Knowledge towards Physical Medicine and Rehabilitation among Training Doctors and Medical Students at the Mohammed VI University Hospital of Marrakech

The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and Pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.

Vision rehabilitation using microperimetric biofeedback training in age-related macular degeneration

·AIM: To determine the impact of microperimetric biofeedback training(MBFT) on the quality of vision in patients with age-related macular degeneration(AMD).·METHODS: This study was a prospective, interventional, comparative study with subjects of patients diagnosed with AMD in the National Eye Center Cicendo Eye Hospital, Indonesia. Patients were randomly divided into two groups, intervention and non-intervention with 18 patients in each group. The intervention group would receive six MBFT training sessions of 10-minute time duration each.·RESULTS: A statistically significant improvement of best corrected visual acuity(BCVA) was found after the intervention, from 1.24±0.416 to 0.83±0.242(log MAR;P<0.001). A statistically significant improvement for near vision acuity(NVA) was also observed, from 1.02±0.307 log MAR to 0.69±0.278 log MAR(P<0.001). In addition, reading rate increased, from 40.83±30.411 to 65.06±31.598 words/min(P<0.001). Similarly, a comparison of changes in BCVA, NVA, and reading rate between intervention and non-intervention groups showed a significant difference(P<0.001).·CONCLUSION: MBFT significantly and positively impacts visual acuity, NVA, and reading rate in patients with AMD.

Effect of scalp acupuncture combined with language rehabilitation training in treating post-stroke motor aphasia:A systematic review and meta-analysis

Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.

Effects of Early-stage Phased Rehabilitation Training on Acute Respiratory Distress Syndrome:A Systematic Review and Meta-analysis

[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were searched.Literature screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this review.The results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),P<0.01],with statistically significant differences.Furthermore,there were significant reductions in ICU length of stay[SMD=-0.70,95%CI(-0.90,-0.50),P<0.01],duration of mechanical ventilation[SMD=-1.15,95%CI(-1.36,-0.94),P<0.01],and occurrence of complications[OR=0.16,95%CI(0.10,0.26),P<0.01],all of which were statistically significant.[Conclusions]Early-stage phased pulmonary rehabilitation training for ARDS patients effectively improves the oxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces complications.These findings support the clinical application and promotion of early-stage phased rehabilitation training.

Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

Rehabilitation training improves exercise tolerance after percutaneous coronary intervention

The aim of this present study was to investigate the effects of training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention.Fifty-seven cases of coronary heart disease after percutaneous coronary intervention were divided randomly into the rehabilitation training group（26 cases） and control group（31 cases）.Patients in the rehabilitation training group received rehabilitation training at different stages and exercise intensities 3 d after percutaneous coronary intervention for 3 months.The heart rate,blood pressure,ECG changes in treadmill exercise test,and the frequency of anginal episodes were observed.The results showed that NST and ΣST of ECG and the frequency of anginal episodes were significantly reduced in the rehabilitation training group.In addition,exercise tolerance was improved and the total exercise time was lengthened in these patients.Moreover,ST segment depression time and emergence time of angina with exercise were also lengthened compared with controls（P 〈 0.05,or 0.01）.However,the heart rate and blood pressure before and after exercise of the two groups were similar.The study indicated that rehabilitation training could significantly relieve angina,amend ischemic features of ECG,and improve exercise tolerance of coronary heart disease patients after percutaneous coronary intervention.

Adaptive Robust Control for a Lower Limbs Rehabilitation Robot Running Under Passive Training Mode

This paper focuses on the problem of the adaptive robust control of a lower limbs rehabilitation robot(LLRR) that is a nonlinear system running under passive training mode. In reality, uncertainties including modeling error, initial condition deviation, friction force and other unknown external disturbances always exist in a LLRR system. So, it is necessary to consider the uncertainties in the unilateral man-machine dynamical model of the LLRR we described. In the dynamical model, uncertainties are(possibly fast) time-varying and bounded. However, the bounds are unknown. Based on the dynamical model, we design an adaptive robust control with an adaptive law that is leakagetype based and on the framework of Udwadia-Kalaba theory to compensate for the uncertainties and to realize tracking control of the LLRR. Furthermore, the effectiveness of designed control is shown with numerical simulations.

Correlation between synaptic plasticity, associated proteins, and rehabilitation training in a rat model of cerebral infarction

All motions provide sensory, motoric, and reflexive input to the central nervous system, as well as playing an important role in cerebral functional plasticity and compensation. Cerebral plasticity has become the theoretical basis of neurorehabilitation. Studies of cerebrovascular disease, in particular, demonstrate that regeneration is accompanied by multiple forms of plasticity, such as functional and structural, in different phases of stroke rehabilitation. This study was designed to measure synaptic plasticity and expression of associated proteins to analyze the effect of rehabilitation training on learning and memory in a rat model of cerebral infarction. Results suggest that rehabilitation training increases expression of nerve growth factor associated protein 43, brain-derived neurotrophic factor, and neural cell adhesion molecules, and also promotes cerebral functional plasticity.

Structural changes in pyramidal cell dendrites and synapses in the unaffected side of the sensorimotor cortex following transcranial magnetic stimulation and rehabilitation training in a rat model of focal cerebral infarct

Very little is known about the effects of transcranial magnetic stimulation and rehabilitation training on pyramidal cell dendrites and synapses of the contralateral, unaffected sensorimotor cortex in a rat model of focal cerebral infarct. The present study was designed to explore the mechanisms underlying improved motor function via transcranial magnetic stimulation and rehabilitation training following cerebral infarction. Results showed that rehabilitation training or transcranial magnetic stimulation alone reduced neurological impairment in rats following cerebral infarction, as well as significantly increased synaptic curvatures and post-synaptic density in the non-injured cerebral hemisphere sensorimotor cortex and narrowed the synapse cleft width. In addition, the percentage of perforated synapses increased. The combination of transcranial magnetic stimulation and rehabilitation resulted in significantly increased total dendritic length, dendritic branching points, and dendritic density in layer V pyramidal cells of the non-injured cerebral hemisphere motor cortex. These results demonstrated that transcranial magnetic stimulation and rehabilitation training altered structural parameters of pyramidal cell dendrites and synapses in the non-injured cerebral hemisphere sensorimotor cortex, thereby improving the ability to compensate for neurological functions in rats following cerebral infarction.

Auditory P300 as an Indicator in Effectiveness of Robot-Assisted Lower Limb Rehabilitation Training among Hemiplegic Patients after Ischemic Stroke

Background: Robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 potential changes have importantly clinical value for evaluating the improvement in nerve function during the training as one of the objective targets. Methods: Sixty hemiplegic patients after stroke were randomly divided into a Lokomat group (30 cases) and a control group (30 cases). The Lokomat group received Lokomat rehabilitation while the control group only received traditional rehabilitation. The gait parameters and the balance ability were evaluated by the K421GAITRite analysis system and the Berg Balance Scale (BBS);ERP components including N100, N200, P200 and P300 potential were evaluated by a muscle electric inducing potentiometer. Results: There were no significant differences in BBS and gait parameters (P > 0.05), as well as in amplitude and incubation periods (IP) (P > 0.05) between the two groups before training. After 8 weeks treatment, the total (48.88 ± 3.68), static (26.40 ± 3.14) and dynamic (22.64 ± 3.68) balance scores improved significantly;the pace (59.22 ± 4.67), stride length (19.04 ± 2.24), feet wide (98.02 ± 7.97) and walking velocity (84.86 ± 9.88) and IP of N200 and P300 shortened obviously and P300 amplitude increased significantly in robot group (P < 0.05). Conclusion: This demonstrated that robot-assisted lower limb rehabilitation training in early stage could improve the limb function among hemiplegic patients caused by ischemic stroke. P300 may be considered as an indicator of neurological function improvement and effective robot-assisted lower limb rehabilitation training.

Effects of active and passive training apparatus combined with rehabilitation training on lower limb function of stroke patients during recovery period

Stroke patients always spontaneously do some learning and training of motor functions; however, learning and training are not prompt and right, while patients do not have enough activity amounts. Active and passive motor training apparatus is aimed directly at lower limb training so as to stimulate nerve function through stimulating muscular movement. Based on motor mileage, motor time, various power supplies and velocity of active and passive training apparatus, we can understand the training condition and adjust training program. OBJECTIVE： To observe the effects of grade-III rehabilitation training combining with active and passive training apparatus on lower limb function, muscle strength and activity of daily living （ADL） in stroke patients during recovery period. DESIGN： Contrast observation. SETTING： Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine. PARTICIPANTS： A total of 80 patients with stroke-induced hemiplegia after stabilizing vital signs for 2 weeks were selected from Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine from January to June 2007. There were 47 males and 33 females, and their ages ranged from 41 to 75 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Disease Academic Meeting in 1995 and were diagnosed as cerebral hemorrhage or cerebral infarction through CT or MRI examinations in clinic. Patients and their parents provided the confirmed consent. Based on therapeutic orders of hospitalization, patients were randomly divided into treatment group and control group with 40 patients in each group. METHODS： Patients in the control group received physical therapy and occupational therapy combining with rehabilitative treatment based on grade-III rehabilitative treatment program, which was set by the National Cerebrovascular Disease Topic Group. In addition, patients in the treatment group were trained with active and passive motor training apparatus based on therapeutic procedures in the control group. The active and passive motor training apparatus was designed as the therapeutic style of nervous system; otherwise, the treatment was performed once a day, 30 minutes once and 6 times per week. Four weeks were regarded as a course. MAIN OUTCOME MEASURES： Before treatment, at 2 weeks after treatment and after the first course, bare-handed muscle strength examination was used to check muscle strength and muscular tension; in addition, simple Fugl-Meyer assessment （FMA） and diagnostic criteria which were set by the Fourth National Cerebrovascular Disease Academic Meeting were used to evaluate motor function of limbs and total ADL. RESULTS： All 80 stroke patients were involved in the final analysis. ① Muscle strength of lower limbs was improved in both treatment group and control group. After the first course, muscle strength in the treatment group was obviously superior to that in the control group （ x^2=6.64, P 〈 0.05）. ② After the first course, Fugl-Meyer scores in the treatment group were higher than those in the control group, and there was significant difference （t =2.82, P 〈 0.05）. ③ Muscular tension of lower limbs was not changed in both treatment group and control group after treatment （P 〉 0.05）. ④ After the first course, ADL in the treatment group was superior to that in the control group （P 〈 0.05）. Among patients in the treatment group, 24 cases （60%） had obvious progress, 16 （40%） had progress, and 0 （0%） did not have any changes. On the other hand, among patients in the control group, 13 cases （32.5%） had obvious progress, 26 （65%） had progress, and 1 （2.5%） did not have any changes. CONCLUSION： Rehabilitation training combining with active and passive motor training apparatus can promote the recovery of lower limb disorder, increase muscle strength, control spasm, improve ADL and cause satisfactorily clinical effects in stroke patients during recovery period.

Health Promotion in Cardiac Rehabilitation Patients through the Use of a High-Intensity Interval Training Protocol

According to the American Heart Association’s (AHA) recent statistical update, over 2150 Americans die each day from cardiovascular disease (CVD), which equals approximately 1 death every 40 seconds;many of which were under the age of 65 years old [1]. In 2009, 386,324 people, 1 in 6 Americans, died as a result of coronary artery disease (CAD) alone [1]. They also estimate 150,000 people have “silent” heart attacks each year [1]. Even though the number of cardiovascular disease deaths has declined in the last 10 years, they still accounted for 32.3% of American deaths [1]. As a result, the AHA updated their 2020 goals to improve the nation’s cardiovascular health by 20% [1]. One of these methods is through the use of cardiac rehabilitation. Cardiac rehabilitation (CR) is a health promotion strategy to help return cardiac patients to their previous level of functioning, increase health, decrease comorbidities and promote education and lifestyle change. For select patients, another alternative exercise plan may exist to gain even better results. High intensity interval training (HIIT) has shown positive training results for athletes and many studies show that it may also be an effective exercise modality for many cardiac patients instead of the traditional circuit training method. This article will review current literature on the effects of HIIT on CR patients as well as a sample HIIT protocol for instituting this treatment with appropriate patients.

Action for Rehabilitation from Neurological Injury (ARNI): A pragmatic study of functional training for stroke survivors

This study evaluated the effectiveness of a twelve-week community-based functional training on measures of impairment, activity and participation in a group of stroke survivors. Isometric strength of the knee musculature, Centre-Of-Pressure (COP) based measures of balance, Berg Balance Scale (BBS), 10 m walk test, and the Subjective Index of Physical and Social Out come (SIPSO), were recorded at baseline, post-intervention, and after twelve weeks (follow-up). Exercise instructors delivered training once a week in a group format at a community centre. Significant improvement was noted in the BBS (p < 0.002), and 10 m walk speed (p = 0.03) post intervention which remained unchanged at follow-up. Total SIPSO score improved significantly post-intervention (p = 0.044). No other significant differences and no adverse effects were observed. It is possible that functional training provided more opportunity for the improvement of dynamic aspects of balance control that could be captured by the BBS but not with the traditional measures of balance using COP data. Results also suggest positive effects on the level of participation, and lack of association between measures of impairment and activity. Community based functional training could be effective and used to extend access to rehabilitation services beyond the acute and sub-acute stages after stroke.

Design of a DSLM-based cerebral palsy action rehabilitation training system

Based on domain specified language mechanism(DSLM),the architecture of the robotic training system for the rehabilitation of children with cerebral palsy(CP)is designed.Application of human-computer interaction(HCI)motion recognition technology is combined with Kinect to improve the effect of cerebral palsy rehabilitation training.In this system,Kinect's bone recognition method is used to judge the patient's training movements,and the collected bone movement information is judged.The human-computer interaction function is based on the Microsoft foundation classes function of Visual Studio based on DSLM development,which can realize real-time interactive training and evaluation of people and actions,and record the training information of patients.The system combines the designed small game to train the upper limb movement ability and reaction ability of the cerebral palsy patient,and provides key technology for improving the cerebral palsy rehabilitation training system.

Effects of respiratory rehabilitation training combined with Corbrin Capsule on the inflammatory response and pulmonary fibrosis in patients with silicosis complicated by COPD

Objective: To explore the effects of respiratory rehabilitation training combined with Corbrin Capsule on the inflammatory response and pulmonary fibrosis in patients with silicosis complicated by COPD. Methods: A total of 80 patients with silicosis complicated by COPD who were treated in our hospital between January 2013 and December 2016 were selected as the research subjects and randomly divided into control group (n=40) and observation group (n=40). Control group were treated with Corbrin Capsule on the basis of routine treatment, and observation group were treated with respiratory rehabilitation training combined with Corbrin Capsule on the basis of routine treatment. The differences in serum levels of inflammatory factors and pulmonary fibrosis indexes were compared between the two groups before intervention, after 6 months of intervention and after 1 year of intervention. Results: Before intervention, there was no statistically significant difference in serum levels of inflammatory factors and pulmonary fibrosis indexes between the two groups. After 6 months of intervention and after 1 year of intervention, serum inflammatory factors IL-6, IL-8, IL-12, IL-17, IL-18 and MCP-1 levels of observation group were lower than those of control group;serum pulmonary fibrosis indexes PCⅢ, LN, HA, ICAM-1 and HO-1 contents were lower than those of control group. Conclusion: Respiratory rehabilitation training combined with Corbrin Capsule therapy can effectively reduce the systemic inflammatory response and inhibit the pulmonary fibrosis process in patients with silicosis complicated by COPD.

Effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction

Objective:To explore the effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction (ACI).Methods: A total of 150 patients with ACI who were admitted in our hospital from October, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group. The patients in the two groups were given anti-coagulation, anti-platelet aggregation, cerebral circulation improving, and brain cell activators. The patients in the control group were given routine neurological nursing, while the patients in the observation group were given early comprehensive rehabilitation training on the basis of stable vital signs and no disease progression within 48 h. The morning fasting peripheral venous blood before treatment, 2 and 4 weeks after treatment in the two groups was collected. The serum NGF, NSE, BDNF, IL-6, hs-CRP, and TNF-α were detected. The activities of daily living and motor function before treatment, 2 and 4 weeks after treatment in the two groups were evaluated.Results:IL-6, hs-CRP, and TNF-α levels 2 and 4 weeks after treatment in the observation group were significantly lower than those in the control group (P<0.05). NGF and BDNF levels 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05), while NSE level was significantly lower than that in the control group (P<0.05). MBI and FMA scores 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions: The early rehabilitation training can effectively reduce the inflammatory reaction of nervous system in patients with ACI, regulate NGF, BDNF, and NSE levels, and play the cerebral function remodeling in order to promote the neural function recovery, and improve the motor function.

Development of a Rehabilitation Instrument of Neurological Training for Cervical Spine

Objective: To develop a kind self active resistance movement training equipment for cervical spine, so as to restore the dynamic balance of the front and back muscle strength of the cervical spine in order to correct the abnormal physiological radian of the cervical spine, thereby relieving the clinical symptoms. Methods: The air spring with adjustable strength was used to provide the power of resistance active movement, and the neurological training cervical audio-visual synthesis training software was used to automatically guide patients to perform resistance active movement training of the cervical spine. Thirty two patients with cervical spondylosis were enrolled for treatment, and SPSS26 was used to statistically analyze the VAS, Lovett muscle strength, head and neck range of motion and C2-3 vertebral body curvature before and after the treatment. Result: There were significant differences in posterior cervical muscle strength (Lovett), dizziness, shoulder and neck pain (VAS) and C2-3 vertebral curvature before and after training in 32 patients (p˂0.001). Conclusion: The application of neurological training cervical vertebra self rehabilitation training instrument can effectively relieve clinical symptoms, restore head and neck range of motion, improve nape muscle strength, restore the dynamic balance of front and rear cervical muscle strength, and also can correct the abnormal physiological radian of the cervical vertebra.

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.

Clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function

Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.

Value of individualized active rehabilitation training for neurological functional reconstruction in the convalescence of cerebral hemorrhage

Objective: To explore the value of individualized active rehabilitation training for neurological functional reconstruction in the convalescence of cerebral hemorrhage. Methods: The rehabilitation programs of 120 patients in the convalescence of cerebral hemorrhage were reviewed and used to divide them into the control group (n=71) who received conventional rehabilitation training and the observation group (n=49) who received individualized active rehabilitation training. The differences in serum contents of nerve injury-related indexes, pituitary-thyroid axis function indexes, neurotransmitters and so on were compared between the two groups of patients before rehabilitation and after 3 months of rehabilitation. Results:Before rehabilitation, there was no statistically significant difference in serum contents of nerve injury-related indexes, pituitary-thyroid axis function indexes and neurotransmitters between the two groups. After 3 months of rehabilitation, serum nerve injury-related indexes NSE, MBP and S100β contents of observation group were lower than those of control group;serum pituitary-thyroid axis function index FT3 content was higher than that of control group whereas FT4 and TSH contents were lower than those of control group;serum neurotransmitters Dny-A, SP and Glu contents were lower than those of control group whereas GABA content was higher than that of control group. Conclusion: The individualized active rehabilitation training can effectively optimize the neurological function and reduce the nerve injury in patients in the convalescence of cerebral hemorrhage, and can help the recovery of disease.