Pusher syndrome (PS) is a postural control disorder that occurs after stroke, which is mainly manifested as a balance dysfunction that is difficult to correct, leading to a significant decline in activity safety of stroke patients and hindering the process of rehabilitation treatment. Proper interventions are needed as soon as possible. Based on the research results of PS both domestic and foreign, this paper firstly summarizes the foundations of the mechanism of PS occurrence, and elaborates the existing disputes. Secondly, this paper systematically introduces the current mainstream assessment and treatment methods of PS, summarizes the problems in relevant clinical practice, and on this basis, gives some suggestions on the possible research directions in the future. The purpose is to provide reference for clinical application and future research directions.
ObjectiveTo explore and verify the effectiveness of task-oriented circuit therapy (TOCT) in rehabilitation training for stroke patients’ walking ability.MethodsSixty patients with stroke were selected from the Department of Neurology and Department of Rehabilitation Medicine of West China Hospital of Sichuan University from September 2019 to December 2020. By envelope method, the patients were randomly divided into the trial group and the control group, with 30 cases in each group. Both groups received routine rehabilitation treatment. The patients in the control group received conventional one-to-one rehabilitation therapy, and the patients in the trial group received TOCT training. The training lasted for 4 weeks. The patients were followed up 3 months after the training. Motor Assessment Scale (MAS) and Functional Ambulation Category Scale (FAC) were used to evaluate the walking ability of the patients before training, at the end of 4 weeks of training (after training) and at the follow-up. SF-36 health survey short form was used to evaluate the quality of life of patients before training and during follow-up.ResultsBefore training, there was no significant difference in gender, age, course of disease, stroke location, walking ability score or SF-36 score between the two groups (P>0.05). After training and at follow-up, the walking ability related scores of the two groups were improved. The trial group was better than the control group (MAS: Z=−3.220, P=0.001; Z=−4.703, P<0.001. FAC: Z=−2.447, P=0.014; Z=−3.249, P=0.001). SF-36 scores of the two groups were improved after 3 months of follow-up. The trial group was better than the control group (Z=−6.674, P<0.001). During the study period, there were no complications or adverse reactions related to rehabilitation training.ConclusionsTOCT has a significant effect on rehabilitation training of lower limb function of stroke patients. It has more advantages than conventional rehabilitation training in improving the walking ability and the quality of life of patients.
ObjectiveTo explore the clinical features, etiological characteristics of co-infections in adult patients with rhinovirus pneumonia.MethodsFourty-nine patients admitted to hospitals for rhinovirus pneumonia were enrolled from 8 medical centers in mainland China between August 2016 and August 2018. Multiplex real-time polymerase chain reaction assays for viral detection were implemented to all bronchoalveolar lavage fluid specimens obtained from the patients. The patients were divided into two groups depending on the status of other etiology co-infection (simple rhinovirus pneumonia group, n=24; coinfections group, n=25). The general data were collected, age, gender, underlying diseases, corticosteroids, symptoms, disease severity, imaging manifestations, etiology, whether patients with respiratory failure, mechanical ventilation, whether the application of vasoactive drugs, antibiotics application, hospital mortality rate of the two groups were reviewed and compared in detail.ResultsThirteen patients (26.5%) with rhinovirus pneumonia had no underlying diseases, 8 patients (16.3%) with chronic underlying lung diseases, 6 patients (12.2%) with diabetes mellitus, 10 patients (20.4%) were immunocompromised patients, 16 patients (32.7%) with respiratory failure, and the hospital mortality rate was 8.2% (4/49). Cases with coinfection were remarkably correlated with more cerebrovascular diseases and disturbance of consciousness, higher PSI score and higher ratio of CURB-65 score >1, more respiratory failure and hospital mortality than those of simple rhinovirus pneumonia group (P< 0.05). There were 25 cases (51.0%) with mixed infection, including 18 bacteria (36.7%), 12 viruses (24.5%), 12 (24.5%) fungi (pneumocystis, aspergillus). Enterobacter and Pseudomonas aeruginosa were most frequently identified bacteria in the viral-bacterial group. Four patients with coinfections died.ConclusionsRhinovirus pneumonia in adult patients often has underlying diseases, and is prone to coinfections (bacteria, fungi, and other viruses). The outcome of these patients is always poor.