Application value research of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke

BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of the application value of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke.METHODS This study selected 86 patients with swallowing disorders after stroke admitted to our rehabilitation department from February 2022 to December 2023 as research subjects.They were divided into a control group(n=43)and an observation group(n=43)according to the treatment.The control group received swallowing rehabilitation training,while the observation group received swallowing treatment device in addition to the training.Both groups underwent continuous intervention for two courses of treatment.RESULTS The total effective rate in the observation group(93.02%)was higher than that in the control group(76.74%)(P=0.035).After intervention,the oral transit time,swallowing response time,pharyngeal transit time,and laryngeal closure time decreased in both groups compared to before intervention.In the observation group,the oral transit time,swallowing response time,and pharyngeal transit time were shorter than those in the control group after intervention.However,the laryngeal closure time after intervention in the observation group was compared with that in the control group(P=0.142).After intervention,average amplitude value and duration of the genioglossus muscle group during empty swallowing and swallowing 5 mL of water are reduced compared to before intervention in both groups.After intervention,the scores of the chin-tuck swallowing exercise and the Standardized Swallowing Assessment are both reduced compared to pre-intervention levels in both groups.However,the observation group scores lower than the control group after intervention.Additionally,the Functional Oral Intake Scale scores of both groups are increased after intervention compared to pre-intervention levels,with the observation group scoring higher than the control group after intervention(P<0.001).The cumulative incidence of complications in the observation group is 9.30%,which is lower than the 27.91%in the control group(P=0.027).CONCLUSION The combination of swallowing therapy equipment with swallowing rehabilitation training can improve the muscle movement level of the genioglossus muscle group,enhance swallowing function,and prevent the occurrence of swallowing-related complications after stroke.

Evidence-Based Design Application of Water Landscaping for Rehabilitation Gardens for Patients with Mental Disorders

The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.

Evaluating Pharmacological and Rehabilitation Strategies for Effective Management of Bipolar Disorder: A Comprehensive Clinical Study

Bipolar disorder presents significant challenges in clinical management, characterized by recurrent episodes of depression and mania often accompanied by impairment in functioning. This study investigates the efficacy of pharmacological interventions and rehabilitation strategies to improve patient outcomes and quality of life. Utilizing a randomized controlled trial with multiple treatment arms, participants will receive pharmacotherapy, polypharmacotherapy, rehabilitation interventions, or combination treatments. Outcome measures will be assessed using standardized scales, including the Hamilton Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Mania Scale. Preliminary data suggest improvements in symptom severity and functional outcomes with combination treatments. This research aims to inform clinical practice, guide treatment decisions, and ultimately enhance the quality of care for individuals living with bipolar disorder. Findings will be disseminated through peer-reviewed journals and scientific conferences to advance knowledge in this field.

The clinical rehabilitation of spine and spinal cord disorders: detection and evaluation using SPECT/CT

Spine-related disorders are caused by several factors including （1） spinal nerve/visceral nerve stimulation by perivertebral aseptic inflammation, （2） spinal nerve/visceral nerve compression by injured periverterbal soft tissue, dislocated perivertebral small joint, and proliferative/degenerative tissue and, （3） secondary damage to the spinal cord, peripheral nerve, vessels and autonomic nerve, which further stimulate nerve root sheath and surround- ing pain-carrying nerve fibers. In many cases, the source of pain cannot be detected by standard image modalities. Particularly in anatomically complex regions like the spine, SPECT/CT can be helpful for some aspects by intro- ducing a metabolical dimension to the classical way of morphology-based diagnostic. The aim of the present review was to give an overview of the adoption of SPECT/CT in a clinical spine-focused setting.

Correlation study between motor rehabilitation level and psychological state in patients with limb movement disorders after stroke

BACKGROUND The psychological state of patients with post stroke limb movement disorders undergoes a series of changes that affect rehabilitation training and recovery of limb motor function.AIM To determine the correlation between motor rehabilitation and the psychological state of patients with limb movement disorders after stroke.METHODS Eighty patients with upper and lower limb dysfunction post stroke were retrospectively enrolled in our study.Based on Hospital Anxiety and Depression Scale(HADS)scores measured before rehabilitation,patients with HADS scores≥8 were divided into the psychological group;otherwise,the patients were included in the normal group.Motor function and daily living abilities were compared between the normal and psychological groups.Correlations between the motor function and psychological status of patients,and between daily living ability and psychological status of patients were analyzed.RESULTS After 1,2,and 3 wk of rehabilitation,both the Fugl-Meyer assessment and Barthel index scores improved compared to their respective baseline scores(P<0.05).A greater degree of improvement was observed in the normal group compared to the psychological group(P<0.05).There was a negative correlation between negative emotions and limb rehabilitation(-0.592≤r≤-0.233,P<0.05),and between negative emotions and daily living ability(-0.395≤r≤-0.199,P<0.05).CONCLUSION There is a strong correlation between motor rehabilitation and the psychological state of patients with post stroke limb movement disorders.The higher the negative emotions,the worse the rehabilitation effect.

Reasoning and Rehabilitation cognitive skills programme for mentally disordered offenders: Predictors of outcome

AIM To investigate factors predicting treatment completion and treatment outcome of the Reasoning and Rehabilitation Mental Health Programme(R&R2MHP) cognitive skills programme for mentally disordered offenders. METHODS Secondary analysis of data previously obtained from 97 male patients who were sectioned and detained under the United Kingdom Mental Health Act in low, medium and high security hospitals and who had completed R&R2MHP. Predictors of treatment completion included background variables and five outcome measures: Four self-reported measures of violent attitudes, social problem-solving skills, reactive anger and locus of control and an objective measure of behaviour on theward that was completed by staff. Completion of the 16 session programme, which was delivered on a weekly basis, was classified as ≥ 12 sessions.RESULTS It was found that the R&R2MHP is appropriate for delivery to participants of different ages, ethnic background, and at different levels of security without the completion rate or treatment effectiveness being compromised. Participants taking oral typical psychotropic medication were over seven times more likely to complete the programme than other participants. Behavioural disturbance on the ward prior to commencing the programme predicted non-completion(medium effect size). As far as treatment completion was concerned, none of the background factors predicted treatment effectiveness(age, ethnic background, level of security, number of previous convictions and number of previous hospital admissions). The best predictor of treatment effectiveness was attitude towards violence suggesting that this should be the primary outcome measure in future research evaluating outcomes of the R&R2MHP cognitive skills program. CONCLUSION The findings suggest that a stable mental state is a key factor that predicts treatment completion.

Prevalence of posttraumatic stress disorder following acute coronary syndrome and clinical characteristics of patients referred to cardiac rehabilitation

BACKGROUND Studies have demonstrated that patients who have experienced acute coronary syndrome(ACS)have an increased risk of developing posttraumatic stress disorder(PTSD)and experiencing worse survival outcomes than those who do not develop PTSD.Nevertheless,the prevalence rates of PTSD following ACS vary widely across studies,and it is noteworthy that in most cases,the diagnosis of PTSD was based on self-report symptom questionnaires,rather than being established by psychiatrists.Additionally,the individual characteristics of patients who develop PTSD after ACS can differ widely,making it difficult to identify any consistent patterns or predictors of the disorder.AIM To investigate the prevalence of PTSD among a large sample of patients undergoing cardiac rehabilitation(CR)after ACS,as well as their characteristics in comparison to a control group.METHODS The participants of this study are patients who have experienced ACS with or without undergoing percutaneous coronary intervention and are enrolled in a 3-wk CR program at the largest CR center in Croatia,the Special Hospital for Medical Rehabilitation Krapinske Toplice.Patient recruitment for the study took place over the course of one year,from January 1,2022,to December 31,2022,with a total of 504 participants.The expected average follow-up period for patients included in the study is about 18 mo,and currently ongoing.Using self-assessment questionnaire for PTSD criteria and clinical psychiatric interview,a group of patients with a PTSD diagnosis was identified.From the participants who do not have a PTSD diagnosis,patients who would match those with a PTSD diagnosis in terms of relevant clinical and medical stratification variables and during the same rehabilitation period were selected to enable comparability of the two groups.RESULTS A total of 507 patients who were enrolled in the CR program were approached to participate in the study.Three patients declined to participate in the study.The screening PTSD Checklist-Civilian Version questionnaire was completed by 504 patients.Out of the total sample of 504 patients,74.2%were men(n=374)and 25.8%were women(n=130).The mean age of all participants was 56.7 years(55.8 for men and 59.1 for women).Among the 504 participants who completed the screening questionnaire,80 met the cutoff criteria for the PTSD and qualified for further evaluation(15.9%).All 80 patients agreed to a psychiatric interview.Among them,51 patients(10.1%)were diagnosed with clinical PTSD by a psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders criteria.Among the variables analyzed,there was a noticeable difference in the percentage of theoretical maximum achieved on exercise testing between the PTSD and non-PTSD groups.Non-PTSD group achieved a significantly higher percentage of their maximum compared to the PTSD group(P=0.035).CONCLUSION The preliminary results of the study indicate that a significant proportion of patients with PTSD induced by ACS are not receiving adequate treatment.Furthermore,the data suggest that these patients may exhibit reduced physical activity levels,which could be one of the possible underlying mechanisms in observed poor cardiovascular outcomes in this population.Identifying cardiac biomarkers is crucial for identifying patients at risk of developing PTSD and may derive benefits from personalized interventions based on the principles of precision medicine in multidisciplinary CR programs.

An Evaluation Study of a Nature Based Rehabilitation in Sweden for Patients with Exhaustion Disorder

The aim of this study was to evaluate a Nature Based Rehabilitation (NBR) for a group of patients with Exhaustion Disorder (ED) in the southwest Sweden. A multidisciplinary team consisting of an occupational therapist, a physiotherapist, a medical doctor practising symbolic drama and a nurse with gardening experience provided NBR in an agricultural environment. Patients were offered 14 weeks of rehabilitation in a group of eight persons, three mornings per week. Seventeen patients participated in the study and 15 completed the study. A semi-structured interview was conducted at the beginning of the rehabilitation and at the end and a follow-up interview by telephone was done one year after completion of the rehabilitation. The interviews were recorded and transcribed. Assessment scales used included: Stress and Crisis Inventory (SCI-93), Coping Resources Inventory (CRI) and Visual Analogue Scale (VAS). Weekly notes from the staff members were reviewed and compared with the patient’s own experience. The interviews and the staff notes were analysed with semantic thematic analysis. Result showed that this kind of NBR with a multidisciplinary team promotes improved health and improved quality of life for patients with ED and may thus constitute a good alternative to treatment, provided the ED has not become chronic.

Rehabilitation and pharmacotherapy of neuromyelitis optica spectrum disorder:A case report

BACKGROUND Neuromyelitis optica spectrum disorder(NMOSD)is a demyelinating autoimmune disease that affects the central nervous system.It typically manifests as optic neuritis or extensive longitudinal myelitis,with or without the presence of anti-aquaporin protein 4 autoantibodies(immunoglobulin G).CASE SUMMARY We report the case of a 45-year-old woman with a history of Sjogren's syndrome who was diagnosed with NMOSD accompanied by spinal cord injury and left calf intermuscular vein thrombosis.The patient received hormone shock and gamma globulin therapy in the acute phase and standard rehabilitation treatment during convalescence.Upon discharge,the patient was able to control urination and defecation,stand independently,and walk short distances with the aid of a walker.CONCLUSION This case suggests that pharmacotherapy and standard rehabilitation treatment can improve the prognosis of NMSOD patients.

Efficacy evaluation of acupuncture plus rehabilitation training for post-stroke deglutition disorders of qi-deficiency blood stasis pattern

Objective:To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke deglutition disorders of qi-deficiency blood stasis pattern.Methods:Sixty-six patients with post-stroke deglutition disorders of qi-deficiency blood stasis patter were divided into an observation group and a rehabilitation group using the random number table method.The two groups both received conventional medications and supportive treatment for stroke.In addition,the observation group received acupuncture plus rehabilitation training while the rehabilitation group only received the same rehabilitation training.The interventions were conducted 3 times a week for a total of 4 weeks in both groups.They were evaluated using Kubota water swallowing test(KWST),Fujishima Ichiro food intake level scale(FILS)and symptoms score of traditional Chinese medicine(TCM)before and after treatment,and at the 1-month follow-up.The therapeutic efficacy was assessed at the 1-month follow-up.Results:The KWST grading and FILS result after treatment and at the follow-up were significantly different from those before treatment in both groups(all P<0.001);the results of these two items at the follow-up were not significantly different from those after treatment in the two groups(all P>0.05).There were significant differences in the KWST grading and FILS result between the two groups after treatment and at the follow-up(all P<0.05).The TCM symptoms score changed significantly after treatment and at the follow-up compared with that before treatment in both groups(all P<0.001).The TCM symptoms grading efficacy at the follow-up was significantly different from that after treatment in the observation group(P<0.05),while the difference was statistically insignificant in the rehabilitation group(P>0.05).The TCM symptoms grading efficacy in the observation group was significantly different from that in the rehabilitation group after treatment and at the follow-up(both P<0.05).Conclusion:Based on the conventional treatment for stroke,acupuncture plus rehabilitation training or use of rehabilitation training alone both can improve the clinical symptoms in post-stroke deglutition disorders of qi-deficiency blood stasis pattern,but acupuncture plus rehabilitation training can produce more significant efficacy and better long-term efficacy in improving TCM symptoms.

Efficacy and safety of transcutaneous auricular vagus nerve stimulation combined with conventional rehabilitation training in acute stroke patients: a randomized controlled trial conducted for 1 year involving 60 patients

Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.

Recent developments in computer assisted rehabilitation environments

Computer Assisted Rehabilitation Environment(CAREN) is a system that integrates a training platform(motion base), a virtual environment, a sensor system(motion capture) and D-flow software. It is useful for both diagnostic and therapeutic use. The human gait pattern can be impaired due to disease, trauma or natural decline. Gait analysis is a useful tool to identify impaired gait patterns. Traditional gait analysis is a very time consuming process and therefore only used in exceptional cases. With new systems a quick and extensive analysis is possible and provides useful tools for therapeutic purposes. The range of systems will be described in this paper, highlighting both their diagnostic use and the therapeutic possibilities. Because wounded warriors often have an impaired gait due to amputations or other extremity trauma, these systems are very useful for military rehabilitative efforts. Additionally, the virtual reality environment creates a very challenging situation for the patient, enhancing their rehabilitation experience. For that reason several Armed Forces have these systems already in use. The most recent experiences will be discussed; including new developments both in the extension of the range of systems and the improvement and adaptation of the software. A new and promising development, the use of CAREN in a special application for patients with posttraumatic stress disorder(PTSD), will also be reviewed.

Rehabilitation in Autism. Pilot Project on the Health Centre-Based Primary Care Model within the National Health Plan Implementation Projects

Background: In Italy, there is a lack of reliable data on the epidemiology of Autism Spectrum Disorder (ASD) on a national scale. The exact etiopathogenesis of ASDs is still largely unknown, with autism representing the final common pathway of different pathological conditions. Aim of the Study: Assessment of the effects produced by the individualised, intensive and holistic rehabilitation programme used by the Il Cireneo Foundation on the daily living skills of people diagnosed with ASD. Materials and Methods: Out of the eighty-seven (n = 87) enrolees, seventy-nine (n = 79), of whom 19 were females (24.1%) and 60 were males (75.9%), with a mean age of 13.41 years (SD = 6.93 years;range = 2 - 33 years) terminated the three-year study. The enrolees were evaluated two times: at the beginning of the rehabilitation programme and at the end of the three-year goal-oriented project. Results: Statistically significant results between T0 and T1 were recorded for CARS (t-4.221;p Conclusions: People diagnosed with autism can be helped to become more autonomous and independent in carrying out activities of daily living thanks to an intensive psycho-educational and cognitive-behavioural rehabilitation programme, of which the Il Cireneo Foundation is the only expression in the Abruzzo region.

Quo vadis cardiac rehabilitation;the role of comprehensive cardiac rehabilitation in modern cardiology

In accordance with the guidelines established by prominent European and global cardiology associations,comprehensive cardiac rehabilitation(CR)stands as an officially endorsed and highly recommended therapeutic approach(class I recommendations;level of evidence A)for a diverse spectrum of cardiac patients.Nevertheless,it is a cause for concern to observe that fewer than 50%of eligible patients are being effectively referred for CR,whether in an outpatient or in-patient setting.Concurrently,studies reveal that a substantial proportion of individuals with atherosclerotic cardiovascular disease maintain unhealthy lifestyles and exhibit suboptimal management of modifiable cardiovascular risk factors,including hypertension,lipid levels,and diabetes.Beyond the conven-tional patient profile encompassing those recovering from acute coronary syndrome with or without percutaneous coronary intervention,as well as patients who have undergone coronary or valvular surgery,contemporary CR now emphasizes specialized subgroups of patients.These include frail elderly patients,the female population with its unique considerations,individuals burdened by multiple cardiovascular comorbidities,those who have developed psychological consequences due to a cardiac illness and particularly those grappling with chronic heart failure.This editorial seeks to offer a state-of-the-art assessment of the significance and role of comprehensive CR within modern cardiology.

The Importance of Teaching Ancient Greek Language in Speech Rehabilitation

This paper recounts the process by which a severely brain-damaged adult student,after a terrible car accident,taught herself to read and write Ancient Greek,and in so doing,improved her ability to read and write in Greek.Initially,Evangelia’s reading and writing were very slow and difficult;memory and word finding challenges were her constant companions.Numerous studies by Greek and foreign scientists have shown that the Ancient Greek language,besides being alive,is also therapeutic,since it has the possibility to heal various dysfunctions and learning difficulties.After nine months,the recovery process was so good that Evangelia found herself writing and reading more fluently in Greek.This paper seeks to contribute to our knowledge of how the Ancient Greek language has the possibility to heal various and serious speech and language disorders.

New Concept of Whiplash Injuries Rehabilitation

Whiplash injuries are a global health problem and a significant financial burden for both health care systems,and insurance providers.The diverse symptomatology after whiplash injury both in the somatic,emotional and behavioral sphere prompted separation of the Whiplash Associated Disorders(WAD)as a separate category of diseases.The exact mechanism of whiplash injury is still under debate and theories explaining pathogenesis of WAD are very diverse ranging from purely biomechanical to neurophysiological,emphasizing central sensitization but the core disability seems to be strictly connected to somatosensory dysfunction.As a result,the optimal algorithm of rehabilitation has not been established and data published in the current literature on effectiveness of such algorithms are inconsistent.Based on the presented here of Head Neutral Reference Point(HNRP),the objective of central desensitization is to restore valid somatosensory output from Cranio-cervical Junction(CCJ).This new concept of rehabilitation after whiplash presented here is based on clinical observations and is supported by initial results.

Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders

The aim of this study was to describe the perceptions of everyday suffering among adults with attention deficit hyperactivity disorder (ADHD) and comorbid mental disease. Directed content analysis guided by Eriksson’s theory on human suffering was performed on data from 20 individual interviews. Expressions of both suffering and well-being were identified;the former centred on loneliness and related to life, illness, and care, which supported Eriksson’s theory, whereas expressions of well-being related to ADHD diagnosis and supportive social relationships. Nevertheless, results indicate the need to expand those expressions in order to better contribute to developing a supportive rehabilitation regimen that can provide more interpersonal care.

维生素D治疗全面性发育迟缓患儿的临床疗效研究

背景 除了某些有明确病因的代谢性疾病导致的全面性发育迟缓(GDD),康复治疗是GDD的主要治疗方式;维生素D通过影响神经营养因子在调节神经细胞的发育和分化方面发挥着重要的神经保护作用;但目前关于补充维生素D对GDD患儿临床疗效的研究开展较少。目的 探讨补充不同剂量的维生素D对GDD患儿康复治疗的临床效果。方法 于2020年9月—2022年6月选取在郑州大学第三附属医院康复医学科首次住院就诊的120例GDD患儿为研究对象,采用随机区组化的方法将其分为常规组(38例)、400 U组(37例)和1 200 U组(35例)。常规组仅进行常规康复治疗;400 U组在常规康复治疗的基础上给予口服400 U/d维生素D;1 200 U组在常规康复训练的基础上给予口服1 200 U/d维生素D。收集3组患儿的性别、就诊年龄等基本资料;于入院时(治疗前)及第3个疗程末(治疗后)行血清25羟维生素D[25(OH)D]水平检测和Gesell发育量表评估[评估适应能力、大运动能力、精细运动能力、语言能力和社交能力5个能区的发育商(DQ)];记录发生在患儿住院期间不良事件的次数,并对上述资料进行分析比较。结果 3组患儿性别、居住地、出生季节、分娩方式、就诊年龄、出生体质量、出生胎龄、主要就诊原因比较,差异均无统计学意义(P>0.05)。治疗前,3组患儿25(OH)D水平、Gesell量表各能区DQ值比较,差异均无统计学意义(P>0.05);治疗后,1 200 U组患儿血25(OH)D水平、Gesell量表大运动能力、精细运动能力、语言能力DQ值高于常规组(P<0.05)。第1、2疗程期间,3组患儿不良事件发生率比较,差异无统计学意义(P>0.05);第3疗程期间,1 200 U组患儿不良事件发生率低于常规组及400 U组(P<0.05)。结论 补充1 200 U维生素D对GDD患儿的康复疗效有益,且能减少康复期间不良事件的发生率。