ObjectiveTo construct the occupational therapy core items oriented by life return for stroke patients, and provide a reliable tool to promote the comprehensive rehabilitation and successful return for stroke patients.MethodsFrom January to February 2020, the primary items were summarized through literature analysis and research group discussion, and then Delphi method was used to determine which items should be included by two rounds of experts consultation.ResultsA total of 22 experts were selected. After two rounds of experts consultation, 60 items in 6 domains were included. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.87±0.54. In the two rounds of experts consultation, the importance scores of consulted items were 7.60±0.97 and 8.06±0.35, respectively; the variation coefficients were 0.14±0.05 and 0.11±0.03, respectively; the Kendall coefficients of concordance were 0.522 (P<0.001) and 0.578 (P<0.001), respectively.ConclusionThrough the Delphi method, the core items oriented by life return are identified with high recognition and consistency from experts, which can be used as a guideline tool for stroke patients in in-hospital occupational therapy, discharge guidance, and community/home rehabilitation.
Spasm is a common complication of stroke with high morbidity and a high disability rate. Spasticity continues to impair the patient’s motor function, and symptoms such as muscle shortening and joint deformity may occur, which seriously affects the patient’s physical and mental health. Systemic therapy is a key part to control spasticity clinically. However, systematic treatment is conducted on the basis of proper assessment. The tools for assessing spasticity are divided into two categories: subjective and objective, and the subjective assessment tools mainly include some scales, which are subjectively assessed and judged by the therapist. Objective methods mainly include electrophysiology testers, ultrasonic measurement techniques, robots, three-dimensional motion analysis systems, isokinetic muscle strength testers, etc. This paper analyzes and summarizes the methods of post-hemiplegic spasticity assessment through a literature review, reviews the advantages, disadvantages and practicability of various assessment methods, and puts forward prospects for future research directions.
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.
Objective To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice. Methods A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables. Results The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS. Conclusions The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.
Low-level laser therapy (LLLT) as an effective therapy with biochemical change has gained more and more attention in clinical treatment. This review sorts many fundamental experiment studis and clinical applications about LLLT published in recent years, and summarizes the advances of evidence-based proofs of the potential mechanisms of LLLT with different wavelengths in treating osteoarthritis. It shows that LLLT could relieve pain, modulate inflammatory response, protect cartilage, and prevent cartilage degeneration, through increasing cell proliferation, stimulating fibroblasts to produce collagen, bone repair, and regulating inflammatory markers and so on. LLLT with different wavelengths has different effect, and it is important for clinical practice.
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.