Evaluation of the Effectiveness and Efficiency of Extracorporeal Shock Wave Combined with Rehabilitation Training in the Treatment of Muscle Articulation Chronic Pain

Objective: To analyze the effect of combined extracorporeal shock wave and rehabilitation training treatment in patients with muscle articulation chronic pain (MACP). Methods: Ninety-seven MACP patients admitted to our hospital from September 2021 to September 2023 were randomly selected and were divided into Group A (control group, 46 cases, rehabilitation training treatment) and Group B (observation group, 51 cases, extracorporeal shock wave with rehabilitation training treatment), and outcomes of the two groups were compared. Results: The treatment efficiency, post-treatment clinical indexes (upper and lower limb function scores, activities of daily living (ADL) scores, visual analog scale (VAS) scores), and short-form 36 (SF-36) scores of Group B were better than those of Group A (P < 0.05). Conclusion: Combined extracorporeal shock wave and rehabilitation training treatment for MACP patients improved their limb function, daily activities, quality of life, and reduced pain.

Safety and effectiveness of electromyography-induced rehabilitation treatment after epidural electrical stimulation for spinal cord injury:study protocol for a prospective,randomized,controlled trial

Epidural electrical stimulation is a new treatment method for spinal cord injury(SCI).Its efficacy and safety have previously been reported.Rehabilitation treatment after epidural electrical stimulation is important to ensure and improve the postoperative efficacy of epidural electrical stimulation in patients with SCI.Considering that electromyography(EMG)-induced rehabilitation treatment can accurately match the muscle contraction of patients with SCI,we designed a study protocol for a prospective,randomized controlled trial.In this trial,on the premise of adjusting the spinal cord electrical stimulator to obtain the maximum EMG signal of the target muscle,patients with SCI receiving epidural electrical stimulation will undergo EMG-induced rehabilitation treatment.Recovery of muscle strength of key muscles,quality of life,safety and therapeutic effects will be monitored.Twenty patients with SCI who are scheduled to undergo epidural electrical stimulation in Shanghai Ruijin Rehabilitation Hospital will be randomly divided into two groups with 10 patients per group.The control group will receive conventional rehabilitation treatment.The EMG-induced rehabilitation group will receive EMG-induced rehabilitation treatment of the target muscles of the upper and lower limbs based on conventional rehabilitation treatment.After rehabilitation treatment,follow up for all patients will occur at 2 weeks and 1,3 and 6 months.The primary outcome measure of this trial will be evaluation of target muscle recovery using the Manual Muscle Testing grading scale.Secondary outcome measures will include modified Barthel Index scores,integrated EMG values,the visual analogue scale,Spinal Cord Independence Measure scores,and modified Ashworth scale scores.The safety indicator will be the incidence of adverse events.This trial will collect data regarding the therapeutic effects of EMG-induced rehabilitation in patients with SCI receiving epidural electrical stimulation for 6 months after rehabilitation treatment.Findings from this trial will help develop rehabilitation methods in patients with SCI after epidural electrical stimulation.This study protocol was approved by Ethics Committee of Shanghai Ruijin Rehabilitation Hospital(Approval No.RKIRB2022-12)on February 15,2022 and was registered with Chinese Clinical Trial Registry(registration number:ChiCTR2200061674;date:June 30,2022).Study protocol version:1.0.

Effects of Perioperative Pain Intervention on Postoperative Rehabilitation of Patients with Partial Resection of Lung Cancer

Objective: To explore the effect of perioperative pain intervention on postoperative rehabilitation of patients who underwent thoracoscopic partial resection of lung cancer. Methods: From January 2021 to May 2021, 100 patients with primary lung cancer who underwent thoracoscopic partial lung resection in Cardiopulmonary Department II of Cancer Center in our hospital were selected. They were divided into observation group and control group by random number table. Routine nursing after surgery was used in both groups, the observation group was given perioperative pain intervention nursing on the basis of routine nursing, and the postoperative pain (6 h, 12 h, 24 h, 48 h after operation), the rate of out-of-bed activity within 24 h after operation, lien chest tube time, the incidence of postoperative complications, the influence of pain on daily life, the satisfaction of patients with pain control methods and pain education and the satisfaction of discharged patients were observed and recorded. Results: There was no significant difference in general data (age, sex, educational level, course of disease, TNM stage of lung cancer, maximum diameter of tumor (CM), surgical site) between the two groups (P > 0.05);the NRS scores of the observation group at 6, 12, 24 and 48 hours after operation were all lower than those in the control group, and the difference was statistically significant (P < 0.05);after operation, the rate of 24 h out-of-bed activity in the observation group was higher than that in the control group, the lien chest tube time was shorter than the control group, and the incidence of postoperative complications was lower than that in the control group, the difference was statistically significant (P < 0.05);after operation, the effect level of pain in the observation group was lower than that in the control group, and the satisfaction of pain health education, pain control methods and discharged patients was higher than that in the control group, with statistical significance (P < 0.05). Conclusion: Perioperative pain intervention can effectively relieve postoperative pain state of patients, promote patients’ early out of bed and conducive to lung expansion, shorten the time of lien chest tube, reduce postoperative complications and the impact of pain on daily life, help patients recover as soon as possible, and improve the satisfaction of patients for medical treatment.

Optimizing pain management in elderly patients post-knee surgery:A novel collaborative strategy

Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.

Pain Assessment as a Tool in Back-to-Work Rehabilitation

The purpose of this study was to elucidate participant experiences with a way to use pain assessment as a tool in vocational rehabilitation and see if the process is perceived to be important for the rehabilitation process in a four-week lasting rehabilitation back to work program for people with chronic pain, mental illness and fatigue symptoms. Design: A qualitative study. Purposeful typical case sampling. Semi-structured qualitative interviews with rehabilitation back to work participants were thematic content analyzed. Setting: Interviews at the end of the 4th week of rehabilitation took place at a Rehabilitation Center in Central Norway. Subjects: Six women and four men aged 23 to 57 years, suffering from chronic pain and mild mental illness symptoms. Main outcome measure: This paper describes the participants’ experiences with pain mapping in back-to-work rehabilitation, used as a tool in a rehabilitation model for people suffering from chronic pain and mild mental illness. Results: The main topic was “empowered to insights”. The results illustrate a process where mapping tools were experienced relevant in the process of growing discovery of pain and ways of pain management. Pain assessment as a joint aid for both themselves and the staff provided a clearer pain understanding. Conclusion: Mapping as own activity, and cooperation with supportive personnel showing respect for patients’ own experiences, may promote empowerment, and further motivate own efforts and progress of the rehabilitation process.

Role of Rehabilitation Counseling and Psychology in Working with Individuals with Work-related Chronic Pain Injuries: An Interdisciplinary Approach-Chronic Pain and Work Injuries in the United States

This paper addresses the topic of an interdisciplinary approach of chronic pain management from a biopsychosocial perspective. The first section provides an introduction to the definitions and theories of chronic pain and the various contributing factors (psychological, interpersonal/environmental and social support, and vocational). The second section presents the role of various health care professions (medical doctors, nurses, physical therapists, occupational therapists, psychologists and rehabilitation counselors) and the evidence of their treatment effectiveness. The third section discusses the concept of an interdisciplinary pain rehabilitation program (IPRP) and its evidence to support its effectiveness. Finally, the clinical implications of rehabilitation counseling and psychology as part of the inter-disciplinary program in treating individuals with chronic pain will be highlighted.

Complex regional pain syndrome: From diagnosis to rehabilitation

Complex regional pain syndrome(CRPS) is a debilitating pathology characterised by intense chronic pain associated with vasomotor, sensory and motor dysfunction of the affected limb. Although the pathophysiology of CRPS is not fully understood, it is recognised that inflammatory processes and autonomic dysfunction are involved. These processes are associated with peripheral and central sensitisation as well as changes in brain structure and function, and are reflected in the clinical presentation of CRPS. CRPS management requires an interdisciplinary team and requires the therapeutic approach to be individualised. With regard to pharmacological treatment, bisphosphonates, corticosteroids, ketamine and anticonvulsants have been demonstrated to be effective for CRPS management. Psychotherapy, including cognitive-behavioural therapy, has produced promising results but more studies are needed to confirm its efficacy. Among rehabilitation interventions, there is evidence of the efficacy of physiotherapy and occupational therapy in diminishing CRPS symptoms and achieving a higher level of functioning. In this regard, the rehabilitation modality that seems the most promising according to the actual literature is graded motor imagery, which can help to reverse the maladaptive neuroplasticity occurring in CRPS.

Results of Chronic Neck Pain Rehabilitation at Cotonou

Background: Neck pain is a real public health problem. Its treatment uses different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of the cervical spine, muscle strength and functional capacity of the patient. Anova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. The neck pain, at least of moderate intensity (97.26%), was present since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.

Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center

Background: Chronic exertional compartment syndrome(CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS, it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center.Methods: Patients from all military services were referred from the special unit for lower leg pain at the Central Military Hospital, Utrecht, the Netherlands. Descriptive analysis was used to report the characteristics of the participants and their baseline measurements. Group differences were analyzed using a Student's t-test or MannWhitney U test, according to the normality of the data distribution. Differences between the pre-and postintervention outcomes were evaluated using the Wilcoxon signed rank test. To evaluate the magnitude of prognostic factors, a univariate logistic regression analysis was performed. The prognostic factors included age, body mass index, body fat percentage, self-efficacy beliefs, foot malalignment, intramuscular pressure, other comorbidities, protein and creatine use, smoking, alcohol use, complaint duration, physical demands, and duration of military service.Results: After the rehabilitation period, we observed 25 patients with a successful outcome, which was defined as a reduction in pain(≥2 points) during the capacity test measured using a verbal rating scale and 20 patients with an unsuccessful outcome. Factors demonstrating a limited increased odds ratio for an unsuccessful outcome included smoking, alcohol use, intramuscular pressure, a complaint duration of more than 6 months, and physical demands of service. However, these factors did not reach significance.Conclusion: This study did not identify any prognostic factors that predict the outcome of a rehabilitation program for CECS. A larger sample using an identical design might provide further evidence regarding prognostic factors, which would facilitate development of a model that predicts the outcomes of a rehabilitation program for CECS.

Modification in self-rated health in patients discharged by a geriatric rehabilitation ward

Self-rated health is a valuable outcome in geriatric rehabilitation besides objective results. The present work aims at measuring and analyzing overall health as it is perceived at admission into and at discharge from a geriatric rehabilitation ward. Overall health was self-appraised through a visual-analogue scale (VAS), spanning from 0 (worst) to 10 (best). We studied 1997 patients (70% females), aged 79 (standard deviation, s.d. 8.7) years;most were frail, either functionally, clinically and cognitively. 80% of patients were discharged to home after a length of stay lasting 47.5 (s.d. 22.7) days. At admission, 3/5 patients appraised favorably their overall health (VAS ≥ 6/10): at discharge, the proportion rose to 3/4, with a mean (s.d.) gain = 2 (2) points. The improvement in self-perceived health score positively correlates with the grade expressing clients’ overall satisfaction for the stay (p 0.001), and with discharge versus admission differences in: Barthel Index (BI) total score (p < 0.001), Tinetti total score, Mini Mental State Examination (MMSE), Geriatric Depression Scale (5?items GDS), pain (VAS 0 to 10). A Linear regression model predicting the changes in self-perceived health included changes in BI, MMSE, GDS, pain, dropping Tinetti test. Changes in self-rated health were positively correlated to functional gain adjusted for pre-morbid level, and to relative functional gain. By analysis of variance, health self-appraisal changed more favorably in patients discharged to home than for other social outcomes (all p < 0.001). As expected, trends in self-perceived health parallel improvements in objective functional gauges and subjective indicators.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective:To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation.Methods:From January to September 2022,300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups,low frequency,high frequency,and alternating frequency,with 100 cases in each group.In addition to routine postpartum care and psychological counseling,the three groups received transcutaneous electrical acupoint stimulation at low-frequency(2 Hz,)high-frequency(100 Hz),and alternating frequency(2/100 Hz),respectively.The differences in initial pain,pain scores before and after treatment,satisfaction with analgesic effect,and postpartum rehabilitation effect were evaluated among the three groups of patients.Results:There was a significant correlation between maternal age and postpartum pelvic girdle pain(P<0.001),but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain(P>0.05).After 1d/2d of treatment,the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group,and the postpartum curative effect of patients in the alternating-frequency group was the best,followed by the low-frequency group,and the high-frequency group;the differences were statistically significant(P<0.001).Among the three groups,the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time;the differences were statistically significant(P<0.001).Conclusion:Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation.Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain.It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction.Therefore,its application in clinical practice is highly recommended.

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.

Pain and Radiographic Changes in Adult Scoliosis Patients Using a Scoliosis Activity Suit: Case-Controlled 10-Year Follow-Up Results

Scoliosis in adult patients is known to increase across the lifespan and increases the chance of chronic pain in later adulthood. Non-surgical scoliosis treatment options for adults are not widely recommended, largely due to lack of research in this area. Pain management options for adults are focused primarily on treating scoliosis-related pain, and not necessarily the scoliosis itself, such as epidural injections, prescription pain medications, and general physical therapy. Recent studies reporting non-surgical, scoliosis-specific treatment methods in adults are encouraging, but their study designs limit extrapolation. The current study reports the self-reported pain and radiographic outcomes in adult patients wearing a scoliosis activity suit for at least 10 years. A total of 22 patient charts that fulfilled the inclusion criteria were selected for review. Cobb angle radiographic measurements and self-rated quadruple numerical pain rating scale (QVAS) at baseline and 10-year follow-up were used as the outcomes. Cobb angle measurements were compared at baseline and 10 years and subdivided according to scoliosis curve pattern. At 10 years, 68% of patients had improvements in their Cobb angle > 5˚, with an overall average of approximately 9˚. Significant differences were also observed in the 10-year Cobb angle measurements when compared to the predicted 10-year Cobb angles based on the established rate of linear progression in adults. A statistically significant change was also observed in the 10-year QVAS scores. These results suggest a potential role of the scoliosis activity suit for improving Cobb angles in adults and reducing scoliosis-related pain.

老年全膝关节置换术患者术后康复训练依从性观察及其影响因素

目的 探讨老年全膝关节置换术(TKA)患者术后康复训练依从性及其影响因素分析。方法 回顾性分析2022年1月至2023年1月于武汉市第一医院行TKA的244例老年患者的临床资料,且在术后3个月评估所有患者康复训练依从性,并比较不同临床特征老年TKA患者康复训练依从性评分差异。通过多因素logistic回归分析影响老年TKA患者康复训练依从性的危险因素并构建风险预测模型。通过受试者工作特征(ROC)曲线分析风险预测模型预测老年TKA患者康复训练依从性的价值。选用SPSS 22.0统计软件对数据进行处理。根据数据类型,分别采用t、F检验进行组间比较。结果 244例老年TKA患者康复训练依从性评分中身体锻炼依从评分为(13.27±3.09)分、主动寻求锻炼依从评分为(6.88±2.04)分、锻炼监督依从评分为(6.12±1.81)分;康复训练依从性总分为15~32(23.27±6.94)分。女性、年龄≥80岁、合并疾病>2种、初中文化程度、无配偶、独居、月收入<500元、有慢性疼痛的老年TKA患者康复训练依从性总分显著低于男性、年龄<80岁、合并疾病≤2种或无、高中及以上文化程度、有配偶、与配偶或子女同住或其他、月收入≥500元、无慢性疼痛的老年TKA患者,差异有统计学意义(P<0.05)。经多因素logistic回归分析证实,女性(OR=3.544,95%CI 1.036~12.123)、年龄≥80岁(OR=1.052,95%CI 1.024~1.081)、合并疾病>2种(OR=4.418,95%CI 1.274~15.321)、初中文化程度(OR=4.274,95%CI 1.542~11.846)、无配偶(OR=3.245,95%CI 1.244~8.465)、独居(OR=1.226,95%CI 1.105~1.360)、月收入<500元(OR=2.429,95%CI 1.442~4.092)、有慢性疼痛(OR=2.015,95%CI 1.009~4.024)为影响老年TKA患者康复训练依从性的危险因素。经ROC分析证实,风险预测模型预测老年TKA患者康复训练依从性的曲线下面积为0.934,标准误为0.014,95%CI为0.907~0.961,最佳截断点为35.499,灵敏度为0.925,特异度为0.890。结论 老年TKA术后康复训练依从性受到较多因素的影响,同时经ROC分析证实风险预测模型对老年TKA患者康复训练依从性具有较好的预测价值,或可为后续康复训练工作的开展提供帮助。

多学科围术期疼痛干预对胸腔镜肺叶切除术患者术后疼痛、术后恢复和并发症的影响

目的:探讨多学科围术期疼痛干预对胸腔镜肺叶切除术(VATS)术后疼痛、术后恢复和并发症的影响。方法:选取施行VATS治疗的116例患者为研究对象。依据干预方式不同将116例VATS患者分为对照组和观察组,每组各58例。对照组实施常规疼痛干预;观察组实施多学科围术期疼痛干预。比较两组疼痛情况[数字疼痛评分法(NRS)]、术后恢复情况、术后康复质量[Quality of Recovery-15,QoR-15]及并发症发生情况。结果:术后24 h及术后72 h观察组静息及咳嗽时NRS评分均低于对照组(P<0.05)。观察组术后首次下床活动时间、首次排气时间、首次经口进食时间及术后住院时间均短于对照组(P<0.05)。术后72 h,两组QoR-15评分均高于术后24 h(P<0.05),且观察组术后24、72 h QoR-15评分均高于对照组(P<0.05)。观察组总并发症发生率低于对照组(8.61%vs.22.41%,P<0.05)。结论:多学科围术期疼痛干预可降低VATS术后疼痛,促进术后恢复进程,提升康复质量,并能在一定程度上减少并发症发生。

系统化快速康复训练在老年股骨颈骨折患者术后的应用效果

目的探究系统化快速康复训练在老年股骨颈骨折患者术后的应用效果。方法选取江苏省南通市第三人民医院2019年1月至2022年1月收治的老年股骨颈骨折患者94例,应用奇偶分组法将其分为对照组和观察组,各47例。对照组行常规训练干预,观察组在对照组的基础上加用系统化快速康复训练。比较两组疼痛情况、行动功能、生活质量及髋关节功能。结果整体分析发现:两组疼痛组间、时间点及交互作用比较差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组组内各时间点疼痛评分比较,差异均有统计学意义(P<0.05);组间比较:观察组术后各时间点疼痛评分均低于对照组,差异有统计学意义(P<0.05)。干预后,两组行动功能评分及髋关节评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。干预后,两组生活质量评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论系统化快速康复训练能够提高老年股骨颈骨折术后患者的行动功能及生活质量,降低患者的疼痛水平,具有重要的应用意义。

基于恐惧-回避模型的康复护理方案在老年慢性心力衰竭患者中的应用

目的减轻老年慢性心力衰竭患者康复运动恐惧心理,促进其运动康复。方法便利抽取70例心内科住院老年慢性心力衰竭患者,按入院时间分为两组各35例;两组均行常规治疗护理,同时对照组行常规康复护理,干预组构建和实施基于恐惧-回避模型的康复运动方案,持续干预至出院后1个月评价效果。结果干预后干预组心功能指标显著优于对照组(均P<0.05),心脏病运动恐惧得分、明尼苏达州心力衰竭生活质量得分显著低于对照组(均P<0.05);运动方案实施过程中未发生运动相关不良事件。结论对老年慢性心力衰竭患者实施基于恐惧-回避模型的康复运动方案能减轻患者运动恐惧心理,改善心功能,提高生活质量。

针刺核心肌群联合康复训练治疗慢性非特异性腰痛的临床观察

【目的】观察针刺核心肌群联合康复训练治疗慢性非特异性腰痛的临床疗效。【方法】将96例慢性非特异性腰痛患者随机分为观察组和对照组,每组各48例,对照组给予康复训练,观察组在对照组治疗的基础上,给予针刺核心肌群训练。2组患者均连续治疗2周。治疗2周后,评价2组临床疗效,观察2组患者治疗前后腹横肌与多裂肌均方根(RMS)值的变化情况,以及Oswestry功能障碍指数评分、Roland-Morris功能障碍调查表评分、魁北克腰痛障碍量表评分的情况。比较2组患者治疗前后血清β-内啡肽、血清P物质、血清前列腺素E2水平的变化情况。治疗后随访5个月,评价2组患者的复发情况。【结果】(1)观察组总有效率为93.75%(45/48),对照组为81.25%(39/48)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的Oswestry功能障碍指数评分、Roland-Morris功能障碍调查表评分、魁北克腰痛障碍量表评分明显改善(P<0.05),且观察组在改善Oswestry功能障碍指数评分、Roland-Morris功能障碍调查表评分、魁北克腰痛障碍量表评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的腹横肌、多裂肌RMS值明显改善(P<0.05),且观察组在改善腹横肌、多裂肌RMS值方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者β-内啡肽、P物质、前列腺素E2水平均明显改善(P<0.05),且观察组在改善β-内啡肽、P物质、前列腺素E2水平方面均明显优于对照组,差异均有统计学意义(P<0.05)。(5)治疗后观察组复发率为6.25%(3/48),对照组为20.83%(10/48),观察组复发率明显低于对照组,差异有统计学意义(P<0.05)。【结论】针刺核心肌群联合康复训练治疗慢性非特异性腰痛,能明显改善患者的临床症状,改善患者β-内啡肽、P物质、前列腺素E2水平,临床疗效显著。

以快速康复理念为指导的整体优化康复训练对老年肌少症全髋关节置换患者康复效果的影响

目的探讨以快速康复理念为指导的整体优化康复训练对老年肌少症全髋关节置换患者康复效果的影响。方法选取2020年4月—2023年4月收治的老年肌少症全髋关节置换患者126例,按照随机数字表法分为研究组和常规组各63例。常规组给予常规干预,研究组在常规组基础上给予基于快速康复理念制订的整体优化康复训练。比较2组康复指标、肺活量、优势手握力、简易躯体能力测试(SPPB)、髋关节功能[Harris髋关节功能评分量表(Harris)]、负性情绪、自我管理能力、日常生活能力[日常生活能力量表(ADL)]及视觉模拟评分法(VAS)评分。结果研究组下床活动、进食、肛门排气、住院时间短于常规组(P<0.01)。研究组术后1、6个月后肺活量、优势手握力、SPPB评分、Harris评分、自我管理能力评分高于常规组,负性情绪、ADL评分低于常规组(P<0.05,P<0.01)。出院当天、术后1个月,研究组VAS评分[(2.03±0.31)、(0.75±0.21)分]均低于常规组[(3.14±0.35)、(1.26±0.39)分](P<0.05,P<0.01)。结论以快速康复理念为指导的整体优化康复训练可促进老年肌少症全髋关节置换患者病情康复,改善术后优势手握力、肺功能,调节患者情绪状态,促进患者躯体功能、髋关节功能恢复,并提升患者自我管理能力及日常生活能力。

抗阻训练对航母舰载机飞行学员颈部疼痛和颈部功能的影响

目的通过运动疗法和颈肌抗阻训练改善飞行员颈部功能,研究抗阻训练对舰母载机飞行学员颈部疼痛水平和表面肌电活动的影响。方法对航母舰载机飞行学员进行颈部疼痛干预实验,实验周期为3个月。纳入23~35岁的男性舰载机飞行学员,运动前进行健康筛查和风险评估,排除高风险人群。发放调查问卷,包括颈椎功能障碍指数表和中国体力活动调查表。进行颈肌功能测试,包括颈肌最大肌力、颈椎关节活动度和表面肌电。将实验对象随机分为两组,每组各8名。第一组为对照组,每天照常进行部队安排的训练;第二组为抗阻训练组,在照常进行部队安排训练的基础上使用自主研发的舰载机飞行员用颈椎病预防训练器,制订有针对性的训练方案。每周进行3次抗阻训练,每次训练时间为20 min,在干预实验结束时再次测试颈肌最大肌力、颈椎关节活动度和表面肌电值。将所有数据导入SPSS 22.0软件,结果采用平均值±标准差(x±s)表示,以P<0.05为差异具有统计学意义。结果(1)干预3个月后,抗阻训练对视觉疼痛模拟评分(VAS)的影响效果显著。(2)干预后受试者颈椎功能障碍指数(NDI)的自身前后测试结果表明,其颈椎功能障碍水平得到明显好转。(3)干预后,受试者自身关节活动度的组间对比结果显示,抗阻训练组受试者的前屈、后伸、左屈、右屈、左旋和右旋的自身变化差值比较,差异具有统计学意义(P<0.05)。(4)干预后,两组受试者的自身颈部肌力结果显示,抗阻训练组受试者的六个动作自身变化差值比较,差异无统计学意义(P>0.05)。(5)干预前后在前屈、后伸、左屈、右屈四个动作测试中抗阻训练组的均方根值(RMS)结果显示,左右胸锁乳突肌和左右侧斜方肌上束的差异均无统计学意义(P>0.05)。(6)干预前后在前屈、后伸、左屈、右屈四个动作测试中抗阻训练组的积分肌电值(iEMG)结果显示,左右胸锁乳突肌和左右侧斜方肌上束的差异均无统计学意义(P>0.05)。结论接受3个月抗阻训练可有效缓解舰载机飞行学员的颈部疼痛,改善颈椎功能障碍以及颈部被测四块肌肉深浅肌纤维的载荷,增强颈部肌肉力量、抗疲劳能力和颈部关节活动度,优化颈部深浅层肌肉的激活模式。