.,2006;Sterr and Saunders,2006）,

Research on Key Technologies of Hand Function Rehabilitation Training Evaluation System Based on Leap Motion

This paper proposes an immersive training system for patients with hand dysfunction who can perform rehabilitation training independently. The system uses Leap Motion binocular vision sensors to collect human hand information, and uses the improved PCA (Principal Component Analysis) to perform data fusion on the real-time data collected by the sensor to obtain more hands with fewer principal components, and improve the stability and accuracy of the data. Immediately, the use of improved SVM (Support Vector Machine) and KNN (K-Nearest Neighbor Algorithm) for gesture recognition and classification is proposed to enable patients to perform rehabilitation training more effectively. Finally, the effective evaluation results of the rehabilitation effect of patients by the idea of AHP (Analytic Hierarchy Process) are taken as necessary reference factors for doctors to follow up treatment. Various experimental results show that the system has achieved the expected results and has a good application prospect.

Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation. OBJECTIVE: To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury. DESIGN: A randomized controlled observation. SETTINGS: Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University. PARTICIPANTS: Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University from January 2001 to August 2006. They were all confirmed by CT and MRI, and had obvious increase of spastic muscle strength in upper limbs, their Ashworth grades were grade 2 or above. The patients were randomly divided into treatment group (n =30) and control group (n =30). METHODS: ① Patients in the treatment group undertook comprehensive rehabilitative trainings, and they were administrated with domestic BTX-A, which was provided by Lanzhou Institute of Biological Products, Ministry of Health (S10970037), and the muscles of flexion spasm were selected for upper limbs, 20-25 IU for each site. ② Patients in the treatment group were assessed before injection and at 1 and 2 weeks, 1 and 3 months after injection respectively, and those in the control group were assessed at corresponding time points. The recovery of muscle spasm was assessed by modified Ashworth scale (MAS, grade 0-Ⅳ; Grade 0 for without increase of muscle strength; Grade Ⅳ for rigidity at passive flexion and extension); The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment (FMA, total score was 226 points, including 100 for exercise, 14 for balance, 24 for sense, 44 for joint motion, 44 for pain and 66 for upper limb); The ADL were evaluated with Barthel index, the total score was 100 points, 60 for mild dysfunction, 60-41 for moderate dysfunction, < 40 for severe dysfunction). MAIN OUTCOME MEASURES: Changes of MAS grade, FMA scores and Barthel index before and after BTX-A injection. RESULTS: All the 60 patients with brain injury and stroke were involved in the analysis of results. ① FMA scores of upper limbs: The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment [(14.98±10.14), (13.10±9.28) points, P < 0.05], whereas there was no significant difference at corresponding time point in the control group. The FMA scores at 1 and 3 months in the treatment group [(23.36±10.69), (35.36±11.36) points] were higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. ② MAS grades of upper limbs: There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks after treatment than before treatment in the treatment group (0, 9 cases, P < 0.05), whereas there was no obvious difference in the control group. There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks and 1 month after treatment in the treatment group (0, 0 case) than the control group (5, 2 cases, P < 0.01). ③ Barthel index of upper limbs: The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group [(30.36±22.25), (28.22±26.21) points, P < 0.05], whereas there was no significant difference in the control group. The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. CONCLUSION: BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury, and relieving muscle spasm; Meanwhile, the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.