Postoperative Exercise Research Articles

Clinical study of early rehabilitation training combined with negative pressure wound therapy for the treatment of deep partial-thickness hand burns.

This study aims to explore the clinical effect of early rehabilitation training combined with negative pressure wound therapy (NPWT) for treating deep partial-thickness hand burns. Twenty patients with deep partial-thickness hand burns were randomly divided into an experimental group (n = 10) and a control group (n = 10). In the experimental group, early rehabilitation training combined with NPWT was performed, including the proper sealing of the negative pressure device, intraoperative plastic brace, early postoperative exercise therapy during negative pressure treatment, and intraoperative and postoperative body positioning. Routine NPWT was conducted in the control group. Both groups received 4 weeks of rehabilitation after wounds healed by NPWT with or without skin grafts. Hand function was evaluated after wound healing and 4 weeks after rehabilitation, including hand joint total active motion (TAM) and the brief Michigan Hand Questionnaire (bMHQ). Twenty patients were involved in this study, including 16 men and 4 women, aged 18-70 years, and the hand burn area ranged from 0.5% to 2% of the total body surface area (TBSA). There was no significant difference in TAM and bMHQ scores between the two groups after negative pressure removal. After 4 weeks of rehabilitation training, the TAM scores and bMHQ scores were significantly improved in both groups (p < 0.05); among them, those of the experimental group were both significantly better than those of the control group (p < 0.05). The application of early rehabilitation training combined with NPWT to treat deep partial-thickness hand burns can effectively improve hand function.

Clinical effect of closed reduction minimally invasive fixation in intra-articular comminuted fractures of the femoral condyle.

To evaluate the advantages of double reverse traction closed reduction combined with minimally invasive fixation in treating femoral condylar comminuted fractures. We retrospectively enrolled a total of 24 patients with femoral condylar comminuted fractures (AO = 33C3) admitted to Third Hospital of Hebei Medical University from March 2018 to February 2020. The patients were divided into two groups: experimental group (double reverse traction, n = 12) and control group (conventional surgery, n = 12). Patient demographics, fracture characteristics, operation time, incision length, and postoperative complications were then collected. The Hospital for Special Surgery (HSS) scores were recorded at the last follow-up visit. The average surgical time was 52.2 (41-73) min in the experimental group and 71.2 (45-103) min in the control group. In addition, the mean total incision length was 13.8 (11-17) cm in the experimental group and 16.3 (14-19) cm in the control group. The average HHS scores at the final follow-up were 86.3 (78-93) and 82.7 (76-90) in the experimental group and control group, respectively. It was found that double reverse traction closed reduction combined with minimally invasive fixation can provide good repositioning results and functional extremity. Moreover, patients tolerate postoperative functional knee exercises well.

The clinical application effects of artificial dermis scaffold and autologous split-thickness skin composite grafts combined with vacuum-assisted closure in refractory wounds.

To investigate the clinical application effects of artificial dermis scaffold and autologous split-thickness skin composite grafts combined with vacuum-assisted closure (V.A.C) in refractory wounds. A retrospective analysis was performed on 70 patients with refractory wounds admitted to the First Affiliated Hospital of Soochow University from June 2019 to December 2021 (44 males and 25 females, with an average age of 49.3 ± 21.4 years). There were 26 patients with chronic ulcers; 3 patients with cancerous wounds; 16 patients with hot crush injuries; and 25 patients with traumatic wounds, including 21 cases of hands, 33 cases of feet, 6 cases of upper limbs, and 10 cases of lower limbs. The patients were divided into an artificial dermis scaffold group (35 patients, including 21 males and 14 females, aged 49.5 ± 21.3 years) and a skin graft group (35 patients, including 23 males and 11 females, aged 49.1 ± 21.5 years). In the artificial dermis scaffold group, after debridement, the artificial dermis scaffold was transplanted for approximately 2 weeks until the wound surface was well vascularized, after which the autologous split-thick skin graft was transplanted. Negative pressure wound therapy was performed throughout the treatment. In the skin grafting group, after debridement, the autologous split-thickness skin graft (aSTSG) was transplanted, and negative pressure wound therapy was performed continuously. The wound healing rate; skin graft survival rate; postoperative wound infection; exudative fluid volume; subcutaneous haematoma; hospitalisation time; hospitalisation cost; Vancouver Scar Scale (VSS) score, used to evaluate the scar of the recipient area at 6months after the operation; and the sensory disorder grading method, used to evaluate the sensory recovery of the recipient area, were compared between the two groups. All 70 refractory wounds healed. In the artificial dermis scaffold group, the skin graft survival rate was 90% (86%-95%), the hospitalisation time was 38 (29-45) days, the hospitalisation cost was 148 102 (118242-192327) yuan, and the VSS score was 1.9 ± 1.3. There were significant differences in skin graft survival rate (70% [60%-80%]), length of hospital stay (21 [14-28] days), hospitalisation cost (76 201 [39228-135 919] yuan) and VSS score [6.1 ± 3.6] between the skin graft group and the artificial dermis scaffold group (P < .05). The skin graft survival rate, scar hyperplasia and sensory recovery of the recipient area in the artificial dermis scaffold group were better than those in the skin graft group, but the hospitalisation time was relatively longer, and the hospitalisation cost was relatively higher. Wound healing rate, postoperative wound infection, exudate volume, and subcutaneous haematoma of patients in the two groups were similar, and there were no significant differences (P > .05). The artificial dermis scaffold and composite transplantation of autologous aSTSG with V.A.C can promote painless wound healing and improve the skin survival rate, skin colour and lustre, and flexible smooth texture and is conducive to less scar hyperplasia and postoperative functional exercise and recovery. This method provides a reasonable and effective scheme for the treatment of clinical refractory wounds.

Effect of Multimodal Health Education Combined with the Feedback Method in Perioperative Patients with Lung Cancer: A Randomised Controlled Study.

To explore the effect of multimodal health education combined with a feedback method in perioperative patients with lung cancer. A total of 200 lung cancer patients were divided into the observation group and the control group. The observation group adopted the multimodal health education combined with the feedback method, and the control group adopted the conventional health education model. The postoperative extubation time, length of hospital stay, time to first leaving the bed, postoperative exercise compliance, emotional-distress index and patient satisfaction were compared between the two groups. The postoperative extubation time (2.80 ± 1.03 days), the emotional-distress index (8.26 ± 3.01) and the time to first leaving the bed (23.74 ± 11.87 h) were all lower in the observation group than in the control group, with a statistically significant difference (P < 0.05). The postoperative exercise compliance (49.69 ± 3.60) and patient satisfaction (98.32 ± 1.66) values were higher in the observation group than in the control group, with statistically significant differences (P < 0.05). Multimodal health education combined with the feedback method can improve the postoperative exercise compliance of lung cancer patients, reduce their postoperative rehabilitation time and improve their postoperative psychological state and satisfaction, which is in line with the concept of promoting the enhanced recovery of lung cancer patients.

EFFECTIVENESS OF EARLY POSTOPERATIVE EXERCISE PROGRAM IN POST HIP ARTHROPLASTY PATIENTS

Background: Patients after undergoing arthroplasty surgery will experience several changes in carrying out functional activities and daily routines. This is due to altered joint and muscle function due to decreased strength and limited range of motion after arthroplasty surgery. Post-hip arthroplasty conditions require comprehensive treatment so as not to cause impairment/disability that will interfere with function and gait. How effective is the early postoperative exercise program in preventing further decline in ability and speeding recovery? Methods: This exercise program is given since the patient has finished surgery and is gradually progressing to standing and walking exercises. This research was conducted on patients in the inpatient room of RS Ortopedi Prof. Dr. R. Soeharso Surakarta. Assessment and evaluation of post-hip arthroplasty results using the Harris Hip Score functional index before and after being given an exercise program. Results: The statistical test showed that the data was not normally distributed (p&lt;0.05) and the results of the influence test using the Wilcoxon Test showed that there was an effect of early postoperative exercise on reducing pain (p=0.005) and increasing the Harris Hip Score (HHS) index. The result of the action is that there is an increase in functional ability in post-hip arthroplasty patients. Conclusion: Based on this study, it can be concluded that the program of giving exercise therapy as early as possible in post-hip arthroplasty patients can accelerate recovery and improve functional ability.

The feasibility of small-caliber veins for autogenous arteriovenous fistula creation: A single-center retrospective study.

Autogenous arteriovenous fistula (AVF) is recommended as the first choice for hemodialysis vascular access. A small-caliber vein is one of the independent risk factors for AVF maturation and patency. However, the specific threshold is still unclear, making it difficult to accurately determine whether these vessels are suitable for AVF creation. This is a single-center retrospective study. Patients who underwent AVF creation in our medical center between January 2020 and September 2022 and satisfied the eligibility criteria were included in this retrospective study. Logistic regression analysis was performed to identify risk factors for functional maturation and additional intervention. The optimal cutoff value was determined based on the receiver operating curve (ROC) and the Youden index. Kaplan-Meier analysis was utilized in further patency rate comparisons. A total of 125 forearm AVFs were created in 121 patients with end-stage renal disease (ESRD). The mean age was 53.88 ± 15.10 years. Preoperative vascular Doppler ultrasound (DUS) was conducted and recorded in 106 cases (84.80%). The mean targeted artery and vein diameters were 2.17 ± 0.54 and 1.71 ± 0.75 mm, respectively. Small-caliber vein is the risk factor for functional maturation failure (OR = 0.256, 95%CI [0.06-0.75], p = 0.033) and additional intervention (OR = 0.306, 95% CI [0.09-0.78], p = 0.031). The optimal cutoff value is 1.35 mm (augmented) when specificity and sensitivity reach 80 and 63.7%, respectively. The AVFs with a vein diameter of more than 1.35 mm (augmented) showed higher patency rates (p < 0.01). After comprehensive DUS evaluation, intraoperative hydrodilation, postoperative active exercise and intensive DUS detection, and application of balloon-assisted maturation, if necessary, using a vein more than 1.35 mm (augmented), could achieve satisfactory functional maturation and postoperative patency in AVF formation.

Detection of abnormal human behavior using deep learning

The complete human body or the various limb postures are involved in human action. These days,Abnormal Human Activity Recognition (Abnormal HAR) is highly well noticed and surveyed in manystudies. However, because of complicated difficulties such as sensor movement, positioning, and so on,as well as how individuals carry out their activities, it continues to be a difficult process. Identifyingparticular activities benefits human-centric applications such as postoperative trauma recovery, gesturedetection, exercise, fitness, and home care help. The HAR system has the ability to automate orsimplify most of the people’s everyday chores. HAR systems often use supervised or unsupervisedlearning as their foundation. Unsupervised systems operate according to a set of rules, whereassupervised systems need to be trained beforehand using specific datasets. This study conducts detailedliterature reviews on the development of various activity identification techniques currently being used.The three methods—wearable device-based, pose-based, and smartphone sensor—are examined in thisinquiry for identifying abnormal acts (AAD). The sensors in wearable devices collect data, whereas thegyroscopes and accelerometers in smartphones provide input to the sensors in wearable devices. Tocategorize activities, pose estimation uses a neural network. The Anomalous Action Detection Dataset(Ano-AAD) is created and improved using several methods. The study examines fresh datasets andinnovative models, including UCF-Crime. A new pattern in anomalous HAR systems has emerged,linking anomalous HAR tasks to computer vision applications including security, video surveillance,and home monitoring. In terms of issues and potential solutions, the survey looks at vision-based HAR

Application effect of quality control circle in postoperative functional exercise compliance of breast neoplasms patients:a meta-analysis

Application effect of quality control circle in postoperative functional exercise compliance of breast neoplasms patients:a meta-analysis

Therapeutic effect of upper extremities exercise based on mirror therapy in the postoperative recovery of shoulder function in breast cancer patients

This study aims to investigate the effect of upper extremities exercise based on mirror therapy in the postoperative recovery of shoulder function in breast cancer patients. A total of 120 patients were selected from January 2021 to December 2021 and randomly divided into the control group (60 cases) and the observation group (60 cases) by random number table method. The control group was given conventional intervention, while the observation group was additionally given mirror therapy. The Constant-Murley Score (CMS), Disability of the Arm, Shoulder and Hand (DASH) Score, compliance of shoulder exercise, and arm circumference were compared between the two groups before the intervention and at 2 weeks, 4 weeks or 8 weeks after surgery. After 2 weeks, 4 weeks and 8 weeks of intervention, patients in the observation group showed higher scores of CMS, lower scores of DASH and better compliance of shoulder exercise than those in the control group. There was no significant difference regarding the bilateral circumference difference of upper limbs between the control group and the observation group. The application of mirror therapy is beneficial to the mobility of shoulder joint, and it promotes the functional recovery of shoulder joint, reduces the occurrence of upper limb dysfunction and increases the compliance of shoulder exercise, whereby preventing lymphedema of the upper extremities in the postoperative shoulder exercise of breast cancer patients.

Effect of ERAS management mode on postoperative functional exercise compliance and functional recovery in male anterior cruciate ligament injury

The study aims to investigate the effect of ERAS (Enhanced Recovery After Surgery) management mode on functional exercise compliance and functional recovery after ACL (anterior cruciate ligament) reconstruction in males. Patients were admitted between June 2021 and December 2021 as the control group, and patients were admitted between January 2022 and June 2022 as the observation group. Routine nursing was adopted in the control group, while ERAS management mode was applied in the observation group for nursing. The clinical nursing efficacy, knee joint function (Lysholm score) and VAS (Visual analogue scale) score, patients’ functional training compliance and complications were compared. After intervention, the swelling disappearance time, pain disappearance time, hospital stay and other indicators of clinical nursing effect in the observation group were better (p &lt; 0.05); the preoperative Lysholm score and VAS score showed no statistical significance (p &gt; 0.05). The Lysholm score and VAS score at each time point after operation were markedly higher, and repeated measures analysis of variance manifested that the Lysholm score, VAS score, intergroup effect, time effect and interaction effect in both groups had statistical significance (p &lt; 0.05). The total compliance rate of functional training in the observation group was conspicuously higher (p &lt; 0.05); the overall incidence of complications in the observation group (13.3%) was evidently lower (28.7%) (p &lt; 0.05). ERAS management mode can improve the functional training compliance, accelerate the recovery of joint function, reduce the incidence of complications and promote the quality of life of patients with ACL injury.

Pre and postoperative nurse-guided incentive spirometry versus physiotherapist-guided pre and postoperative breathing exercises in patients undergoing cardiac surgery: An evaluation of postoperative complications and length of hospital stay

Atelectasis is the most occurring postoperative complication after cardiac surgeries. Postoperative respiratory exercises and incentive spirometry led to decrease in postoperative complications, especially atelectasis and hospital stay. The objectives of the study were to evaluate postoperative complications and length of hospital stay of patients who received pre and postoperative nurse-guided incentive spirometry against those of patients who received pre and postoperative breathing exercises by the physiotherapist in patients who underwent cardiac surgery. Data of patients who received 2 days preoperative and 2 days postoperative nurse-guided incentive spirometry with a spirometer (PPN cohort, n = 102) or received 2 days preoperative and 2 days postoperative breathing exercises by physiotherapist without spirometer (PPP cohort, n = 105), or 2 days postoperative physiotherapist-guided breathing exercises only without spirometer (PPB cohort, n = 114) were collected and analyzed. The acute or chronic collapse of part or entire lung was defined as atelectasis. The length of stay in the hospital was from the day of admission to discharge. Patients of the PPN cohort had fewer numbers of incidences of atelectasis, dyspnea, and sweating >1 day after operations compared to those of the PPB and the PPP cohorts (P < .05 for all). The partial pressure of oxygen and oxygen saturation of arterial blood ≥6 hours after operations reported higher, the duration of ventilation was shorter, and numbers of re-intubation processes reported fewer for patients of the PPN cohort than those of the PPB and the PPP cohorts (P < .05 for all). The hospital length of the stay of patients in the PPN cohort was fewer than those of the PPB and the PPP (P < .0001 for both) cohorts. Pre and postoperative nurse-guided incentive spirometry with a spirometer following cardiac surgeries would have better postoperative pulmonary outcomes and fewer hospital stays than those of postoperative-only or pre and postoperative physiotherapist-guided breathing exercises (level of evidence: IV; technical efficacy stage: 5).

A Randomized Trial of Postoperative Handgrip Exercises for Fistula Maturation in Patients With Newly Created Wrist Radiocephalic Arteriovenous Fistulas

We aimed to substantiate the benefit of postoperative handgrip exercises (HGEs) in enhancing the maturation of an arteriovenous wrist fistula. We randomly assigned 119 patients aged 20 to 80 years who had wrist arteriovenous fistulas (AVFs) to undergo either a basic HGE program (group A), an advanced program (group B), or an advanced-plus upper arm banding program (group C). Outcomes were assessed by ultrasonographic evaluation of the diameter and flow at each follow-up. The attending nephrologist decided the clinical use of the fistula. We identified no significant differences among the HGE groups in the mean diameter and blood flow 14, 30, 60, and 90 days after the creation of the wrist AVF (P= 0.55, 0.88, 0.21, and 0.19 for the diameter; 0.94, 0.81, 0.49, and 0.56 for the flow, respectively). The intent-to-treat analysis also found no difference in the clinical use of fistulas for hemodialysis (HD) (P= 0.997). In patients with a newly created wrist AVF, advancing frequency, with or without adding intensity using an upper arm tourniquet, of postoperative HGEs did not enhance the growth of the fistula or increase the rate of clinical use over 3 months. (ClinicalTrials.gov ID: NCT03077815).

Effects of Electrical Impedance Tomography-Guided Positive End-Expiratory Pressure on Postoperative Cardiopulmonary Exercise Capacity in Elderly Patients: Study Protocol for a Randomized Controlled Trial.

BACKGROUND Mechanical ventilation can lead to cardiopulmonary complications in elderly patients undergoing abdominal surgery plus general anesthesia. The cardiopulmonary exercise test (CPET) is a dynamic and noninvasive evaluation method for assessing the cardiopulmonary system function under rest and stress. Positive end-expiratory pressure (PEEP) titration guided by electrical impedance tomography (EIT) can individualize lung protection strategies and may be beneficial in postoperative cardiopulmonary exercise capacity for these patients. MATERIAL AND METHODS This study is a prospective, single-center, randomized, and controlled trail that will include 80 elderly patients scheduled for major abdominal surgery. The patients will be divided into 2 groups: (1) intervention group: using individualized PEEP ventilation; and (2) control group: using fixed PEEP ventilation (3-5 cmH₂O). RESULTS The primary outcome is the change of postoperative cardiopulmonary exercise capacity. CONCLUSIONS In this study, we will evaluate if EIT-guided PEEP titration can improve postoperative cardiopulmonary exercise capacity and reduce postoperative complications in elderly patients undergoing open abdominal surgery plus general anesthesia. If the result is in accordance with the hypothesis, it would provide evidence to aid the perioperative management for these patients.

Effectiveness analysis of proximal humerus internal locking system plate combined with rotator cuff reinforcement suture in treatment of Neer type Ⅳ proximal humerus fracture

To investigate the effectiveness of proximal humerus internal locking system (PHILOS) plate combined with rotator cuff reinforcement suture in the treatment of Neer type Ⅳ proximal humerus fracture. The clinical data of 48 patients with proximal humeral fractures admitted between January 2016 and December 2020 were retrospectively analyzed, including 18 males and 30 females. The age ranged from 28 to 69 years (mean, 56.3 years). The causes of injury included falling in 39 cases and traffic accident in 9 cases. The time from injury to operation was 2-5 days (mean, 2.8 days). All of them were Neer type Ⅳ proximal humerus fractures, including 11 patients with dislocation. All patients underwent internal fixation with a PHILOS plate after anatomical reduction of the greater nodule, and the rotator cuff was sutured to the plate to reinforce fixation. The operation time was recorded, the wound healing, fracture healing, and complications were observed. The visual analogue scale (VAS) score, Constant-Murley shoulder score, University of California Los Angeles (UCLA) score, and American Shoulder and Elbow Surgeons (ASES) score were used to evaluate shoulder function before operation, at 3 months after operation, and at last follow-up. The operation time ranged from 65 to 90 minutes (mean, 76.9 minutes). All incisions healed by first intention. All patients were followed up 9-16 months (mean, 12 months). Fracture reduction was good and all fractures healed, the healing time was 2-6 months (mean, 4.6 months). There was no complication such as subacromial impingement, fracture redisplacement, and screw removal during follow-up. One patient had humeral head necrosis, but the basic function of the shoulder joint was acceptable, the symptoms were mild, and no treatment was performed. At 3 months after operation, the upper limb function of the patients basically recovered. The VAS score, Constant-Murley score, UCLA score, and ASES score significantly improved at 3 months after operation and at last follow-up when compared with preoperative, and further improved at last follow-up than at 3 months after operation ( P<0.05). PHILOS plate combined with rotator cuff reinforcement suture in the treatment of Neer type Ⅳ proximal humerus fracture has the advantages of promoting early postoperative rehabilitation exercise, improving postoperative function of shoulder joint, and reducing complications.

Exercise oxygen desaturation is a predictor of cardiopulmonary complications after lung resection

BackgroundTo investigate whether oxygen desaturation during low technology tests was associated with complications after lung resection.MethodsA retrospective cohort study was conducted on 1097 candidates for pulmonary resection; seven metabolic equivalents...

The Concerns and Experiences of Patients With Lumbar Spinal Stenosis Regarding Prehabilitation and Recovery After Spine Surgery: A Qualitative Study

To improve our understanding of patients' perspectives regarding: (1) the decision-making and prehabilitation before lumbar spinal stenosis (LSS) surgery and (2) their postoperative experiences. Qualitative research with semi-structured interviews. General community. Individuals who received (N=10) and who did not receive (N=15) prehabilitation before LSS surgery were recruited at the 6-month postoperative follow-up (8 females; average age: 67.7±6.7 years) by purposive sampling. Additionally, 1 participant invited her daughter to accompany her in an interview. Not applicable. Concerns and experiences of patients with LSS regarding prehabilitation and recovery after spine surgery. Thematic analysis was conducted to identify 4 themes inductively: (1) sources of information about LSS surgery; (2) factors affecting the surgical decision-making; (3) attitudes toward prehabilitation; and (4) postoperative recovery. All participants desired to have more preoperative education to inform their surgical decision-making. There were mixed opinions regarding the perceived benefits of prehabilitation because some individuals hesitated to participate in prehabilitation because of their symptoms, or the cost or time of traveling. Many participants expected some or even complete relief of LSS-related symptoms after surgery. However, not all participants experienced the expected postoperative improvements. Some participants only experienced temporary symptomatic relief, while others experienced new postoperative symptoms. Patients generally found that postoperative exercises taught by physiotherapists were useful although their compliance decreased over time. Our study highlights the need for better preoperative LSS education. Because face-to-face prehabilitation or postoperative rehabilitation may not be feasible for all patients, future studies should explore whether online-based prehabilitation or postoperative rehabilitation may benefit certain patient subgroups.

Efficacy of bed exercise in elderly patients after total hip arthroplasty: A retrospective study of 539 patients.

The purpose of this study was to observe the necessity of bed exercise therapy in the rehabilitation of elderly patients after hip replacement and to analyze whether bed exercise therapy has an impact on patients' psychological scores, hip function and postoperative complications. From January 2018 to January 2021, a total of 539 patients with end-stage femoral head necrosis or hip osteoarthritis were retrospectively analyzed. According to the method of postoperative rehabilitation exercise, patients were divided into 2 groups: Group A (routine gait) and Group B (bed exercise). There was no significant difference in general information between the 2 groups. There was no significant difference in baseline pain scores between patients in Group A and Group B (25.2 ± 9.6 vs 24.8 ± 10.4, P = .429). However, at 5 weeks post-operatively, the pain scores of patients in Group A were significantly higher than those in Group B (38.6 ± 7.7 vs 34.1 ± 8.1, P = .016). At 17 weeks post-operatively, the difference between Group A and Group B remained (40.9 ± 6.9 vs 37.5 ± 7.5, P = .041). Similar to the pain score, the hip function score compared between the 2 groups was significantly different at 5 weeks (39.7 ± 8.4 in Group A, 45.9 ± 9.2 in Group B, P < .001) and 17 weeks post-operatively (41.5 ± 7.6 in Group A, 47.2 ± 8.8 in Group B, P < .001). At 17 weeks post-operatively, between the 2 groups, only the range of motion (ROM) of abduction showed no significant difference. Patients in Group B exhibited a better ROM in any other movement posture. The results showed that compared with Group A, bed exercise rehabilitation training could reduce the incidence of deep venous thrombosis. This study demonstrates that bed exercise can improve the hip function and quality of life of elderly patients with total hip arthroplasty (THA) at an early postoperative stage. It can reduce the incidence of deep venous thrombosis of the lower limbs after surgery. For these patients, systematic bed exercise rehabilitation training is recommended in the early postoperative period.

Exploration and thinking on functional preservation after orthotopic neobladder construction

The concept of functional preservation after orthotopic neobladder construction has gradually attracted attention. Reconstruction of urine storage and voiding is the basic function preservation of orthotopic neobladder. Clinical exploration mainly focuses on the optimization of neobladder reconstruction methods and procedures, and there is still a lack of summary of existing surgical characteristics and high-quality functional comparative studies. For strictly selected patients, on the basis of tumor control and standardized postoperative rehabilitation guidance, most patients with preserved nerve can retain satisfied sexual function after surgery. The protection of neurovascular bundle and ancillary structures combined with postoperative exercise is crucial to the improvement of urinary continence. According to the characteristics of patients, choosing the appropriate urinary diversion methods and function preserving can help patients establish a normal life style after surgery and improve their self-image and quality of life.

Active exercise therapy improves the recovery of knee joint function and reduction of muscle atrophy after medial patellofemoral ligament reconstruction for recurrent patellar dislocation.

Medial patellofemoral ligament (MPFL) reconstruction is an important surgical therapy for recurrent patellar dislocation. However, few studies have focused on exercise therapy after MPFL reconstruction. Therefore, the first purpose was to compare the active and traditional postoperative exercise therapies on the recovery of knee joint function and reduction of muscle atrophy after MPFL reconstruction, and the second purpose was to compare the active and traditional postoperative exercise therapies on the patellar stability after MPFL reconstruction. The cases of 31 patients with recurrent patellar dislocation treated with patella double semi-tunnel anatomical MPFL reconstruction from February 2016 and February 2019 were retrospectively reviewed. The clinical outcomes, including the patellar tilt angle (PTA), lateral patellofemoral angle (LPFA), thigh circumference reduction, Kujala score, and Lysholm score, were compared between two groups (i.e., active exercise and traditional exercise groups) preoperatively, 3 months postoperatively, 6 months postoperatively, 12 months postoperatively, and 24 months postoperatively. The Kujala score was significantly higher in the active exercise group than traditional exercise group 3 months postoperatively (80.06 vs. 74.80, P < 0.01), 6 months postoperatively (89.19 vs. 82.07, P < 0.01), 12 months postoperatively (91.43 vs. 86.60, P < 0.01), and 24 months postoperatively (92.50 vs. 90.27, P = 0.02). Similarly, there was a higher Lysholm score in the active exercise group compared with traditional exercise group 3 months postoperatively (81.25 vs. 76.53, P < 0.01), 6 months postoperatively (89.81 vs. 84.80, P < 0.01), 12 months postoperatively (93.25 vs. 88.40, P < 0.01), and 24 months postoperatively (93.69 vs. 90.67, P < 0.01). Significantly lower thigh circumference reduction was reported in the active exercise group compared with that in the traditional exercise group 3 months postoperatively (1.90 ± 0.57 vs. 2.45 ± 0.45, P < 0.01) and 6 months postoperatively (1.50 ± 0.31 vs. 1.83 ± 0.32, P < 0.01). No statistical difference was observed between the two groups in terms of PTA (P > 0.05) or LPFA postoperatively (P > 0.05). Our results suggested that active exercise therapy might benefit the early recovery of knee joint function and reduction of muscle atrophy in patients with recurrent patellar dislocation after MPFL reconstruction.

Application of high-resolution anorectal manometry in postoperative pelvic floor muscle exercises in children with tethered cord syndrome

Application of high-resolution anorectal manometry in postoperative pelvic floor muscle exercises in children with tethered cord syndrome