Comprehensive Rehabilitation Care Research Articles

Early comprehensive pulmonary rehabilitation for hospitalized patients with acute ex-acerbation of chronic obstructive pulmonary disease: a randomized controlled trial.

To investigate whether an early comprehensive pulmonary rehabilitation intervention initiated during hospital admission is safe and effective for patients with acute exacerbation of chronic obstructive pulmonary disease. Prospective randomized controlled study. Patients with acute exacerbation of chronic obstructive pulmonary disease. In total, 108 patients were randomized to the early comprehensive pulmonary rehabilitation and usual care groups within 48 hours. The 6-min walking distance, quality of life, breathlessness, and inspiratory muscle strength were measured on admission and discharge. Any adverse events of pulmonary rehabilitation were recorded. On discharge, the patients in the early comprehensive pulmonary rehabilitation group had a more significant improvement in the 6-min walking distance (47.5 vs 23.0, p = 0.04). There was no significant difference in quality of life and breathlessness between the 2 groups. In the early comprehensive pulmonary rehabilitation group, inspiratory muscle strength and peak inspiratory flow were significantly improved, and the changes were much more pronounced than in the usual care group. There were no adverse events. Early comprehensive pulmonary rehabilitation is safe and effective for hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease, and should be performed during the early stage of hospitalization.

Radiofrequency echographic multi-spectrometry-based measurement of bone mineral density in patients with severe motor and intellectual disability: An opportunity for patients with severe scoliosis and hip dislocation

PurposeRadiofrequency echographic multi-spectrometry (REMS) is an ultrasound technology currently used for the densitometric evaluation of osteoporosis and has been validated against dual-energy X-ray absorptiometry. However, the use of REMS for bone densitometry in patients with severe motor and intellectual disabilities (SMID) remains to be reported. This study aimed to investigate whether REMS technology can be used for densitometric evaluation of osteoporosis in patients with SMID with hip dislocation and severe scoliosis. MethodsSixty-five patients with SMID, who resided in a long-term care facility and received comprehensive medical and rehabilitation care, underwent REMS scans of the femoral neck and/or lumbar spine. Data regarding anthropometric parameters (height and weight), bone mineral density (BMD), clinical diagnostic classification, physical ability, presence of scoliosis and hip dislocation, and frontal radiographs of both hip joints were obtained. ResultsWe included 29 men and 34 women (mean age: 52.6 years). All patients underwent successful scanning at either the femoral neck (82.5 %) or lumbar spine (95.2 %). BMD measurements obtained using REMS revealed low values, with a mean BMD, T-score, and Z-score of 0.67 g/cm2, −2.39 standard deviation (SD), and − 1.38 SD, respectively, at the femoral neck and 0.66 g/cm2, −2.70 SD, and − 1.87 SD, respectively, at the lumbar spine. The average Cobb angle of the lumbar spine was 34.0°; furthermore, dislocation rates did not significantly differ between those with and without successful BMD measurements (p = 0.073). Lumbar BMD T-scores were significantly correlated with femoral neck BMD T-scores (p < 0.001, r = 0.530). ConclusionAll patients with SMID were able to undergo measurements of either spinal or femoral neck BMD; furthermore, 77.7 % of the patients underwent measurements at both the lumbar spine and femur. Our data suggest that REMS is useful for measuring BMD in patients with SMID who are residing in institutions.

Integrating Comprehensive Rehabilitation Care to Multimorbidity Approach: A Challenge for the Chilean Public Health System.

The multimorbidity approach involves promotional and preventive strategies. The demand for rehabilitation services has grown exponentially in recent years, leading to the urgency of rethinking care delivery. In Chile, there are laws, programs, and guidelines that, from their theoretical basis, include a person-centered care focus. But in real practice, multiple barriers trigger important fragmentation of care. In response, a new strategy has been proposed to answer whether comprehensive rehabilitation care based on multimorbidity positively impacts the health system performance, people's functionality, and quality of life, which will be implemented as a pilot study with a national scale-up focus.

Medical convergence technology in the system of comprehensive rehabilitation of children with neurotrauma: our experience of implementation (with case report)

BACKGROUND: The annual increase of childhood trauma with severe consequences is 2% per year (WHO, 2020/21). This motivates rehabilitation specialists to search for new technologies and effective approaches. Timely resuscitation, early specialized and comprehensive rehabilitation care largely determine the outcome of a serious injury and prevent serious consequences. In this context, medical convergent technologies used to provide effective medical care become particularly relevant. This article of scientific, methodological and applied nature is devoted to the description of medical convergent technology implemented in the system of comprehensive rehabilitation care of children with severe neurotrauma.&#x0D; AIM: The aim of the study was to substantiate and develop an effective rehabilitation technology at the level of unified (convergent) interdisciplinary managerial and clinical-diagnostic medical solutions in rehabilitation of children with severe injuries.&#x0D; MATERIALS AND METHODS: Children, aged 2–17, (n=420) with consequences after severe traumatic injuries who were admitted to the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (Moscow) for treatment and rehabilitation in 2018–2022 with diagnoses: traumatic brain injury, consequences of spinal cord injury, combined trauma, mine-explosive trauma, severe skeletal trauma, infected extensive wounds. More than 300 of these patients had neurotrauma. The researchers used: literature sources on the discussed problem, findings of objective and subjective examinations (clinical examination, neuroimaging, neurofunctional, laboratory, radiation, instrumental as well as questionnaires, surveys, scales; electronic medical histories). To develop medical convergent technology, rehabilitation diagnosis, potentials and prognostic options according to the decision-making algorithm developed by physicians/specialists as well as differentiated personified rehabilitation programs were used. While developing these programs, the researchers assessed specific features of the injury, disease course, severity and level of functional impairment, activity and participation expressed in the criteria of the International Classification of Functioning, Disability and Health.&#x0D; RESULTS: The researchers have enunciated the essence of the medical convergent technology in the rehabilitation of children after severe injuries as convergence, the alliance of interests from different fields, process of integration of traditional and new approaches which are united by a single goal of managing patients after severe traumatic injuries.&#x0D; CONCLUSION: An interdisciplinary/multidisciplinary approach with medical convergent technology component in restoring children after severe trauma allows to optimize the rehabilitation process and the patient’s routing within this process. Integrity and continuity in management and rehabilitation of injured patients as well as step-by-step approach, help physicians to choose the most effective tactics.

Importance Of Preventive Pediatrics

The article highlights the priority areas of preventive pediatrics related to the formation of the health of the younger generation, the organization of medical care for children, and the reduction of morbidity, disability and mortality. The importance of vaccination in the control of the most widespread infections was noted, and the need to create a system for providing comprehensive rehabilitation care to disabled children was substantiated.

Participation in Everyday Occupations Among Rohingya Refugees in Bangladeshi Refugee Camps

Abstract Importance: Bangladesh hosts a large number of Rohingya refugees from Myanmar. Living in refugee camps, the Rohingya refugees face challenges in everyday occupations because of violence, limited opportunities, and corporal punishment by the community. Objective: To explore how Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. Design: Phenomenological study to describe, understand, and interpret the meanings of life experiences in particularly adverse conditions. Setting: Rohingya refugee camps in Bangladesh. Participants: Fifteen purposively selected participants from the camps. Outcomes and Measures: In-depth semistructured interview, as well as participant and environmental observations. Researchers used line-by-line data analysis to capture quotations and patterns using interpretive phenomenological analysis, which included establishment of initial codes, interpretation, determining selected codes, and categorization. Results: The research identified four major themes—(1) mental stress, sleep disturbances, and daily occupations; (2) adjustment to inconsistent daily activities; (3) complex relationships and limited social roles that decreased occupational engagement; and (4) involvement in precarious occupations that exacerbated severe health risks—and four subthemes—(1) fragmented family relationships, (2) formation of new relationships to perform social roles, (3) inconvenient and inaccessible living conditions, and (4) continuation of unlawful work to survive. Conclusions and Relevance: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. What This Article Adds: Rohingya refugees experience imbalanced, deprived, and maladapted occupations in refugee camps. Suggestions to improve their lived experience with further peer support programs may help them participate in occupation-based rehabilitation services to facilitate their social integration.

Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer–Related Lymphedema

Background: Individuals with breast cancer–related lymphedema (BCRL) require self-management strategies to reduce risk of infection, exacerbation, and/or progression of lymphedema. The coronavirus pandemic thrust the medical field into the world of telehealth; both patients and providers were forced to reduce in-person treatments and engage in this new platform of rehabilitation delivery. The role of telehealth in promotion of self-management for BCRL is unknown. Purpose: This study examines self-efficacy during cancer rehabilitation for in-clinic versus telehealth visits among individuals with BCRL during the pandemic quarantine April to November 2020. Methods: Forty women who recently completed oncology rehabilitation for BCRL were asked to complete demographics and 2 Likert surveys, including the Exercise Self-Efficacy Scale (ESES) and the Self-Care Self-Efficacy Scale (SCSE), to compare the efficacy of telehealth versus in-person treatment modalities. Results: Thirty-two participants completed the survey and indicated that the percentage of telehealth visits was less than face-to-face visits. Despite this, the participants indicated numerous positive moderately strong correlations between self-care self-efficacy and exercise self-efficacy for both types of visits (P &lt; .05). Limitations: Self-report surveys by a convenience sample, multifactorial characteristics of rehabilitation treatment across modes, and varying severity of lymphedema may limit study findings. Conclusion: Telehealth provided safe and effective care to participants and bolstered confidence in self-care and self-management of BCRL. Data support that telehealth visits can be considered an essential part of comprehensive cancer rehabilitation care. Future research is needed to establish and optimize practice guidelines in both health delivery systems.

Participation in Everyday Occupations Among Rohingya Refugees In Bangladeshi Refugee Camps

<h3>Research Objectives</h3> This research explores how the Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. <h3>Design</h3> A phenomenological study was conducted to describe, understand, and interpret the meanings of experiences of human life in particularly adverse conditions. Fifteen adults were purposively selected to participate in an in-depth semi-structured interview and participant observations. Researchers used line-by-line data analysis for capturing quotations and patterns using the strategy of interpretive phenomenological analysis. <h3>Setting</h3> Bangladesh. <h3>Participants</h3> Rohingya Refugees. <h3>Interventions</h3> No. <h3>Main Outcome Measures</h3> Qualitative. <h3>Results</h3> The research identified three major themes: 1) mental health conditions impacted the ability to participate fully in daily activities, 2) complex relationships and limited social roles decreased occupational engagement, and 3) involvement in precarious occupations exacerbated severe health risks. Six sub-themes were identified: a) past incidents destroying peaceful sleep, b) adjusting to inconsistent daily activities, c) fragmented family relationships, d) forming new relationships to perform social roles, e) inconvenient and inaccessible living conditions, and f) continuing unlawful work to survive. <h3>Conclusions</h3> Conclusion and Relevance: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. Peer-led support may help the refugees participate in occupation-based rehabilitation services that may facilitate their social integration. <h3>Author(s) Disclosures</h3> This research doesn't have any conflict of interest.

The Effect of Comprehensive Rehabilitation Nursing on the Rehabilitation of Sports-Induced Ankle Joint Injuries.

The purpose of participating in sports is to enhance physical fitness and promote physical and mental health. The occurrence of sports injuries will cause physical and mental injuries to athletes, especially the ankle joint injuries that often occur. Therefore, it is particularly important to understand the causes, symptoms, treatment, and prevention of athletes' ankle injuries. This article aims at studying the significance of comprehensive rehabilitation nursing for the rehabilitation of sports-induced ankle joint injuries and introduces the concepts of comprehensive rehabilitation nursing and ankle joint injuries. This article proposes how to use comprehensive rehabilitation nursing to recover ankle injuries caused by sports based on smart medical care. In the experiment of this article, it can be seen from Table 5 that the recovery speed of 5 athletes with ankle joint injuries before rehabilitation training was 8% (lowest) and 14% (highest). The recovery rate after rehabilitation care is up to 25%. It can be seen that comprehensive rehabilitation care is of great help to athletes with ankle injuries. As can be seen from Table 4, the number of ankle injuries in acute secondary injuries is 25, accounting for 33%, which is the highest; the number of contusions is 15, accounting for 21%, which is the lowest ratio, so it can be seen that the ankle joint injury in sports is the most serious. Therefore, the application of comprehensive rehabilitation care needs to be popularized, which is of great significance to ankle joint injuries. The ankle joint is one of the most easily sprained joints in the human body, not only because of the flexibility of the ankle joint, but also because of the anatomical characteristics of the ankle joint. The main cause of ankle injuries is inappropriate behavior in sports.

Use of Virtual Care Strategies to Join Multidisciplinary Teams Evaluating Work-Related Injuries in Rural Residents.

Background: Rural injured workers requiring multidisciplinary assessments for musculoskeletal disorders face health access disparities, which include travel to urban centers. Virtual care can enhance access to multidisciplinary team care for musculoskeletal conditions in rural areas. Materials and Methods: A retrospective chart audit of 136 multidisciplinary assessment reports of injured workers was conducted. Comprehensive management recommendations from the health care assessment team were extracted for analysis. The health care team used virtual technologies to join with patients and at least one local rural health practitioner in one of three locations. Remote presence robotics (RPR; Xpress Technology™) or laptop-based telehealth was used to complete the assessments. Results: RPR were used in 46% of assessments over two sites, with 54% using laptop-based telehealth at a third site. Frequencies of team members' assessment using technologies were as follows: physical therapist (100%), psychologist (78%), plastic surgeon (8%), and physician (43%). Spine (42%) and shoulder (32%) disorders were the most common problems. Most workers (79%) were 3 or more months postinjury. The most common management recommendation was the need for daily comprehensive rehabilitation care (76%). Travel time was saved by 89% of participants. Conclusions: Virtual care was used to unite multidisciplinary assessment teams for the evaluation of injured rural workers with complex musculoskeletal injuries. Future research recommendations include comparing between virtual and fully in-person multidisciplinary assessment and recommendation findings, and evaluation of patient and practitioner experiences with comprehensive virtual team assessments.

Effect of an Interdisciplinary Stroke Consult Service on the Transition to Postacute Rehabilitation

ObjectiveTo evaluate the effect of a physiatry-led stroke consult service on access and time to intensive postacute rehabilitation. DesignProspective observational study. SettingUrban Joint Commission Comprehensive Stroke Center. ParticipantsAdult (older than 18 years) acute stroke hospital discharges between January 1, 2018, and December 31, 2020 (N=1190). InterventionsWeekday huddle rounds were interdisciplinary, which created a pathway to ensure patients with stroke received comprehensive rehabilitation care followed by a virtual rounding tool, allowing clinicians to evaluate plan of care facilitation using the electronic medical record. Main Outcome MeasuresProportion of acute stroke discharges to home, inpatient rehabilitation facility (IRF), or skilled nursing facility (SNF) and onset days to IRF transfer. ResultsDuring the 3-year study period, sociodemographic characteristics, stroke severity at admission, and mortality rates did not change significantly.Discharges of patients with acute stroke patient to IRFs increased 5.9%, from 24.2% in 2018 to 30.1% in 2020. A total of 11% of patients were discharged to SNF in 2018 compared with 8.7% in 2020. Proportion of patients with acute stroke discharged to home decreased 4.9%, from 49.6% in 2018 to 44.7% (P=.0325). For patients with ischemic stroke, the average onset days to IRF transfer decreased 7.5% between 2018 and 2020, from 8 days to 7.4 days. For patients with hemorrhagic stroke, the average onset days decreased 17.5%, from 12 days in 2018 to 9.9 days in 2020. The decrease in onset days were not statistically significant for either stroke type (P=.3794). ConclusionsImplementation of huddle rounds and a virtual rounding tool by a physiatry-led stroke consult service significantly increased referrals to IRFs, with a concomitant decrease in referrals to SNFs or directly home. Next steps include validating model efficacy, with the goal of implementation at stroke centers in the United States.

The Effects of Comprehensive Home-Based Cardiac Rehabilitation versus Usual Care in Patients with Ischemic Heart Disease in Iran: Study Protocol for a Multicenter Randomized Controlled Trial.

Background:Cardiovascular diseases are the leading causes of mortality all around the world. Patients with Ischemic heart disease (IHD) are at an increased risk of ischemic events; therefore, secondary prevention measures should continue for these patients. Although Cardiac rehabilitation (CR) is one of the secondary prevention measures for IHD patients which has favorable clinical outcomes, only 50% of patients are referred and among them, a small percentage attends CR. Therefore, other strategies should be considered, one of which is home-based cardiac rehabilitation.Methods:A multicenter, parallel-group randomized controlled trial has been conducting in three hospitals in Isfahan and patients have been assigned into a 1:1 ratio for the evaluation of the effectiveness of home-based cardiac rehabilitation versus usual care. Psycho-educational consultation based on the Health Action Process Approach including heart-healthy diet, stress management, lifestyle changes, smoking cessation, and physical activity has been performed. Primary outcomes, including the quality of life, psychological and smoking status, body mass index, blood pressure, blood cholesterol level, and physical activity level have been measured at 6 months after the randomization and intervention. One year after the intervention, primary and secondary outcomes, including cardiovascular events, the frequency of hospital admissions, and the death rates due to cardiovascular reasons will be assessed.Conclusion:HBCR program can increase patient accessibility to CR services its implantation can be reduce burden IHD.

Retrospective observational study of characteristics of persons with amputations accessing International Committee of the Red Cross (ICRC) rehabilitation centres in five conflict and postconflict countries

ObjectivesLimb amputation incidence is particularly high in fragile contexts due to conflict, accidents and poorly managed diabetes. The study aim was to analyse (1) demographic and amputation characteristics of persons...

Effect of Comprehensive Rehabilitation Care on the Rehabilitation of Patients with Lumbar Disc Herniation Surgery

The clinical symptoms of lumbar disc herniation, one of the most common low back pain diseases, are a series of manifestations of low back pain, sciatica, and cauda equina compression, and the recurrence rate after treatment is high, which seriously affects work and life. Surgery is a serious physiological stress in patients with degenerative changes in the lumbar spine and symptoms of nerve damage. If the corresponding nursing work cannot be performed effectively and timely after the operation, it may affect the recovery of postoperative function, cause complications, and cause motor dysfunction. It may also be accompanied by psychological problems such as depression, which seriously affect the quality of life of the patient. In addition, training can enhance the strength of the back muscles, thereby making up for the destruction of the surgery, helping to consolidate and improve the treatment effect. However, clinicians often overlook postoperative functional recovery. Therefore, this paper studies the effect of comprehensive rehabilitation nursing on the rehabilitation of patients with lumbar disc herniation, and discusses the comprehensive rehabilitation nursing intervention measures for patients with lumbar disc herniation. Thereby promoting patients to receive comprehensive rehabilitation care increase health behaviors and improve the quality of life. The proposed method is very effective in the rehabilitation of patients with lumbar disc herniation.

Application Effect of Comprehensive Nursing Intervention Model in Nursing of Children with Epilepsy

At present, the epilepsy disease of children in the growing groups of children and adolescents in my country is a very common mental disease, and it is very important to strengthen the early comprehensive treatment care and intervention therapy for children with epilepsy. The purpose of this study is to deeply explore the specific application effect of this comprehensive clinical nursing intervention model in the clinical nursing treatment of early childhood epilepsy patients. In this research, 80 cases of children with new-type pediatric epilepsy who received rehabilitation treatment in our hospital from August 2018 to December 2019 were selected as the observation objects of the clinical study.The children in the control group received short-term routine rehabilitation care, while the observation group adopted short-term comprehensive rehabilitation care and interventional treatment in parallel with long-term clinical rehabilitation care. The results of the research analysis show that the observation group’s hospitalization satisfaction of children with acute epilepsy is 96.73%, which is significantly higher than that of the general control group, 85.32%. The compliance rate of hospitalized children with acute epilepsy in the observation group was 95.22%, which was significantly higher than that of the general control group, 83.48%. The difference was obviously statistically significant (p&lt;0.05). It can be seen from this that the treatment of children with epilepsy early adopting comprehensive nursing intervention mode can effectively improve the effect of epilepsy treatment.

Image Features of Magnetic Resonance Angiography under Deep Learning in Exploring the Effect of Comprehensive Rehabilitation Nursing on the Neurological Function Recovery of Patients with Acute Stroke.

This study was to explore the effects of imaging characteristics of magnetic resonance angiography (MRA) based on deep learning on the comprehensive rehabilitation nursing on the neurological recovery of patients with acute stroke. In this study, 84 patients with acute stroke who were treated in hospital were selected as the research objects, and they were rolled into a control group (routine care) and an experimental group (comprehensive rehabilitation care). The dense dilated block-convolution neural network (DD-CNN) algorithm under deep learning for cerebrovascular was adopted to assess the effect of comprehensive rehabilitation care on the neurological recovery of patients with acute stroke. The results showed that the Berg scale scores, Fugl-Meyer scores, and Functional Independence Measure (FIM) scores of the experimental group of patients after 6 weeks and 12 weeks of comprehensive rehabilitation nursing were greatly different from those before treatment, showing statistical differences (P < 0.05). Compared with conventional magnetic resonance imaging (MRI) images, MRA images based on CNN algorithm, Dense Net algorithm, and DD-CNN algorithm can more clearly show the patient's cerebral artery occlusion. The average dice similarity coefficient (DSC) values of CNN algorithm, Dense Net algorithm, and DD-CNN algorithm were determined to be 84.3%, 95.7%, and 97.8%, respectively; the average sensitivity (Sen) values of the three algorithms were 76.1%, 95.4%, and 96.8%, respectively; and the average accuracy (Acc) values were 87.9%, 96.3%, and 97.9%, respectively. Thus, there were statistically obvious differences among the three algorithms in terms of average values of DSC, Sen, and Acc (P < 0.05). The MRA images processed by the DD-CNN algorithm showed that the degree of neurological recovery of the experimental group was observably greater than that of the control group, and the difference was statistically obvious (P < 0.05). In short, the image features of MRA based on the deep learning DD-CNN algorithm showed good application value in studying the effect of comprehensive rehabilitation nursing on the neurological recovery of patients with acute stroke, and it was worthy of promotion.

Rehabilitation care for chronic venous insufficiency

Chronic venous insufficiency (CVI) is a common medical condition with a major socio-economic impact. The prevalence among the adult population is estimated at 5–30%. Her pathology is based on venous hypertension of the lower extremities. This leads to swelling, subcutaneous fibrosis, pigmentation, chronic pain and ulceration. Treatment options for CVI include medical, interventional, surgical treatments, as well as exercise. Primary treatment of CVI includes conservative approaches to reduce symptoms and prevent the development of secondary complications and disease progression. Comprehensive Rehabilitation Care (CRC) includes positional treatment, drainage technician, supportive skin care methods, structured exercise program, and physiotherapy - intermittent pneumatic compression (IPC), compression stocking (CS), patient training, and other methods. CVI is a chronic disease that needs lifelong care. The purpose of this report is to summarize the types of rehabilitation care (RG) as part of the conservative treatment approach in patients with CVD based on literature sources.

National Cancer Control Plan

Comprehensive systemic approaches are needed to address cancer, which is a major public health issue. In 2010, Slovenia adopted the first National Cancer Control Plan. A new document, for the period 2022–2026, will include issues set forward in the Europe's Beating Cancer Plan, which was adopted in 2021. The National Cancer Control Plan has three strategic goals: (1) to slow the increase in the incidence of cancer, (2) to improve survival, and (3) to improve the quality of life of cancer patients through comprehensive rehabilitation and palliative care and here we present achievements and indicate our future challenges.Prevention programmes for chronic non-communicable diseases and the introduction of national screening programs for cervical and colorectal cancer had significant impact on the incidence of preventable cancers. Of concern, however, is the rising trend of lung cancer in women. The survival of all cancer patients improved, more cancers were detected at an earlier stage and modern treatments are widely available. Our challenge in the future is to establish monitoring of quality of care by establishing clinical registries for the five most common cancers. To improve the quality of life of patients, a pilot project for breast cancer patients has been launched in the field of integrated rehabilitation in two regions. Its results will serve as a model for implementation in the whole country and also for other types of cancer. In the field of palliative care, we are facing many challenges that we are only slowly overcoming. Comprehensive rehabilitation and palliative care are certainly areas to which we need to pay more attention.

Further understanding on osteopetrotic femoral fractures: a case report and literature review

BackgroundOsteopetrosis is a genetic disease characterized by defects in osteoclast formation and function. There were a few cases of subtrochanteric femur fractures treated with dynamic hip screw (DHS) in patients with osteopetrosis, but unfortunately the healing outcome was rather poor.Case presentationWe present our experience for treating a patient with intermediate autosomal recessive osteopetrosis (IRO) suffering from subtrochanteric femur fracture. In this case, we successfully used dynamic hip screw (DHS) internal fixation through meticulous preoperative planning and postoperative care, as well as application of surgical techniques. The patient displayed stable internal fixation with no limitation of activities during follow-up for 15 months. In addition to this case, a review of previous case reports showed an increasing number of case reports demonstrating that surgical treatment-related complications could be avoided preoperatively, intraoperatively, and postoperatively.ConclusionDHS for this patient, who suffered from subtrochanteric fractures with osteopetrosis, was successfully implemented. In the light of a comprehensive literature review, preoperative planning, surgical techniques, and postoperative rehabilitation care can significantly reduce the complications.

Patient and Provider‐Reported Satisfaction of Cancer Rehabilitation Telemedicine Visits During the COVID‐19 Pandemic

IntroductionThe coronavirus disease 2019 (COVID‐19) pandemic has accelerated the growth of telemedicine services across the United States. In this study, we examined cancer rehabilitation patient and physician satisfaction with telemedicine visits. We also sought to evaluate the types of provider services that are given during telemedicine visits.ObjectiveTo assess overall patient and provider satisfaction with telemedicine visits and explore whether satisfaction varied by contact method (phone or video) and encounter type (new problem, worsening problem, stable/improving problem).DesignProspective survey study.SettingCancer rehabilitation program at an academic medical center.ParticipantsThree cancer rehabilitation providers and 155 unique patients participated in the study.InterventionsNot applicable.Main Outcome MeasuresProvider and patient satisfaction measured by customized surveys.ResultsOne hundred eighty‐four encounters with 169 unique patients were scheduled. Of these, 14 were new visits and 170 were follow‐up visits. Eighteen encounters (9.8%) were either no shows or rescheduled, making for 166 encounters with 155 unique patients. Patient and provider responses comprised the following: 94.8% of patient responses reported “quite a bit” or “very much” for the telemedicine visit being a good experience; 63.1% of patient responses reported “quite a bit” or “very much” for interest in using telemedicine visits in the future; and 83.9% of provider responses reported “quite a bit” or “very much” for the patient's main problem being addressed by the visit. Providers were more likely to prefer an in‐person visit for a new or worsening problem versus a stable/improving problem. The most common services provided were medication prescription/titration and education/counseling. The least common services provided were making of new diagnoses, ordering interventional procedures, and making referrals.ConclusionTelemedicine visits were well received by both patients and providers in a cancer rehabilitation medicine clinic setting. However, in the case of a new or worsening problem, satisfaction declined. These data support that telemedicine visits should be considered essential as part of comprehensive cancer rehabilitation care, especially during a public health crisis.