Early treadmill exercise increases macrophage migration inhibitory factor expression after cerebral ischemia/reperfusion

The neuroprotective function of macrophage migration inhibitory factor(MIF) in ischemic stroke was rarely evaluated.This study aimed to investigate the effects of early treadmill exercise on recovery from ischemic stroke and to determine whether these effects are associated with the expression levels of MIF and brain-derived neurotrophic factor(BDNF) in the ischemic area.A total of 40 male Sprague-Dawley rats were randomly assigned to the ischemia and exercise group [middle cerebral artery occlusion(MCAO)-Ex,n = 10),ischemia and sedentary group(MCAO-St,n = 10),sham-surgery and exercise group(Sham-Ex,n= 10),or sham-surgery and sedentary group(Sham-St,n = 10).The MCAO-Ex and MCAO-St groups were subjected to MCAO for 60 minutes,whereas the Sham-Ex and Sham-St groups were subjected to an identical operation without MCAO.Rats in the MCAO-Ex and Sham-Ex groups then ran on a treadmill for 30 minutes once a day for 5 consecutive days.After reperfusion,the hanging time tested by the wire hang test was longer and the relative fractional anisotropy determined by MRI was higher in the peri-infarct region of the MCAO-Ex group compared with the MCAO-St group.The expression levels of MIF and BDNF in the peri-infarct region were upregulated in the MCAO-Ex group.Increased MIF and BDNF levels were positively correlated with relative fractional anisotropy changes in the peri-infarct region.There was no significant difference in the levels of MIF and BDNF in the peri-infarct region between the Sham-Ex and Sham-St groups.Our study demonstrated that early exercise(initiated 48 hours after the MCAO) could improve motor and neuronal recovery after ischemic stroke.Furthermore,the increased levels of MIF and BDNF in the peri-infarct region(penumbra) may be one of the mechanisms of enhanced neurological function recovery.All experiments were approved by the Institutional Animal Care and Use Committee in Asan Medical Center in South Korea(2016-12-126).

Early Aerobic Exercise Promotes Neurological Function Recovery of Rats after Cerebral Ischemia/Reperfusion by Upregulating the Expression of Heat Shock Protein A5

Objective The neuroprotective function of heat shock protein A5(HSPA5)in ischemic stroke has been confirmed.This study aimed to investigate the effects of early aerobic exercise on neurological function recovery from cerebral ischemia/reperfusion and to determine whether these effects are associated with the expression level of HSPA5 in the ischemic penumbra.Methods A total of 72 male Sprague-Dawley rats were randomly assigned to the ischemia and exercise group[middle cerebral artery occlusion(MCAO)-Ex,n=18],ischemia and sedentary group(MCAO-St,n=18),sham-surgery and exercise group(Sham-Ex,n=18),or sham-surgery and sedentary group(Sham-St,n=18).The MCAO-Ex and MCAO-St groups were subjected to MCAO for 60 min,whereas the Sham-Ex and Sham-St groups were subjected to an identical operation without MCAO.Rats in the MCAO-Ex and Sham-Ex groups then ran on a treadmill for 30 min once a day for 5 consecutive days.After reperfusion,the motor function of the rats was scored by the Bederson neurological function test,balance beam test,and screen test.Nissl staining was conducted to assess morphological and structural change of nerve cells in the ischemic penumbra.The reverse transcription-quantitative polymerase chain reaction was applied to detect the mRNA expression of HSPA5.Western blot analysis was conducted to determine the protein expression of HSPA5.Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)staining was carried out in the ischemic penumbra after MCAO.Results Rats receiving early treadmill exercise had lower Bederson neurological function,balance beam,and screen test scores on the 3rd,7th,and 14th days after MCAO;in addition,more neurons survived in the ischemic penumbra after MCAO,and higher mRNA and protein expression of HSPA5 and fewer TUNEL-positive stained cells were observed.Conclusion Our study demonstrated that early aerobic exercise can improve neurological function recovery after ischemia/reperfusion.Furthermore,the increased level of HSPA5 in the ischemic penumbra might be one of the mechanisms of enhanced neurological function recovery.

Continuity and Change in Dao Yin:Comparing and Contrasting the Therapeutic Exercises in Yin Shu(The Book of Pulling,c.2nd Century BCE)and Zhu Bing Yuan Hou Lun(Treatise on the Origins and Manifestations of Various Diseases,610 CE)

The manuscript Yin Shu(The Book of Pulling),excavated from Zhangjiashan Han Tomb No.247,is the earliest surviving text on therapeutic exercise known as Dao Yin(lit.guiding and pulling).Discovered in 1983,this Dao Yin text,together with the drawings of 44 figures performing“guiding and pulling”exercises found in the Mawangdui Han Tomb in 1974,are of great significance to the study of the early history of Dao Yin.Prior to these discoveries,researchers into Dao Yin relied mainly on material found in the Dao Zang(the Daoist Canon),compiled in 1145.This led to their conclusion that Dao Yin was essentially Daoist.The development of Dao Yin reached its zenith during the Sui Dynasty(581–618 CE),when it became one of the three medical departments at the imperial medical education institution.As part of the medical reform of the second Sui Emperor,Yang Di,Dao Yin became the treatment of choice,and the employment of a large number of Dao Yin specialists to the Sui court transformed the state medical service.The compilation of Zhu Bing Yuan Hou Lun(Treatise on the Origins and Manifestations of Various Diseases)under Yang Di’s decree,incorporated an abundance of resources on Dao Yin,enabling physicians to potentially“prescribe”Dao Yin to their patients.Situating both Yin Shu and Zhu Bing Yuan Hou Lun in their social and historical contexts,this article analyses their editorial treatments,examines their different objectives,styles,and readerships,and compares the various exercises described in the two texts.It emphasizes the fact that over a period of nearly a thousand years,from the late Warring States(475–221 BCE)to the Sui and Tang periods,Dao Yin was an important medical practice,culminating in its institutionalization by the Sui government.

Early exercise premium method for pricing American options under the J-model

Background:This study develops a new model called J-am for pricing American options and for determining the related early exercise boundary(EEB).This model is based on a closed-form solution J-formula for pricing European options,defined in the study by Jerbi(Quantitative Finance,15:2041-2052,2015).The J-am pricing formula is a solution of the Black&Scholes(BS)PDE with an additional function called f as a second member and with limit conditions adapted to the American option context.The aforesaid function f represents the cash flows resulting from an early exercise of the option.Methods:This study develops the theoretical formulas of the early exercise premium value related to three American option pricing models called J-am,BS-am,and Heston-am models.These three models are based on the J-formula by Jerbi(Quantitative Finance,15:2041-2052,2015),BS model,and Heston(Rev Financ Stud,6:327-343,1993)model,respectively.This study performs a general algorithm leading to the EEB and to the American option price for the three models.Results:After implementing the algorithms,we compare the three aforesaid models in terms of pricing and the EEB curve.In particular,we examine the equivalence between J-am and Heston-am as an extension of the equivalence studied by Jerbi(Quantitative Finance,15:2041-2052,2015).This equivalence is interesting since it can reduce a bi-dimensional model to an equivalent uni-dimensional model.Conclusions:We deduce that our model J-am exactly fits the Heston-am one for certain parameters values to be optimized and that all the theoretical results conform with the empirical studies.The required CPU time to compute the solution is significantly less in the case of the J-am model compared with to the Heston-am model.

Consideration of the Self-Care Supporting Program Including Simple Exercise for Patients with Early Stages of Secondary Lower-Limb Lymphedema

Aim: We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. Methods: The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. Results: The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. Conclusions: We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.

Integrated Review of Lifestyle Interventions Targeting Diet and Exercise in Early or First-Episode Psychosis

Aims: Life expectancy is reduced by 10 - 20 years in psychotic disorders compared with the general population, largely due to high incidence of physical health disorders: heart attack, stroke, obesity, cardiovascular disease (CVD), and type 2 diabetes. Early or first-episode psychosis patients can be especially vulnerable to physical health, psychological and social consequences of antipsychotic medication weight gain. The aim of this paper is to review diet and exercise lifestyle interventions employed to address these issues. Method: A review of research evidence on lifestyle interventions (diet and exercise) for individuals with early or first-episode psychosis (2000 to 2020) was undertaken. An internet-based literature search employed Medline, PsycINFO, Embase, PubMed and Web of Science. Results: Nine studies meeting the criteria were identified: comprising of three exercise intervention studies, one diet intervention study, and five combined diet and exercise intervention studies. Only one study used a RCT design with prior power analysis to determine participant numbers, two had a RCT design, two had a comparison group and four had no control group. Overall, these studies show that exercise and diet focused interventions may provide beneficial physical and mental health outcomes, but participant engagement and behaviour change may be difficult to achieve in early or first-episode psychosis due to individual factors associated with the experience of psychosis and medication prescribed, and health service related factors. Conclusion: There is a need for evidence-based lifestyle programmes in early or first-episode psychosis that includes individually targeted evidence based exercise and diet interventions. Further appropriately powered RCTs are required to strengthen the evidence base.

“Exercise as the Human Body’s Conductor”or the Significance of Exercise in Early Childhood

The focus of our topic is doing regularly physical exercises,regarding healthy way of life,which is also the basis of development of kindergarten aged children.The children of consecutive generations are growing fat and the number of overweight children in the generation change has increased.Although not all fat children will become fat adults,but this is very likely.Prevention should be started as early as the age of preschool.Physical activity must play an outstanding role in ensuring healthy development of children’s organisms.

Early exercise European option and early termination American option pricing models

The maximum relative error between continuous-time American option pricing model and binomial tree model is very small. In order to improve the European and American options in trade course, the thesis tried to build early exercise European option and early termination American option pricing models. Firstly, the authors reviewed the characteristics of American option and European option, then there was compares between them. Base on continuous-time American option pricing model, this research analyzed the value of these options.

循证下早期功能锻炼方案在乳腺癌术后的应用效果

目的研究循证下早期功能锻炼方案在乳腺癌术后的应用效果。方法选取2022年1月至2023年12月江西省肿瘤医院收治的乳腺癌改良根治术患者120例作为研究对象,采用随机数字表法将其分为对照组和观察组,各60例,对照组采用单纯术后功能锻炼运动干预,观察组采用乳腺癌术后功能锻炼的量化指标锻炼方法干预,比较两组患者手功能、肩关节活动度、伤口恢复及生活质量。结果护理后,观察组手指关节活动度、腕关节背伸活动度、拇指与食指对捏次数、肩关节活动度高于对照组,差异有统计学意义(P<0.05);护理后,观察组Fugl-Meyer运动评估表(FMA)评分高于对照组,Bates-Jensen伤口评估工具(BWAT)评分低于对照组,差异有统计学意义(P<0.05);观察组各项世界卫生组织生存质量测定量表简表(WHOQOL-100)评分高于对照组,差异有统计学意义(P<0.05)。结论采用乳腺癌术后功能锻炼的量化指标锻炼方法干预,有效促使乳腺癌患者术后肩关节活动度恢复,改善其手功能,促进伤口愈合,提高其生活质量,值得推广。

早期量化功能锻炼联合中医三联干预措施对糖尿病周围血管病变患者的影响

目的:观察早期量化功能锻炼联合中医三联干预措施对糖尿病周围血管病变患者的影响。方法:将68例糖尿病周围血管病变患者按照随机数字表法分为对照组和研究组各34例,对照组采用常规护理措施,研究组采用早期量化功能锻炼联合中医三联干预措施,比较两组患者干预前后下肢动脉血流量、负性情绪评分及干预后糖尿病生活质量特异性量表(diabetes specific quality of lifescale,DSQL)总评分与护理效果。结果:干预1个月后,两组患者下肢动脉血流量高于干预前,研究组高于对照组(P<0.05);两组患者焦虑自评量表、抑郁自评量表评分低于干预前,研究组低于对照组(P<0.05);研究组DSQL总评分低于对照组(P<0.05),研究组总有效率为97.06%(33/34),高于对照组的79.41%(27/34)(P<0.05)。结论:早期量化功能锻炼联合中医三联干预措施能增加糖尿病周围血管病变患者下肢动脉血流量,提高患者生活质量和护理效果,改善患者不良情绪。

血栓预防操联合预警分级管理在老年髋部骨折患者中的应用

目的探讨血栓预防操联合预警分级管理在老年髋部骨折患者中的应用效果,以期为临床治疗提供参考。方法本研究选取2020年1月—2023年6月成都市龙泉驿区第一人民医院收治的200例老年髋部骨折患者为研究对象。采用随机数字表法将患者分为观察组与对照组,每组100例。对照组患者采用常规健康护理干预,观察组患者在对照组基础上采用血栓预防操联合预警分层管理干预。分别于干预前、出院时比较2组患者深静脉血栓(DVT)健康信念水平、血小板计数(PLT)、血小板体积(MPV)、血小板分布宽度(PDW)、凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)水平;比较2组患者住院期间DVT发生率;比较2组患者出院时护理满意度。结果出院时,2组患者DVT健康信念中疾病易得感、疾病严重性、健康行为益处、自我效能评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组患者DVT发生率比较,差异无统计学意义(P>0.05)。出院时,2组患者MPV和PDW均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者PLT比较,差异无统计学意义(P>0.05)。出院时,2组患者APTT、PT均长于干预前,且观察组均长于对照组,差异均有统计学意义(P<0.05);出院时,2组患者Fbg水平均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组患者护理满意度为96.00%,高于对照组的87.00%,差异有统计学意义(P<0.05)。结论实施血栓预防操联合预警分级管理,可增强老年髋部骨折患者健康信念,避免DVT风险的增加,改善血小板功能,纠正机体血凝状态,提高患者在护理过程中的满意度,值得临床推广应用。

关节镜双后内入路手术结合早期运动康复与物理治疗对后交叉韧带胫骨止点撕脱骨折膝关节功能的影响

目的探究关节镜双后内入路手术结合早期运动康复与物理治疗对后交叉韧带胫骨止点撕脱骨折膝关节功能的影响。方法前瞻性选取2020年4月至2022年4月在秦皇岛市第一医院接受关节镜双后内入路手术的后交叉韧带胫骨止点撕脱骨折患者90例,按照信封法将其分为研究组与对照组,每组各45例。在常规治疗的基础上,对照组接受物理治疗,研究组接受早期运动康复治疗。随访6个月,对两组患者术后疗效、下肢功能恢复情况(下床行走时间、住院时间、骨折愈合时间、术后下肢负重时间)、膝关节活动范围[屈曲角度、伸直受限角度及关节活动范围]、美国特种外科医院膝关节评分(HSS)量表(疼痛、功能、活动度、肌力、屈曲畸形及稳定性HSS)、患者满意度进行记录,并分析组间差异。结果研究组患者的治疗有效率为91.11%,高于对照组(75.56%),差异有统计学意义(P<0.05)。研究组患者下床行走时间、住院时间、骨折愈合时间、术后下肢负重时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后6个月,两组患者的屈曲角度、关节活动范围均较治疗前增大,伸直受限角度均较治疗前减小,研究组屈曲角度、关节活动范围分别为(112.55±5.16)°、(108.66±11.02)°,均大于对照组[(97.89±4.51)°、(95.16±12.04)°],研究组伸直受限角度为(3.35±1.08)°,小于对照组[(4.89±1.62)°],差异均有统计学意义(P<0.05);治疗后6个月,两组患者在疼痛、功能、活动度、肌力、屈曲畸形及稳定性等方面的评分均较治疗前升高,且研究组在各方面的评分均高于对照组,差异均有统计学意义(P<0.05)。研究组患者的满意率为95.56%,高于对照组(80.00%),差异有统计学意义(P<0.05)。结论关节镜双后内入路手术结合早期运动康复对后交叉韧带胫骨止点撕脱骨折的治疗效果较好,可以明显改善患者的症状、促进愈合、提高膝关节功能,同时提高患者的满意度。

早期功能锻炼治疗桡骨远端骨折手法复位后动态小夹板固定患者的临床疗效

目的:探讨早期功能锻炼对桡骨远端骨折手法复位后动态小夹板固定患者肢体肿胀、疼痛及功能恢复的影响。方法:选取2022年3月—2023年3月四川省骨科医院收治的94例桡骨远端骨折患者,根据随机数字表法分为试验组和对照组,各47例。对照组行手法复位、动态小夹板固定治疗及常规康复训练,试验组在对照组基础上予以早期功能锻炼。比较两组患者治疗前后肿胀值、疼痛度、腕关节功能、炎症因子水平、临床疗效及骨痂愈合情况。结果:治疗后,两组患者肿胀值、视觉模拟量表疼痛评分均低于治疗前,且试验组明显低于对照组(P<0.05)。两组患者Cooney腕关节评分组间、时间及交互比较,差异均有统计学意义(P<0.05);两组患者治疗后不同时点Cooney腕关节评分均高于治疗前,且试验组显著高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后C反应蛋白、白细胞介素-6水平均低于治疗前,且试验组明显低于对照组(P<0.05)。试验组总有效率为93.62%,对照组为76.60%,试验组显著优于对照组(P<0.05)。试验组Lane-Sandhu X线片评分大于对照组(P<0.05)。结论:桡骨远端骨折手法复位后动态小夹板固定患者行早期功能锻炼,可有效缓解患肢肿胀及疼痛,减轻炎症反应,促进腕关节功能恢复及骨痂愈合。

疼痛护理联合早期康复锻炼在卒中后肩手综合征患者中的应用效果

目的:观察疼痛护理联合早期康复锻炼在卒中后肩手综合征(SHS)患者中的应用效果。方法:选取2020年9月至2022年9月该院收治的106例卒中后SHS患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各53例。对照组给予早期康复锻炼,研究组在对照组基础上联合疼痛护理。比较两组护理前后疼痛程度[视觉模拟评分法(VAS)]评分、肿胀程度(MRC)评分、上肢功能[Fugl-Meyer运动功能评估表(FMA)]评分、肩关节活动度、肩手等速肌力和生命质量[生活质量综合评定问卷-74(GQOLI-74)]评分。结果:护理后,两组MRC和VAS评分均低于护理前,且研究组低于对照组,两组上肢FMA评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);两组肩关节外展、前屈活动度均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);两组肩、手的屈肌群平均功率、峰值力矩水平均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);两组GQOLI-74评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:疼痛护理联合早期康复锻炼应用于卒中后SHS患者,可减轻患者肢体肿胀程度和疼痛程度,改善肩关节活动度和肩手等速肌力,提高上肢运动功能和生命质量,效果优于单纯早期康复锻炼。

早期活动联合电刺激神经肌肉改善重症肺炎患者ICU获得性衰弱

目的 探究早期活动联合电刺激神经肌肉用于改善重症肺炎重症监护室获得性衰弱(ICU-AW)患者的效果。方法 选取150例上海市某三甲医院急诊重症监护室(EICU)入住的重症肺炎引发的ICU-AW患者作为研究对象,随机分为对照组(75例)和联合组(75例)。其中对照组给予早期活动,联合组给予早期活动联合电刺激神经肌肉。比较2组机械通气恢复情况(ICU住院时间、机械通气时间、脱机拔管率、ICU转出率)、肺功能[用力肺活量(FVC)、第1s用力呼气容积(FEV1)/FVC、最大吸气末压力(MIP)]、肌力[医学研究理事会(MRC)评分]、疾病严重程度[急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)]及并发症发生情况。结果 联合组ICU住院时间、机械通气时间明显低于对照组(P<0.05);与干预前比较,2组干预后FVC、FEV1/FVC、MIP及MRC评分均明显升高(P<0.05),且与对照组比较,联合组明显升高(P<0.05);2组APACHEⅡ评分均明显降低(P<0.05),且与对照组比较,联合组明显降低(P<0.05);联合组并发症发生率(9.33%)明显低于对照组(24.00%)(P<0.05)。结论 早期活动联合电刺激神经肌肉用于重症肺炎ICU-AW患者可有效促进机体恢复,提高肺功能,安全有效。

运动疗法对早期膝骨关节炎患者下肢生物力学风险因素的影响研究

目的:采用无线表面肌电分析技术探究运动疗法对早期膝骨关节炎患者干预前后的生物力学风险因素的影响。方法:选取2022年2月至2023年6月在福州市第二医院骨科和康复科门诊就诊的早期膝骨关节炎患者98例,随机分为观察组和对照组,每组49例。观察组采用等速肌力训练和平衡本体感觉训练,每周3次,持续4周;对照组采用健康宣教的方式,每周1次,持续4周。观察2组治疗前后股内外侧肌激活比值(VM/VL)、股外侧肌和腘绳肌的激活比值(VL/BF)、前后轴距和左右轴距、西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟评分法(VAS)评分。结果:治疗后,观察组VM/VL提高,VL/BF降低,前后轴距和左右轴距降低,WOMAC评分、VAS评分显著下降,差异均有统计学意义(P < 0.05)。对照组治疗前后VM/VL、VL/BF、前后轴距和左右轴距、WOMAC评分、VAS评分比较,差异均无统计学意义(P > 0.05)。治疗后,观察组以上指标均优于对照组,差异有统计学意义(P < 0.05)。结论:运动疗法可提升早期膝骨关节炎膝周内外侧和前后侧肌群协同收缩能力,提升患者下肢平衡和本体感觉能力,改善患者疼痛与僵硬的症状,对早期膝骨关节炎患者疾病生物力学风险因素具有调控作用,可延缓疾病进展,提高患者膝关节功能。

Cardiac rehabilitation after cardiac surgery:An important underutilized treatment strategy

Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.

老年腰椎术后患者早期“站立位”功能锻炼方法的研制

目的:基于快速康复理念研制老年腰椎术后患者早期“站立位”功能锻炼方法,为临床功能锻炼提供参考。方法:通过文献回顾制定老年腰椎术后患者早期“站立位”功能锻炼方法初稿,通过专家会议、专家函询确定最终功能锻炼方法。结果:参与会议专家共5名,权威系数为0.915。参与函询专家共10名,权威系数为0.950。条目的重要性评分为4.51~4.92分,变异系数为0.06~0.15。最终构建的功能锻炼方法包括5个一级条目、20个二级条目。结论:本研究构建的老年腰椎术后患者早期“站立位”功能锻炼方法具有一定的科学性、安全性,可进一步进行临床验证。

早期功能锻炼运用于全膝关节置换术的研究进展

全球老龄化进一步增加了膝骨关节炎(KOA)的发生率。全膝关节置换术(TKA)是治疗终末期KOA的金标准。尽管如此,TKA术后如果缺乏正确的康复训练,会严重影响肢体功能的恢复,增加住院时间,加重患者经济负担,严重者甚至造成残疾导致不良结局。早期功能锻炼是手术成功的重要因素,并且可以确保患者持续的功能改善。目前国际上对于早期功能锻炼的研究设计、康复方法和结局研究较多,国内尚处于起步阶段。本文综述早期功能锻炼在TKA的研究进展,以期为我国TKA早期功能锻炼提供临床参考。

早期运动联合呼吸康复在心肾联合移植中的应用

目的总结早期运动联合呼吸康复在心肾联合移植中的应用2例,为心肾联合移植受者行早期运动联合呼吸康复提供临床实践理论。方法选取2020年11月至2021年3月在广西医科大学第二附属医院移植医学中心行心肾联合移植后进行早期运动联合呼吸康复受者临床资料,采用病例回顾性分析,收集受者临床及随访资料,分析受者焦虑抑郁评分、肌力评分、营养评分、血栓评分、血气分析指标及术后随访肺部感染指标。结果2例心肾联合移植行早期运动联合呼吸康复受者,术后焦虑及抑郁评分明显下降,术后肌力、营养及血栓评分明显改善,受者动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、血氧饱和度(arterial oxygen saturation,SaO_(2))升高,动脉血二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))降低,随访2年未出现肺部感染。结论早期运动联合呼吸康复可改善心肾联合受者心理状态,改善受者血气分析指标,提高受者运动耐力,为心肾联合移植实施早期运动联合呼吸康复提供临床实践理论指导。