Early Comprehensive Rehabilitation 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.

Effect of early pulmonary rehabilitation therapy on the pulmonary function of patients with stroke-associated pneumonia and analysis of its effectiveness.

This study aimed to evaluate the clinical effectiveness of early pulmonary rehabilitation (PR) treatment methods for stroke-associated pneumonia (SAP). This is a prospective, randomized controlled intervention study. Eighty SAP patients admitted to the rehabilitation department of Liuzhou People's Hospital from June 2020 to December 2021 were selected and divided into an intervention group (40 cases) and a control group (40 cases) using the random number table approach. Patients in both groups received conventional treatments. Patients in the intervention group received early PR interventions, while patients in the control group received conventional rehabilitation treatment. The clinical effectiveness and pulmonary function indexes were compared. The intervention group showed shorter durations of stay in the intensive care unit, relief from symptoms, and mechanical ventilation compared to the control group following treatment (P < 0.05). The total clinical efficacy after intervention in the treatment group was 82.50%, significantly higher than the control group's rate of 47.50% (P < 0.05). After 21 days of treatment, the forced expiratory volume in one second (FEV1)/predicted value in the intervention group was 64.92 ± 8.53, while it was 52.69 ± 7.08 in the other group. The FEV1/forced vital capacity in the intervention group was 59.73 ± 7.18, compared to 50.36 ± 6.54 in the control group. The intervention group had a clinical pulmonary infection score of 2.62 ± 1.13, while the control group had a score of 4.17 ± 2.08. The intervention group showed a significant improvement in lung function, with statistically significant differences compared to the other group (P < 0.05). Moreover, the intervention group had significantly lower levels of interleukin-4 and interleukin-10 compared to the control group, with statistical significance (P < 0.05). The average National Institute of Health Stroke Scale score of the intervention group was significantly lower than that of the control group in the second and third weeks after treatment (P < 0.05). Early comprehensive pulmonary rehabilitation can significantly enhance the pulmonary function and respiratory status of SAP patients and facilitate the early recovery of brain function. This approach archives significantly better outcomes compared to conventional PR; therefore, it is worth clinical implementation.

Application Value of Early Comprehensive Rehabilitation Nursing in Patients with Occupational Asthma

Application Value of Early Comprehensive Rehabilitation Nursing in Patients with Occupational Asthma

Use of magnetic source imaging to assess recovery after severe traumatic brain injury-an MEG pilot study.

Severe TBI (sTBI) is a devastating neurological injury that comprises a significant global trauma burden. Early comprehensive neurocritical care and rehabilitation improve outcomes for such patients, although better diagnostic and prognostic tools are necessary to guide personalized treatment plans. In this study, we explored the feasibility of conducting resting state magnetoencephalography (MEG) in a case series of sTBI patients acutely after injury (~7 days), and then about 1.5 and 8 months after injury. Synthetic aperture magnetometry (SAM) was utilized to localize source power in the canonical frequency bands of delta, theta, alpha, beta, and gamma, as well as DC-80 Hz. At the first scan, SAM source maps revealed zones of hypofunction, islands of preserved activity, and hemispheric asymmetry across bandwidths, with markedly reduced power on the side of injury for each patient. GCS scores improved at scan 2 and by scan 3 the patients were ambulatory. The SAM maps for scans 2 and 3 varied, with most patients showing increasing power over time, especially in gamma, but a continued reduction in power in damaged areas and hemispheric asymmetry and/or relative diminishment in power at the site of injury. At the group level for scan 1, there was a large excess of neural generators operating within the delta band relative to control participants, while the number of neural generators for beta and gamma were significantly reduced. At scan 2 there was increased beta power relative to controls. At scan 3 there was increased group-wise delta power in comparison to controls. In summary, this pilot study shows that MEG can be safely used to monitor and track the recovery of brain function in patients with severe TBI as well as to identify patient-specific regions of decreased or altered brain function. Such MEG maps of brain function may be used in the future to tailor patient-specific rehabilitation plans to target regions of altered spectral power with neurostimulation and other treatments.

Метаболитная терапия в реабилитации детей с последствиями перинатальной гипоксии

Perinatal hypoxia is a common cause of developmental delays, disorders of the nervous and cardiovascular systems, and immune disorders. Early comprehensive rehabilitation of children with hypoxic lesions to the central nervous system can alleviate pathological manifestations and normalize the process of development. This review discusses different aspects of metabolic therapy for the rehabilitation of such children and describes the results of some studies assessing the efficacy of Glycine and Biotredin in children with various disorders. The combination of these two drugs proved to be effective in premature infants of various gestational age through normalizing their neurological status and improving weight and growth parameters. The article also describes the principles of metabolic correction of speech disorders in the critical preschool period, as well the mechanisms underlying the effect of the drugs on the cellular metabolism of the nervous system. Key words: hypoxia, metabolic therapy, preterm birth, glycine, speech disorders

Long-term results of the restoration of the mobility of the mandible after fractures and prolonged immobilization

BACKGROUND: Fractures of the lower jaw accounts for up to 85% of the total number of fractures of the facial bones. Its damage leads to the formation of temporary and persistent functional disorders of the stomatognathic apparatus. Understanding the regularities of the processes of restoring the motor functions of the mandible and chewing apparatus is necessary for planning and improving rehabilitation programs in these patients.&#x0D; AIM: To examine the degree and rate of restoration of the amplitude of movements of the mandible in the long-term period of the rehabilitation stage of patients with mandibular fractures.&#x0D; MATERIAL AND METHODS: A prospective study was conducted on 40 patients with unilateral and bilateral mandibular fractures, who made up two groups depending on the volume of treatment according to current clinical protocols: group 1 included 22 people who underwent double-jaw splinting during treatment, and group 2 included 18 people who, according to indications, also underwent osteosynthesis of the mandible with subsequent intermaxillary immobilization in the postoperative period. One year after the removal of splinting structures, all mobile patients underwent a clinical assessment of the range of motions of the lower jaw.&#x0D; RESULTS: Even 1 year after the successful treatment of patients in the acute period of trauma, despite the implementation of myogymnastics in the rehabilitation period, the range of motions of the lower jaw remains limited. In group 1, after 1 year of observations, the average values correspond to the lower limits of the norms according to literature data: opening, 4.35 cm; with protrusion, 0.78 cm; laterotrusion with unilateral fractures in the damaged side, 0.95 cm; intact, 0.91; bilateral, the damaged side 1 (right), 0.86 cm, damaged side 2 (left), 0.86 cm. In group 2, during the observation period, these indicators remained significantly lower, not reaching the limits of the norm in any case. Moreover, in both groups, their values were significantly lower than those of the healthy volunteers&#x0D; CONCLUSIONS: Data obtained on the patterns of restoration of the range of motion of the lower jaw after sustaining a fracture and prolonged immobilization in the long-term justify the need to develop and conduct mandatory early comprehensive rehabilitation measures. Their clinical effectiveness should be confirmed from the standpoint of evidence-based medicine, which enables the comprehensive assessment of the function of the stomatognathic apparatus. This study established indicators that can be considered control criteria when performing relevant studies.

Evaluation on the Value of Early Comprehensive Rehabilitation Nursing in Patients with Acute Ischemic Stroke and the Influence of Daily Living Activities

Evaluation on the Value of Early Comprehensive Rehabilitation Nursing in Patients with Acute Ischemic Stroke and the Influence of Daily Living Activities

Effect of Early Comprehensive Rehabilitation Nursing on Daily Living Ability of Hemiplegic Patients with Cerebral Infarction and Cerebral Hemorrhage

Effect of Early Comprehensive Rehabilitation Nursing on Daily Living Ability of Hemiplegic Patients with Cerebral Infarction and Cerebral Hemorrhage

EFFECT OF REHABILITATION TRAINING ON CRUCIATE LIGAMENT INJURY

ABSTRACT Introduction: Sports injuries in the anterior cruciate ligament of the knee are common and serious in the field of sports and rehabilitation medicine. Objective: To observe the effect of early comprehensive rehabilitation training on knee function recovery after anterior cruciate ligament reconstruction. Methods: 40 patients were randomly divided into observation group (n = 19) and control group (n = 21). The control group received routine rehabilitation training and the observation group had water exercise added to their intervention. The active knee flexion range, extension range, and Lysholm score were observed before and 3 months after rehabilitation training. Results: 3 months after training, the active knee flexion range and extension range in the observation group were better than those in the control group (p&lt; 0.05). Lysholm score in the observation group (91.2 ± 5.6) was higher than that in the control group (78.3 ± 4.8), and the difference was statistically significant (p&lt; 0.05). Conclusions: Early systematic rehabilitation training can reduce pain and swelling and improve the function of the knee joint after operation. Level of evidence II; Therapeutic studies - investigation of treatment results.

Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial

BackgroundPerioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Limited reports, however, have focused on quantitative, detailed early activity plans for patients receiving minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in the recovery of bowel and physical functions for patients undergoing MIE.MethodsIn this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2019 to February 2020 were selected and randomly assigned to an intervention group (IG) or a control group (CG). The participants in the IG received medical care based on the t-ECRP strategy during perioperative period, and participants in the CG received routine care. The recovery of bowel and physical functions, readiness for hospital discharge (RHD), and postoperative hospital stay were evaluated on the day of discharge.ResultsTwo hundred and fifteen cases with esophageal cancer (EC) were enrolled and randomized to the IG (n = 107) or CG (n = 108). The mean age was 62.58 years (SD 9.07) and 71.16% were male. For EC, 53.49% were mid-location cancers and 79.07% were classified as pathological stage II and III cancers. There were no significant differences between the two groups in terms of demographic and clinical characteristics and baseline physical functions. Participants in the IG group presented significantly shorter lengths of time to first flatus (P < 0.001), first postoperative bowel movement (P = 0.024), and for up and go test (P < 0.001), and lower scores of frailty (P < 0.001). The analysis also showed that participants in the IG had higher scores of RHD and shorter lengths of postoperative stay than in the CG (P < 0.05).ConclusionsThe t-ECRP appears to improve bowel and physical function recovery, ameliorate RHD, and shorten postoperative hospital stay for patients undergoing MIE. Clinicians should consider prescribing quantitative, detailed, and individualized early activity plans for these patients.Trial registrationClinicalTrials.gov (Identifier: NCT01998230)

Spinal cord injury

A spinal cord injury (SCI) is damage to any part of the spinal cord or nerves extending from the spinal cord that often results in permanent changes in motor and/or sensory abilities and other body functions below the point of the injury. The physical impairments from SCI vary as a function of the level and completeness of the injury. Nearly every aspect of a person's life physical health, work, personal relationships, and recreation may be affected following SCI. Adjustment involves learning new adaptive behaviors and attitudinal change, so psychologists play a crucial role in assisting the rehabilitation process. This self-directed learning module highlights basic management and approaches to intervention both established and experimental. The revised American Spinal Injury As sociation classification of spinal cord injury (SCI) further defines the examination and classification guidelines. The incidence of traumatic SCI remains at approximately 10,000 cases per year, with 32 years the average age at injury. Initial management includes establishment of oxygenation, circulation (mean blood pressure >85mmHg), radiographic evaluations for spine instability, intravenous methylprednisolone, and establishment of spinal alignment. Prevention measures for medical complications include pressure relief for skin, thromboembolism prophylaxis, prevention of gastric ulcers, Foley catheter drainage to prevent urine retention, and bowel care to prevent colonic impaction. Nontraumatic SCI from spinal stenosis, neoplastic compression, abscess, or multiple sclerosis becomes more common with aging. Experimental treatments for SCI include antibodies to block axonal growth inhibitors, gangliosides to augment neurite growth, 4-aminopyridine to enhance axonal conduction through demyelinated nerve fibers, and fetal tissue to fill voids in cystic spinal cord cavities. Early comprehensive rehabilitation at a SCI center prevents complications and enhances functional gains.

Effect of Early Comprehensive Rehabilitation Nursing on Hemiplegia Patients after Severe CraniocerebralInjury

Effect of Early Comprehensive Rehabilitation Nursing on Hemiplegia Patients after Severe CraniocerebralInjury

Preparation for decannulation of children with the consequences of cervical vertebrospinal cord injuries in surgical hospitals

BACKGROUND: Approximately 40 million people worldwide suffer from vertebrospinal cord injuries every year. According to different authors, children account for 1% to 5% of those injured. The relevance of developing a protocol for preparing children with vertebrospinal cord injuries for decannulation is due to the frequency of respiratory disorders and the peculiarities of the mechanism of their occurrence in patients with cervical spinal cord injuries, the lack of clear recommendations on preparing the patient for decannulation, and early comprehensive rehabilitation measures that contribute to restoring or compensating respiratory, muscular function, and the need for a unique approach to performing rehabilitation measures that consider the age of the child.&#x0D; AIM: This study aims to develop a preparation protocol and an algorithm for decannulation of children with cervical vertebrospinal cord injuries and assess the efficiency of early rehabilitative measures in the preparation process.&#x0D; MATERIALS AND METHODS: This study included 74 children with vertebrospinal cord injuries admitted to the Emergency Childrens Surgery and Traumatology Research Institute from 2014 to 2019. The patients were divided into two groups depending on the time of admission. Group 1 consisted of children admitted to the institute in the acute and early periods of vertebrospinal cord injuries. Group 2 included children in the intermediate and recovery periods. All patients were prepared for spontaneous breathing according to the protocol.&#x0D; RESULTS AND DISCUSSION: Group 1 patients with C2C4 vertebrospinal cord injury levels were decannulated on days 110140 after the injury. One child was diagnosed with an overgrowth of granulations over the tracheostomy tube, which required medical correction followed by successful decannulation. Group 1 patients with C5C8 vertebrospinal cord injury levels were decannulated on days 1541 after the injury. All Group 1 patients underwent early rehabilitation measures, which began immediately after stabilizing vital functions.&#x0D; On days 97110 after the injury, 12 patients of Group 2 with С5С8 vertebrospinal cord injury levels were decannulated. In contrast to Group 1 patients with the same injuries, Group 2 patients did not undergo early rehabilitation measures in primary inpatient settings. Therefore, they required much more time to adapt to spontaneous breathing.&#x0D; CONCLUSIONS: Compliance with the proposed protocol allows determining the patients readiness for decannulation, reduces the risk of potential complications that may arise due to the untimely removal of the tracheostomy tube, increases the effectiveness of rehabilitation measures in this patient category, and reduces the length of the hospital stay. The preparation algorithm for decannulation may serve as a practical guide for specialists involved in treating and rehabilitating children with vertebrospinal cord injuries.

Scientific Idea of Professor Marian Weiss.

This year marks the 100th birth anniversary of Professor Marian Alan Weiss. The following article serves as a reminder of this magnificent man, doctor and scientist and his indisputable multifaceted accomplishments. Prof. Weiss was a brilliant organizer. He proposed and then formed the largest medical rehabilitation centre in Poland, the STOCER Capital Rehabilitation Centre in Konstantin, and established one of the first university departments of rehabilitation in Europe. His medical achievements included Weiss' spring arthroplasty, a me-thod for stabilising the spine after an injury. He also promoted myoplastic amputation and early intraoperative prosthetic support (so-called rapid prosthesis) as well as early comprehensive rehabilitation, which is widely recognized today. Prof. Weiss was a first-rate scientist and lecturer. He published more than 200 articles in Polish and international journals, a few textbooks and monographs. He delivered many lectures and presentations at domestic and international congresses and symposia. As early as 1959, he lectured at international seminars on prosthetics and rehabilitation of amputees. As an expert of the WHO Regional Bureau, he organized international training workshops on rehabilitation, with English and French as languages of instruction. He was an honorary member of the New York Physical Medicine Society, held an honorary doctorate from Rennes University and an honorary membership of the Swedish Orthopaedic Society, and received the Honorary Medal of Vishnevsky Institute in Moscow. He also was Vice-president of the "Paraplegia" International Medical Society. His unexpected death in 1961 put an end to his further organizational, professional, scientific and educational plans.

Study on the effect of rehabilitation therapy based on deep learning on functional recovery of stroke patients with hemiplegia

Objective: Based on deep learning, to explore the clinical effect of early rehabilitation intervention management model on the recovery of neurological function in patients with acute stroke. Methods: A total of 86 inpatients in our department from June 2019 to August 2020 were selected. According to the ward distribution, the hospital was randomly divided into routine drug treatment group (control group, 44 cases) and another ward was divided into early comprehensive rehabilitation treatment group (treatment group, 42 cases). The treatment group received regular rehabilitation training in addition to clinical medication, while the control group received clinical medication and self-exercise without guidance. They were evaluated 24 hours before treatment and 7-10 weeks after treatment. The motor function was evaluated by Furl—Meyer motor function integral method (FMA), and the daily living ability was scored by Barthel index. Results: There was no significant difference in Barthel index and FMA score between the treatment group and the control group before treatment. After treatment, the two indexes in the control group improved to a certain extent, but compared with the treatment group, the improvement degree was far less than that in the treatment group, and the difference was statistically significant (P < 0.01). The effective rate and total effective rate in the treatment group were significantly higher than those in the control group, with statistical difference between the two groups (P<0.05). Conclusion: Early rehabilitation intervention management model can effectively improve the neurological function of patients with acute stroke and improve the clinical efficacy, which is worthy of further promotion and use in clinical practice.

EARLY COMPLEX REHABILITATION TREATMENT OF PATIENTS WITH FRACTURE OF DISTAL METAEPIPHYSIS OF THE RADIUS

Relevance. Fractures of the distal metaepiphysis of the radial bone among all fractures range from 11% to 30%. Unsatisfactory results of treatment in patients over 70 years old are found in 44% of cases. Timely and adequate rehabilitation treatment is important for obtaining good results in the treatment of such patients.&#x0D; Objective: to improve the results of the treatment of patients with fractures of the distal metaepiphysis of the radial bone based on early comprehensive individual rehabilitation treatment.&#x0D; Materials and methods. 97 patients with displaced fractures of the distal metaepiphysis of the radius were observed. Among them, 67 are women (69.1%), over 50 years old – 64 (66%). Used conservative treatment with a sparing technique of one-stage reduction. Upon completion of the correction, according to the indications, measures were prescribed for the prevention of neurodystrophic syndrome, depending on the likelihood of its development (according to the temperature gradient of the fingers of the extremities) in the form of drug therapy. Massage, kinesiotherapy, and physiotherapy began on the second day. The pain intensity was determined using a visual analog scale. The nature of pain was determined by the DN4 questionnaire (questionnaire for the diagnosis of neuropathic pain). For subjective unified assessment of hand function in the long term after a hand injury, I used a specific questionnaire DASH (Disability of the Arm, Shoulder and Hand Outcome Measure) – a questionnaire of outcomes and disability of the hand and hand.&#x0D; Results. Rehabilitation treatment at admission and at the early outpatient stage was complex, individual, taking into account the periods of illness. The debris correction was painless, low-traumatic, rational fixing bandages were used. The volume of drug therapy was determined by the value of the temperature gradient of the fingers.&#x0D; Conclusion. The proposed method for the rehabilitation of patients with fractures of the distal metaepiphysis of the radius is highly effective: good and satisfactory (according to the DASH scale) results were obtained in 97.8% of cases, unsatisfactory – in 2.2%.

Clinical Value of Early Comprehensive Rehabilitation Nursing Intervention for lCU Stroke Patients

Clinical Value of Early Comprehensive Rehabilitation Nursing Intervention for lCU Stroke Patients

Concept of early rehabilitation in children with spinal cord injury in a surgical department

Authors present a concept of early rehabilitation in children with spinal cord injury in a surgical department. The patient’s route at an early stage of rehabilitation is defined: general intensive care unit, intensive care ward in neurosurgical department and general ward in neurosurgical department. Three main stages of early comprehensive rehabilitation are also defined: perioperative, adaptation to motor deficit, motor retraining. Goals of early rehabilitation and role of multidisciplinary team involved in the care are stated as well. Article shows the role of various physical training techniques and rehabilitation tools effectiveness in patients’ care, complications prevention, motor retraining, persistent self-care skills acquisition, improvement of mobility and quality of patients' life.

Implementation of early comprehensive rehabilitation of children with cleft lip and palate using the example of the Moscow region

Lack of early comprehensive rehabilitation of children with congenital cleft lip and palate, with age leads to aggravation of anatomical and functional disorders. Aesthetic external deformation is progressing, requiring multiple corrections. The absence of orthopedic correction in the pre-surgical period, functional correction of anatomically restored muscles in the postoperative period, exacerbates the pathology of the bite, causes persistent speech disorders. The pathology of speech adversely affects the general physical, intellectual development of the child, as well as his full adaptation in society. Problems not eliminated in childhood subsequently interfere in work and in everyday life. The patient should receive such medical care that would fill the health gap and contribute to the formation of socially significant personality traits. An integrated approach has become the only possible and only it brings optimal results. The organization of cooperation between specialists should be carried out on the basis of the Federal, Regional General Medical Profile of the medical institution.

Method of virtual reality for early comprehensive rehabilitation of patients with acute stroke

Despite significant advances in the treatment and rehabilitation of stroke, level of post-stroke disability remains at a fairly high level. Recent innovative developments in the rehabilitation of these patients provide good results in terms of functional outcome. One of such developments is method of virtual reality (VR), which affects not only the speed and volume of regaining movement, as well as coordination, but also normalizes the psycho-emotional background, increasing the motivation of patients to improve the recovery process. This article provides a literature review of the use of the VR method in the rehabilitation of post-stroke patients, neurophysiological aspects of recovery of lost functions using this method are considered.