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 Mirror Therapy on the upper Limb Functionality:A study on the perception of Occupational Therapists

With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.

Effectiveness of modified constraint-induced movement therapy for upper limb function intervention following stroke:A brief review

Neglecting the use of the affected limb in stroke patients can result in learned non-use.Modified constraint-induced movement therapy(mCIMT)is a form of rehabilitation therapy that limits the less paretic side,and through repeated and concentrated training improve the upper limb function of the paretic side.The aim of this paper is to develop a critical systematic review on the research evidence evaluating the effectiveness of applying mCIMT in the recovery of upper limb function in stroke patients.The outcome of this evaluation support that mCIMT significantly improves the upper limb function of stroke patients.Moreover,group mCIMT modality and TR(trunk restraint)+mCIMT modality provide greater benefits than mCIMT alone.

Application of cross-migration theory in limb rehabilitation of stroke patients with hemiplegia

BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration,an increase in bilateral muscle strength,and an improvement in lower limb motor function.METHODS We randomly divided 120 patients with hemiplegic stroke into two groups:Eexperimental and control groups,with 60 patients in each group.Both groups received routine rehabilitation treatment,while the experimental group additional-ly received ankle dorsiflexion resistance training on the healthy side for 6 wk.We measured the maximum voluntary contract(MVC),changes in surface electromyography(EMG),and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale(FMA)before and within 1 wk after training.RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score(P<0.05).The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before(P<0.05).Furthermore,the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group(P<0.05).CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle,indicating a cross-migration phenomenon of strength training.Furthermore,this type of training can also improve lower limb motor function,providing a new exercise method for improving early ankle dorsiflexion dysfunction.

Demonstration of the test-retest reliability and sensitivity of the Lower Limb Functional Index-10 as a measure of functional recovery post burn injury:a cross-sectional repeated measures study design

Background:Lower limb burns can significantly delay recovery of function.Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid tools.The aims of this study were to examine the test-retest reliability,sensitivity,and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10(LLFI-10)questionnaire for measuring functional ability in patients with lower limb burns over time.Methods:Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the study.In addition,the minimal detectable change(MDC)was calculated for Section 1 and 3 of the LLFI-10.Section 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury duties.Results:Section 1 of the LLFI-10 demonstrated excellent test-retest reliability(intra-class correlation coefficient(ICC)0.98,95%CI 0.96–0.99)whilst Section 3 demonstrated high test-retest reliability(ICC 0.88,95%CI 0.79–0.94).MDC scores for Sections 1 and 3 were 1.27 points and 30.22%,respectively.Internal consistency was demonstrated with a significant negative association(rs=?0.83)between Sections 1 and 3 of the LLFI-10(p<0.001).Conclusions:This study demonstrates that Section 1 and 3 of the LLFI-10 are reliable for measuring functional ability in patients who have sustained lower limb burns in the previous 12 months,and furthermore,Section 1 is sensitive to changes in patient function over time.

Application of the Somatosensory Interaction Technology Combined with Virtual Reality Technology on Upper Limbs Function in Cerebrovascular Disease Patients

Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. Methods: Form January, 2019 to December, 2019, 80 cerebrovascular disease patients were recruited, and had been divided into control group (n = 40) and observation group (n = 40), randomly. The control groups received conventional rehabilitation treatment, for 40 minutes per day, while observation group received conventional rehabilitation treatment, for 20 minutes per day, and virtual reality technology treatment, 20 minutes per day, 5 days a week for 4 weeks. Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and ADL before and after treatment. Results: Before treatment, the scores of WMFT, FMA-UE and MBI were no significant difference between two groups (P > 0.05). The scores improved in both groups after treatment (P < 0.01), and were higher in the observation group than in the control group (P < 0.05). Conclusion: The somatosensory interaction technology combined with virtual reality technology could facilitate to improve the upper limbs function and ADL in cerebrovascular disease patients.

Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction

Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.

Effects of Water Weight-Loss Walking Training on Lower Limb Motor Function and Gait in Stroke Patients

Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.

Major ozonated autohemotherapy promotes the recovery of upper limb motor function in patients with acute cerebral infarction

Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.

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.

Evaluation of the Curative Effect of "Xingnao Kaiqiao" Acupuncture Based on Brunnstrom Staging on Upper Limb and Hand Motor Function in the Recovery Period after Stroke

Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.

Early application of percutaneous neuromuscular electric stimulation in interfering motor function of limbs and difference in temperature of axilla of patients with ischemic stroke

BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.

头针联合上肢功能性电刺激对脑卒中后上肢运动功能影响的随机对照研究

目的:探讨头针联合功能性电刺激(FES)对脑卒中患者上肢运动功能的影响。方法:本研究采取单盲随机对照研究,纳入符合标准的脑卒中上肢功能障碍患者60例,使用信封法随机分为头针联合FES组、FES组和常规康复组,每组各20例。给予5次/周,连续4周的干预。比较三组在干预第2周、第4周,及治疗结束后的第4周随访时的上肢运动功能变化情况。采用Fugl-Meyer运动功能评定量表-上肢部分(FMA-UE)、Wolf运动功能评价量表及Brunnstrom分期进行干预效果的评价。结果:(1)三组一般资料及结局指标治疗前对比均无显著性差异(P>0.05);(2)治疗4周后及出院4周进行随访时,FMA-UE评分:头针联合FES组较FES组、常规康复组在FMA-UE评分明显提升,差异具有显著性意义(P<0.05);(3)三组间Wolf评分及Brunnstrom分期在干预后及随访中均无显著性差异(P>0.05)。结论:头针联合上肢FES治疗可以提高脑卒中患者的上肢运动功能。

维持性血液透析患者内瘘侧上肢功能障碍及影响因素的研究

目的评估维持性血液透析(maintenance hemodialysis,MHD)动静脉内瘘右利手患者的双侧上肢功能,了解动静脉内瘘对上肢功能的影响及内瘘侧上肢功能的影响因素。方法横断面研究,纳入北京市6家血液透析中心的MHD动静脉内瘘且右利手患者,收集人口学资料、生化资料、握力、关节活动度及简易上肢功能检查(simple test for evaluating hand function,STEF)等上肢功能指标。内瘘侧及非内瘘侧上肢功能的比较采用t检验(或非参数检验),采用多元线性回归分析MHD患者动静脉内瘘侧握力的影响因素。结果共入组MHD患者90例,其中男性51例(56.7%),年龄(59.63±10.60)岁,中位透析龄62.50(24.00,113.00)月。患者非内瘘侧握力高于内瘘侧握力(t=-5.133,P<0.001);多元线性回归结果显示MHD患者内瘘侧握力与血肌酐(β=0.353,P<0.001)、认知功能评分(β=0.223,P=0.006)呈正相关,与尿素清除指数(Kt/V)呈负相关(β=-0.235,P=0.007),男性握力大于女性(β=-0.253,P=0.004)。非内瘘侧腕关节尺偏的角度大于内瘘侧(t=-2.814,P=0.006)。在STEF各项操作中,内瘘侧在大球(t=2.327,P=0.021)、大圆片(t=2.472,P=0.015)、布(t=2.688,P=0.008)项目中操作时间长于无内瘘侧。结论MHD患者内瘘侧握力、关节活动度及灵活性均存在下降,影响内瘘侧握力的因素包括性别、血肌酐、Kt/V和认知功能评分。

心功能等级化康复护理在心肌梗死介入术后患者中的应用

目的:探讨心功能等级化康复护理在心肌梗死介入术后患者中的应用效果。方法:选取2021年4月1日~2022年11月30日心血管科收治的120例心肌梗死介入术后患者作为研究对象,按照随机数字表法分为参照组和干预组各60例,对照组实施常规康复护理,干预组实施心功能等级化康复护理措施。比较两组心功能指标、肢体功能[采用简式Fugl-Meyer评定量表(FMA)]、心绞痛发作频次、首次下床时间、平均住院时间、心脏不良事件发生情况。结果:干预4周后,两组凝血酶原时间(PT)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)指标水平均优于入院1 d(P<0.05),且干预组优于参照组(P<0.01);干预4周后,两组FMA中下肢评分、上肢评分、总得分均高于入院1 d(P<0.05),且干预组高于参照组(P<0.01);干预组心绞痛发作频次、心脏不良事件发生例数均少于参照组(P<0.05),首次下床时间、平均住院时间均短于参照组(P<0.05)。结论:对心肌梗死介入术后患者采取心功能等级化康复护理,有利于提高心脏、肢体功能水平,减少心绞痛发作频次,缩短首次下床时间和住院时间,降低心脏不良事件发生率。

肌电生物反馈治疗早期脑卒中偏瘫患者上肢功能障碍的疗效分析

目的:探讨肌电生物反馈治疗早期脑卒中偏瘫患者上肢功能障碍的疗效。方法:选取2019年11月—2020年1月于吉林大学第二医院康复医学科早期脑卒中偏瘫后上肢功能障碍患者42例,随机分为对照组20例和观察组22例,所有患者均接受常规康复治疗(物理治疗、作业治疗、针灸治疗),观察组在常规康复治疗的基础上,加用上肢腕伸肌群肌电生物反馈治疗。两组于治疗前、治疗后分别采用日常生活活动(ADLs)评分、肌电生物反馈(EMG)波幅、Brunnstrom分期、Fugl-Meyer运动功能量表(FMA)对偏瘫患者的上肢功能进行评定。结果:观察组治疗后ADLs评分、EMG波幅、Fugl-Meyer评分均高于治疗前(P<0.05),且均高于对照组(P<0.01);观察组Brunnstrom分期上肢功能达到IV级及以上者多于对照组(P<0.05)。结论:肌电生物反馈疗法有助于早期脑卒中偏瘫患者上肢运动功能恢复,提高患者日常生活能力。

虚拟现实技术对不完全脊髓损伤患者下肢功能的影响

目的探讨虚拟现实技术(VR)对不完全脊髓损伤患者下肢运动功能、平衡能力、躯干控制能力及步行能力的影响。方法选自郑州大学第一附属医院康复医学科2022年1月至2023年12月治疗的46例不完全脊髓损伤患者,采用随机数字法分成治疗组、对照组,各23例。两组接受相同的康复治疗,治疗组在此基础上增加VR 30 min,对照组在常规康复治疗的基础上继续康复训练30 min,每周5 d,疗程8周。治疗前及治疗8周后,分别采用脊髓损伤下肢功能量表(ASIA)、Berg平衡量表(BBS)、躯干控制测试量表(TCT)、Holden功能性步行量表(FAC)对患者下肢运动能力、平衡能力、躯干控制能力及步行能力进行评定。结果两组治疗前ASIA、BBS、TCT、FAC评分比较,差异无统计学意义(P>0.05);两组治疗后ASIA、BBS、TCT、FAC评分比治疗前提高,且治疗组高于对照组(P<0.05)。结论基于VR的康复治疗能改善不完全脊髓损伤患者的下肢功能,提高其平衡能力、躯干控制能力和步行能力。

基于莱温守恒模式的护理对急性脑梗死患者自我管理能力及神经功能的干预效果

目的探讨基于莱温守恒模式的护理干预对急性脑梗死患者自我管理能力及神经功能的影响。方法选择医院2021年3月—2022年6月收治的138例急性脑梗死患者,按照组间基线资料可比的原则分为对照组和观察组,各69例。对照组实施常规护理模式干预,观察组在对照组基础上采用基于莱温守恒模式的护理干预,干预6周。比较两组护理满意度、自我管理能力、神经功能[神经功能缺损评分表(NIHSS)]、肢体运动功能[运动功能评分量表(Fugl-Meyer)]及心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]。结果护理干预后,观察组患者护理满意率为92.75%,与对照组的79.71%对比,差异有统计学意义(P<0.05)。护理干预前,两组自我管理能力、神经功能、肢体运动功能及心理状态比较,差异无统计学意义(P>0.05);护理干预后,观察组自我管理能力各维度评分、肢体运动功能评分均高于对照组,差异有统计学意义(P<0.05);而观察组患者神经功能评价量表各项评分、SAS评分、SDS评分则低于对照组,差异有统计学意义(P<0.05)。结论基于莱温守恒模式的护理干预对急性脑横死患者效果更佳,可使患者负性情绪得到有效缓解,自我管理能力得到提高,还可有效改善患者神经功能,提高护理满意度。

基于IMB模型的康复干预对老年脑梗死患者上肢功能运动功能及神经功能的影响

目的探讨信息-动机-行为技巧(IMB)下的康复干预在老年脑梗死患者中的应用效果。方法将符合本研究纳入及排除标准的116例脑梗死患者随机分成2组各58例,对照组采用常规康复,观察组采用基于IMB模型的康复干预。2组患者均在院内进行为期1个月的康复训练,院外监督患者继续进行2个月的康复训练并线上汇报每日康复训练情况,共连续干预3个月后评估2组患者上肢功能、运动功能、神经功能、生活质量及并发症发生情况。结果干预后2组患者Fugl-Meyer评估量表(FMA)及上肢Wolf(沃尔夫)运动功能测试量表(WMFT)评分均增加,且观察组增加幅度更显著[FMA:(25.91±4.42)分比(29.37±4.58)分,t=4.140,P<0.05;WMFT:(30.42±3.56)分比(34.29±4.05)分,t=5.466,P<0.05]。干预后2组患者FCA及BBS评分均增加,且观察组分值增加幅度更显著[FCA评分:(50.08±8.21)分比(57.63±8.58)分,t=4.842,P<0.05;BBS评分:(31.98±5.36)分比(37.41±5.79)分,t=5.241,P<0.05]。干预后2组患者NIHSS评分均降低,ADL评分均增加,且观察组分值变化幅度更显著[NIHSS评分:(9.60±1.73)分比(6.83±1.55)分,t=9.082,P<0.05;ADL评分:(75.33±5.56)分比(80.74±5.82)分,t=5.119,P<0.05]。干预后2组患者WHOQOL-BREF量表各维度评分及总分均升高,且观察组患者WHOQOL-BREF量表各维度评分及总分值变化幅度更显著(P<0.05)。观察组并发症发生率(1.72%)与对照组(18.97%)相比显著降低(P<0.05)。结论基于IMB模型的康复干预有效改善了老年脑梗死患者上肢功能、运动功能及神经功能,提高了患者生活质量,降低了并发症发生率。

探讨渐进性康复训练配合预见性干预对乳腺癌术后患者上肢功能的影响

目的观察渐进性康复训练配合预见性干预对乳腺癌术后患者上肢功能的影响。方法100例乳腺癌术后患者,以随机数字表法分成对照组和研究组,各50例,对照组实施以常规的康复指导,研究组实施以渐进性康复训练配合预见性干预。比较两组干预前后的患侧肢体关节活动度、上肢运动功能、日常生活能力、自我干预能力及生活质量评分,术后并发症发生情况。结果两组干预患侧肢体后各方向活动度较干预前增加,研究组前屈、后伸、内旋、外旋、内收、外展活动度分别为(158.96±13.55)、(56.36±2.77)、(89.05±10.96)、(88.34±2.95)、(58.76±2.95)、(162.34±10.18)°,与对照组的(147.10±10.96)、(49.00±3.62)、(83.75±7.36)、(81.02±3.11)、(54.34±2.76)、(156.84±12.43)°相比更高,具有显著的差异性(P<0.05)。两组干预后上肢运动功能、日常生活能力、自我干预能力及生活质量较干预前增加,研究组上肢运动功能、日常生活能力、自我干预能力及生活质量评分分别为(52.58±6.61)、(91.15±3.99)、(94.43±3.11)、(92.26±3.42)分,高于对照组的(48.17±5.62)、(87.02±4.74)、(89.43±4.11)、(87.08±4.03)分,具有显著的差异性(P<0.05)。研究组患者术后并发症发生率6.00%低于对照组的22.00%,具有显著的差异性(P<0.05)。结论乳腺癌术后患者开展渐进性康复训练配合预见性干预,可改善患侧肢体的上肢各方向活动度,提升术后上肢运动功能、日常生活能力、自我干预能力及生活质量,减少术后并发症的发生。