Effects Of Rehabilitation In Patients Research Articles

REHABILITATION IN PALLIATIVE CARE

ABSTRACT: The objective of this study was to describe the activities and effects of functional rehabilitation in patients receiving palliative care. It is an integrative review, in which LILACS, BDENF, Coleciona SUS (Brazil) and PUBMED were used, 20 articles were selected, subsequently characterized as having designs of medium and low impact, more than half ranked with evidence levels II, III and IV and with samples not always consistent with the research designs. However, the results revealed the potential of rehabilitation to improve the functional status, quality of life and symptoms like pain and anxiety in this population, through interventions that are many times undervalued in palliative care. The conclusion is that rehabilitation is a feasible strategy to combat functional decline and improve the quality of life of patients in palliative care.

Factors affecting the Functional Independence Measure Gain of Patients with Stroke

Objective: To investigate the effect of rehabilitation in patients admitted to our clinic after stroke on the latest situation. Material and Methods: Medical records of 126 patients who were brought to the PMR Clinic at Antalya Education and Research Hospital between October 2010 and November 2011 and were hospitalized and received a rehabilitation program were evaluated retrospectively. Patients were divided into the following groups according to etiology, ischemic and hemorrhagic; age, under and over 65years of age; the time passed until the onset of rehabilitation, early (<3 months) and late (≥3 months); and by affected side, right and left. The functional status of patients at admission to our center, at discharge from our center, and the functional gains during hospitalization were evaluated by Functional Independence Measure (FIM), FIM gain, and FIM efficiency. Results: Admission FIM values were found to be 73.2±29.1 for patients with acute phase and 80.7±32.9 for patients with chronic phase. There was no statistically significant difference between the two groups. Mean FIM gain was 17.7±18.2 for patients with acute phase and 9.3±11.7 for patients with chronic phase; FIM gain in patients with acute phase was statistically significant (p=0.02). FIM efficiency in patients with acute phase was statistically significant (p=0.03). Conclusion: As a result, FIM gain and FIM efficiency in patients with acute phase were higher in patients with chronic phase in this retrospective study conducted in 126 hemiplegic patients. The early onset of rehabilitation will enable patients to perform more comfortable daily life activities and to achieve more functional gain.

Application of systematic rehabilitation nursing procedure on improving the quality of life of patients with long-term conscious disturbance

Objective To investigate the application of systematic rehabilitation nursing procedure on improving the life quality of patients with long-term conscious disturbance. Methods A total of 7 patients with long-term conscious disturbance had been chosen as sampling and applied warm bath to stimulate, back slight vibration, sports training and other rehabilitation nursing program. The mild disturbance of consciousness re-scoring(NASVA ) was used to evaluate the quality of life improving in patients. Results The 7 patients received four stages rehabilitation nursing care (average 6 months) as its procedure, in which two patients got rid of decerebrate rigidity completely while five patients minimized the upper and lower extremity contractures of joint. Compared with the implementation of rehabilitation care before, the 7 cases of patients with long-term conscious disturbance improved their exercise, feeding, excretion, cognition, language expression, verbal commands and other aspects of NASVA score after rehabilitation care with statistically differences (P<0.01). Quality of life of 7 patients were significantly improved, of which one patients return to school to continue study, and four patients′ contractures of lower and upper extremity joint improved and they could go back home, and live with their family and eat by mouth. Conclusions Implementation of systematic rehabilitation nursing procedure can improve the rehabilitation effects for patients with long-term conscious disturbance and contributes to those patients′ quality of life. Key words: Quality of life; Long-term conscious disturbance; Systematic rehabilitation nursing procedure

Melatonin in the correction of sleep in post-stroke patients

To assess an effect of melatonin on quality of life and effectiveness of rehabilitation in patients with ischemic stroke (IS) suffered from insomnia due to sleep initiation disturbance. Sixty post-stroke patients with insomnia were stratified into two groups matched for characteristics assessed in the study. Patients of the main group received melatonin during 21 days. In the first three days after admission and 21 days after the first examination, we administered the MMSE, the Rankin scale, FOSQ, NIHSS, EuroQol, the Epworth sleepiness scale (ESS) and used instrumental methods of examination (computed and magnetic-resonance tomography, electroencephalography, polysomnography). After 3 weeks, there was a reduction (p<0.05) in ESS scores in the main group compared to the control group (5.7 and 10 scores, respectively). Significant between-group differences were identified for polysomnographic parameters: latency to sleep was 17.8 min in the main group and 20.5 min in the control group (p<0.05), the number of microactivations was 15 and 18, respectively (p<0.05). There was a trend towards more rapid recovery in the main group (on average 8.4 days) compared to the control group (10.2 days), but the differences did not reach the level of statistical significance p<0.05. Melatonin reduced sleepiness (measured with the ESS), latency to sleep and number of wakings (microactivations) and was likely to promote the recovery in IS patients with insomnia due to sleep initiation disturbance.

运用数字多媒体传播媒介对促进全膝关节置换患者术后康复的效果评价

目的：探讨运用数字化多媒体传播媒介对促进全膝关节置换术后患者功能锻炼依从性及膝关节功能康复的效果。方法：219例行全膝关节置换术后患者根据入院日期分为试验组和对照组。试验组利用数字化多媒体传播媒介分阶段进行健康教育指导，对照组仅给与常规健康教育指导。比较①两组患者术后功能锻炼完成情况；②入院时、出院时和出院后3个月膝关节功能的HSS评分。结果：两组患者术后功能锻炼完成情况差异有统计学意义(p Objective: To investigate the function training compliance and rehabilitation effect of patients after total knee arthroplasty using digital multimedia transmission medium. Methods: 219 patients after total knee arthroplasty were divided into experimental group and control group based on the date of admission. The experimental group used health education guidance by stages using digital multimedia transmission medium, while the control group used common health education guidance. The function training performance after operation, and the HSS score of knee function on admission, at discharge, and 3 months after discharge respectively between the two groups were compared. Results: The difference of function training performance between the two groups was significant (p < 0.05); the HSS score was not significant on admission, while the difference of it at discharge and 3 months after discharge was statistically significant (p < 0.05), and the experimental group scored higher. Conclusion: Using digital multimedia transmission medium for health education guidance after operation helps to improve the function training compliance and knee function of patients after total knee arthroplasty.

Effects of Pulmonary Rehabilitation in Patients with Diffuse Interstitial Lung Disease

Effects of Pulmonary Rehabilitation in Patients with Diffuse Interstitial Lung Disease

Application of self-designed foot-drop-prevention holder in lower limb dysfunction patients

Objective To design a foot-drop-prevention holder for paralysis patients , to prevent patients from long-term foot-drop causing limbs disuse atrophy , effecting function recovery , and to discuss the rehabilitation effect of patients .Methods The foot-drop-prevention holder included a lower limb placing and T-shaped groove , and sponge covering the T-shaped groove .Fifty-five patients were selected from neurology department as the experimental group , placed foot-drop-prevention holder .Another fifty-three patients were not given foot-drop-prevention holder and selected as the control group .Maryland foot function score and short form Fugl-Meyer movement function score of lower limbs in the two groups were compared .Results Before the intervention, there was no significant difference between the two groups （ P 〉0.05）.After one month of intervention, Maryland foot function scores were （90.85 ±3.02） of the experimental group and （83.50 ±2.43） of the control group.The difference was statistically significant （t=12.52, P〈0.05）.The short form Fugl-Meyer movement function scores were （30.90 ±2.14） of the experimental group and （22.13 ±2.26） of the control group.The difference was statistically significant （t=19.75, P〈0.05）.Conclusions The foot-drop-prevention holder is beneficial to rehabilitation of patients ’ lower limbs function , and can effectively replace nursing staff manual fixing .It is suitable for neurology patients . Key words: Lower limb paralysis; Foot-drop-prevention holder; Lower limb dysfunction

Effectiveness of Carpal Tunnel Syndrome Rehabilitation after Endoscopic Versus Open Surgical Release

BACKGROUND. Carpal tunnel syndrome is a common upper limb compression neuropathy. Postoperative rehabilitation improves the function of the limb. The aim of this study was to assess the effects of rehabilitation in patients who had undergone endoscopic vs. open surgical carpal tunnel release. MATERIAL AND METHODS. Twenty-six patients were divided into endoscopy (E) and open surgery (K) groups. The following parameters were assessed after rehabilitation: two-point discrimination by fingertips of the operated hand, ranges of motion of joints of the hand, circumferences of the radiocarpal and metacarpo pha langeal joints and the severity of pain and other symptoms. RESULTS. The groups differed regarding the severity of symptoms (numbness), joint circumferences and tactile sensation in fingertips I-IV. The mean values of these parameters were significantly higher in group K compared to group E. In group E, rehabilitation decreased severity of pain and other symptoms and increased the ranges of motion. Recovery of two-point discrimination by fingertips I-IV was also observed. Group K patients showed the greatest improvement in the range of motion. Pain intensity decrease did not reach statistical significance. The two-point discrimination test demonstrated better tactile sensation, but the mean distance between caliper points for particular fingers still showed reduced two-point discrimination ability. CONCLUSIONS. 1. Rehabilitation improved hand function in patients from groups that operated on using different techniques of median nerve release. 2. Rehabilitation resulted in improved innervation density, which was reflected by changes in two-point discrimination scores in fingertips in the operated hand of patients from both groups. 3. Great er improvement was achieved in the pa tients who had undergone an endoscopic procedure.

Changes of brain resting state functional connectivity predict the persistence of cognitive rehabilitation effects in patients with multiple sclerosis

Objective: We investigated whether the efficacy of 12-week cognitive rehabilitation in MS patients persists six months after treatment termination and, together with resting state (RS) functional connectivity (FC), changes on neuropsychological performance at follow-up. Methods: Eighteen MS patients with cognitive deficits, assigned randomly either to undergo treatment (n=9) or not (n=9), underwent neuropsychological evaluation at baseline (t0), after 12 weeks of rehabilitation (t1) and at six-month follow-up (t2). RS fMRI was obtained at t0 and t1. Changes in neuropsychological performance and their correlations with RS FC modifications were assessed using longitudinal linear models. Results: At t2 vs. t0, compared with the control group, treated group patients improved in tests of attention, executive function, depression and quality of life (QoL). Neuropsychological scores in these tests at t2 were significantly correlated with RS FC changes in cognitive-related networks and RS FC of the anterior cingulum. RS FC changes in the default mode network predicted cognitive performance and less severe depression, whereas RS FC changes of the executive network predicted better QoL. Discussion: Changes in RS FC of cognitive-related networks helps to explain the persistence of the effects of cognitive rehabilitation after several months in relapsing–remitting multiple sclerosis patients and their improvement on depression and QoL scales.

Local dynamic stability as a responsive index for the evaluation of rehabilitation effect on fall risk in patients with multiple sclerosis: a longitudinal study

BackgroundGait and balance problems are common in patients with multiple sclerosis, leading to high risk for falls. Local Dynamic Stability (LDS), a non-linear gait stability index, has been advocated as an early indicator of risk for falls. With this longitudinal study over three weeks, we aimed to assess the responsiveness of Local Dynamic Stability to a rehabilitation program and to compare it to other measures.MethodsEighteen patients (mean 54 years, median EDSS score: 5) participated. They were admitted to inpatient rehabilitation and received a three weeks individually tailored program. They performed a 3-minute walking test at the beginning and at the end of the stay, as well as pain, wellbeing, fatigue, and balance assessment. The Local Dynamic Stability was computed from the acceleration signals measured with a 3D-accelerometer.ResultsAt the end of the rehabilitation process, patients reported reduced pain (Effect Size: −0.7), fatigue (ES:-0.6), and increased wellbeing (ES: 1.1). A small positive effect on static balance was observed (ES: 0.3). LDS was improved (ES: 0.6), and the effect was higher than walking speed improvement (ES: 0.4).ConclusionsThe Local Dynamic Stability seemed responsive to assess rehabilitation effects in patients with multiple sclerosis. It could constitute a valuable gait quality index, which could evaluate potential effects of rehabilitation on fall risk.Trial registrationCurrent Controlled Trials ISRCTN69803702.

A Randomized Controlled Trial of Postthoracotomy Pulmonary Rehabilitation in Patients with Resectable Lung Cancer

Little is known about the effects of rehabilitation for patients with lung cancer after thoracotomy. The primary objective of this study was to evaluate the effect of a multidisciplinary rehabilitation program on quality of life (QOL) and secondary objectives were to determine its effects on pain and exercise capacity and the feasibility of combining rehabilitation with adjuvant chemotherapy. Patients who had undergone a thoracotomy for lung cancer were randomized between rehabilitation and usual care. Rehabilitation consisted of twice-weekly training for 12 weeks starting 1 month after hospital discharge, scheduled visits to pain specialists, and medical social work. QOL and pain were measured with validated questionnaires at baseline and after 1, 3, 6, and 12 months. Exercise tolerance was assessed at baseline and after 3 months with a 6-minute walking distance test. The study closed prematurely because of the introduction of video-assisted thoracoscopic surgery. Of 57 randomized patients, 49 patients (23 active and 26 control) were analyzed. QOL was not significantly different between groups, although, the active group reported more pain after 3 and 6 months and more limitations because of physical problems after 3 months. In the active group, 6-minute walking distance improved by 35 m from preoperative baseline, as opposed to the control group that showed a decline by 59 m (p = 0.024 for difference). Patients treated with adjuvant chemotherapy showed decreased attendance at training sessions. Rehabilitation did not result in a better QOL. Exercise tolerance improved at the cost of more pain and more limitations because of physical problems. We suggest that rehabilitation is better postponed for 3 to 4 months after hospital discharge.

Peripheral Facial Nerve Palsy

To review the current literature to assess the effectiveness of rehabilitation treatment for peripheral facial nerve palsy. A review of the literature was conducted using the following database: PubMed, EMBASE, PEDro, and Scopus. All randomized or quasi randomized controlled trials, case control, cohort studies and case series greater than 6 published between 1990 and 2010 in the English language were included. All types of peripheral facial nerve palsy were included. We considered all the exercises or rehabilitation programs provided by a physiotherapy in outpatient or home setting and excluded trials in which a drug therapy or surgical intervention was investigated. Three reviewers independently selected the articles. To rate the methodological quality of the studies the American Academy of Neurology classification of evidence for therapeutic intervention (Classes I-IV) was applied. Peripheral injury of the VIIth cranial nerve can have serious repercussions on the patient's functioning and quality of life. The recovery rate is related to the preservation of the nerve and to the cause of palsy. We obtained a third level of recommendation (level C); mime therapy could be effective to improve functional outcome in these patients. Evidence of specific treatment addressed to specific cause is lacking; likewise, no evidence is available on timing of intervention with respect to time of onset. Well-designed randomized controlled trials are required to evaluate the effect of rehabilitation in patients with facial palsy.

Pulmonary Rehabilitation for Moderate COPD (GOLD 2) –Does it Have an Effect?

Background: Although pulmonary rehabilitation is an integrated part of standard care in patients with severe COPD, it is uncertain whether those with less severe COPD benefit from such treatment. The aim of the present survey was to evaluate the effect of rehabilitation in patients with moderate COPD and to determine their willingness to participate in rehabilitation. Material and methods: In a single-centre, randomized, placebo-controlled, unblinded clinical trial, participants comprised 61 of 133 referred subjects with moderate COPD. Of the 61 participants, 35 were randomized to receive rehabilitation and 26 subjects to receive standard COPD care from their GP. After randomization 19 subjects dropped out. Results: Effects of physical training were seen during the period of intervention. Compared with those receiving standard GP care, those receiving rehabilitation showed improvements in walking distance and leg strength as well as improvements in quality of life; however, the effect was temporary, and at 18 months’ follow-up there was no significant difference between the groups. Only 61 subjects of the referred group of 133 with moderate COPD accepted the offer of rehabilitation. Conclusion: Although an effect was found of pulmonary rehabilitation in subjects with moderate COPD, it disappeared over 18 months. Only a minority of patients with moderate COPD referred for rehabilitation accepted and completed the treatment offer.

Influence of early rehabilitation nursing on rehabilitation effect of patients after heart valve replacement

Objective To discuss influence of early rehabilitation nursing on rehabilitation effect of patients after heart valve replacement.Methods 60 patients with heart valve replacement were divided into the rehabilitation group and the control group with 30 patients in each group.The control group was given normal nursing and self-exercise ad libitum.Based upon the above,the rehabilitation group was given systemic and normative rehabilitation nursing according to programs established for each individual.The incidence of complications,guardianship time and hospitalization time were compared between the two groups.Results The incidence of complications of the patients in the rehabilitation group was much lower than the patients in the control group.And the time of the patients in the rehabilitation group in ICU and hospitalization time was shorter than the patients in the control group.Conclusions Early rehabilitation care can effectively reduce the incidence of complications after cardiac surgery,promote recovery of cardiac function,also can improve the quality of life of patients. Key words: Heart valve replacement; Rehabilitation nursing; Effect

Endurance and Resistance Training in Radically Treated Respiratory Cancer patients: A Pilot Study

Introduction. Respiratory cancer and its treatment are known to contribute to muscle weakness and functional impairment. Aim. To assess the effects of rehabilitation in patients with respiratory cancer. Methods. Radically treated respiratory cancer patients were included in a 12-week multidisciplinary rehabilitation program. Results. 16 patients (age: 61 ± 7 years; FEV1: 57 ± 16% pred.) showed a reduced exercise tolerance (VO2max: 56 ± 15% pred.; 6 MWD: 67 ± 11% pred.), muscle force (PImax: 54 ± 22% pred.; QF: 67 ± 16% pred.), and quality of life (CRDQd: 17 ± 5 points; CRDQf: 16 ± 5 points). Exercise tolerance, muscle force, and quality of life improved significantly after rehabilitation. Conclusion. Radically treated patients with respiratory cancer have a decreased exercise capacity, muscle force, and quality of life. 12 weeks of rehabilitation leads to a significant improvement in exercise capacity, respiratory muscle force, and quality of life.

Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Trial

Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Trial

Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Trial

Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Trial

Self-monitored, home-based pulmonary rehab was noninferior to outpatient, hospital-based rehab for COPD

Source Citation Maltais F, Bourbeau J, Shapiro S, et al. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med. 2...

Biologic disease modifying anti-rheumatic drugs and the effects of rehabilitation for patients with rheumatoid arthritis

Biologic disease modifying anti-rheumatic drugs and the effects of rehabilitation for patients with rheumatoid arthritis

Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Lung Disease

Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Lung Disease