ObjectiveTo discuss the clinical curative effect of internal fixation for metacarpal and phalanx fractures using stainless steel mini-plate and the early rehabilitation. MethodsThe study included 47 cases treated from January 2006 to June 2011, including 25 cases of 72 phalangeal fractures, 17 cases of 43 metacarpal fractures, and 5 cases of 23 complex metacarpal and phalangeal fractures. All the patients underwent open reduction and micro-plate internal fixation. Three days after surgery, passive function training was initiated. Patients accompanied with blood vessel damage began the training one week later. The training was carried out based on the early rehabilitation schedule. ResultsPrimary healing occurred in all the 47 cases. There was one case of broken plate because of crashing. Postoperative follow-up lasted for 4 to 10 months, and the fractures were healed in 138 lesions. X-ray examination showed that bone union took place at week 8 to 11 averaging at 10. According to the functional evaluation of total autive movement scales, the excellent and good rate was 83.0%. ConclusionThe stainless steel mini-plate in the treatment of metacarpal and phalangeal fractures has a firm fixation and is advantageous. Combined with early rehabilitation training, it can maximize the recovery of hand function with satisfactory clinical results.
ObjectiveTo investigate the effectiveness of ileal mucosal seromuscular patch for bladder expansion combined with rehabilitation training for treating neurogenic bladder dysfunction (NBD) with hyperreflexia. MethodsA retrospective study was performed on the clinical data of 61 patients with NBD and hyperreflexia who were treated and followed up between July 2008 and June 2013. There were 36 males and 25 females, aged 6-23 years (mean, 10 years). The reasons included meningomyelocele operation (43 patients), surgery for lipoma in lumbar vertebra (4 patients), operation of thoracolubar teratoma (2 patients), and lumbosacral spina bifida (12 patients). The results of urodynamics indicated that bladder volume decreased obviously and the residual urine increased. The voiding cystourethrography (VCUG) showed the vesicoureteral reflux (VUR), including 6 cases (10 sides) of grade V, 7 cases (12 sides) of grade IV, and 6 cases (8 sides) of grade III. The color doppler ultrosound showed mild hydronephrosis in 23 cases (41 sides), moderate hydronephrosis in 25 cases (42 sides), and severe hydronephrosis in 13 cases (22 sides). The blood biochemical examination suggested chronic renal failure (CRF) in 13 cases. The treatment included augmentation for bladder and rehabilitation training after operation. ResultsThe operation time was (157±26) minutes; the intraoperative blood loss was (43±15) mL, and no patient was given blood transfusion. The patients were followed up 1.5-6.0 years (mean, 4.5 years). Vesical fistula occurred in 4 cases, urinary infection in 5 cases, dysuresia in 2 cases, and cystolith in 1 case after operation. At 1 year after operation, the International Consultation on Incontinence Questionnaire-Urinary Incontience Short Form (CIQ-SF) score was significantly better than preoperative score (H=89.813, P=0.000). The urodynamic data showed that the difference value between observed and theoretical bladder volumes, bladder compliance, residual urine volume, maximum flow rate, and maximum storage detrusor pressure were significantly better than preoperative ones (P<0.05). And the color doppler ultrasound showed mild hydronephrosis in 34 cases (56 sides), moderate hydronephrosis in 18 cases (33 sides), and severe hydronephrosis in 9 cases (16 sides). VCUG showed that bladder volume obviously increased, no contracture was observed; and VUR was improved. And renal function was improved in 13 patients with CRF. ConclusionIleal mucosal seromuscular patch for bladder expansion combined with postoperative rehabilitation training has good effectiveness in treating NBD with hyperreflexia.
Objective To investigate and explore the clinical effect of preoperative exercise intervention on total hip arthroplasty. Methods Seventy-three patients who underwent primary unilateral total hip replacement (THR) in the Orthopedics Department, the Second Hospital of Jilin University between March 2017 and January 2018 were divided into 2 groups: treatment group (n=37) and control group (n=36). Patients in treatment group received exercise intervention and routine education since 4 weeks before surgery; the control group just received routine education before surgery and both groups underwent the same routine rehabilitation training. The Visual Analogue Scale (VAS) was evaluated and compared separately between the two groups at 4 weeks before surgery (T0), 1 day before surgery (T1), before discharge (T2), 1 month after discharge (T3), and 3 months after discharge (T4). The results of Hip Harris score and Time Up and Go test (TUG) were evaluated and compared separately between the two groups at T0, T1, T3 and T4. Results Time of TUG of the treatment group and the control group at T1, T3 and T4 were (14.59±3.15) vs. (16.31±3.31) s, (13.61±2.76)vs. (15.25±3.08) s, (12.49±2.37)vs. (14.22±2.65) s, respectively, and the differences between the two groups at T1, T3 and T4 were all statistically significant (P<0.05). In terms of VAS and Harris scores, both groups showed significant improvement after surgery at different time nodes (P<0.05), but the differences between the two groups was not statistically significant (P>0.05). Conclusion Preoperative exercise intervention can effectively improve the walking ability of THR patients and reduce the risk of falls after discharge, but it did not reduce postoperative pain or improve postoperative hip Harris score after discharge.
ObjectiveTo systematically evaluate the effectiveness of acupuncture combined with rehabilitation training compared with simple rehabilitation training or acupuncture treatment of dysphagia after stroke, and make clear whether the effect of acupuncture combined with rehabilitation training is better than simple rehabilitation training or acupuncture treatment.MethodsSix databases including China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP, PubMed, Cochrance Library, and Embase were searched by computer for the randomized controlled trials on acupuncture combined with rehabilitation training treatment of post-stroke dysphagia, which were published from January 1st, 2010 to December 31st, 2018. After literature including, excluding, and screening, RevMan 5.3 software was used to conduct a meta-analysis.ResultsA total of 22 studies were included, including 1 987 patients. All the included studies took simple rehabilitation training or rehabilitation training combined with sham acupuncture as the control. Meta-analysis of efficiency and outcome measures for relevant studies showed that: compared with simple rehabilitation training, the effectiveness of acupuncture combined with rehabilitation training on post-stroke dysphagia was higher [17 studies included; odds ratio=3.66, 95% confidence interval (CI) (2.66, 5.05), P<0.000 01], the video fluoroscopy swallowing study score of acupuncture combined with rehabilitation training after treatment was higher [8 studies included; mean difference (MD)=2.31, 95%CI (1.75, 2.87), P<0.000 01], and the StandardizedSwallowing Assessment score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=−3.20, 95%CI (−3.78, −2.61), P<0.000 01]; at the same time the Watian Drinking Water Test score of acupuncture combined with rehabilitation training after treatment was lower [6 studies included; MD=−0.65, 95%CI (−0.91, −0.39), P<0.000 01].ConclusionsAcupuncture combined with rehabilitation training is effective in dysphagia after stroke, and the combined effect is better than simple rehabilitation training. However, due to the limitations of quality of included literature and sample size, the above results and conclusions still require high quality and large sample studies to testify.
ObjectiveTo explore the effect of rehabilitation training focusing on early exercise on the time of first getting out of bed after surgery, pain during early activities, postoperative infection rate and the length of hospital stay for renal transplant recipients.MethodsThe clinical data of patients undergoing allogeneic renal transplantation in West China Hospital of Sichuan University from June to August 2020 were analyzed retrospectively. According to the time of multidisciplinary postoperative management and the time of early rehabilitation intervention, the patients were divided into the conventional group (from June 2020 to the beginning of multidisciplinary postoperative management) and the rehabilitation group (after multidisciplinary postoperative management). The time to get out of bed for the first time after surgery, the Visual Analogue Score (VAS) during weight monitoring on the second day post operation, the number of days required to complete an independent walk of 100 meters, postoperative complications, the incidence of postoperative infection and the length of hospital stay were compared between the two groups.ResultsA total of 79 patients were included. There were 46 cases in the conventional group and 33 cases in the rehabilitation group. Among the included patients, 14 patients had postoperative infection, 1 patients in the conventional group developed thrombosis, no catheter shedding or bleeding after exercise occurred. The differences between the rehabilitation group and the conventional group in the time to get out of bed for the first time after surgery [(1.1±0.2) vs. (2.2±0.4) d; t=13.224, P<0.001], the VAS during weight monitoring on the day post operation (2.5±0.9 vs. 3.4±1.4; t=3.267, P<0.001), the number of days required to complete an independent walk of 100 meters [(2.2±0.4) vs. (4.0±0.8) d; t=11.312, P<0.001], and the incidence of postoperative infection (6.1% vs. 26.1%; χ2=5.285, P=0.022) were statistically significant. There was no significant difference in the length of stay between the rehabilitation group and the conventional group [(19.8±5.8) vs. (20.7±7.4) d; t=0.584, P=0.561].ConclusionEarly postoperative rehabilitation training reduces the time required for renal transplant recipients to get out of bed for the first time post operation and to walk 100 meters independently, reduce the pain response during early activities, and reduce the incidence of postoperative infection.
The body weight support rehabilitation training system has now become an important treatment method for the rehabilitation of lower limb motor dysfunction. In this paper, a pelvic brace body weight support rehabilitation system is proposed, which follows the center of mass height (CoMH) of the human body. It aims to address the problems that the existing pelvic brace body weight support rehabilitation system with constant impedance provides a fixed motion trajectory for the pelvic mechanism during the rehabilitation training and that the patients have low participation in rehabilitation training. The system collectes human lower limb motion information through inertial measurement unit and predicts CoMH through artificial neural network to realize the tracking control of pelvic brace height. The proposed CoMH model was tested through rehabilitation training of hemiplegic patients. The results showed that the range of motion of the hip and knee joints on the affected side of the patient was improved by 25.0% and 31.4%, respectively, and the ratio of swing phase to support phase on the affected side was closer to that of the gait phase on the healthy side, as opposed to the traditional body weight support rehabilitation training model with fixed motion trajectory of pelvic brace. The motion trajectory of the pelvic brace in CoMH mode depends on the current state of the trainer so as to realize the walking training guided by active movement on the healthy side of hemiplegia patients. The strategy of dynamically adjustment of body weight support is more helpful to improve the efficiency of walking rehabilitation training.
The cleft lip and palate (CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training (Bclp) and 23 CLP patients after rehabilitation training (Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas (cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas (right motor area, Broca area, etc.) was also increased. Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.
Maculopathy caused by various fundus diseases in the late stage is a common cause of low vision. Medical technology is difficult to reverse the loss of macular function currently, so interventions that help improve the visual system, utilize residual visual function, and improve quality of life deserve attention. Damage to the fovea of the macula does not mean that the entire retinal function is impaired. There may be one or more retinal regions adjacent to the fovea that can serve as a fixation center. It is possible to form stable paracentral fixation, complete functional remodeling of the visual system, and effectively utilize residual visual function by taking appropriate training on these potential paracentral fixation points for most patients. In 2021, a clinical guideline has been published for low vision rehabilitation in China. In order to strengthen the precise management of diseases and develop a standard operating procedure for visual training specifically for patients with low vision due to macular disease, the National Clinical Research Center for Eye Diseases initiated and organized relevant domestic experts, utilizing the latest research experience at home and abroad, and through repeated discussions, this consensus (International Practice Guideline Registration Number: PREPARE-2023CN199) was formed as a reference for ophthalmologists, optometrists and rehabilitation physicians in their clinical research and practice.