Objective To review the methods of metacarpal and phalange lengthening and to point out the problems at present as well as to predict the trend of development in the field. Methods Domestic and abroad l iterature concerning the methods of metacarpal and phalange lengthening in recent years was reviewed extensively and thoroughly analyzed. Results At present, there are many methods to treat the short finger disabil ity, but the methods of metacarpal and phalange lengthening have an advantage, which include closed osteotomy lengthening, callus-lengthening, and modified Il izarovmethod. Each surgical method has its advantages and l imitations. However, the part of osteotomy, the length and speed, and the postoperative compl ications etc. have been disputed. Conclusion The modified Il izarov method has the advantages of simple operation, minimal invasion, and less compl ications, but the long-term results of each treatment method are unknown and need more further studies.
Objective Depression is a common consequence after stroke and has become a significant issue in clinical practice and research. The aim of this study was to explore associated factors of post-stroke depression among first-ever stroke patients in Hong Kong. Methods A longitudinal study was conducted to collect data in face-to-face interviews and by physical assessment at two time points: T1, within 48 hours of admission to a rehabilitation hospital; and T2, 6 months after the first interview. T2 interviews and assessments were conducted in the participant’s current place of residence. Participants were first-ever stroke patients in Hong Kong. Post-stroke depression was measured using the Center of Epidemiological Study-Depression (CES-D) Scale. Backward linear regression analysis was performed to examine factors associated with level of post-stroke depression at T2. Results Our findings showed that 69% of participants exhibited clinically relevant levels of depressive symptoms at T1 and 48% at T2. Regression analysis revealed complex relationships between the level of depressive symptoms, demographic characteristics and variations in perceived levels of social support. Five variables were found to explain 55% of the variance in depressive symptoms at T2. The variables with significant standardized regression coefficients (β) were: companionship (P=0.001), informational support (P=0.025), baseline level of depressive symptoms (Plt;0.001), ADL dependence level (Plt;0.001) and being a homemaker before the stroke (P=0.039). Conclusions We have followed a group of stroke patients over a 6-month period. Our findings suggest that when screening for post-stroke depression, health professionals must take into consideration of the clinical, socio-personal characteristics that might increase a stroke patient’s vulnerability to develop depression after stroke.
The number of people with physical disabilities is increasing year by year, and the trend of population aging is more and more serious. In order to improve the quality of the life, a control system of accessible home environment for the patients with serious disabilities was developed to control the home electrical devices with the voice of the patients. The control system includes a central control platform, a speech recognition module, a terminal operation module, etc. The system combines the speech recognition control technology and wireless information transmission technology with the embedded mobile computing technology, and interconnects the lamp, electronic locks, alarms, TV and other electrical devices in the home environment as a whole system through a wireless network node. The experimental results showed that speech recognition success rate was more than 84% in the home environment.
Objective To develop the short version of the elderly disability assessment scale (EDAS-SF), and to evaluate its validity and reliability. Methods We conducted a face-to-face investigation in five rural communities in Suining and three urban communities in Chengdu city for elderly adults. We consulted gerontologists and rehabilitation physicians through an internet survey. Proper items were selected from the EDAS according to the results from the following statistical methods: critical ration, Cronbach’s α, correlation coefficient and exploratory factor analysis. Based on these work, the EDAS-SF was developed. The Cronbach’s α was used to assess the internal reliability and confirmatory factor analysis (CFA) to assess the construct validity of the EDAS-SF. Results A totally of 916 elderly adults were surveyed, among which, 887 finished the questionnaire, accounting for 96.8%. The mean age of the studied population was 70.8±6.9 years old. Finally, seven items were chosen for the EDAS-SF which included mental function, organ function, communication, activity, self-care, family function, economic and social function. The Cronbach’s α of the scale was 0.836. Except for the " economy and social function” dimension and the " communication” dimension, the Cronbach’s α of other dimensions were higher than 0.8. EDAS-SF was proved to have good internal reliability. In addition, the CFA indicated that the theoretical model of the EDAS-SF was well fit to the data of the checking sample, which meant EDAS-SF had good construct validity. Conclusion The current study develops the short version of elderly disability assessment scale. The internal reliability and construct validity of the EDAS-SF are good.
ObjectiveTo explore the clinical, genetic and prognostic features of early infantile epileptic encephalopathy caused by DNM1 gene pathogenic variations.MethodsClinical phenotype, genotype and prognosis of 3 individuals with de novo variants in DNM1 gene were analyzed retrospectively. Through using “Dynamin-1” or “DNM1” as key words to search literature at database of China National Knowledge Infrastructure, Wanfang, PubMed and OMIM. Genotype-phenotype correlations were analyzed by analysis of variance (ANOVA).ResultAmong the 3 patients, 1 female and 2 males. 2 cases with epileptic spasm and 1 case with focal clonic seizure or secondary generalized tonic-clonic seizure were manifested with onset age from 2 to 17 months. De novo variants at NM_004408.4: c.415 G>A(P. Gly 139Arg) in 2 inviduals and NM_004408.4: c.545 C>A(P. Ala 182Asp)in 1 invidual of DNM1 gene were identified by gene testing. After follow-up at age of 2~3 years, all patients were presented with hypotonia, severe intellectual disability, non-verbal, non-ambulatory, drug-resistant epilepsy and feeding difficulties. 36 cases with pathogenic DNM1 variants were reported by far, totally 39 cases were included. Of the 39 patients, hypotonia were found to be independent of the locus of genetic variants, while those inviduals with variants in the GTPase and middle domains almost presented severe or profound intellectual disability and epilepsy. 31 patients diagnosed with epilepsy and complete clinical data were further analyzed, epileptic spasm was the most common types of seizure. Absent seizure was significantly more common in those patients with variants in the GTPase domains (P=0.02), compared to those patients with variants in the middle domains. No statistical differences were found in gender, onset age, other types of seizure and drug treatment response between variants in the GTPase and middle domains.ConclusionHypotonia, early onset epilepsy, severe intellectual and movement disability were the common features in patients with DMN1 related encephalopathy. Epileptic spasm was the most common types of seizure, no significant differences were found in the phenotype between the GTPase and middle domains expect for absent seizure. Our patients also presented with feeding difficulties.
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.
Industrial rehabilitation is a new concept that primarily encompasses four aspects: medical industrial rehabilitation, educational industrial rehabilitation, disability industrial rehabilitation, and rehabilitation engineering industry. The development of industrial rehabilitation in China is rapid, presenting numerous opportunities while also facing significant challenges. However, to date, no scholars have summarized the definition, current status, challenges, and opportunities of industrial rehabilitation, which hinders its development in China. This paper summarizes the development status of the four aspects mentioned above, analyzes the challenges and opportunities faced, and provides suggestions for development, offering a reference for the advancement of industrial rehabilitation in China.
Objective To investigate the influencing factors of moderate to severe disability in migraine patients. Methods Patients diagnosed with migraine between September 2022 and January 2024 in the outpatient service or inpatient Department of Neurology of Baotou Central Hospital and Baotou Eighth Hospital were included. According to the scores of the Migraine Disability Assessment questionnaire, patients were divided into a group with no or mild disabilities and a group with moderate to severe disabilities. The sociodemographic, disease characteristics, and scale datas of two groups of patients were collected, and a multivariate logistic regression model was used to explore the influencing factors of moderate to severe disability in migraine patients. Results A total of 116 patients were included. Among them, there were 49 cases in the group with no or mild disabilities, and 67 cases in the group with moderate to severe disabilities. There were statistically significant differences in gender, duration of headache, severity of headache, number of headache days per month, drug overuse, the scores of Generalized Anxiety Disorder-7 scale, the scores of Patient Health Questionnaire-9 scale, the scores of Pittsburgh Sleep Quality Index scale, the scores of Headache Impact Test scale, the scores of Montreal Cognitive Assessment scale, and the scores of 36-item Short-Form Health Survey questionnaires between the two groups (P<0.05). There was no statistically significant difference in other sociodemographic information and disease characteristics between the two groups of patients (P>0.05). The results of multivariate logistic regression analysis showed that the number of headache days per month, the scores of Generalized Anxiety Disorder-7 scale, the scores of Headache Impact Test scale, and the scores of 36-item Short-Form Health Survey questionnaire were independent influencing factors for moderate to severe disability in migraine patients (P<0.05). Conclusions Headache duration, anxiety disorders and health-related quality of life are influencing factors for moderate to severe disability in migraine patients. Early screening and intervention of influencing factors for migraine patients should be emphasized.