Objective To observe the effect of comprehensive rehabilitation in patients with peripheral nerve injuries after the Wenchuan earthquake. Methods A total of 24 cases of peripheral nerve injuries who were admitted to the Rehabilitation Center for Earthquake Victims of West China Hospital of Sichuan University were treated with comprehensive rehabilitation, including exercise therapy, acupuncture therapy, functional electrical stimulation, and occupational therapy (mainly sensory training and wearing orthosis). After 30 treatment sessions, patient motor and sensory function, upper limb functional activity, and electrodiagnostic parameters were evaluated. Meanwhile, concomitant injuries were also recorded. Results As for the recovery of motor and sensory functions, the effective rate was 41.66%. The difference in the scores of upper limb functional activities was statistically significant before and after treatment (Plt;0.01). As assessed by electromyogram and nerve conduction velocity, the response rate was 87.50%. Patients with more concomitant injuries were likely to have slower recovery. Conclusion Comprehensive rehabilitation is appropriate and effective for patients with peripheral nerve injuries after the Wenchuan earthquake.
目的:评价综合康复措施对预防地震髋部骨折伤员深静脉血栓形成的作用。方法：按深静脉血栓形成的高危因素对195例地震髋部骨折伤员进行分级评估,并针对性实施综合康复措施,观察深静脉血栓的症状和体征,了解深静脉血栓的发生情况。结果：地震髋部骨折伤员应用综合康复措施后,尚未发现下肢深静脉血栓形成的病例。结论：综合康复措施能有效地预防地震髋部骨折伤员深静脉血栓的形成。
【摘要】 目的 观察综合康复治疗对汶川地震截肢伤员功能障碍的临床疗效。 方法 对5•12汶川大地震22例挤压伤截肢患者的24条截肢残端实施护理、摆放良肢位、运动治疗、残端塑形、紫外线疗法、红外线疗法、石蜡疗法、音频电疗法、经皮电刺激神经疗法、关节松动、按摩和拍打、超短波治疗、作业疗法和心理治疗等综合康复治疗，直至截肢伤员出院为止。视觉模拟评分法量表评定幻肢痛疼痛强度、测定膝关节和髋关节活动范围、Barthel指数评定日常活动。 结果 治疗前幻肢痛疼痛强度为2.95±1.33，治疗后为0.50±0.96；治疗前肘关节活动范围为（90.0±28.3）º，治疗后为（135.0±7.1）º；治疗前肩关节屈伸活动范围为（68.8±27.8）º，治疗后为（137.5±9.6）º；治疗前肩关节收展活动范围为（53.8±7.5）º，治疗后为（96.3±4.8）º；治疗前膝关节活动范围为（91.0±23.0）º，治疗后为（123.0±6.7）º；治疗前髋关节屈伸活动范围为（86.9±25.9）º，治疗后为（132.3±13.8）º；治疗前髋关节收展活动范围为（46.9±10.9）º，治疗后为（64.6±8.7）º；治疗前Barthel指数为57.05±18.69，治疗后为78.18±13.85，康复治疗前后均有统计学意义（Plt;0.05）。 结论 地震后截肢不良残肢发生率高，综合康复治疗能促进截肢残端伤口愈合和消除残肢疼痛，可明显改善残肢条件，有利于地震截肢患者功能恢复和日常生活能力的提高，为后期的假肢安装及步态训练创造了条件。【Abstract】 Objective To observe the efficiency of comprehensive rehabilitation therapy on amputation patients after Wenchuan earthquake. Methods Twenty-two amputation patients after Wenchuan earthquake with 24 stumps were treated with postoperative wound care, maintaining the correct position of the limbs, exercise therapy, stump shaping, ultraviolet therapy, infrared therapy, paraffin therapy, audio electrotherapy, transcutaneous electrical nerve stimulation therapy, joint mobilization, massage, beat, ultrashort wave therapy, occupational therapy and psychotherapy and so on until discharged. The results were measured from the following aspects: pain intensity using VAS, rangement of knee joint and hip joint, Barthel index of ADL before and after rehabilitation. Results Pain intensity of phantom limb pain were (2.94±1.53) before rehabilitation,and (0.44±1.03) after; the movement range of elbow was (90.0±28.3)º before and(135.0±7.1)º after; the movement range of shoulder flexion and extension was (68.8±27.8)º before and (137.5±9.6)º after; the movement range of shoulder abduction and adduction was (53.8±7.5)º before and (96.3±4.8)º after rehabilitation; the movement range of knee was (91.0±23.0)º before and (123.0±6.7)º after rahabiliation; the movement range of hip flexion and extension was (86.9±25.9)º before and (132.3±13.8)º after; the movement range of hip abduction and adduction was (46.9±10.9)º before and (64.6±8.7)º after; the score of Barthel index was 57.05±18.69 before and 78.18±13.85 after. The difference between before and after rehabilitation were statistically significant (Plt;0.05). Conclusion The incidence of adverse amputation stumps after the earthquake was high. Integrative rehabilitation has an positive effect on promoting wound healing, by eliminating stump pain and recovering lower limb function, improving daily living function and social ability, and creating conditions for installing prosthesis limbs and gait training in later period.
The aging of the population is grim, and the functional disability of older adults is increasing, bringing heavy burden to society. Previous studies have shown that rehabilitation is beneficial to improve the various functional disorders of the functional disability of older adults, and help them recover their activities of daily living and improve their quality of life. However, the multi-disciplinary comprehensive management model is still in its infancy in China, and there is a lack of multi-disciplinary full-period comprehensive rehabilitation management exploration for the functional disability of older adults. Therefore, based on the relevant literature, this experts consensus summarizes the rehabilitation evaluation and intervention of the functional disability of older adults from nine functional dimensions: movement, vision, hearing, cognition, swallowing, cardiopulmonary, defecation, psychology and activities of daily life, in order to provide reference for the comprehensive rehabilitation management of the functional disability of older adults.
Objective To construct the expert consensus on comprehensive rehabilitation assessment system for the elderly in the hospital and community. MethodsMedline, Embase, Cochrane Library, China National Knowledge Infrastructure and VIP databases were searched for geriatric rehabilitation assessment materials from June 2016 to June 2021. The primary items were summarized through literature review and research group discussion, and then Delphi method was used among 20 experts in geriatric rehabilitation medicine to develop consensus-based core items for the elderly comprehensive rehabilitation assessment system. Results A total of 158 references were included. Through integration, sorting and screening, the research team initially formulated 41 items and four major sections including cardiopulmonary exercise, sensory perception, cognition and psychology (speech contained), and swallowing, urination and defecation. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.92±0.05, the variation coefficients were 0.174±0.043 and 0.172±0.063, respectively; the Kendall coefficients of concordance were 0.587 and 0.601, with P values<0.05 for both, respectively. Finally, The comprehensive rehabilitation assessment system for the elderly including 16 items would be formed. Conclusion The expert consensus on comprehensive rehabilitation assessment system for the elderly constructed by Delphi method includes motor, sensory perception, cognition, swallowing, speech, cardiopulmonary, defecation, mental and psychological elements, which are identified with high recognition and consistency from experts.