The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China.In connection with the previous section, this 12thsection of the report offers a comprehensi...The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China.In connection with the previous section, this 12thsection of the report offers a comprehensive analysis of rehabilitation of cardiovascular diseases. In recent years, China's cardiac rehabilitation has developed vigorously, and its clinical benefits have been proven by more and more evidences. More cardiac rehabilitation centers are built and standards are constantly being promoted.Despite the rapid development and progress, there are still major shortcomings in the current situation, such as lack of awareness among patients and families about the significance and importance of cardiac rehabilitation, and under participation in cardiac rehabilitation;the development of cardiac rehabilitation is uneven, with the majority concentrated in tertiary hospitals in economically developed areas;lack of high-level evidence-based evidences, quality control and safety standards need to be improved;the medical payment system is not thorough;lack of a systematic training and admission system, hindering the development of cardiac rehabilitation in China. Therefore, continuous efforts are needed to strengthen the construction of cardiac rehabilitation centers, which should sink from tertiary hospitals to secondary and primary medical service centers;encourage clinical research on cardiac rehabilitation;introduce consensus on quality control and safety standards;explore more on phase Ⅲ cardiac rehabilitation;increase investment in integrating high-tech, artificial intelligence, etc. With the unique advantages of traditional Chinese medicine, exploring a Chinese characteristic cardiac rehabilitation model that is in line with China's national conditions.Evidence-based medicine has confirmed that rehabilitation is the most effective method to reduce the disability rate of stroke, and it is also an indispensable key sector in the organized management model of stroke. Rehabilitation should span the entire process of stroke treatment. Perfecting the rehabilitation medical management system, steadily improving the rehabilitation medical service capacity, expanding diversified service methods, and emphasizing early and whole-range rehabilitation treatment have important clinical value and social significance for stroke rehabilitation.展开更多
BACKGROUND:Poisoned patients often suffer damage to multiple systems,and those experiencing central nervous system disorders present more severe conditions,prolonged hospital stays,and increased mortality rates.We aim...BACKGROUND:Poisoned patients often suffer damage to multiple systems,and those experiencing central nervous system disorders present more severe conditions,prolonged hospital stays,and increased mortality rates.We aimed to assess the efficacy of rehabilitation interventions for patients with toxic encephalopathy.METHODS:This retrospective,observational,comparative cohort study was performed at the teaching hospital affiliated of Nanjing Medical University,from October 2020 to December 2022.Patients who met the diagnostic criteria for toxic encephalopathy and exclusion criteria were included,and patients were divided into three subgroups according to Glasgow Coma Scale(GCS).Demographic and clinical characteristics were collected.The effect of the rehabilitation intervention on patients were assessed in the improvement of consciousness status(Glasgow Coma Scale[GCS]score),muscle strength and movement and swallowing function(Fugl-Meyer Assessment[FMA]scale,Water Swallow Test[WST],and Standardized Swallowing Assessment[SSA]).Subgroup analysis was based on different toxic species.RESULTS:Out of the 464 patients with toxic encephalopathy,184 cases received rehabilitation treatments.For the severe toxic encephalopathy patients,patients without rehabilitation intervention have a 2.21 times higher risk of death compared to patients with rehabilitation intervention(Hazard ratio[HR]=2.21).Subgroup analysis revealed that rehabilitation intervention significantly increased the survival rate of patients with pesticide poisoning(P=0.02),while no significant improvement was observed in patients with drug/biological agent poisoning(P=0.44).After rehabilitation intervention,significant improvement in GCS and FMA were observed in severe patients with toxic encephalopathy(P<0.01).CONCLUSION:Active rehabilitation intervention for patients exposed to poisons that can potentially cause toxic encephalopathy may improve the prognosis and reduce the mortality rate in clinical practice.展开更多
BACKGROUND:Prolonged invasive respiratory support and extracorporeal membrane oxygenation(ECMO)in patients requiring urgent lung transplantation(ULTx)present signifi cant challenges to clinical practice due to severe ...BACKGROUND:Prolonged invasive respiratory support and extracorporeal membrane oxygenation(ECMO)in patients requiring urgent lung transplantation(ULTx)present signifi cant challenges to clinical practice due to severe underlying diseases and complex conditions.The aim of the study was to report the clinical outcomes of patients who received ULTx and followed the perioperative rehabilitation protocol implemented in a lung transplant center.METHODS:A retrospective analysis was conducted in ULTx patients who required preoperative invasive mechanical ventilation(IMV)and ECMO between January 2018 and January 2023.Data were retrieved from electronic medical records at our lung transplant center.RESULTS:Fourteen patients(mean age 57.43±10.97 years;12 males,2 females)underwent ULTx with bridging ECMO and IMV.The mean body mass index was 23.94±3.33 kg/m²,and the mean Acute Physiology and Chronic Health Evaluation(APACHE)II score was 21.50±3.96.The Nutritional Risk Screening 2002(NRS 2002)scores were≥3.ULTx was performed after an 8.5-day waiting period(interquartile interval[IQR]5.0-26.5 d).Following the surgeries,the average lengths of ECMO and IMV were 1.0(IQR 1.0-2.0)d and 5.0(IQR 3.0-7.3)d,respectively.The total length of hospital stay was 60.1±30.8 d,with an average intensive care unit stay of 38.3±22.9 d and post-operative hospitalization stay of 45.8±26.1 d.Two patients died within 30 d after ULTx,with a 30-day survival rate of 85.71%.CONCLUSION:Patients receiving ULTx showed an acceptable short-term survival rate,validating the practicality and safety of the treatment protocols implemented in our center.展开更多
Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors ...Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.展开更多
Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated ...Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.展开更多
Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition.The full cycle of care model encompasses inpatient,outpatient,rehabil...Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition.The full cycle of care model encompasses inpatient,outpatient,rehabilitation as well as supportive care such as palliative care and nutrition support.Cancer rehabilitation and palliative care have emerged as two important parts of value-based practice for oncology patients.More clinical evidence suggests that early intervention of oncology rehabilitation program and palliative care are likely to improve the patient outcome and reduce the overall medical cost for the patient and his or her family as well as for medical service providers.Although interest has been raised in Chinese oncologists,but effectiveness of incorporating these two services in clinical practices has not been adequately demonstrated.An understanding of scope of cancer rehabilitation and palliative care may help facilitate the integration of both into the oncology care continuum in efforts to improve patients'physical,psychological,cognitive,functional health and quality of life.展开更多
In stroke rehabilitation,rehabilitation equipments can help with the training.But traditional equipments are not convenient to carry,which limits patients to use related rehabilitation techniques.To solve this kind of...In stroke rehabilitation,rehabilitation equipments can help with the training.But traditional equipments are not convenient to carry,which limits patients to use related rehabilitation techniques.To solve this kind of problem,a new embedded rehabilitation system based on brain computer interface(BCI)is proposed in this paper.The system is based on motor imagery(MI)therapy,in which electroencephalogram(EEG)is evoked by grasping motor imageries of left and right hands,then collected by a wearable device.The EEG is transmitted to a Raspberry Pie processing unit through Bluetooth and decoded as the instructions to control the equipment extension.Users experience the limb movement through the visual feedback so as to achieve active rehabilitation.A pilot study shows that the user can control the movement of the rehabilitation equipment through his mind,and the equipment is convenient to carry.The study provides a new way to stroke rehabilitation.展开更多
BACKGROUND: For patients in intensive care unit(ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physica...BACKGROUND: For patients in intensive care unit(ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation.METHODS: A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE II score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test.RESULTS: There was no significant difference in body mass index, APACHE II score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group(P>0.05). Patients in the rehabilitation group had shorter days to first out of bed(3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation(5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay(12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group.CONCLUSION: Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.展开更多
Background Evaluation of patient outcomes following transcatheter aortic valve implantation （TAVI） has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from c...Background Evaluation of patient outcomes following transcatheter aortic valve implantation （TAVI） has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days （range： 192-738 days）, five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.展开更多
Computer Assisted Rehabilitation Environment(CAREN) is a system that integrates a training platform(motion base), a virtual environment, a sensor system(motion capture) and D-flow software. It is useful for both diagn...Computer Assisted Rehabilitation Environment(CAREN) is a system that integrates a training platform(motion base), a virtual environment, a sensor system(motion capture) and D-flow software. It is useful for both diagnostic and therapeutic use. The human gait pattern can be impaired due to disease, trauma or natural decline. Gait analysis is a useful tool to identify impaired gait patterns. Traditional gait analysis is a very time consuming process and therefore only used in exceptional cases. With new systems a quick and extensive analysis is possible and provides useful tools for therapeutic purposes. The range of systems will be described in this paper, highlighting both their diagnostic use and the therapeutic possibilities. Because wounded warriors often have an impaired gait due to amputations or other extremity trauma, these systems are very useful for military rehabilitative efforts. Additionally, the virtual reality environment creates a very challenging situation for the patient, enhancing their rehabilitation experience. For that reason several Armed Forces have these systems already in use. The most recent experiences will be discussed; including new developments both in the extension of the range of systems and the improvement and adaptation of the software. A new and promising development, the use of CAREN in a special application for patients with posttraumatic stress disorder(PTSD), will also be reviewed.展开更多
Background Cardiac rehabilitation （CR） protocols have diversified to include home-based cardiac tele-rehabilitation （HBCTR） as an alternative to hospital-based or center-based CR. To adopt the use of home-based ca...Background Cardiac rehabilitation （CR） protocols have diversified to include home-based cardiac tele-rehabilitation （HBCTR） as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients＇ attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional （PCI） surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age （OR： 0.92, 95% CI： 0.864）.98; P = 0.007）, average family monthly income （OR： 0.13, 95% CI： 0.05-0.341 P 〈 0.001）, education level （OR： 0.24, 95% CI： 0.10-0.59; P = 0.002） and physical exercise time （OR： 0.19, 95% CI： 0.06-0.56; P = 0.003） were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected： enhanced safety and independ ence （28.3%）, ability to self-monitor physical conditions daily （25 A%）, and having automatic and emergency alert （23.1%）. Reasons for refusal were： too cumbersome operation （34.3%） and unnecessary protocol （19.4%）. Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation.展开更多
To undertake the pilot experiments of prevention of disability (POD) in 14 different geographical areas to serve as examples for future development of rehabilitation work in China and in Asia. Methods.According to the...To undertake the pilot experiments of prevention of disability (POD) in 14 different geographical areas to serve as examples for future development of rehabilitation work in China and in Asia. Methods.According to the principles and national criterion, 27 000 people affected by leprosy were selected and assessed using disability record forms at beginning and followed up regularly for observing changes of different indicators. Results. A total of 197 neuritis cases were detected and treated with prednisolone out of 1 407 new or active cases. Self care training of eyes, hands and feet were conducted for 10 500 disabled people affected by leprosy. Comprehensive therapy was given to 1 804 cases having complicated ulcers of which 1 055 cases have got their ulcers healed. Out of 706 prostheses, 613 were given to patients with satisfactory results. Surgical treatment was given to 269 cases and 251 have shown good progress. Conclusion. Most of patients have got benefit from the project in function or appearance which is very helpful for their going back to the society and agreed by foreign experts during the final evaluation. The experiences from the project can be implemented in the whole country.展开更多
BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilit...BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters.METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses(PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubM ed, Scopus, Science Direct, Ovid, ProQ uest, Wiley, Google Scholar were searched.RESULTS: In this study a total of 11 928 articles were considered and 25 articles were selected for f inal review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-f ive studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic.CONCLUSION: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups.展开更多
An experimental study of an active body-weight support（BWS） system for improving treadmill-based locomotion training is performed.The dynamical foundation of the proposed system is developed based on a simplified ca...An experimental study of an active body-weight support（BWS） system for improving treadmill-based locomotion training is performed.The dynamical foundation of the proposed system is developed based on a simplified cable suspended mass-spring-damping system which is used to mimic the vertical gait of a walking human.A specifically designed cable pulley suspended cam-slider system is used to mimic the walking gait of a human in vertical direction.A load cell is installed to connect the slider and the cable which is driven by a winch based on the acceleration feedback.The contact force between the slider and the cam is measured to evaluate the walking load of the system.The experimental results demonstrate that the proposed active BWS system can simultaneously reduce both gravitational and inertial load of the walking body,which implies that the walking body suspended in such a BWS system will dynamically behave as if certain amount of body mass had been removed.展开更多
Malnutrition is described as a state of insufficient intake of energy,protein and other nutrients leading to changes in body composition(weight loss,reduced fat-free mass)as well as adverse functional and clinical out...Malnutrition is described as a state of insufficient intake of energy,protein and other nutrients leading to changes in body composition(weight loss,reduced fat-free mass)as well as adverse functional and clinical outcomes.[1]Depending on the assessments and definition used,the prevalence in older patients ranges between 12%in communitydwelling adults to 60%of patients in geriatric care facilities.[2–5]Older populations are at high risk of nutritional deficiencies because of risk factors such as multimorbidity,polypharmacy,cognitive and physical decline,poor appetite,depressive syndromes and socioeconomic changes.[4,6].展开更多
Background: Maxillofacial war injuries usually cause severe facial organ defects and deformities, handicapping the patient's daily activities, even result in a tendency to commit suicide. The application of maxill...Background: Maxillofacial war injuries usually cause severe facial organ defects and deformities, handicapping the patient's daily activities, even result in a tendency to commit suicide. The application of maxillofacial prosthesis is an alternative to surgery in functional–aesthetic facial reconstruction. Computer aided design and computer aided manufacturing has opened up a new approach to the fabrication of maxillofacial prosthesis. An intelligentized rapid simulative design and manufacture system for prosthesis was developed to facilitate the prosthesis fabrication procedure.Methods: Maxillofacial prosthesis rapid simulation design and rapid fabrication system consists of three components: digital impression, intelligentized prosthesis designing, and rapid manufacturing. The patients' maxillofacial digital impressions were taken with Structured-light 3D scanner; and then the 3D model of prostheses and their negative molds could be designed in specific software; finally, with the resin molds fabricated by rapid prototyping machine, the prostheses could be produced directly and quickly.Results: Fifteen patients of maxillofacial defect caused by traumatic injuries received prosthesis rehabilitation provided by the established system. The contour of the prostheses coordinated properly with the appearance of the patients, and the uniform-thickness border sealed well to adjacent tissues. All the patients were satisfied with their prostheses.Conclusions: The rapid simulative rehabilitation system of maxillofacial defects has been approaching completion. It could provide advanced technological reservation for the Army in the issue of maxillofacial defect rehabilitation.展开更多
Cardiac rehabilitation （CR） programs are well known to improve patients＇ functional status after cardiac surgery and are recommended by current guideline. In fact, they pro- mote not only structured physical exerci...Cardiac rehabilitation （CR） programs are well known to improve patients＇ functional status after cardiac surgery and are recommended by current guideline. In fact, they pro- mote not only structured physical exercises but also a complete secondary prevention determining an overall reduction in recurrent cardiac events and an improvement in functional, psychosocial status and survival.展开更多
Although occupational therapy for substance abuse,as a field in psychiatric rehabilitation,has been implemented for over half a century,it still seems underdeveloped.This area of rehabilitation aims to enhance the qua...Although occupational therapy for substance abuse,as a field in psychiatric rehabilitation,has been implemented for over half a century,it still seems underdeveloped.This area of rehabilitation aims to enhance the quality of life of substance abuse rehabilitants and prevent them from relapse.1 It can be achieved by enabling them to identify their meaningful occupations and occupational roles,and supporting them to re-engage in the occupations that they value,which would help empower them to overcome abuse.12 The interventions around the world include brief intervention,motivational strategy,cognitive behavioural therapy.展开更多
Degeneration of joint disease is one of the problems that threaten global public health.Currently,the therapies of the disease are mainly conservative but not very effective.To solve the problem,we need to find effect...Degeneration of joint disease is one of the problems that threaten global public health.Currently,the therapies of the disease are mainly conservative but not very effective.To solve the problem,we need to find effective,convenient and inexpensive therapies.With the rapid development of artificial intelligence,we innovatively propose to combine Traditional Chinese Medicine(TCM)with artificial intelligence to design a rehabilitation assessment system based on TCM Daoyin.Our system consists of four subsystems:the spine movement assessment system,the posture recognition and correction system,the background music recommendation system,and the physiological signal monitoring system.We incorporate several technologies such as keypoint detection,posture estimation,heart rate detection,and deriving respiration from electrocardiogram(ECG)signals.Finally,we integrate the four subsystems into a portable wireless device so that the rehabilitation equipment is well suited for home and community environment.The system can effectively alleviate the problem of an inadequate number of physicians and nurses.At the same time,it can promote our TCM culture as well.展开更多
Background: Chronic exertional compartment syndrome(CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in th...Background: Chronic exertional compartment syndrome(CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS, it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center.Methods: Patients from all military services were referred from the special unit for lower leg pain at the Central Military Hospital, Utrecht, the Netherlands. Descriptive analysis was used to report the characteristics of the participants and their baseline measurements. Group differences were analyzed using a Student's t-test or MannWhitney U test, according to the normality of the data distribution. Differences between the pre-and postintervention outcomes were evaluated using the Wilcoxon signed rank test. To evaluate the magnitude of prognostic factors, a univariate logistic regression analysis was performed. The prognostic factors included age, body mass index, body fat percentage, self-efficacy beliefs, foot malalignment, intramuscular pressure, other comorbidities, protein and creatine use, smoking, alcohol use, complaint duration, physical demands, and duration of military service.Results: After the rehabilitation period, we observed 25 patients with a successful outcome, which was defined as a reduction in pain(≥2 points) during the capacity test measured using a verbal rating scale and 20 patients with an unsuccessful outcome. Factors demonstrating a limited increased odds ratio for an unsuccessful outcome included smoking, alcohol use, intramuscular pressure, a complaint duration of more than 6 months, and physical demands of service. However, these factors did not reach significance.Conclusion: This study did not identify any prognostic factors that predict the outcome of a rehabilitation program for CECS. A larger sample using an identical design might provide further evidence regarding prognostic factors, which would facilitate development of a model that predicts the outcomes of a rehabilitation program for CECS.展开更多
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China.In connection with the previous section, this 12thsection of the report offers a comprehensive analysis of rehabilitation of cardiovascular diseases. In recent years, China's cardiac rehabilitation has developed vigorously, and its clinical benefits have been proven by more and more evidences. More cardiac rehabilitation centers are built and standards are constantly being promoted.Despite the rapid development and progress, there are still major shortcomings in the current situation, such as lack of awareness among patients and families about the significance and importance of cardiac rehabilitation, and under participation in cardiac rehabilitation;the development of cardiac rehabilitation is uneven, with the majority concentrated in tertiary hospitals in economically developed areas;lack of high-level evidence-based evidences, quality control and safety standards need to be improved;the medical payment system is not thorough;lack of a systematic training and admission system, hindering the development of cardiac rehabilitation in China. Therefore, continuous efforts are needed to strengthen the construction of cardiac rehabilitation centers, which should sink from tertiary hospitals to secondary and primary medical service centers;encourage clinical research on cardiac rehabilitation;introduce consensus on quality control and safety standards;explore more on phase Ⅲ cardiac rehabilitation;increase investment in integrating high-tech, artificial intelligence, etc. With the unique advantages of traditional Chinese medicine, exploring a Chinese characteristic cardiac rehabilitation model that is in line with China's national conditions.Evidence-based medicine has confirmed that rehabilitation is the most effective method to reduce the disability rate of stroke, and it is also an indispensable key sector in the organized management model of stroke. Rehabilitation should span the entire process of stroke treatment. Perfecting the rehabilitation medical management system, steadily improving the rehabilitation medical service capacity, expanding diversified service methods, and emphasizing early and whole-range rehabilitation treatment have important clinical value and social significance for stroke rehabilitation.
基金funded by the National Natural Science Foundation of China(82372214).
文摘BACKGROUND:Poisoned patients often suffer damage to multiple systems,and those experiencing central nervous system disorders present more severe conditions,prolonged hospital stays,and increased mortality rates.We aimed to assess the efficacy of rehabilitation interventions for patients with toxic encephalopathy.METHODS:This retrospective,observational,comparative cohort study was performed at the teaching hospital affiliated of Nanjing Medical University,from October 2020 to December 2022.Patients who met the diagnostic criteria for toxic encephalopathy and exclusion criteria were included,and patients were divided into three subgroups according to Glasgow Coma Scale(GCS).Demographic and clinical characteristics were collected.The effect of the rehabilitation intervention on patients were assessed in the improvement of consciousness status(Glasgow Coma Scale[GCS]score),muscle strength and movement and swallowing function(Fugl-Meyer Assessment[FMA]scale,Water Swallow Test[WST],and Standardized Swallowing Assessment[SSA]).Subgroup analysis was based on different toxic species.RESULTS:Out of the 464 patients with toxic encephalopathy,184 cases received rehabilitation treatments.For the severe toxic encephalopathy patients,patients without rehabilitation intervention have a 2.21 times higher risk of death compared to patients with rehabilitation intervention(Hazard ratio[HR]=2.21).Subgroup analysis revealed that rehabilitation intervention significantly increased the survival rate of patients with pesticide poisoning(P=0.02),while no significant improvement was observed in patients with drug/biological agent poisoning(P=0.44).After rehabilitation intervention,significant improvement in GCS and FMA were observed in severe patients with toxic encephalopathy(P<0.01).CONCLUSION:Active rehabilitation intervention for patients exposed to poisons that can potentially cause toxic encephalopathy may improve the prognosis and reduce the mortality rate in clinical practice.
文摘BACKGROUND:Prolonged invasive respiratory support and extracorporeal membrane oxygenation(ECMO)in patients requiring urgent lung transplantation(ULTx)present signifi cant challenges to clinical practice due to severe underlying diseases and complex conditions.The aim of the study was to report the clinical outcomes of patients who received ULTx and followed the perioperative rehabilitation protocol implemented in a lung transplant center.METHODS:A retrospective analysis was conducted in ULTx patients who required preoperative invasive mechanical ventilation(IMV)and ECMO between January 2018 and January 2023.Data were retrieved from electronic medical records at our lung transplant center.RESULTS:Fourteen patients(mean age 57.43±10.97 years;12 males,2 females)underwent ULTx with bridging ECMO and IMV.The mean body mass index was 23.94±3.33 kg/m²,and the mean Acute Physiology and Chronic Health Evaluation(APACHE)II score was 21.50±3.96.The Nutritional Risk Screening 2002(NRS 2002)scores were≥3.ULTx was performed after an 8.5-day waiting period(interquartile interval[IQR]5.0-26.5 d).Following the surgeries,the average lengths of ECMO and IMV were 1.0(IQR 1.0-2.0)d and 5.0(IQR 3.0-7.3)d,respectively.The total length of hospital stay was 60.1±30.8 d,with an average intensive care unit stay of 38.3±22.9 d and post-operative hospitalization stay of 45.8±26.1 d.Two patients died within 30 d after ULTx,with a 30-day survival rate of 85.71%.CONCLUSION:Patients receiving ULTx showed an acceptable short-term survival rate,validating the practicality and safety of the treatment protocols implemented in our center.
基金supported by the National Key R&D Program of China(2018YFC2000600)
文摘Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.
文摘Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.
文摘Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition.The full cycle of care model encompasses inpatient,outpatient,rehabilitation as well as supportive care such as palliative care and nutrition support.Cancer rehabilitation and palliative care have emerged as two important parts of value-based practice for oncology patients.More clinical evidence suggests that early intervention of oncology rehabilitation program and palliative care are likely to improve the patient outcome and reduce the overall medical cost for the patient and his or her family as well as for medical service providers.Although interest has been raised in Chinese oncologists,but effectiveness of incorporating these two services in clinical practices has not been adequately demonstrated.An understanding of scope of cancer rehabilitation and palliative care may help facilitate the integration of both into the oncology care continuum in efforts to improve patients'physical,psychological,cognitive,functional health and quality of life.
基金Supported by the National Natural Science Foundation of China(61671193)Science and Technology Program of Zhejiang Province(2018C04012,2017C33049)Science and Technology Platform Construction Project of Fujian Science and Technology Department(2015Y2001)
文摘In stroke rehabilitation,rehabilitation equipments can help with the training.But traditional equipments are not convenient to carry,which limits patients to use related rehabilitation techniques.To solve this kind of problem,a new embedded rehabilitation system based on brain computer interface(BCI)is proposed in this paper.The system is based on motor imagery(MI)therapy,in which electroencephalogram(EEG)is evoked by grasping motor imageries of left and right hands,then collected by a wearable device.The EEG is transmitted to a Raspberry Pie processing unit through Bluetooth and decoded as the instructions to control the equipment extension.Users experience the limb movement through the visual feedback so as to achieve active rehabilitation.A pilot study shows that the user can control the movement of the rehabilitation equipment through his mind,and the equipment is convenient to carry.The study provides a new way to stroke rehabilitation.
文摘BACKGROUND: For patients in intensive care unit(ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation.METHODS: A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE II score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test.RESULTS: There was no significant difference in body mass index, APACHE II score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group(P>0.05). Patients in the rehabilitation group had shorter days to first out of bed(3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation(5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay(12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group.CONCLUSION: Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.
文摘Background Evaluation of patient outcomes following transcatheter aortic valve implantation （TAVI） has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days （range： 192-738 days）, five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.
文摘Computer Assisted Rehabilitation Environment(CAREN) is a system that integrates a training platform(motion base), a virtual environment, a sensor system(motion capture) and D-flow software. It is useful for both diagnostic and therapeutic use. The human gait pattern can be impaired due to disease, trauma or natural decline. Gait analysis is a useful tool to identify impaired gait patterns. Traditional gait analysis is a very time consuming process and therefore only used in exceptional cases. With new systems a quick and extensive analysis is possible and provides useful tools for therapeutic purposes. The range of systems will be described in this paper, highlighting both their diagnostic use and the therapeutic possibilities. Because wounded warriors often have an impaired gait due to amputations or other extremity trauma, these systems are very useful for military rehabilitative efforts. Additionally, the virtual reality environment creates a very challenging situation for the patient, enhancing their rehabilitation experience. For that reason several Armed Forces have these systems already in use. The most recent experiences will be discussed; including new developments both in the extension of the range of systems and the improvement and adaptation of the software. A new and promising development, the use of CAREN in a special application for patients with posttraumatic stress disorder(PTSD), will also be reviewed.
文摘Background Cardiac rehabilitation （CR） protocols have diversified to include home-based cardiac tele-rehabilitation （HBCTR） as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients＇ attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional （PCI） surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age （OR： 0.92, 95% CI： 0.864）.98; P = 0.007）, average family monthly income （OR： 0.13, 95% CI： 0.05-0.341 P 〈 0.001）, education level （OR： 0.24, 95% CI： 0.10-0.59; P = 0.002） and physical exercise time （OR： 0.19, 95% CI： 0.06-0.56; P = 0.003） were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected： enhanced safety and independ ence （28.3%）, ability to self-monitor physical conditions daily （25 A%）, and having automatic and emergency alert （23.1%）. Reasons for refusal were： too cumbersome operation （34.3%） and unnecessary protocol （19.4%）. Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation.
文摘To undertake the pilot experiments of prevention of disability (POD) in 14 different geographical areas to serve as examples for future development of rehabilitation work in China and in Asia. Methods.According to the principles and national criterion, 27 000 people affected by leprosy were selected and assessed using disability record forms at beginning and followed up regularly for observing changes of different indicators. Results. A total of 197 neuritis cases were detected and treated with prednisolone out of 1 407 new or active cases. Self care training of eyes, hands and feet were conducted for 10 500 disabled people affected by leprosy. Comprehensive therapy was given to 1 804 cases having complicated ulcers of which 1 055 cases have got their ulcers healed. Out of 706 prostheses, 613 were given to patients with satisfactory results. Surgical treatment was given to 269 cases and 251 have shown good progress. Conclusion. Most of patients have got benefit from the project in function or appearance which is very helpful for their going back to the society and agreed by foreign experts during the final evaluation. The experiences from the project can be implemented in the whole country.
文摘BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters.METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses(PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubM ed, Scopus, Science Direct, Ovid, ProQ uest, Wiley, Google Scholar were searched.RESULTS: In this study a total of 11 928 articles were considered and 25 articles were selected for f inal review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-f ive studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic.CONCLUSION: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups.
文摘An experimental study of an active body-weight support（BWS） system for improving treadmill-based locomotion training is performed.The dynamical foundation of the proposed system is developed based on a simplified cable suspended mass-spring-damping system which is used to mimic the vertical gait of a walking human.A specifically designed cable pulley suspended cam-slider system is used to mimic the walking gait of a human in vertical direction.A load cell is installed to connect the slider and the cable which is driven by a winch based on the acceleration feedback.The contact force between the slider and the cam is measured to evaluate the walking load of the system.The experimental results demonstrate that the proposed active BWS system can simultaneously reduce both gravitational and inertial load of the walking body,which implies that the walking body suspended in such a BWS system will dynamically behave as if certain amount of body mass had been removed.
基金The study had been approved by the ethics committee of the University of Potsdam(No.39/2018).
文摘Malnutrition is described as a state of insufficient intake of energy,protein and other nutrients leading to changes in body composition(weight loss,reduced fat-free mass)as well as adverse functional and clinical outcomes.[1]Depending on the assessments and definition used,the prevalence in older patients ranges between 12%in communitydwelling adults to 60%of patients in geriatric care facilities.[2–5]Older populations are at high risk of nutritional deficiencies because of risk factors such as multimorbidity,polypharmacy,cognitive and physical decline,poor appetite,depressive syndromes and socioeconomic changes.[4,6].
基金funded by National Natural Science Foundation of China (81271188)supported by National Key Technology R&D Program of China (2012BAI07B02)
文摘Background: Maxillofacial war injuries usually cause severe facial organ defects and deformities, handicapping the patient's daily activities, even result in a tendency to commit suicide. The application of maxillofacial prosthesis is an alternative to surgery in functional–aesthetic facial reconstruction. Computer aided design and computer aided manufacturing has opened up a new approach to the fabrication of maxillofacial prosthesis. An intelligentized rapid simulative design and manufacture system for prosthesis was developed to facilitate the prosthesis fabrication procedure.Methods: Maxillofacial prosthesis rapid simulation design and rapid fabrication system consists of three components: digital impression, intelligentized prosthesis designing, and rapid manufacturing. The patients' maxillofacial digital impressions were taken with Structured-light 3D scanner; and then the 3D model of prostheses and their negative molds could be designed in specific software; finally, with the resin molds fabricated by rapid prototyping machine, the prostheses could be produced directly and quickly.Results: Fifteen patients of maxillofacial defect caused by traumatic injuries received prosthesis rehabilitation provided by the established system. The contour of the prostheses coordinated properly with the appearance of the patients, and the uniform-thickness border sealed well to adjacent tissues. All the patients were satisfied with their prostheses.Conclusions: The rapid simulative rehabilitation system of maxillofacial defects has been approaching completion. It could provide advanced technological reservation for the Army in the issue of maxillofacial defect rehabilitation.
文摘Cardiac rehabilitation （CR） programs are well known to improve patients＇ functional status after cardiac surgery and are recommended by current guideline. In fact, they pro- mote not only structured physical exercises but also a complete secondary prevention determining an overall reduction in recurrent cardiac events and an improvement in functional, psychosocial status and survival.
文摘Although occupational therapy for substance abuse,as a field in psychiatric rehabilitation,has been implemented for over half a century,it still seems underdeveloped.This area of rehabilitation aims to enhance the quality of life of substance abuse rehabilitants and prevent them from relapse.1 It can be achieved by enabling them to identify their meaningful occupations and occupational roles,and supporting them to re-engage in the occupations that they value,which would help empower them to overcome abuse.12 The interventions around the world include brief intervention,motivational strategy,cognitive behavioural therapy.
基金National Key R&D Program of China(No.2019YFC1711800,2020AAA0108300)National Natural Science Founda⁃tion of China(No.62072112)Fudan University-CIOMP Joint Fund(No.FC2019-005).
文摘Degeneration of joint disease is one of the problems that threaten global public health.Currently,the therapies of the disease are mainly conservative but not very effective.To solve the problem,we need to find effective,convenient and inexpensive therapies.With the rapid development of artificial intelligence,we innovatively propose to combine Traditional Chinese Medicine(TCM)with artificial intelligence to design a rehabilitation assessment system based on TCM Daoyin.Our system consists of four subsystems:the spine movement assessment system,the posture recognition and correction system,the background music recommendation system,and the physiological signal monitoring system.We incorporate several technologies such as keypoint detection,posture estimation,heart rate detection,and deriving respiration from electrocardiogram(ECG)signals.Finally,we integrate the four subsystems into a portable wireless device so that the rehabilitation equipment is well suited for home and community environment.The system can effectively alleviate the problem of an inadequate number of physicians and nurses.At the same time,it can promote our TCM culture as well.
文摘Background: Chronic exertional compartment syndrome(CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS, it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center.Methods: Patients from all military services were referred from the special unit for lower leg pain at the Central Military Hospital, Utrecht, the Netherlands. Descriptive analysis was used to report the characteristics of the participants and their baseline measurements. Group differences were analyzed using a Student's t-test or MannWhitney U test, according to the normality of the data distribution. Differences between the pre-and postintervention outcomes were evaluated using the Wilcoxon signed rank test. To evaluate the magnitude of prognostic factors, a univariate logistic regression analysis was performed. The prognostic factors included age, body mass index, body fat percentage, self-efficacy beliefs, foot malalignment, intramuscular pressure, other comorbidities, protein and creatine use, smoking, alcohol use, complaint duration, physical demands, and duration of military service.Results: After the rehabilitation period, we observed 25 patients with a successful outcome, which was defined as a reduction in pain(≥2 points) during the capacity test measured using a verbal rating scale and 20 patients with an unsuccessful outcome. Factors demonstrating a limited increased odds ratio for an unsuccessful outcome included smoking, alcohol use, intramuscular pressure, a complaint duration of more than 6 months, and physical demands of service. However, these factors did not reach significance.Conclusion: This study did not identify any prognostic factors that predict the outcome of a rehabilitation program for CECS. A larger sample using an identical design might provide further evidence regarding prognostic factors, which would facilitate development of a model that predicts the outcomes of a rehabilitation program for CECS.
