Rehabilitation Treatment Of Patients Research Articles

Atrial fibrillation, prevention and rehabilitation in a primary healthcare setting. A feasibility study

Abstract Background Atrial fibrillation (AF) often influences daily life with symptoms like palpitations, dyspnoea, fatigue, fear and anxiety. Research show that patients with AF benefit from prevention and rehabilitation interventions. However, evidence is scarce and mainly hospital-based, and it is unknown whether the transition to the primary healthcare sector gives the same positive results. In 2019, a Danish primary care Health Center and the cardiology department at the local hospital completed a multidimensional prevention and rehabilitation intervention for patients with AF. Purpose To investigate the feasibility of delivering a multidimensional prevention and rehabilitation intervention for patients with AF in a primary care Health Center. Methods This study was a mixed-methods, non-randomized, intervention, feasibility study. A convergent mixed-methods design was used, and results were illustrated in side-by-side joint displays. Patients were included at a Hospital AF clinic referring to the Health Center. The prevention and rehabilitation intervention consisted of risk factor management, patient education, physical activity and yoga. Two patient-reported outcomes measures (PROMs) were used, the HeartQoL measuring health-related quality of life (HRQoL) and the Hospital Anxiety and Depression Scale (HADS) measuring symptoms of anxiety and depression. Data were collected at baseline (T0), at end of intervention (T1), and at two-months follow-up (T2) and analysed descriptively. Focus group interviews were analysed thematically and covered experiences of participating, needs and preferences, outcomes and feasibility of collecting PROMs. The reporting was guided by the Consolidated Standards of Reporting Trials (CONSORT) extension to pilot and feasibility trials. Results 43 patients (53% women; median age 66 (range 52-81) years) completed the intervention. Table 1 shows that HRQoL increased, and symptoms of anxiety and depression decreased. These results maintained at follow-up. Figure 1 shows the qualitative themes. Patients experienced being understood and supported by health professionals and peers. They thought it difficult to know what their needs were. However, some patients had specific preferences for interventions. For changes in outcomes, the patients identified that gaining tools and knowledge about the disease from the interventions helped. It was feasible to collect PROMs during the intervention and finally, the patients had an attention to what comes next, when finishing the intervention in the primary care setting. Conclusion It was feasible to deliver a multidimensional prevention and rehabilitation intervention for patients with AF at a primary care Health Center. HRQoL increased and symptoms of anxiety and depression decreased. The patients experienced being supported and gaining tools and knowledge to handle AF. Future large randomized controlled trials must confirm these results.

High-intensity pulse magnetic therapy and drinking mineral water in rehabilitation treatment of patients with chronic pancreatitis at inpatient stage

BACKGROUND: Sanogenetic effects of physical factors, providing restoration of disturbed functions of the organism, are the basis for their inclusion in the standardised programme of restorative treatment of patients with chronic pancreatitis. AIM: To study the effectiveness of high-intensity pulse magnetic therapy and low-mineralized drinking mineral waters in the restorative treatment of patients with chronic pancreatitis at the inpatient stage. MATERIALS AND METHODS: There has been carried out an open-label, randomized, controlled, prospective study of 125 patients with chronic pancreatitis. The patients were divided into 3 groups using the simple randomization method. In the control group (n=40) the patients underwent restorative treatment in accordance with federal clinical guidelines; in the group of comparison (n=42) he patients were additionally prescribed low-mineralized drinking mineral water; in the main group (n=43) the patients had high-intensity pulse magnetic therapy in addition to the treatment of the group of comparison. The effectiveness of rehabilitation measures was monitored using a visual analogue scale, a carbolene test, a hospital scale of anxiety and depression. RESULTS: The statistical analysis showed that the inclusion of drinking mineral water and high-intensity pulse magnetic therapy contributed to a significant reduction of pain (p 0.01) and dyspeptic syndromes (p 0.01), an improvement in motor evacuation function of intestine (p 0.01), a decrease in enzymatic activity and the severity of anxiety-depressive manifestations (p 0.01). The effectiveness of the developed programmes of restorative treatment of the patients suffering from chronic pancreatitis was 87.8–92.5%, the standardized programme ― 78.5%. CONCLUSION: The inclusion of drinking mineral waters and high-intensity pulse magnetic therapy in the standardized program of restorative treatment of the patients suffering from chronic pancreatitis at the inpatient stage provides a significant restoration of pancreatic external secretory function.

Application of pelvic floor rehabilitation in patients with colorectal cancer: a scoping review.

Pelvic floor rehabilitation is common in patients with colorectal cancer,the purpose of this study is to analyze the role of pelvic floor rehabilitation in patients with colorectal cancer and to understand the specific details of pelvic floor rehabilitation intervention in patients with colorectal cancer. Six databases were searched for this scoping review and reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews. A total of 1014 studies were searched, and 12 studies were finally included for analysis. The study found that pelvic floor rehabilitation for colorectal cancer patients can help improve bowel symptoms, quality of life, and psychological status of colorectal cancer patients after surgery, but details of the interventions for pelvic floor rehabilitation for colorectal cancer patients are not standardized. Pelvic floor rehabilitation has shown positive significance in patients with colorectal cancer, but there is a lack of uniform standards in the process of pelvic floor rehabilitation intervention in patients with colorectal cancer.

A comprehensive approach to rehabilitation interventions in patients with limb amputation and metabolic disorders in the multidisciplinary team of the Charitable Organization “Charitable Fund “Superhumans”

A comprehensive approach to rehabilitation interventions in patients with limb amputation and metabolic disorders in the multidisciplinary team of the Charitable Organization “Charitable Fund “Superhumans”

Evaluation of the efficiency of rehabilitation interventions in patients after unilateral biportal endoscopic discectomy

Background. Unilateral bi-portal endoscopic discectomy (UBED), as other surgical methods of treatment, may require the use of additional rehabilitation interventions in the recovery process of patients. Unfortunately, studies on the effectiveness of nonpharmacological methods in the postoperative period for these patients are insufficient. The study purposed to evaluate the effectiveness of a rehabilitation intervention program in the patients who have undergone UBED. Materials and methods. The study was conducted at the Department of Neurosurgery of the Spine and Spinal Cord of the Ivano-Frankivsk Regional Clinical Hospital in 2022–2023. The sample consisted of the main group (MG, n = 74) — patients who underwent removal of the hernia of the intervertebral disc used UBED and complex rehabilitation and control group (CG, n = 68) — UBED was performed without a rehabilitation course. Study methods: we used visual-analogue scale (VAS) and Oswestry questionnaire before surgery and after it (in 1 day and 1, 6 and 12 months). Results. In the preoperative period, the back pain index was 5.3 ± 1.4 and 5.6 ± 1.1 cm in MG and CG, respectively. In the postoperative period the back pain index according to the VAS decreased to 1.5 ± 0.4 cm in one day after surgery in the MG with its positive dynamics during the year of observation. In CG this index also decreased to 1.4 ± 0.9 cm with a gradual improvement to 0.3 ± 0.1 cm in 12 months. At the 12 months after the surgery the Oswestry index demonstrated that quality of life was better in the subjects of MG compared to the CG (5.4 ± 3.2 and 17.4 ± 3.3 %, respectively). Conclusions. The use of physical ­exercises in combination with massage and hardware physiotherapy in patients who have UBED improved the quality of life of the patients in the long-term observation period, but did not affect the reduction of pain after the surgery in both short-term and long-term observation

The effectiveness of neurorehabilitation in inpatient department

The objective of the study is to evaluate the effectiveness of rehabilitation treatment in patients with neurological pathology in inpatient department.Materials and methods. The study included 101 patients undergoing hospital treatment due to an existing neurological disease. The mean age was 52.41 ± 13.49 years. The condition of each patient upon admission and after the course of inpatient treatment was assessed using special tools – scales, tests, indices and questionnaires, such as the Rehabilitation Routing Scale and the modified Rankin scale, and according to the clinical specifics and needs of rehabilitation treatment – the Ashworth scale, Caprini Scale, Muscle Strength Grading Scale, National Institutes of Health Stroke Scale, HAS-BLED Scale, Berg Scale, Functional Independence Measure, Waterlow Score, Numeric Pain Rating Scale, Frenchay Arm Test, Rivermead Mobility Index, Hauser Index, EQ-5D, Barthel Index. The dynamics of recovery were calculated by comparing scores obtained using special instruments upon admission to rehabilitation treatment and after it.Results. By analyzing the results of the study, a positive dynamic of recovery was established, confirming the effectiveness of an inpatient course of neurorehabilitation, which is expressed in an improvement in the condition of patients when assessed using the designated tools for its objectification.Conclusions. The study confirms the effectiveness of an inpatient course of medical rehabilitation in restoring neurological deficits, increasing the activity of daily living, reducing the degree of social maladjustment and improving the rehabilitation prognosis.

Effectiveness of early rehabilitation interventions in patients with traumatic brain injury using a large database.

Rehabilitation is important for patients with moderate-to-severe traumatic brain injury (TBI). However, the timing of early rehabilitation initiation is ambiguous, and its safety and effectiveness are unknown. To examine the effectiveness and safety of early rehabilitation in patients with moderate-to-severe TBI using propensity score analysis and a large database. Retrospective cohort study. A large medical database (JMDC database) of tertiary care facilities was used to compare outcomes of early and delayed rehabilitation. Patients aged between 20 and 90 years who were diagnosed with TBI were admitted to acute care hospitals. Inclusion criteria were patients undergoing rehabilitation within 7 days of admission with a Glasgow Coma Scale score of 3 to 12 on admission. This study included 3074 patients with moderate-to-severe TBI. Patients were classified into an early rehabilitation group (within 2 days of admission) or a delayed rehabilitation group (3 to 7 days postadmission), depending on when rehabilitation started after TBI. Rehabilitation was defined as any type or intensity of intervention provided by a physical, occupational, and/or speech/language therapist. Interventions were not controlled. The primary outcome was Barthel Index (BI) efficiency (BI gain/length of stay). Secondary outcomes included BI gain (discharge BI - admission BI), incidence of aspiration pneumonia complications during hospitalization, discharge to home, mortality, and length of stay. After applying inverse probability weighting with propensity scores, the total was 6152 patients. 3074 (50.0%) patients received early rehabilitation. The early rehabilitation group showed no difference in inpatient mortality (p = .438), improved BI efficiency (β = 0.86, p < .001), and shorter length of stay (β = -5.00, p = .018). Early rehabilitation in patients with moderate-to-severe TBI is associated with more efficient functional improvement and reduced hospital stays without an increase in inpatient mortality.

A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders.

Defined by chronic pain, rheumatic diseases are often co-occurring with anxiety and depression. Among the available psychological interventions, cognitive-behavioral therapies have an already-proven efficiency in these cases. However, the need to adjust their structure became ubiquitous during the post-pandemic period. Hence, the objective of this study was to investigate the impact of a single-session, process-based cognitive-behavioral intervention for patients with rheumatic conditions within an in-patient setting. A total of 31 participants (mean age 58.9 years) completed the single-session intervention. Assessments were conducted prior to the intervention, post-intervention and after one month. Pearson's correlations, paired samples T tests and a covariance analysis based on the Linear Mixed Model were performed for exploring the relations between baseline variables and evaluating the impact of the SSI intervention. Immediately after the intervention, a significant reduction in cognitive fusion (p = 0.001, d = 1.78), experiential avoidance (p = 0.001, d = 1.4) and dysfunctional behavioral processes was observed. At the one-month evaluation, participants reported decreased pain (p = 0.001, d = 1.11), anxiety (p = 0.004, d = 0.55) and depression (p = 0.001, d = 0.72). The single-session, process-based approach represents a promising intervention in healthcare contexts, as an integrative part of a multimodal rehabilitation treatment in patients with rheumatic conditions.

Efficacy of Rehabilitative Techniques on Pain Relief in Patients With Vulvodynia: A Systematic Review and Meta-Analysis.

Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; I2= 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia.

Хірургічне лікування природженої аноректальної вади розвитку з ректовезикальною норицею в хлопчиків

Congenital rectovesical fistula (RVF) is the most complex variant of anorectal malformations (ARM) in boys, characterized by a fistula connecting the rectum with the bladder. Purpose - to evaluate the results of surgical correction of RVF in children, using a differentiated approach to the diagnosis of this defect, depending on the anatomical options, the clinical course of associated defects, and, based on this, to develop the main tactical requirements for the treatment of this complex congenital ARM in children. Materials and methods. The study included 9 boys: 7 - RVF without pouch colon and 2 - RVF with congenital pouch colon, which accounted for 5.8% of all treated anorectal anomalies (n=154). Results. In patients with RVF without pouch colon: a double-stem disconnecting colostomy was performed in 3 (33.3%) and a double-stem loop colostomy in 4 (44.4%) boys. In children with RVF and pouch colon: a longitudinal, narrowing, stapler coloplasty of the large intestinal "pouch" was performed, with removal of the terminal stoma (n=1); formation of a double-stem disconnecting stoma without separation of the RVF, and at the II stage - elimination of the RVF, removal of the large intestinal «bag» and preservation of the ileostomy - as a permanent, lifelong stoma (n=1). In 7 (100%) patients with RVF without pouch colon at the II stage, abdomino-perineal posterosagittal anorectoplasty with separation of RVF was performed (n=5). At the III stage, 5 patients with RVF without a pouch colon underwent local access stoma closure. At the stages of primary correction of RVF 55.6% (n=5) of children had coloproctological complications. Conclusions. The use of a differentiated approach to diagnosis and methods of anorectoplasty, as well as the use of a complex of rehabilitation treatment in patients with RVF without a pouch colon made it possible to obtain good results in 50% and satisfactory results in 50% of children. Congenital pouch colon - a significant expansion of part or the entire colon already in the fetus, makes it possible to suspect and diagnose this defect in the prenatal period, and to carry out delivery and surgical correction in a specialized perinatal center. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research. No conflict of interests was declared by the author.

THE ROLE AND CORRECTION OF SEXUAL DYSFUNCTION AS A COMPONENT OF THE QUALITY OF LIFE IN PATIENTS OPERATED ON FOR CEREBRAL ANEURYSM RUPTURE

Introduction. Hemorrhagic stroke due to the rupture of the intracranial aneurysm (IA) is a typical clinical manifestation of the disease and one of the main causes of disability, affecting the quality of life in operated patients.&#x0D; The aim. To determine the feasibility and safety of implementing protocols for diabetes mellitus (DM) treatment as part of rehabilitation interventions in patients who have undergone surgery for the rupture of intracranial aneurysm (IA) in the brain.&#x0D; Materials and methods. To determine the effectiveness and safety of implementing diabetes mellitus (DM) treatment protocols in individually developed rehabilitation interventions following surgery for the rupture of intracranial aneurysm (IA) in the brain, a retrospective cohort study was conducted in parallel groups.&#x0D; Results. Sexual dysfunctions (SD) resulting from the rupture of IA are multifactorial. The causes of SD can be categorized as primary, secondary, and tertiary. Primary causes include damage to brain structures by hemorrhagic stroke or vascular ischemic events affecting sexual functioning, pre-existing medical conditions, and side effects related to medication therapy during treatment. Secondary causes encompass persistent sensorimotor disturbances due to a prior stroke. Issues related to cognitive, behavioral, and psychosocial adaptation constitute tertiary causes of SD. The effective and prompt correction of sexual dysfunction in patients following the rupture of cerebral blood vessel aneurysms largely depended on the proper administration of anesthesia during surgical interventions and intensive therapy in the perioperative period. This includes preoperative preparation and patient analgesia, the administration of anesthesia, and adequate postoperative care.&#x0D; Conclusions. The application of SD correction in men as part of rehabilitation measures from the 6th to the 24th month after surgical treatment of intracranial aneurysm (IA) has a positive impact, reducing SD regression from 88.9% (n=56/63) to 34.9% (n=22/63).

Determining the Algorithm of Rehabilitation Procedures in Patients with Brachial Plexus Injuries Based on the Prospective Single-Centre Clinical Neurophysiology Studies: Preliminary Results

The clinical neurophysiological tests allow us to determine the type, extent, and nature of brachial plexus damage. They are crucial in decision making regarding surgical procedures or conservative treatment. This report aimed to present an algorithm for rehabilitation procedures in patients with brachial plexus injury of various origins based on the results of neurophysiology findings for the selection of procedures supporting the process of nerve and muscle regeneration. The research group consisted of patients whose medical documentation was analysed concerning the reason, level, and localization of damage to the brachial plexus structures, surgical and or rehabilitative treatment, as well as the MRI results. Among the group of fourteen patients, the clinical studies showed the greatest incidence of brachial plexus injuries of the mixed (both pre- and postganglionic), all trunks, and cervical root injuries, respectively. Results of the motor evoked potentials (MEP) and electroneurography (ENG) recordings induced at levels of spinal roots and Erb’s point showed a decrease of more than 40% in amplitudes on the symptomatic side in comparison to the asymptomatic side. This diffeence was recorded for the axillary and radial innervation and the C5, C6, and C7 root domains, ranging from 57% to 66%; the lowest decrease was recorded following electrical stimulation at Erb’s point for the ulnar nerve (34%). The latency prolongation on the symptomatic side in CMAP and MEP tests ranged from 0.2 to 1.7 ms, with the most following magnetic stimulation of the C5 cervical root for the axillary innervation. Most of the results indicated the axonotmesis and neuropraxia type of injury in motor fibers (40%) confirmed by EMG results. The sensory conduction studies (SNCS) in distal nerve branches did not confirm the severe advancement of the brachial plexus injury (63%). The proposed algorithm of the physiotherapeutic procedures should be mainly targeted for recovery of motor dysfunction as the consequence of brachial plexus injury. Rehabilitation should incorporate the treatment supporting nerve regeneration, muscle strengthening, and maintaining functional ranges of motion of the injured extremities. The rehabilitation treatment for patients with brachial plexus injuries is an individualised process, and the selection of procedures and the effectiveness of the treatment undertaken should be confronted with results of neurophysiological tests verifying the motor neural transmission from the level of the cervical motor centre to the effector, peripheral nerve function, and muscle’s motor unit activity.

Software application for predicting the efficacy of rehabilitation treatment in patients with discirculatory encephalopathy

Software application for predicting the efficacy of rehabilitation treatment in patients with discirculatory encephalopathy

Application of low-frequency electrostatic therapy in respiratory system diseases

The question of enhancing treatment effectiveness in managing respiratory diseases based on physiotherapeutic methods remains highly relevant. We consider the possibility of using pulsed low-frequency electrostatic massage therapy in the rehabilitation treatment of patients with chronic obstructive heart disease, bronchial asthma, pneumonia, and cystic fibrosis. The biological action and therapeutic effects of low-frequency electrostatic therapy are presented. Effects of low-frequency electrostatic therapy on muscle tone, as well as its decongestion, trophic, and regenerative action, are demonstrated. The mechanisms of pathogenetic action in respiratory pathologies require further research and elucidation.

The significance of early neurological rehabilitation intervention in patients with severe stroke.

The significance of early neurological rehabilitation intervention in patients with severe stroke.

Effect of strengthening exercises in individuals with patellofemoral pain syndrome: a randomised controlled trial

Background/Aims Muscle imbalance in patella stabilisers leads to patellar lateral glide and can cause patellofemoral pain syndrome. This study investigated the effect of progressive strengthening exercises of the vastus medialis oblique on pain and patellar alignment in patients with patellofemoral pain syndrome and patellar lateral glide. Methods A double-blind, randomised controlled trial was conducted with 40 individuals with patellofemoral pain syndrome with patellar lateral glide aged 20–40 years. The study group received vastus medialis oblique-specific strengthening exercises and routine physiotherapy treatment, and the control group received routine physiotherapy treatment only (stretching exercises, gluteal and quadriceps isometric exercises and conventional transcutaneous electrical nerve stimulation). Participants performed these exercises three times a week for 8 weeks. Pain intensity was measured before and after the intervention using a visual analogue scale and patellar alignment was measured using ultrasonographic parameters, including the trochlear angle, patella offset angle and distance between patellar tip and trochlear groove. Results In the between-groups comparison, there was a significant decrease in pain intensity in both the study and control groups, although the study group had a greater decrease (study group before intervention: 71.15 ± 1.54, study group after intervention: 22.21 ± 0.35, P=0.001); control group before intervention: 70.09 ± 1.22, control group after intervention: 31.82 ± 0.36 (P=0.001)) and patella offset angle (in the study group compared to the control group after 8 weeks of intervention. In within-groups comparison, a significant decrease of the patella offset angle in the study group was observed (before intervention: 16.2 ± 1.53; after intervention: 13.2 ± 1.87, P=0.001). No significant differences were found for the other parameters. Conclusions Specific strengthening of the vastus medialis oblique muscle in patients with patellofemoral pain syndrome and patellar lateral glide can lead to pain reduction and improvement of patellar alignment to correct lateralisation. This change may delay the process of patellofemoral joint degeneration. Including vastus medialis oblique-specific strengthening exercises in standard physiotherapy treatments may help to reduce pain levels in people with patellofemoral pain syndrome. Implications for practice Investigating the main cause of patellofemoral pain syndrome could have an essential role in the rehabilitation treatment of patients.

Muscle quality improvement in subacute post-stroke patients after rehabilitation: Usefulness of segmental phase angle from bioelectrical impedance analysis

During stroke rehabilitation, the whole-body Phase Angle (PhA) from Bioelectrical Impedance Analysis (BIA) is measured to assess whole-body muscle quality, which reflects cellular integrity and function. The segmental BIA is a valuable method for assessing the body composition of specific body segments, such as the arms, legs, and hemisoma. After a stroke insult, patients frequently experience hemiparesis, and segmental PhA from segmental BIA appears to be an appropriate parameter for examining the muscle quality of affected and unaffected limbs separately. This study aims to investigate whether segmental PhA is more informative than whole-body PhA in (a) assessing the deterioration of muscle quality in post-stroke patients and (b) monitoring its recovery following rehabilitative treatment. This longitudinal study recruited subacute post-stroke patients who were admitted to our rehabilitation center. At admission, demographic, anamnestic, and clinical information, such as the presence of comorbidities, were recorded. BIA was used to evaluate the whole-body PhA and segmental PhA of the affected and unaffected hemisoma, arms, and legs at admission (T0) and after a six-week rehabilitation program (T1). The modified Barthel Index (mBI), Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), and Motricity Index of the Upper (MI-UE) and Lower (MI-LE) Extremities were evaluated at T0 and T1 to determine the patient's Activity of Daily Living (ADL) performance, upper limb motor performance, and upper and lower limb muscle strength, respectively. We evaluated segmental and whole-body BIA in 70 subacute post-stroke patients (women n=34, ischemic n=56, mean age 70±11) at T0 and T1. Whole-body PhA values of the patients were below the normal range. Considering segmental data, the affected hemisoma, arm, and leg had considerably lower PhA values as compared to the unaffected body segments. Furthermore, at T1, the PhA values of all affected body segments improved, while those of the unaffected ones and whole-body PhA did not. At both T0 and T1, the segmental PhA values of the affected body segments showed to be related with all clinical outcome measures, while whole-body PhA correlated only with mBI. This study emphasizes the significance of measuring segmental PhA in hemiparetic subacute stroke patients undergoing rehabilitation treatment. Segmental PhA is a more accurate parameter to evaluate rehabilitation treatment in patients with hemiparesis because it can distinguish affected from unaffected body segments, hence facilitating accurate monitoring of muscle quality improvements resulting from a rehabilitation program.

Effect of Ginkgo biloba Extract on Rehabilitation Treatment in Patients with Sepsis

Ginkgo biloba extract (GBE), as a natural herbal medicine, is thought to play a positive role in the rehabilitation of sepsis. This article aimed to explore the application effect of GBE in the rehabilitation treatment of patients with sepsis. Firstly, the system applicability test and chromatographic conditions were used to determine the content of GBE, the content was determined after solution preparation, and the precision of GBE was tested after sample collection to analyze the composition of GBE. 70 patients with sepsis admitted to hospital were retrospectively analyzed. The patients were divided into Controls (conventional treatment, n = 35) and GBE group (GBE treatment, n = 35). Through treatment, the levels of procalcitonin (PCT), interleukin-33 (IL-33), sequential organ failure assessment (SOFA), cTn1, CK-MB, IL-6, and TNF-α were compared between the two groups. H9C2 cells were cultured and treated. Normal group was cultured in DMEM medium having FBS without treatment. H2O2 group was treated with DMEM medium having FBS with 100 μmol/L H2O2 solution. H2O2 + GBE group was treated with 100 μmol/L H2O2 solution and 15 μmol/L ginkgetin solution. Western blot was used to detect the protein expression of Caspase-3, Caspase-6, Bax/Bcl-2, and FOXO1. It revealed the RSD of quercetin, kaempferol, and isorhamnetin in GBE was 0.51%, 0.92%, and 1.32%, respectively, less than 2.0%. Sample content determination indicated that the dried products met the requirements. PCT and SOFA, and the level of IL-33 in GBE group was clearly higher as against Controls, and cTnI, CK-MB, IL-6, and TNF-α in the Controls were clearly higher as against the GBE group (P &lt; 0.05). In vitro cell experiments suggested that the Bax/Bcl-2 ratio and the expression of Caspase-3, Caspase-6, and FOXO1 proteins were gradually increased in Normal, H2O2, and H2O2 + GBE groups. The H2O2 group was clearly superior as against the Normal, and the H2O2 + GBE group was clearly superior as against the H2O2 group (P &lt; 0.05). As against the Normal, the expressions of Caspase-3 and Caspase-6, and the ratio of Bax to Bcl-2 was clearly decreased in the H2O2 + GBE group (P &lt; 0.05). In conclusion, GBE can promote the recovery process of patients by reducing inflammatory response, inhibiting oxidative stress, and improving immune function.

Blood flow restriction training improves the efficacy of routine intervention in patients with chronic ankle instability

As a new means of rehabilitation, blood flow restriction training (BFRT) is widely used in the field of musculoskeletal rehabilitation. To observe whether BFRT can improve the efficacy of routine rehabilitation intervention in patients with chronic ankle instability (CAI). Twenty-three patients with CAI were randomly divided into a routine rehabilitation group (RR Group) and a routine rehabilitation ​+ ​blood flow restriction training group (RR ​+ ​BFRT Group) according to the Cumberland Ankle Instability Tool (CAIT) score. The RR Group was treated with routine rehabilitation means for intervention, and the RR ​+ ​BFRT Group was treated with a tourniquet to restrict lower limb blood flow for rehabilitation training based on routine training. Before and after the intervention, the CAIT score on the affected side, standing time on one leg with eyes closed, comprehensive scores of the Y-balance test, and surface electromyography data of tibialis anterior (TA) and peroneus longus (PL) were collected to evaluate the recovery of the subjects. Patients were followed up 1 year after the intervention. After 4 weeks of intervention, the RR ​+ ​BFRT Group CAIT score was significantly higher than the RR Group (19.33 VS 16.73, p ​< ​0.05), the time of standing on one leg with eyes closed and the comprehensive score of Y-balance were improved, but there was no statistical difference between groups (p ​> ​0.05). RR ​+ ​BFRT Group increased the muscle activation of the TA with maximum exertion of the ankle dorsal extensor (p ​< ​0.05) and had no significant change in the muscle activation of the PL with maximum exertion of the ankle valgus (p ​> ​0.05). There was no significant difference in the incidence of resprains within 1 year between the groups (36.36% VS 16.67%, p ​> ​0.05). The incidence of ankle pain in the RR ​+ ​BFRT Group was lower than that in the RR Group (63.64% VS 9.09%, p ​< ​0.01). Therefore, four-weeks BFRT improves the effect of the routine intervention, and BFRT-related interventions are recommended for CAI patients with severe ankle muscle mass impairment or severe pain.

The effect of educational level on the recurrence rate and number of episodes of stroke in stroke survivors

ObjectivesThis study aimed to assess the influence of educational level on the recurrence rate and number of stroke episodes in stroke survivors. Materials and methodsFor this cross-sectional study, information regarding patient characteristics, medical history, ability to perform activities of daily living, level of disability, number of episodes, and stroke recurrence was collected. Analyses were conducted using the chi-square test, analysis of variance, nonparametric test, Cox regression model, and the Kaplan-Meier method. ResultsOf the 696 stroke survivors enrolled in this study, the average stroke recurrence rate was 20.83 %, and the recurrence rates in patients with primary (or lower), secondary, and university (or higher) education were 26.58, 19.54 and 14.29 %, respectively. Patients with primary (or lower) or secondary education had a higher risk for stroke recurrence than those with a university education or higher. We found that the recurrence rate 10 years after an initial stroke was higher than that after 5 years. Moreover, there was a statistically significant difference in the cumulative recurrence rate among the three groups (χ2 = 9.36, P < 0.05). Lastly, the proportions of the number of stroke episodes differed between the various education level groups (P < 0.05). ConclusionsA lower educational level was shown to be a risk factor for stroke recurrence and education levels have an impact on the number of stroke episodes. Our results suggest that is necessary to strengthen post-stroke management and rehabilitation interventions for patients with low educational levels.