Research and Practice of Cardiopulmonary Rehabilitation Training Programs

In today’s society, the incidence of cardiopulmonary diseases is increasing annually, seriously affecting patients’ quality of life. Therefore, developing a scientific and effective rehabilitation training program is of great significance. This study first analyzes the theoretical basis of cardiopulmonary rehabilitation training, including the effects of aerobic exercise, interval training, and strength training on cardiopulmonary function. Based on this, a comprehensive rehabilitation training program is designed, which includes personalized training plans, comprehensive interventions, multidisciplinary collaboration, patient education, and regular follow-up visits. The cardiopulmonary rehabilitation training plan developed in this study has certain scientific practicability, which provides a theoretical basis for cardiopulmonary rehabilitation training, and also provides a reference for medical institutions, rehabilitation centers and communities, which is helpful for promotion and application to a wider range of patients with cardiopulmonary diseases.

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.

Intelligent model of rehabilitation training program for stroke

In view of the uncertainty and complexity,the intelligent model of rehabilitation training program for stroke was proposed,combining with the case-based reasoning(CBR) and interval type-2 fuzzy reasoning(IT2FR).The model consists of two parts:the setting model based on CBR and the feedback compensation model based on IT2FR.The former presets the value of rehabilitation training program,and the latter carries on the feedback compensation of the preset value.Experimental results show that the average percentage error of two rehabilitation training programs is 0.074%.The two programs are made by the intelligent model and rehabilitation physician.That is,the two different programs are nearly identical.It means that the intelligent model can make a rehabilitation training program effectively and improve the rehabilitation efficiency.

Advantages of Short-term Personalized Vestibular Rehabilitation at Home Guided by Professional Therapist for Treatment of Decompensated Vestibular Vertigo

Objective Patients suffered a lot from decompensated vestibular vertigo.Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation.Routine rehabilitation training is faced with the challenges of patients’compliance,completion,the average recuperation time and so on.This study is aimed to investigate advantages of short-term personalized vestibular rehabihitation at home guided by professional therapist.Methods A short-term personalized vestibular rehabilitation program(ST-PVR)was designed for patients with decompensated vestibular vertigo in this study.Results Patients experiencing the ST-PVR program showed significant improvement of Self-Rating Anxiety Scale(SAS),Dizziness Handicap Inventory(DHI),Activities-Specific Balance Confidence Scale(ABC)scores by the second follow-up(at 2nd week after treatment,P<0.05).However-improvement in the medication group occurred slightly later,DHI for 1 month and SAS for 2 months after treatment(P<0.05).Also,the improvement in the onset time of unilateral weakness(UW)at 2nd week after treatment in the personalized vestibular rehabilitation(PVR)group was faster than that in the medication group.Conclusion In general,the short-term PVR program showed great advantages by prompting vestibular compensation quickly and putting forward future direction for clinical treatment on decompensated vestibular vertigo.

Seasonal variation and living alone are related to pulmonary rehabilitation non-completion

AIM: To identify baseline characteristics that independently predict pulmonary rehabilitation non-completion and compare these findings against the participant's reasons for non-completion. METHODS: Participants with chronic obstructive pulmonary disease(COPD) who attended a standardised twice weekly, eight week pulmonary rehabilitation program(located in the sub-tropics, latitude 27°29' South) between 2010 and 2012 were recruited. Thebaseline characteristics of program completers and non-completers were compared in a case-controlled design. Participants who attended < 12/16 sessions were classified as a non-completer. Non-completers(those who missed > 4 session of the program) were asked by one independent investigator to participate in a survey about their pulmonary rehabilitation experience. Baseline characteristics were assessed for differences between program completers and non-completers. The baseline characteristics included disease severity, exercise capacity, smoking history, participant's social support and the season when each participant commenced rehabilitation. Non-completers that agreed to participate in the survey were asked to indicate what personal factors or external factors contributed to their program non-completion. Comparisons of completers and non-completers baseline characteristics were performed using cross-tabulations and t-tests, with significant measures analysed in a multivariate binary logistic regression model. Non-completers survey responses were compared to the identified independent predictors using cross-tabulations.RESULTS: Twenty-six participants(23.4%) of the 111 participants with COPD [(mean ± SD) age was 67.4 ± 9.2 years and FEV1 54.6% ± 22.3%)], were classified as non-completers. Forty-five participants(40.5%) commenced pulmonary rehabilitation during winter. Thirty-six participants(32.4%) were living alone at program commencement. In the multivariate analysis(n = 111), only programs that commenced in winter(Exp B: 0.255, 95%CI: 0.090-0.727, P = 0.011) and participants that lived alone(Exp B: 2.925, 95%CI: 1.039-8.229, P = 0.042) were identified as independent predictors of program non-completion. Twenty participants of the twenty-six non-completers agreed to participate in the survey about their pulmonary rehabilitation experience. The reasons given for non-completion were grouped into: medical reasons(75%), other personal reasons(30%) and external barriers(45%), with ten non-completers reporting more than one reason.No participant reported living alone or that the program commenced during winter as a reason for noncompletion. There was no relationship between illness being the participant's reason for non-completion and the programs that commenced in winter(P = 0.135). CONCLUSION: Despite winter commencing programs and participants who lived alone being independent predictors of program non-completion, neither measure was reported by participants as a reason for noncompletion.

Rehabilitation of Oncological Amputee Patients

Peripheral vascular disease is the main reason for lower limb amputation, mostly present in old persons. The number of lower limb amputations due to cancer is small, but affects all age groups. Surgery is the primary （main） treatment for most bone tumors, the main goal is to remove all of the tumor. Sometimes limb amputation is the only possible solution, resulting in severe impairment of body function and activity limitations. The final goal of rehabilitation is to enable patients to re-integrate to the highest possible level into their previous social life and work. The article presents the functional outcome of patients with lower limb amputation due to oncological disease--cancer of bone or soft tissue admitted for rehabilitation to the University Rehabilitation Institute So^a in the period from 2002 to 2012. During this period 67 amputees were admitted and 60 of them were fitted with appropriate lower limb prosthesis. Younger age and transtibial level of amputation were of better functional outcome than in transfemoral or hip disarticulation amputees.

基于功能性体适能指标构建老年慢性阻塞性肺疾病患者的居家康复护理方案

目的 基于功能性体适能指标构建老年慢性阻塞性肺疾病患者的居家康复护理方案。方法 通过文献检索、病例回顾,以及结合老年慢性阻塞性肺疾病患者日常生活需要、疾病特点、体适能等核心指标,构建老年慢性阻塞性肺疾病患者居家康复护理方案初稿。编制专家函询问卷,并通过小组讨论,遴选出12名呼吸、康复相关专家,进行2轮专家函询。结果 2轮专家函询问卷回收率均为83.3%。专家权威系数为0.90。居家康复护理方案共有4个一级指标、11个二级指标和33个三级指标。结论 以功能性体适能指标构建的老年慢性阻塞性肺疾病患者居家康复护理方案具有可实施性、科学性、创新性,可为临床应用提供理论依据。

骨科人工全膝关节置换伴肌少症患者围手术期运动方案的制定和应用效果评价

目的 探究围手术期运动方案的制定和应用对骨科人工全膝关节置换(TKA)伴肌少症患者的影响。方法 选取2023年1—8月郑州大学第一附属医院接受TKA伴肌少症患者98例,根据随机数表法分为对照组和观察组,各49例。对照组采取常规护理,观察组在对照组基础上采取运动护理方案。观察两组康复情况、美国膝关节协会评分(AKS)、身体成分指标[四肢骨骼肌量(ASM)、手握力(HGS)]、恐动心理[简版恐动症评估量表(TSK-11)]。结果 观察组骨折愈合时间与负重时间短于对照组(P>0.05);干预2个月后,观察组AKS评分高于对照组(P<0.05),TSK-11评分低于对照组(P<0.05),ASM、HGS水平高于对照组(P<0.05)。结论 围手术期运动方案的制定和应用能减轻TKA伴肌少症患者恐动心理,改善患者骨骼肌量,加速患者术后康复。

早期分阶段肺康复在肺叶切除术重症肺癌患者中的应用

目的分析早期分阶段肺康复方案对肺叶切除术重症肺癌患者肺功能、癌因性疲乏及身体活动量的影响。方法随机抽样选取2019年6月至2020年5月于新疆医科大学附属肿瘤医院行肺叶切除术的112例重症肺癌患者为研究对象。按照入组先后顺序将其分为对照组和观察组,每组56例,2组患者基线资料比较差异无统计学意义(P>0.05),具有可比性。对照组给予常规康复护理,观察组在对照组基础上添加早期分阶段肺康复方案干预,对2组患者进行为期18个月的随访研究,比较2组患者干预前或术前3 d以及干预后1、6、18个月肺功能指标[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)]、癌因性疲乏发生率、每日身体活动时间、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分。结果观察组癌因性疲乏发生率(44.64%)低于对照组(64.29%),差异有统计学意义(P=0.037)。重复测量方差分析显示,FEV1、FEV1/FVC、每日身体活动时间、SAS评分、SDS评分主体内效应及主体间效应有统计学意义(P<0.05),FEV1、FEV1/FVC、每日身体活动时间、SAS评分、SDS评分随时间发生变化,且因组别不同而存在差异。干预后1、6、18个月,观察组FEV1、FEV1/FVC、每日身体活动时间高于对照组,SAS评分、SDS评分低于对照组,差异有统计学意义(P<0.05)。结论在常规康复护理基础上添加早期分阶段肺康复干预,能够改善肺叶切除术重症肺癌患者远期肺功能与负性情绪,降低癌因性疲乏发生率,提高身体活动量。

烧伤肢体功能障碍患者康复运动方案的最佳证据总结

目的 总结烧伤肢体功能障碍患者康复运动方案的最佳证据。方法 按“6S”模型系统检索国内外数据库和专业网站中有关烧伤肢体功能康复的证据,包括指南、专家共识、证据总结、临床决策、推荐实践及系统评价。检索时限为建库至2023年6月15日。由2名研究者独立对纳入的文献进行质量评价,并对符合条件的文献进行证据提取。结果 共纳入17篇文献,包括13篇指南、1篇专家共识、1篇推荐实践、2篇系统评价,从运动的必要性、运动计划、早期活动与康复、运动评估、运动方式、运动处方实施、早期下床活动、特殊部位的护理、运动安全监测、注意事项、效果评价、随访12个方面汇总了41条证据。结论 本研究总结了烧伤肢体功能障碍患者康复运动方案的最佳证据,可用于临床烧伤肢体功能康复运动过程中,但建议医务工作者应用证据时需结合临床情景,充分考虑患者情况和意愿制定个体化的康复运动方案。

肺结核结构性肺病患者肺康复运动方案的构建

目的:构建肺结核结构性肺病患者肺康复运动方案,为其运动训练提供系统、规范的参考。方法:系统检索国内外数据库和网站中关于结构性肺病患者肺康复运动训练的文献。研究者独立评价文献并提取证据,形成方案初稿。采用德尔菲专家函询法进一步论证方案的可行性。结果:共纳入21篇文献,得到35条结构性肺病肺康复运动相关的证据。共16名专家参与两轮德尔菲专家函询,两轮函询的专家积极系数分别为88.89%和100.00%,专家权威系数分别为0.891和0.907。肺结核结构性肺病患者肺康复运动方案包括组建多学科团队、总体要求、评估内容、运动处方及效果评价5项一级条目、20项二级条目、43项三级条目。结论:肺结核结构性肺病患者肺康复运动方案科学、实用,可为临床开展肺结核结构性肺病患者的肺康复运动干预提供依据。

基于快速康复理念的集束化护理方案对颈椎病手术患者术后康复的影响研究

目的探究基于快速康复理念的集束化护理方案对颈椎病手术患者术后康复的影响。方法方便选取2020年9月—2022年9月福建省泉州市第一医院骨科收治的116例颈椎病手术患者为研究对象,根据住院编号的单双数将其分为对照组(单数)和观察组(双数),每组58例。对照组实施常规护理,观察组实施基于快速康复理念的集束化护理,比较两组干预前后的颈椎活动度和生活质量。结果干预后,观察组患者颈椎前屈后伸、左右弯屈、左右旋转的活动度大于对照组,差异有统计学意义(P均<0.05);观察组颈椎病临床评价量表的主观症状、临床体征及适应能力评分及总分高于对照组,差异有统计学意义(P均<0.05)。结论颈椎病手术患者采用基于快速康复理念的集束化护理方案,可以促进其颈椎功能改善,提升其生活质量。

高依赖康复病房内重症康复综合管理方案对气切术后患者康复效果及预后的影响

目的探讨高依赖康复病房内气管切开术后患者给予重症康复综合管理方案对其康复效果、预后的影响。方法选取2022年4月至2023年10月高依赖康复病房内收治的重症且行气管切开术的患者80例,按照入院号随机分为观察组(重症康复综合管理方案)和对照组(常规管理)各40例,对比两组干预效果。结果观察组刺激性咳嗽、痰液黏稠、呼吸道黏膜出血评分,并发症发生率,住院时间和置管时间,焦虑自评量表(SAS)和抑郁自评量表(SDS)评分数据均低于对照组(均P<0.05);观察组格拉斯哥昏迷量表(GCS)评分高于对照组(P<0.05)。结论重症康复综合管理方案可加快气管切开术后患者康复,改善预后,价值较高。

一体化康复管理方案在重症机械通气患者中的应用

目的 研究一体化康复管理方案在重症机械通气患者中的应用效果。方法 纳入2021年1月至2022年6月收治的实施机械通气治疗的重症患者150例为研究对象,随机分为观察组与对照组,每组75例。对照组实施常规重症机械通气干预,观察组患者实施一体化康复管理方案。比较2组患者呼吸机相关事件发生率、机械通气相关指标、肌力情况、镇静情况、血栓发生率、获得性衰弱率的差异。结果 干预后2组患者潮气量均增加,呼吸频率与呼吸阻力均下降,且观察组变化大于对照组(P<0.05);干预后2组患者的氧分压与氧合指数/吸入氧浓度均增高,二氧化碳分压均下降,且观察组变化大于对照组(P<0.05);干预后2组肌力均增加,观察组肌力高于对照组(P<0.05);观察组患者的浅镇静率高于对照组,谵妄发生率低于对照组(P<0.05);观察组患者机械通气时间、ICU住院时间短于对照组,获得性衰弱及并发症率低于对照组(P<0.05)。结论 一体化康复管理方案能够降低重症机械通气患者并发症率与获得性衰弱风险,提高患者呼吸功能、肌力水平与镇静效果,优化患者预后。

新生儿缺氧缺血性脑损伤程序性细胞死亡及康复治疗干预机制的研究进展

新生儿缺氧缺血性脑损伤(HIBD)是一种脑细胞缺血缺氧性坏死病变,可导致神经发育性残疾,降低儿童生存质量,给患儿家庭及社会带来沉重负担。程序性细胞死亡(PCD)作为一种重要的神经元细胞死亡调控机制,参与HIBD的发生发展。康复治疗是改善HIBD后功能障碍的主要干预方式,临床应用广泛,但其效应机制目前尚未完全阐明。康复治疗可调控PCD,是促进HIBD后功能恢复的关键。因此,深入研究PCD特别是凋亡、自噬、焦亡、铁死亡在HIBD中的作用机制及康复干预机制,可以为疾病的治疗提供新思路。

肺康复分级策略联合风险管理对社区获得性肺炎患者康复效果研究

目的探究肺康复分级策略联合风险管理在社区获得性肺炎患者中应用的康复效果,观察联合方案对并发症的预防效果。方法前瞻性随机对照研究,选取2022年11月至2023年5月首都医科大学附属北京友谊医院收治的70例社区获得性肺炎患者为研究对象,将其按照随机数字表法分为试验组和对照组,每组35例。对照组实施常规风险管理干预,试验组进行肺康复分级策略指导下的风险管理干预,干预至出院。检测并比较干预前后2组患者血气指标水平,以评价患者肺部功能,反映康复效果;统计2组患者风险管理期间并发症发生情况,比较并发症总发生率;记录2组主要症状改善时间及住院时间;干预前后,采用生活质量综合评定问卷(GQOLI-74)评分评估2组患者生活质量。结果干预前,2组患者动脉血气指标水平比较,差异无统计学意义(P>0.05),干预后,2组二氧化碳分压、血乳酸值降低,氧合指数升高,试验组二氧化碳分压、血乳酸值低于对照组,氧合指数高于对照组,差异有统计学意义(P<0.05);试验组并发症总发生率低于对照组,差异有统计学意义(P<0.05);试验组各症状改善时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。干预前,2组患者GQOLI-74评分比较,差异无统计学意义(P>0.05),干预后,2组GQOLI-74评分显著升高,且试验组GQOLI-74评分高于对照组,差异有统计学意义(P<0.05)。结论肺康复分级策略联合风险管理可改善社区获得性肺炎患者肺部功能,并有效预防并发症的发生,患者主要症状得到更好更快的缓解,促进患者康复,提高患者生活质量。

基于行动研究的盆底康复专项护士实践培训方案的优化

目的探讨基于行动研究法的盆底康复专项护士临床实践培训方案优化的效果。方法以行动研究为理论指导,针对参加培训的35名(3轮分别为10、12、13名)盆底康复专项护士临床实践存在的问题,进行3轮行动调整、优化培训方案,以柯氏四级评估模型为基础对临床实践培训方案进行评价。结果形成了以需求为导向的盆底康复专项护士临床实践培训方案;在3轮行动研究中,学员对临床实践培训的整体满意率分别为90.0%、91.7%、100.0%,培训后(第2、3轮共25名)学员对盆底相关知识技能掌握度评分显著高于培训前(均P<0.05),80.0%以上的学员认为能够将盆底相关专业知识和技能应用于临床实践。结论行动研究法有利于优化盆底康复专项护士临床实践培训方案,从而提高培训效果和学员满意度,并对学员的临床工作产生积极影响。

用于康复训练的永磁同步电机等速运动控制仿真

为实现康复训练中的等速运动控制,课题组根据等速运动的概念和特点搭建了永磁同步电机速度控制系统仿真模型。在建立电机数学模型基础上,利用PID控制器实现电机电流环和速度环控制;采用余弦函数设计动态速度规划器,实现升速阶段和减速阶段速度和加速度无突变;采用判断转矩阈值方法,实现运动意图识别。结果表明:系统仿真模型输出的速度和转矩与规划的训练速度和模拟的用户输入转矩基本重合,在等速运动阶段和换向时,速度波动小。该仿真模型可用于康复用等速运动控制。

支气管扩张肺康复研究进展

支气管扩张是临床较常见的一种慢性呼吸系统疾病,其发病率较高、恶化后死亡率高、生存质量低、疾病负担重,严重影响人民的身体健康。肺康复是慢性呼吸系统患者非药物治疗策略的主要目标和支柱之一,近年来被广泛应用在改善慢性阻塞性肺疾病患者生活质量及预后方面,已被证实可行,且疗效显著。有研究表明肺康复也可提高支气管扩张患者的运动能力和生活质量,其疗效并不因疾病严重程度而异,但在支气管扩张症中却很少被关注,本文就支气管扩张肺康复治疗措施及其进展进行综述,以期为临床实践和进一步研究提供参考。

胃癌术后中医特色护理方案的构建与实证研究

目的构建胃癌术后中医特色护理方案,并探讨其有效性。方法选取2021年5月至2023年6月就诊于郑州市第三人民医院的胃癌患者114例,按照护理方法不同分为研究组与常规组,各57例。常规组给予常规护理干预,研究组在常规组基础上给予中医特色护理方案,均干预至患者出院。比较两组康复指标、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、癌因性疲乏[Piper疲乏自评量表(PFS)]、并发症发生率、护理满意度。结果研究组肠鸣音恢复、首次排气、首次排便及出院时间短于常规组(P<0.05);干预后研究组SAS、SDS、情感疲乏、躯体疲乏、综合疲乏评分及PFS总分均低于常规组(P<0.05);研究组并发症总发生率1.75%(1/57)低于常规组14.04%(8/57),总护理满意度94.74%(54/57)高于常规组80.70%(46/57,P<0.05)。结论中医特色护理方案可减轻胃癌术后患者癌因性疲乏、负性情绪,预防并发症发生,促进病情康复,提升护理满意度。