Evaluation of progressive early rehabilitation training mode in intensive care unit patients with mechanical ventilation

BACKGROUND Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which ultimately affects the prognosis.AIM To evaluate the effect of progressive early rehabilitation training on treatment and prognosis of patients with mechanical ventilation in ICU.METHODS The convenience sampling method selected 190 patients with mechanical ventilation admitted to the Fourth Hospital of Hebei Medical University from March 2020 to March 2021.According to the random number table method,they were divided into the control and intervention groups.The control group received routine nursing and rehabilitation measures,whereas the intervention group received progressive early rehabilitation training.In addition,the incidence and duration of delirium were compared for the two groups along with mechanical ventilation time,ICU hospitalization time,functional independence measure(FIM)score,Barthel index,and the incidence of complications(deep venous thrombosis,pressure sores,and acquired muscle weakness).RESULTS In the intervention group,the incidence of delirium was significantly lower than in the control group(28%vs 52%,P<0.001).In the intervention group,the duration of delirium,mechanical ventilation time,and ICU stay were shorter than in the control group(P<0.001).The FIM and Barthel index scores were significantly higher in the intervention group than the control group(P<0.001).The total incidence of complications in the intervention group was 3.15%,which was lower than 17.89%in the control group(P<0.001).CONCLUSION Progressive early rehabilitation training reduced the incidence of delirium and complications in ICU patients with mechanical ventilation,which improved prognosis and quality of life.

Enhanced neuroprotection and improved motor function in traumatized rat spinal cords by rAAV2-mediated Glial-derived neurotrophic factor combined with early rehabilitation training

Background Spinal cord injury （SCI） is a serious neurological injury that often leads to permanent disabilities for the victims. The aim of this study was to determine the effects of glial-derived neurotrophic factor （GDNF） mediated by recombinant adeno-associated virus type 2 （rAAV2） alone or in combination with early rehabilitation training on SCI. Methods SCI was induced on the T8-9 segments of the spinal cord by laminectomy in adult male Sprague-Dawley rats. Then besides the sham operation group, the SCI rats were randomly divided into four groups： natural healing group, gene therapy group, rehabilitation training group, and combination therapy group （gene therapy in combination with rehabilitation training）. Motor dysfunction, protein expression of GDNF, edema formation, and cell injury were examined 7, 14, and 21 days after trauma. Results The topical application of rAAV-GDNF-GFP resulted in strong expression of GDNF, especially after the 14th day, and could protect the motor neuron cells. Early rehabilitative treatment resulted in significantly improved motor function, reduced edema formation, and protected the cells from injury, especially after the 7th and 14th days, and increased the GDNF expression in the damaged area, which was most evident after Day 14. The combined application of GDNF and early rehabilitative treatment after SCI resulted in a significant reduction in spinal cord pathology and motor dysfunction after the 7th and 14th days. Conclusion These observations suggest that rAAV2 gene therapy in combination with rehabilitation therapy has potential clinical value for the treatment of SCI.