Rehabilitation Exercise Group Research Articles

Effects of Exercise Rehabilitation on Cardiorespiratory Fitness in Long-COVID-19 Survivors: A Meta-Analysis.

Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In this study, we aim to systematically summarise and synthesise whether exercise rehabilitation improves CRF among long-COVID-19 survivors. Methods: A comprehensive search was performed through PubMed, CINAHL, Embase, Scopus, and the Cochrane Library (since their inception to November 2023) and study reference lists. Studies presenting the effects of exercise rehabilitation on CRF (peak oxygen consumption (VO2peak) and six-minute walk distance (6MWD)) in long-COVID-19 survivors were identified. The standardised mean difference (SMD), mean difference (MD), and 95% confidence interval (CI) were used for analyses. The certainty of evidence was measured using a Grading of Recommendation Assessment, Development and Evaluation approach. Results: Twelve eligible studies (five RCTs and seven non-RCTs) with 682 participants were analysed. The meta-analysis showed significantly improved 6MWDs (MD 76.47, 95% CI 59.19-93.71, low certainty) and significantly greater 6MWDs (SMD 0.85, 95% CI 0.11-1.59, very low certainty) in the exercise rehabilitation group compared to the control group. A significantly improved 6MWD was found in subgroups of young to middle-aged adults and subgroups of patients who undertook aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. Conclusions: Exercise rehabilitation is effective for improving CRF, as measured by the 6MWD in long-COVID-19 survivors. Improvements are likely to be more pronounced in specific subgroups of young to middle-aged adults and patients undertaking aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. However, recommendations for clinical practice are limited due to the very low evidence certainty.

Effect of Early Rehabilitation Exercise on Lower Limb Function and Psychological State After Coronary Artery Bypass Grafting: A Randomized Controlled Trial

Background: While early rehabilitation exercise has been shown to improve cardiopulmonary function and functional outcomes after revascularization in individuals who have undergone coronary artery bypass grafting (CABG), further research is still needed to fully understand the importance of psychological status and limb functional rehabilitation following CABG. Therefore, the purpose of this study was to investigate the effects of early rehabilitation exercise on lower limb function and mental health after coronary artery bypass grafting. Methods: Eighty patients who underwent CABG were randomly divided into a routine exercise group and an early rehabilitation exercise group. The degree of lower limb swelling, the amount of incision complications, the first time the patient got out of bed after the operation, the length of postoperative hospital stay, activity tolerance and postoperative psychological state were compared between the two groups. Results: The incidence of postoperative lower extremity oedema was 30% in the early rehabilitative exercise group as compared to 52.5% in the routine exercise group. Between the two groups, there was a statistically significant difference (p < 0.05) in the incidence of postoperative lower limb edema as well as the amount of swelling in the thighs and ankles on postoperative days 1, 3, and 5. In the routine exercise group, the first time the patients got out of bed was 3.45 ± 1.09 days, and the length of postoperative hospitalization was 12.75 ± 5.06 days. In the early rehabilitation exercise group, the first time the patients got out of bed was 1.93 ± 0.57 days, and the length of postoperative hospitalization was 9.50 ± 2.92 days. There were statistically significant differences in these two indices between the two groups (p < 0.05). The activity tolerance of patients in the routine exercise group was 46.10 ± 19.09 min at 2 months after surgery and 69.88 ± 19.05 min at 3 months after surgery. The activity tolerance of patients in the early rehabilitation exercise group was 56.40 ± 17.42 min at 2 months after surgery and 105 ± 23.04 min at 3 months after surgery, and there was a significant difference in activity tolerance between the two groups at these time points following surgery (p < 0.05). In addition, there were statistically significant differences in the Patient Health Questionnaire-9, Generalized Anxiety Self-Assessment Scale-7 and Pittsburgh Sleep Quality Index scores between the two groups (p < 0.05). Conclusions: Early rehabilitation exercises can promote the recovery of lower limb function after CABG to a certain extent, shorten the postoperative bed rest time and hospital stay, and effectively improve postoperative psychological well-being and sleep quality.

Cognitive rehabilitation and aerobic exercise for cognitive impairment in people with progressive multiple sclerosis (CogEx): a randomised, blinded, sham-controlled trial

Cognitive dysfunction in people with relapsing-remitting multiple sclerosis can improve with cognitive rehabilitation or exercise. Similar effects have not been clearly shown in people with progressive multiple sclerosis. We aimed to investigate the individual and synergistic effects of cognitive rehabilitation and exercise in patients with progressive multiple sclerosis. CogEx was a randomised, sham-controlled trial completed in 11 hospital clinics, universities, and rehabilitation centres in Belgium, Canada, Denmark, Italy, UK, and USA. Patients with progressive multiple sclerosis were eligible for inclusion if they were aged 25-65 years and had an Expanded Disability Status Scale (EDSS) score of less than 7. All had impaired processing speed defined as a performance of 1·282 SD or greater below normative data on the Symbol Digit modalities Tests (SDMT). Participants were randomly assigned (1:1:1:1), using an interactive web-response system accessed online from each centre, to cognitive rehabilitation plus exercise, cognitive rehabilitation plus sham exercise, exercise plus sham cognitive rehabilitation, or sham exercise plus sham cognitive rehabilitation. The study statistician created the randomisation sequence that was stratified by centre. Participants, outcome assessors, and investigators were blinded to group allocation. The study statistician was masked to treatment during analysis only. Interventions were conducted two times per week for 12 weeks: cognitive rehabilitation used an individualised, computer-based, incremental approach to improve processing speed; sham cognitive rehabilitation consisted of internet training provided individually; the exercise intervention involved individualised aerobic training using a recumbent arm-leg stepper; and the sham exercise involved stretching and balance tasks without inducing cardiovascular strain. The primary outcome measure was processing speed measured by SDMT at 12 weeks; least squares mean differences were compared between groups using linear mixed model in all participants who had a 12-week assessment. The trial is registered with ClinicalTrials.gov, NCT03679468, and is completed. Between Dec 14, 2018, and April 2, 2022, 311 people with progressive multiple sclerosis were enrolled and 284 (91%) completed the 12-week assessment (117/311 [38%] male and 194/311 [62%] female). The least squares mean group differences in SDMT at 12 weeks did not differ between groups (p=0·85). Compared with the sham cognitive rehabilitation and sham exercise group (n=67), differences were -1·30 (95% CI -3·75 to 1·16) for the cognitive rehabilitation plus exercise group (n=70); -2·78 (-5·23 to -0·33) for the sham cognitive rehabilitation plus exercise group (n=71); and -0·71 (-3·11 to 1·70) for the cognitive rehabilitation plus sham exercise group (n=76). 11 adverse events possibly related to the interventions occurred, six in the exercise plus sham cognitive rehabilitation group (pain, dizziness, and falls), two in the cognitive rehabilitation plus sham exercise group (headache and pain), two in the cognitive rehabilitation and exercise group (increased fatigue and pain), and one in the dual sham group (fall). Combined cognitive rehabilitation plus exercise does not seem to improve processing speed in people with progressive multiple sclerosis. However, our sham interventions were not inactive. Studies comparing interventions with a non-intervention group are needed to investigate whether clinically meaningful improvements in processing speed might be attainable in people with progressive multiple sclerosis. MS Canada.

12주간 재활운동 방법에 따른 척수장애인의 건강관련 체력에 미치는 영향

Purpose: This study aims to analyze the effect on health-related physical fitness when various types of rehabilitation exercises are applied for 12 weeks to males with spinal cord injuries.BR Method: The subjects of this study were males with spinal cord injuries residing in the metropolitan area. After explaining the purpose and method of this study in detail, consent was requested from those who voluntarily expressed their intention to participate, and 24 people who agreed were selected. As rehabilitation exercise methods, aerobic circuit rehabilitation exercise ,resistance circuit rehabilitation exercise, and combined circuit rehabilitation exercise were selected. As fort he exercise intensity, participants engaged in medium-intensity exercise four times a week, and the total exercise period was set at 12 weeks. As measurement variables, body composition, cardiorespiratory endurance, muscular strength, muscular endurance, and flexibility were measured. As a statistical method, SPSS version 25.0 was used to calculate the mean and standard deviation. A two-way repeated measures ANOVA was applied to verify the effect of 12 weeks of rehabilitation exercise. As a post hoc test, a paired-sample t-test was used for differences within groups, and Tukey was used for analysis between groups. All statistical significance levels were set at α= .05.BR Results: The results of this study are as follows. First, in the case of body composition, the statistical difference appeared only in the weight variable p(.05). Second, cardiopulmonary endurance was improved in the aerobic circuit rehabilitation exercise group and in the combined circuit rehabilitation exercise group (p.05, p.01). Third, in the case of muscle strength, it was significantly improved in the resistance circuit rehabilitation exercise group and in the combined circuit rehabilitation exercise group (p.05, p.01). Fourth, there was a significant difference in flexibility over time (p.01), and there was a tendency for improvement in the group that inderwent aerobic circuit rehabilitation exercise.BR Conclusion: Various types of circuit rehabilitation exercise programs are thought to have an effect on improving or maintaining health-related physical strength that may be impaired in people with spinal cord injuries. Therefore, it is necessary to understand their physical fitness level and participate in exercise programs tailored to their needs.

중둔근 강화 운동을 포함한 무릎관절 재활 운동 프로그램이 무릎관절 전치환술 환자의 무릎관절 기능장애 및 근기능에 미치는 영향

This study was conducted to investigate the effect of exercise programs, including gluteus medius muscle strengthening on knee joint function score, strength, and pain for 12 weeks at the beginning after total knee replacement. The subjects were selected for 14 patients, 7 were randomly distributed to the general rehabilitation exercise group and 7 to the gluteus medius exercise group. The subjects performed exercise three times a week, 30 to 50 minutes per session. In K-WOMAC, the gluteus medius exercise group was applied significantly decreased(p=.016), and there was a significant difference in both groups in the post-measurement between groups(p=.034). In VAS, both groups showed a significant decrease (p=.002), (p=.007) compared to prior and post(p=.047). In muscle function of the knee joint, both groups significantly increased in extension(p=.031) and flexion(p=.039) strength(60°/sec) and muscle endurance (180°/sec) compared to prior and post measurements(p=.018), (p=.039). It is considered that if the gluteus medius muscle strengthening exercise is applied to patients with total knee replacement, it is believed that basic data can be provide for rapid recovery after surgery and improvement of function in daily life by improving knee joint dysfuction, muscle function, and pain.

The effects of qigong intervention based on the Internet on quality of life and physical fitness in Chinese postoperative breast cancer patients: a protocol of randomized controlled trial

BackgroundThe purpose of this study is to verify the improvement of remote qigong intervention on the quality of life and physical fitness of breast cancer patients after surgery by means of a randomized controlled trial and to compare it with the conventional exercise combination of aerobic exercise and resistance training.Methods/designThe research approach applied in this study is a randomized controlled trial. After completing the baseline questionnaire and physical fitness test, participants were randomly assigned to either the qigong group or the combined exercise rehabilitation group. Patients in the qigong group performed Qigong-Baduanjin twice a week for 30 min each time under remote guidance and practiced Baduanjin by themselves at other times. Patients in the combined exercise rehabilitation group were given resistance training twice a week for 30 min under remote guidance, and walking the rest of the time. At the end of the 12-week intervention, outcomes testing and data collection were carried out. The primary outcomes are quality of life, measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Functional Assessment of Cancer Therapy-Breast (FATC-B). The secondary outcomes include cardiopulmonary endurance, upper limb strength, lower limb strength, and skinfold thickness.DiscussionThe importance of postoperative exercise rehabilitation for breast cancer has been gradually accepted by more and more doctors and patients, but further research and development of simple and practical means of exercise rehabilitation are necessary. Remote qigong intervention for breast cancer patients via the Internet will be a great alternative.Trial registrationChinese Clinical Trial Registry ChiCTR1900027989. Registered on December 7, 2019.

Effects of different positions on rehabilitation after rotator cuff repair under shoulder arthroscopy

ObjectiveShoulder arthroscopic rotator cuff tear repair is currently the main treatment for full-thickness rotator cuff tears, and postoperative rehabilitation training is essential. However, pain and limitation of activity during the rehabilitation process will lead to poor results. Hence, identifying rehabilitation approaches is crucial. This study aimed to compare patient's rehabilitation outcomes and experience between rehabilitation in the supine position and in the standing position. MethodsThis prospective study included patients diagnosed with full-thickness rotator cuff tears who underwent shoulder arthroscopic double-row rivet repair at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from March 2019 to September 2021. The patients were randomly assigned to the standing rehabilitation exercise group (group A) and the supine rehabilitation exercise group (group B). All patients were followed up for 6 months to record and compare the visual analog scale (VAS) scores, shoulder range of motion, and rehabilitation compliance. ResultsAltogether, 86 patients participated in the study, of whom 79 patients completed the 6-month follow-up. Groups A and B had 39 and 40 patients, respectively. Before operation, the VAS score, forward flexion and extension angle, and abduction angle were comparable between groups A and B. After operation, the patients in groups A and B all experienced a significant improvement in the VAS score, forward flexion and extension angle, and abduction angle (p < 0.05). In addition, patients in group B had better VAS score (4.58 ± 0.87 vs. 5.21 ± 1.13, p = 0.0068; 2.15 ± 0.66 vs. 2.51 ± 0.51, p = 0.0078; 0.78 ± 0.86 vs. 1.33 ± 0.81, p = 0.0015), forward flexion and extension angle (109.30 ± 2.87 ° vs. 102.33 ± 3.74°, p = 0.0001; 109.53 ± 3.39° vs. 104.18 ± 2.76°, p = 0.0001; 125.22 ± 6.05° vs. 117.59 ± 2.27°, p = 0.0001), and abduction angle (91.78 ± 2.77° vs. 82.92 ± 2.12°, p = 0.0001; 91.62 ± 2.78° vs. 82.82 ± 1.45°, p = 0.0001; 109.48 ± 3.37° vs. 100.10 ± 2.94°, p = 0.0001) at 2 wk, 6 wk and 6 m postoperatively. ConclusionAfter 6 months of follow-up, the patients who performed rehabilitation exercises in the supine position achieved better rehabilitation outcomes than those who performed rehabilitation exercises while standing.

COMPARING INPATIENT REHABILITATION AND HOME-BASED REHABILITATION PRACTICES FOLLOWING ACUTE STROKE: A PROSPECTIVE CONTROLLED STUDY

OBJECTIVE: The aim of this study is to evaluate whether home-based rehabilitation (HBR) is as effective as inpatient rehabilitation in patients with acute stroke as well as to identify patients at increased risk of mortality/morbidity during rehabilitation.MATERIAL AND METHODS: The present study included 64 patients with acute stroke who were referred from the neurology service and intensive care units to an inpatient rehabilitation unit (n=28) or HBR programs (n=36). Brunnstrom motor stages, Functional Independence Measure and Stroke Impact Scale scores of all patients were recorded before treatment and 12 weeks after therapy. Evaluation parameters were compared between 2 groups. The presence of any morbidity/mortality that developed during rehabilitation period were recorded. Afterward, all the patients were divided into 3 groups as inpatient, HBR and patients with mortality/morbidity and evaluation parameters before therapy were compared among the groups.RESULTS: At third month, while there was no significant change in all quality of life subscales following HBR, the improvement in all quality of life subscales following inpatient rehabilitation, except for the memory and emotion subscales were significant. At the end of 12th week; 5 (13.90%) of the 36 patients were died, and another 5 (13.90%) had developed a new cerebrovascular disease in HBR group. The memory, communication and emotion subscales scores of 10 patients with mortality/morbidity were significantly lower than the patients without mortality/morbidity in other 2 groups.CONCLUSIONS: To better manage difficult clinical encounters, the physician needs to well identify acute stroke patients who will be referred to inpatient rehabilitation or home exercise group. When choosing a rehabilitation program, physicians may also consider the mortality/morbidity related to memory, communication and emotional scores.

Is Exercise Rehabilitation an Effective Adjuvant to Clinical Treatment for Myofascial Trigger Points? A Systematic Review and Meta-Analysis.

To systematically evaluate the effect of exercise rehabilitation as an adjuvant to clinical treatment for myofascial trigger points (MTrPs). ESBCO, PubMed, Science Direct, Web of Science, China Knowledge Network (CNKI), and Wanfang databases were comprehensively searched from database inception date through July 2022. Randomized controlled trials comparing MTrPs treatments that included exercise rehabilitation with a single clinical treatment. Two researchers independently screened articles using inclusion/exclusion criteria, scored methodologic quality, and extracted data including patient demographics, interventions, and outcomes. We included 14 RCTs (N = 734). Results showed short-term (mean difference [MD], -2.25; 95% confidence interval [CI], -4.08 to -0.41; Z = 2.40; P = 0.02) and long-term (MD = -0.47; 95% CI: -0.80 to -0.17; Z = 3.05; P = 0.02) adjuvant exercise rehabilitation treatments were superior in reducing musculoskeletal pain intensity to single clinical treatment in controls, but long-term versus short-term effectiveness was not significantly different. The exercise rehabilitation group more effectively increased the range of motion (ROM) (standardized mean difference [SMD], 1.04; 95% CI: 0.32 to 1.77; Z = 2.84; P = 0.005) and decreased dysfunction (SMD = -0.93; 95% CI: -1.82 to -0.05; Z = 2.06; P = 0.04) than controls; no significant difference was observed in the pressure pain threshold (PPT) between two groups. Exercise rehabilitation as an adjuvant to clinical treatment for MTrPs was moderately effective in relieving pain intensity, increasing ROM, and improving dysfunction versus single clinical intervention. These findings must be validated by larger, higher-quality studies.

Effects of Rehabilitation Exercise with Blood Flow Restriction after Anterior Cruciate Ligament Reconstruction

The present study examined the effects of a rehabilitation exercise program with blood flow restriction (BFR) vs. a general rehabilitation exercise program in patients who have undergone anterior cruciate ligament (ACL) reconstruction. Among a total of 24 patients, the general rehabilitation exercise group (GRE, n = 12) and blood flow restriction group (BFR, n = 12) were assigned the same. The GRE group conducted a general rehabilitation exercise, and the BFR group conducted a BFR exercise along with the general rehabilitation exercise. All participants performed the rehabilitation exercise program session for 60 min three times a week for 12 weeks under supervision. All dependent parameters (Lysholm score and International Knee Documentation Committee (IKDC) subjective score, muscle activity, isokinetic muscular function, Y-balance test) were evaluated before and after the rehabilitation exercise program. GRE improved the Lysholm score, IKDC subjective score and Y balance test (posterior-medial, posterior-lateral) (p &lt; 0.05). Moreover, BFR was effective in improving the Lysholm score and IKDC subjective score and muscle activity (e.g., vastus medialis oblique during isokinetic contraction and rectus femoris during isometric contraction), isokinetic function (e.g., peak torque and total work) and Y-balance test (e.g., anterior, posterior medial, posterior lateral) (p &lt; 0.05). Our study confirmed that a rehabilitation exercise program with BFR after ACL reconstruction is a more effective rehabilitation modality for improving muscle activity during muscle contraction and muscle function compared with GRE. Therefore, it is recommended to use BFR as an effective rehabilitation program for rapid recovery after ACL reconstruction.

In the Dark About Physical Activity - Exploring Patient Perceptions of Physical Activity After Elective Total Knee Joint Replacement: A Qualitative Study.

The study aimed to explore patient perceptions of and motivations for physical activity after total knee joint replacement. Participants were purposively sampled after completing a public outpatient rehabilitation exercise group. Semistructured interviews were completed with 22 participants (mean age 70 years, 45% women) 6 to 12 months after total knee joint replacement. Interviews were audiotaped and transcribed verbatim. Themes were identified by an inductive and iterative process of data analysis. The main theme to emerge was participants were in the dark about physical activity. Participants were typically not familiar with physical activity guidelines and had difficulty distinguishing between low- and moderate-intensity physical activity. Three subthemes were identified: 1) people prioritize participation in meaningful life situations after total knee joint replacement, 2) rehabilitation was perceived to not explicitly address moderate-intensity physical activity levels, and 3) other health and social reasons replaced knee osteoarthritis as barriers to physical activity. Limited understanding of physical activity recommendations, prioritization of participation in meaningful life situations, rehabilitation that was impairment focused, and other health and social reasons appeared to contribute to low levels of moderate-intensity physical activity in adults after knee joint replacement. Addressing being in the dark about physical activity may be an important first step to increase the effectiveness of behavioral interventions designed to promote physical activity after total knee joint replacement.

Efficacy and safety of rehabilitation exercise in neuromyelitis optica spectrum disorder during the acute phase: A prospective cohort study

BackgroundRehabilitation treatment may alleviate the disease severity of patients with NMOSD. The reports of rehabilitation exercise for NMOSD during acute phase are rare. ObjectiveTo explore the efficacy and safety of rehabilitation exercise in patients with NMOSD during acute phase. MethodsThis is a prospective cohort study of 36 patients (rehabilitation exercise group, RG) and 37 patients (control group, CG) in whom acute attack of NMOSD involved the spinal cord with EDSS≥4.5 were included. EDSS, American Spinal Injury Association Impairment Scale (AIS) grade, total motor score (TMS), light touch score (LTS), pin prick score (PPS), Berg balance scale (BBS), and Barthel index (BI) were used as outcome measures. ResultsDuring hospitalization, EDSS scores of both groups decreased significantly (P<0.05). After treatment, the decline in EDSS was more significant in RG than in CG (P<0.05). The change reaching minimal clinically important difference (MCID) was observed in 90% (9/10) of patients in RG and in 27.78% (5/18) of patients in CG in the subgroup with EDSS 4.5–6.0 (MCID, 1.0), which was statistically significant between the groups (P<0.05). In the subgroup with EDSS 6.5–10.0 (MCID, 0.5), the proportion of patients with the change that reached MCID was significantly different between CG and RG (P<0.05). BBS, TMS, and BI score significantly improved after treatment (P<0.001). The improvement ranges of BBS, TMS, and BI scores were more significant in RG than CG (P<0.05). AIS grade improvement in RG was significantly higher than in CG. There were no significant changes in LTS and PPS after treatment in either of the groups. In RG, two mild adverse events were recorded. ConclusionRehabilitation exercise may improve nervous system function, balance function, and activities of daily living in patients with acute NMOSD, with few adverse reactions.

Short-term perioperative cognitive therapy combined with rehabilitation exercise reduces the incidence of neurocognitive disorder in elderly patients: a randomized controlled trial

To investigate whether short-term perioperative cognitive therapy combined with rehabilitation exercise decreases the incidence of neurocognitive disorder (NCD) in elderly patients who have undergone hip joint replacement surgery. This was a randomized, parallel controlled trial on elderly patients who underwent unilateral total hip joint replacement surgery at the Third Xiangya Hospital of Central South University. Patients in the perioperative cognitive therapy combined with rehabilitation exercise group underwent preoperative cognitive training and postoperative cognitive training, rehabilitation exercise, and standardized health care services; the control group received only postoperative standardized health care service. Patients with NCD were defined as those with two or more abnormalities on 11 neuropsychological tests. Of the 607 individuals that we screened, 86 (exercise, 50; control, 36) who completed the study were included. The baseline characteristics were similar for the two groups. The incidence of NCD in the exercise group (10%, 5/50) was significantly lower than that in the control group (27.8%, 10/36) (P=0.032). The HVLT-R, HVLT-R delayed recall test, and HVLT-R recognition discriminating index were significantly improved in the exercise group compared with the control group (all P<0.05). Our findings highlight the clinical significance of perioperative cognitive exercise combined with rehabilitation exercise in preventing NCD among patients after surgery and anesthesia. Our study indicates that perioperative cognitive therapy combined with rehabilitation exercise can effectively reduce the incidence of NCD in elderly patients after total hip joint replacement surgery.

The impact of cardiomotor rehabilitation on endothelial function in elderly patients with chronic heart failure

BackgroundTo explore the effects of cardiac exercise rehabilitation on peripheral blood endothelial progenitor cells (EPC) in elderly patients with chronic heart failure.Methods80 elderly patients with chronic heart failure were selected from March 2017 to March 2019 and randomly divided into two groups (N = 40). The control group was treated routinely and walked freely for 30–60 min every day. The patients in the exercise rehabilitation group developed a cardiac exercise rehabilitation plan. Then, cardiac function and peripheral blood B-natriuretic peptide (BNP) levels in the two groups were compared. The cell viability, proliferation, apoptosis, and invasion ability of EPCs were detected. The levels of the PI3K/AKT pathway and eNOS and VEGF were compared.ResultsThere were no significant differences in all indexes between the two groups before treatment (P > 0.05), and both improved significantly after treatment (P < 0.05). After treatment, LVEF and LVFS in the exercise rehabilitation group were significantly higher than those in the control group (P < 0.05), and LVEDD and LVESD were significantly lower than those in the control group (P < 0.05). The BNP level in the exercise rehabilitation group was significantly lower than that in the control group (P < 0.05). The cell viability, proliferation, invasion ability of EPC, and the levels of PI3K, AKT, eNOS, and VEGF mRNA and protein in the exercise rehabilitation group were significantly higher than those in the control group. Apoptosis rate was significantly lower than those in the control group (P < 0.05).ConclusionsVisceral exercise rehabilitation can improve cardiac ejection and myocardial function in elderly patients with chronic heart failure, and can promote the vitality, proliferation, and invasion of peripheral blood EPC, and promote the expression of eNOS and VEGF by upregulating the PI3K/AKT pathway to promote angiogenesis and endothelial function.

Retrospective Study of Rehabilitation Exercise Combined with Extracorporeal Shock Wave Therapy for Knee Osteoarthritis.

BackgroundThe aim of this study was to investigate the effect of rehabilitation exercise combined with extracorporeal shock wave therapy (ESWT) on knee osteoarthritis (KOA).Material/MethodsThe clinical data of 217 patients with KOA who underwent ESWT in our hospital from December 2017 to January 2020 were retrospectively analyzed. The patients were divided into a rehabilitation exercise (RE) group and a non-rehabilitation exercise (NRE) group according to whether they were given RE. The treatment course of the 2 groups was 5 weeks. Pain Visual Analog Scale (VSA), Western Ontario and McMaster Universities knee osteoarthritis index visualized scale (WOMAC), Lequesne index scores, Range of motion (ROM) score, and Japanese Orthopaedic Association (JOA) scores were used to evaluate the treatment effect of the 2 groups of patients.ResultsAfter 5 weeks of treatment, the VSA scores (p<0.001), WOMAC scores (P<0.001) and Lequesne index scores (P<0.001) of the RE group and NRE group were significantly lower than those before treatment, while ROM score (P<0.001) and JOA score (p=0.006) were significantly increased. Compared with the NRE group, the VAS score (3.14±0.64 vs. 4.78±0.85, P=0.002), WOMAC score (20.37±4.06 vs. 27.82±4.57, P<0.001) and Lequesne index score (6.13±1.83 vs. 7.35±2.21, P=0.019) in the RE group were significantly lower than those in the NHE group; however, the ROM score (89.13±9.83 vs. 79.15±6.25, P=0.021) and JOA score (79.53±7.59 vs. 67.85±8.27, P=0.016) were significantly higher than those in the NRE group.ConclusionsRE combined with ESWT has a positive effect on KOA, which may more significantly relieve the patient’s clinical symptoms and improve joint function and quality of life.

The application of medical alliance mode inexercise rehabilitation management of patients after percutaneous coronary interventioninchest paincenter

Objective: To explore the comprehensive effect of exercise-based cardia crehabilitation in patients managed with medical alliance who have undergone percutaneous coronary intervention (PCI) from Chest Pain Center. Methods: A total of 91 post PCI patients with coronary atherosclerotic heart disease were enrolled into the study. Fifty-four patients were in exercise rehabilitation group and 37 patients were in control group according to whether they were managed with medical alliance. Scores of Short Form -36 Health Survey (SF-36),qualified rate of blood pressure, blood glucose, blood lipid and incidence of MACEs of patients were compared at discharge, 1 month after discharge and 3 months after discharge between two groups. Results: The qualified rate of blood lipid of patients in exercise rehabilitation group was significantly higher than that in control group 3 months after discharge (P<0.05). There was significant difference in Scores of physical functioning, role-physical (RP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), mental health (MH) and Quality of Life (QL) between the two groups 1 month after discharge(P<0.05)and there was significant difference in Scores of RP, GH, VT, SF, RE, MH and QL between the two groups 3 months after discharge(P<0.05). Conclusion: Medical alliance management has positive effects on patients who have undergone PCI from Chest Pain Center, improves the motor function and quality of life. Therefore, it is worthy of promotion with the support of the policy.

Radial extracorporeal shock wave therapy for patients with subacromial impingement syndrome

Objective To analyze the short-term therapeutic efficacy of radial extracorporeal shock wave therapy for patients with subacromial impingement syndrome. Methods A total of 106 patients diagnosed as having subacromial impingement syndrome between October 2017 and April 2019 were randomized into a radial extracorporeal shock wave therapy (rESWT) group of 36, an exercise rehabilitation group of 35 and a conventional therapy group of 35. In addition to family exercise therapy, the rESWT group underwent 2000 to 2500 shots of extracorporeal shock wave therapy at 10 Hz and a pressure of 1.5-2.5 bar, once a week for four consecutive weeks. The exercise group was given range of motion exercises, joint control training and tendon movement training for 45 minutes, three times a week for four consecutive weeks. The conventional therapy group was treated with a laser apparatus and low-frequency electrotherapy, once a day, three times a week. Constant-Murle scores (CMSs) and the short form health survey (SF-36) were used to evaluate the clinical efficacy before and after 1 month of treatment. Results Before the treatment there were no significant differences among the 3 groups in any of the measurements. After one month of treatment the average CMS pain score and total score of the exercise rehabilitation group were significantly better than the conventional therapy group′s averages. Moreover, the average body pain score, daily life ability, range of motion, muscle strength and total score of the rESWT group were all significantly better than the exercise and conventional therapy groups′ averages. In the SF-36 the average physical function, bodily pain, general health, and mental health scores of the rESWT groups were also significantly better than the other 2 groups′ averages. Conclusions Radial extracorporeal shock wave therapy is superior to exercise therapy and conventional therapy for patients with subacromial impingement syndrome. It can restore shoulder joint function and improve the quality of life in one month. Key words: Radial extracorporeal shock wave therapy; Subacromial impingement syndrome; Constant-Murley scoring; Shock wave therapy

Comparing the effects of home-based exercise rehabilitation and center based Cardiac rehabilitation on Liver Enzymes of the patients with coronary Artery disease

Background: Liver enzymes are known markers for liver dysfunction which can be associated with the risk of heart disease. This study aimed to compare the effects of the home-based exercise rehabilitation and center-based CR on changes in liver enzymes of patients with heart failure. Methods: In a semi-experimental study, 40 patients (mean age, 59 ± 6.28 years) voluntarily were divided into 3 groups: home-based exercise rehabilitation (n=13), centre –based CR (n=15) and control (n=12). Liver enzymes (Aspartat aminotransferaz (AST), Alanine aminotransferase (ALT, alkaline phosphatase (ALP), Lactate dehydrogenase (LDH) and Creatine phosphokinase (CPK)) were measured at baseline and after 2 months of CR. Data were analyzed using analysis of covariance (ANCOVA) in P < 0.05 level. Results: For the centre –based CR group, the levels of LDH and CPK after 2 months were reduced (P<0/05), While there were no significant differences in AST, ALT and ALP levels. Levels of ALT significantly reduce in the home-based exercise rehabilitation group. Conclusion: CR may have been reduce some of the liver enzymes through increased cardiac output and insulin sensitivity and improved perfusion.

Study on exercise rehabilitation after closed Achilles tendon rupture

PURPOSE: To study the influence of exercise rehabilitation therapy on the postoperative recovery of patients with closed Achilles tendon rupture. METHODS: The clinical data of 5353 patients with closed Achilles tendon rupture were analyzed and postoperative follow-up was performed for 6 to 12 month s. RESULTS: The excellent and good rate was 93.5% in the exercise rehabilitation group and 68.1% in the spontaneous rehabilitation group. After surgery, there were 2 cases of wound infection and 1 case of second rupture in patients with exercise rehabilitation; there were 2 cases of wound infection, 2 cases of skin necrosis and 2 cases of second fracture in the spontaneous rehabilitation group. CONCLUSION: Exercise rehabilitation therapy after closed Achilles tendon rupture surgery could effectively improve the efficacy of postoperative rehabilitation treatment and reduce postoperative complications.

Effects of exercise rehabilitation on the depression and anxiety state and quality of life in patients with chronic heart failure

Objective To explore the effects of exercise rehabilitation on the depression and anxiety state and quality of life in patients with chronic heart failure. Methods 400 cases of chronic heart failure patients were selected as the research objects.They were randomly divided into control group(n=200)and exercise rehabilitation group(n=200) by random number table.Two groups were given symptomatic treatment and routine care on a regular basis, and exercise rehabilitation group again on this foundation to give rehabilitation therapy for 3 weeks.Self-rating anxiety scale(SAS) and Self-rating depression scale(SDS)were used to score the anxiety and depression of the two groups before and after rehabilitation.The SF-36 was used to assess the quality of life of patients.Rehabilitation satisfaction questionnaire was used to investigate the satisfaction degree of rehabilitation. Results There was no significant difference in SAS and SDS scores between the two groups before intervention (P>0.05). After intervention, the SAS and SDS scores of the two groups were significantly lower than those before intervention (P 0.05). After intervention, the scores of SF-36 scale were significantly increased in the two groups, and the difference was statistically significant compared with that before intervention (P<0.05). All the factors of SF-36 in exercise rehabilitation group were significantly higher than those in control group (mental health: (72.06±7.48)vs(64.34±7.01), emotional function: (81.06±7.01)vs(76.05±6.92), social function: (81.14±7.83)vs(71.26±7.65), overall health: (70.14±8.05)vs(61.26±7.95), energy: (74.56±7.81)vs(69.46±7.40), the body pain: (68.51±7.36)vs(60.26±7.51), physical limitations: (64.99±7.31)vs(59.62±7.53 ), physiological function: (69.71±7.63)vs(63.84±7.04), all P<0.05). The satisfaction of the exercise rehabilitation group (92.5%)was significantly higher than that of the control group(75.0%) (P<0.05). Conclusion Exercise rehabilitation training can not only improve the anxiety and depression of patients with chronic heart failure, but also effectively improve the quality of life of patients.Exercise rehabilitation training has a high degree of recognition, and is worthy of extensive application in clinical practice. Key words: Exercise rehabilitation; Chronic heart failure(CHF); Quality of life; Anxiety; Depression