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 Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which u...BACKGROUND Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which ultimately affects the prognosis.AIM To evaluate the effect of progressive early rehabilitation training on treatment and prognosis of patients with mechanical ventilation in ICU.METHODS The convenience sampling method selected 190 patients with mechanical ventilation admitted to the Fourth Hospital of Hebei Medical University from March 2020 to March 2021.According to the random number table method,they were divided into the control and intervention groups.The control group received routine nursing and rehabilitation measures,whereas the intervention group received progressive early rehabilitation training.In addition,the incidence and duration of delirium were compared for the two groups along with mechanical ventilation time,ICU hospitalization time,functional independence measure(FIM)score,Barthel index,and the incidence of complications(deep venous thrombosis,pressure sores,and acquired muscle weakness).RESULTS In the intervention group,the incidence of delirium was significantly lower than in the control group(28%vs 52%,P<0.001).In the intervention group,the duration of delirium,mechanical ventilation time,and ICU stay were shorter than in the control group(P<0.001).The FIM and Barthel index scores were significantly higher in the intervention group than the control group(P<0.001).The total incidence of complications in the intervention group was 3.15%,which was lower than 17.89%in the control group(P<0.001).CONCLUSION Progressive early rehabilitation training reduced the incidence of delirium and complications in ICU patients with mechanical ventilation,which improved prognosis and quality of life.展开更多
Craniosynostosis is a common congenital craniofacial deformity caused by premature ossification and closure of one or more cranial sutures.Craniosynostosis will not only affect the normal development of the skull,but ...Craniosynostosis is a common congenital craniofacial deformity caused by premature ossification and closure of one or more cranial sutures.Craniosynostosis will not only affect the normal development of the skull,but also may cause a variety of complications,damage the nervous system,and cause long-term effects on the development of physical and mental health.Therefore,it is particularly important to provide new ideas for clinical treatment by studying the rehabilitation methods of craniosynostosis,and to improve the cure rate.To this end,this paper studies the early rehabilitation methods after craniosynostosis surgery and designs a comprehensive early rehabilitation process and corresponding comprehensive early rehabilitation measures after surgery.The comparative data also shows that after comprehensive early rehabilitation nursing measures,the duration of the postoperative swelling of sick children was reduced and the degree was significantly reduced,which alleviated the discomfort of sick children;and the time of sick children spent in ICU treatment and monitoring was reduced,and the separation time between sick children and their parents was shorten,is of great significance to the postoperative rehabilitation of craniosynostosis.In addition,the total cost of hospitalization was reduced accordingly,which greatly increased the satisfaction of patients.展开更多
Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018...Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018 to March 2020 were selected for the present study.Twenty patients in each group were divided into two groups by random number table method,either in experimental group or control group.Routine nursing was used in the control group,while early rehabilitation nursing was carried out in the experimental group.The clinical nursing effect of the two groups of patients was compared.Results:After nursing,the neurological function of the patients was significantly improved(P<0.05),the improvement of the experimental group was better than that of the control group(P<0.01),the daily activities of the patients in the experimental group were significantly improved,and the score of the experimental group was higher than that of the control group(P<0.05).After nursing,anxiety and depression scores in the experimental group were significantly lower than those in the control group(P<0.05),and the recovery of limb function in the experimental group was better than that in the control group(P<0.05).Conclusion:The implementation of early rehabilitation nursing measures plays an important role in the recovery of stroke patients with hemiplegia by promoting the recovery of neurological function,improving the psychological state of patients,and promoting the recovery of limbs.展开更多
Objective:This research studied the clinical value of implementing early rehabilitation in the nursing of patients with cerebral infarction.Methods:Eighty-four patients with cerebral infarction in Hubei Third People&#...Objective:This research studied the clinical value of implementing early rehabilitation in the nursing of patients with cerebral infarction.Methods:Eighty-four patients with cerebral infarction in Hubei Third People's Hospital from January 2019 to January 2021 were selected and divided into a control group and a study group using the digital table method in which routine care and early rehabilitation care were given respectively and the effects were observed.Results:Prior to the nursing intervention,there was no significant difference in the National Institutes of Health Stroke Scale(NIHSS)and Barthel index between the two groups of patients,P>0.05.After the nursing intervention,the NIHSS of the study group was lower than that of the control group whereas the Barthel index,Quality of Life Scale,and patient satisfaction in the study group were higher than the control group,P<0.05.Conclusion:The implementation of early rehabilitation in the nursing of patients with cerebral infarction can effectively improve their neurological function and quality of life in addition to a higher satisfaction among them.展开更多
During the past several decades,early rehabilitation programs for the care of patients with colorectal surgery have gained popularity.Several randomized controlled trials and meta-analyses have confirmed that the impl...During the past several decades,early rehabilitation programs for the care of patients with colorectal surgery have gained popularity.Several randomized controlled trials and meta-analyses have confirmed that the implementation of these evidence-based detailed perioperative care protocols is useful for early recovery of patients after colorectal resection.Patients cared for based on these protocols had a rapid recovery of bowel movement,shortened length of hospital stay,and fewer complications compared with traditional care programs.However,most of the previous evidence was obtained from studies of early rehabilitation programs adapted to open colonic resection.Currently,limited evidence exists on the effects of early rehabilitation after laparoscopic rectal resection,although this procedure seems to be associated with a higher morbidity than that reported with traditional care.In this article,we review previous studies and guidelines on early rehabilitation programs in patients undergoing rectal surgery.We investigated the status of early rehabilitation programs in rectal surgery and analyzed the limitations of these studies.We also summarized indications and detailed protocol components of current early rehabilitation programs after rectal surgery,focusing on laparoscopic resection.展开更多
Objective To investigate the clinical implications of early rehabilitative treatment for uncomplete dislocation of shoulder after stroke.Method 420 patients received the anti－ spasticity treatment of upper limb,prote...Objective To investigate the clinical implications of early rehabilitative treatment for uncomplete dislocation of shoulder after stroke.Method 420 patients received the anti－ spasticity treatment of upper limb,protecting techniques and sling were also used for all patients.Result The recovery of uncomplete dislocation of shoulder after stroke was satisfying.Conclusion Early rehabilitative treatment was beneficial for the improvement of uncomplete dislocation of shoulder after stroke.展开更多
Objective:To explore the effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction (ACI).Methods: A total of 150 patients with ACI who were admi...Objective:To explore the effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction (ACI).Methods: A total of 150 patients with ACI who were admitted in our hospital from October, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group. The patients in the two groups were given anti-coagulation, anti-platelet aggregation, cerebral circulation improving, and brain cell activators. The patients in the control group were given routine neurological nursing, while the patients in the observation group were given early comprehensive rehabilitation training on the basis of stable vital signs and no disease progression within 48 h. The morning fasting peripheral venous blood before treatment, 2 and 4 weeks after treatment in the two groups was collected. The serum NGF, NSE, BDNF, IL-6, hs-CRP, and TNF-α were detected. The activities of daily living and motor function before treatment, 2 and 4 weeks after treatment in the two groups were evaluated.Results:IL-6, hs-CRP, and TNF-α levels 2 and 4 weeks after treatment in the observation group were significantly lower than those in the control group (P<0.05). NGF and BDNF levels 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05), while NSE level was significantly lower than that in the control group (P<0.05). MBI and FMA scores 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions: The early rehabilitation training can effectively reduce the inflammatory reaction of nervous system in patients with ACI, regulate NGF, BDNF, and NSE levels, and play the cerebral function remodeling in order to promote the neural function recovery, and improve the motor function.展开更多
Objective To explore the effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia.Methods Divided the 96 patients with acute stroke hemiple...Objective To explore the effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia.Methods Divided the 96 patients with acute stroke hemiplegia into group A and B randomly (group B as control). Evaluate the rehabilitation before and after therapy, and deal with the data in statistics. The courses are 26 to 28 days. In group A, stab negative channel and points of upper limb as well as positive channel and points of lower limb of paralysis side in flaccid paralysis stage. After the muscular tension resumed, stab positive points of upper limb and negative points of lower limb, and try to recover the balance of muscular tension, and avoid muscular spasm to establish normal moving pattern. Results Compared with control group, group A had prominent difference on the process of muscular tension resuming, incidence rate of muscular spasm, the ratio of reducing of neurologic impairment scores and increasing of motor function integral (FMA), MBI of the ability of daily life (ADL) as well as index of quality of life (QLI), P<0.01. Conclusion Acuppuncture and balance facillitation of muscular tension are useful in the early rehabilitation in hemiplegia.展开更多
Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of ...Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.展开更多
BACKGROUND Hands are one of the most common burn sites in children.Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion(ROM),motility,and fine motor activit...BACKGROUND Hands are one of the most common burn sites in children.Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion(ROM),motility,and fine motor activities.Rehabilitation can improve the function of hands.But the optimal time of rehabilitation intervention is still unclear.Therefore,this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention.AIM To investigate the effects of early rehabilitation management of paediatric burnt hands.METHODS A total of 52 children with burnt hands were allocated into the early intervention group(≤1 mo from onset)and a late intervention group(>1 mo from onset)between January 2016 and December 2017.The children received the same rehabilitation programme including skin care,scar massage,passive ROM exercises,active ROM exercises,compression therapy,orthotic devices wearing and game or music therapy.Rehabilitation assessments were performed before and after the rehabilitation treatment.RESULTS In the early intervention group,the ROM of the hands was significantly improved after rehabilitation(P=0.001).But in the late group the effect was not significant statistically(P=0.142).In the early group,38.5%of the patients showed significant improvement,while in the late group,69.2%of the patients showed no significant improvement.The time from onset to posttraumatic rehabilitation(P=0.0007)and length of hospital stay(P=0.003)were negatively correlated with the hand function improvement.The length of rehabilitation stay was positively correlated with the hand function improvement(P=0.005).CONCLUSION These findings suggest that early rehabilitation might show better results in terms of ROM.展开更多
Sixty elderly patients, who suffered from acute stroke and were admitted within a 1-year period to the Department of Geriatrics in the First Affiliated Hospital of School of Medicine, Zhejiang University, China, under...Sixty elderly patients, who suffered from acute stroke and were admitted within a 1-year period to the Department of Geriatrics in the First Affiliated Hospital of School of Medicine, Zhejiang University, China, underwent early rehabilitation in combination with neuroprotective drug therapy. Limb movement, cognitive functions and daily life self-care ability in elderly patients upon admission and discharge were assessed using the Hunt-Hess scale, functional independence measures and mini-mental state examination. The mean duration of hospital stay among the 60 patients was 35 days. Upon discharge, 42 (75%) of the patients exhibited cognitive impairment to varying degrees, and 25 (45%) of the 56 stroke patients who underwent rehabilitation evaluation attained independence in daily living activities, 11 (20%) required intermittent supervision, and 20 (36%) required 24-hour constant supervision during performance of these activities. Results demonstrated that early rehabilitation treatment in combination with neuroprotective therapy for acute stroke was effective.展开更多
Objective: To study the effect of early rehabilitation training combined with edaravone on oxygen free radical generation and nerve injury in patients with cerebral hemorrhage. Methods: A total of 56 patients with acu...Objective: To study the effect of early rehabilitation training combined with edaravone on oxygen free radical generation and nerve injury in patients with cerebral hemorrhage. Methods: A total of 56 patients with acute cerebral hemorrhage who were treated in Zigong Third People's Hospital between July 2014 and March 2017 were selected and randomly divided into early rehabilitation group and routine rehabilitation group, the early rehabilitation group began the rehabilitation training 2 d after cerebral hemorrhage condition was stabilized, and routine rehabilitation group began the rehabilitation training 14 d after cerebral hemorrhage. Serum contents of oxygen free radicals, nerve injury markers and neurotrophic molecules were detected 28 d and 56 d after cerebral hemorrhage. Results: 28 d and 56 d after cerebral hemorrhage, serum MDA, AOPP, 8-OHdG, GFAP, NSE, Tf, Ft and S100B levels of early rehabilitation group were significantly lower than those of routine rehabilitation group while BDNF, NGF, NTF-α and IGF-I levels were significantly higher than those of routine rehabilitation group. Conclusion: Early rehabilitation training combined with edaravone for cerebral hemorrhage can inhibit the oxygen free radical generation, reduce the degree of nerve injury and improve the neurotrophic state.展开更多
To investigate the effect of early rehabilitation on neurofunctional outcome after surgery in children with spinal tumors, this study reviewed the medical charts and radiographic records of 70 pediatric patients(1–17...To investigate the effect of early rehabilitation on neurofunctional outcome after surgery in children with spinal tumors, this study reviewed the medical charts and radiographic records of 70 pediatric patients(1–17 years old) who received spinal tumor surgical removal. The peddiatric patients received rahabilitation treatment at 4(range, 2–7) days after surgery for 10(range, 7–23) days. Results from the Modified McCormick Scale, Functional Independence Measure for Children, American Spinal Injury Association Impairment Scale and Karnofsky Performance Status Scale demonstrated that the sensory function, motor function and activity of daily living of pediatric children who received early rehabilitation were significantly improved. Results also showed that tumor setting and level localization as well as patients' s clinical symptoms have no influences on neurofunctional outcomes.展开更多
Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related...Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related to the nature of asthma. In some specific industries, such as workers who are exposed to asthmatic isocyanates for a long time, the incidence of occupational asthma can reach 5%-10%, and the incidence of occupational asthma can even reach 50% or higher among workers engaged in the detergent industry who are in contact with proteolytic enzymes for a long time. Objective To analyze the clinical value of early comprehensive rehabilitation nursing for patients with occupational asthma, methods a total of 48 patients with occupational asthma who were admitted from January 2020 to December 2022 were divided into control group and study group by random number table method The disappearance time of chest tightness and shortness of breath, the disappearance time of wheezing and cough, and the FEV1, forced vital capacity (FVC) and peak expiratory flow (PEF) indexes before and after treatment were compared between the two groups after nursing, the disappearance time of clinical symptoms in the study group was shorter than that in the control group, and the levels of FEV1, FVC and PEF were higher than those in the control group, and the P < 0.05 was significantly improved.展开更多
BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early ste...BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with sepsis.METHODS A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment regimen.Cardiac function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after treatment.RESULTS After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.展开更多
Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were ran...Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were randomly selected and divided into two groups:Group A(68 cases,receiving early enteral nutrition)and Group B(71 cases,receiving sequential early enteral nutrition),using computer randomization.The effects of the interventions on both groups were compared.Results:Seven days post-operation,the levels of nutritional indicators in Group B were significantly higher than those in Group A(P<0.05).Group B showed significantly better levels of inflammatory factors and immune factors compared to Group A seven days post-operation(P<0.05).The postoperative complication rate in Group B was 4.23%,2 significantly lower than that in Group A,which was 16.18%(χ=5.477,P=0.019).Conclusion:The utilization of sequential early enteral nutrition in gastric cancer patients after surgery demonstrated notable improvements in nutritional status and inflammation markers,along with enhanced immunity,effectively reducing postoperative complications.展开更多
Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction...Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.展开更多
Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,sur...Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.展开更多
[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilato...[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were searched.Literature screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this review.The results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),P<0.01],with statistically significant differences.Furthermore,there were significant reductions in ICU length of stay[SMD=-0.70,95%CI(-0.90,-0.50),P<0.01],duration of mechanical ventilation[SMD=-1.15,95%CI(-1.36,-0.94),P<0.01],and occurrence of complications[OR=0.16,95%CI(0.10,0.26),P<0.01],all of which were statistically significant.[Conclusions]Early-stage phased pulmonary rehabilitation training for ARDS patients effectively improves the oxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces complications.These findings support the clinical application and promotion of early-stage phased rehabilitation training.展开更多
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 Mechanical ventilation is a common resuscitation method in the intensive care unit(ICU).Unfortunately,this treatment process prolongs the ICU stay of patients with an increased incidence of delirium,which ultimately affects the prognosis.AIM To evaluate the effect of progressive early rehabilitation training on treatment and prognosis of patients with mechanical ventilation in ICU.METHODS The convenience sampling method selected 190 patients with mechanical ventilation admitted to the Fourth Hospital of Hebei Medical University from March 2020 to March 2021.According to the random number table method,they were divided into the control and intervention groups.The control group received routine nursing and rehabilitation measures,whereas the intervention group received progressive early rehabilitation training.In addition,the incidence and duration of delirium were compared for the two groups along with mechanical ventilation time,ICU hospitalization time,functional independence measure(FIM)score,Barthel index,and the incidence of complications(deep venous thrombosis,pressure sores,and acquired muscle weakness).RESULTS In the intervention group,the incidence of delirium was significantly lower than in the control group(28%vs 52%,P<0.001).In the intervention group,the duration of delirium,mechanical ventilation time,and ICU stay were shorter than in the control group(P<0.001).The FIM and Barthel index scores were significantly higher in the intervention group than the control group(P<0.001).The total incidence of complications in the intervention group was 3.15%,which was lower than 17.89%in the control group(P<0.001).CONCLUSION Progressive early rehabilitation training reduced the incidence of delirium and complications in ICU patients with mechanical ventilation,which improved prognosis and quality of life.
基金This work is supported by science and technology development fund of Nanjing Medical University(Grand No.NMUB2018095).
文摘Craniosynostosis is a common congenital craniofacial deformity caused by premature ossification and closure of one or more cranial sutures.Craniosynostosis will not only affect the normal development of the skull,but also may cause a variety of complications,damage the nervous system,and cause long-term effects on the development of physical and mental health.Therefore,it is particularly important to provide new ideas for clinical treatment by studying the rehabilitation methods of craniosynostosis,and to improve the cure rate.To this end,this paper studies the early rehabilitation methods after craniosynostosis surgery and designs a comprehensive early rehabilitation process and corresponding comprehensive early rehabilitation measures after surgery.The comparative data also shows that after comprehensive early rehabilitation nursing measures,the duration of the postoperative swelling of sick children was reduced and the degree was significantly reduced,which alleviated the discomfort of sick children;and the time of sick children spent in ICU treatment and monitoring was reduced,and the separation time between sick children and their parents was shorten,is of great significance to the postoperative rehabilitation of craniosynostosis.In addition,the total cost of hospitalization was reduced accordingly,which greatly increased the satisfaction of patients.
文摘Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018 to March 2020 were selected for the present study.Twenty patients in each group were divided into two groups by random number table method,either in experimental group or control group.Routine nursing was used in the control group,while early rehabilitation nursing was carried out in the experimental group.The clinical nursing effect of the two groups of patients was compared.Results:After nursing,the neurological function of the patients was significantly improved(P<0.05),the improvement of the experimental group was better than that of the control group(P<0.01),the daily activities of the patients in the experimental group were significantly improved,and the score of the experimental group was higher than that of the control group(P<0.05).After nursing,anxiety and depression scores in the experimental group were significantly lower than those in the control group(P<0.05),and the recovery of limb function in the experimental group was better than that in the control group(P<0.05).Conclusion:The implementation of early rehabilitation nursing measures plays an important role in the recovery of stroke patients with hemiplegia by promoting the recovery of neurological function,improving the psychological state of patients,and promoting the recovery of limbs.
文摘Objective:This research studied the clinical value of implementing early rehabilitation in the nursing of patients with cerebral infarction.Methods:Eighty-four patients with cerebral infarction in Hubei Third People's Hospital from January 2019 to January 2021 were selected and divided into a control group and a study group using the digital table method in which routine care and early rehabilitation care were given respectively and the effects were observed.Results:Prior to the nursing intervention,there was no significant difference in the National Institutes of Health Stroke Scale(NIHSS)and Barthel index between the two groups of patients,P>0.05.After the nursing intervention,the NIHSS of the study group was lower than that of the control group whereas the Barthel index,Quality of Life Scale,and patient satisfaction in the study group were higher than the control group,P<0.05.Conclusion:The implementation of early rehabilitation in the nursing of patients with cerebral infarction can effectively improve their neurological function and quality of life in addition to a higher satisfaction among them.
文摘During the past several decades,early rehabilitation programs for the care of patients with colorectal surgery have gained popularity.Several randomized controlled trials and meta-analyses have confirmed that the implementation of these evidence-based detailed perioperative care protocols is useful for early recovery of patients after colorectal resection.Patients cared for based on these protocols had a rapid recovery of bowel movement,shortened length of hospital stay,and fewer complications compared with traditional care programs.However,most of the previous evidence was obtained from studies of early rehabilitation programs adapted to open colonic resection.Currently,limited evidence exists on the effects of early rehabilitation after laparoscopic rectal resection,although this procedure seems to be associated with a higher morbidity than that reported with traditional care.In this article,we review previous studies and guidelines on early rehabilitation programs in patients undergoing rectal surgery.We investigated the status of early rehabilitation programs in rectal surgery and analyzed the limitations of these studies.We also summarized indications and detailed protocol components of current early rehabilitation programs after rectal surgery,focusing on laparoscopic resection.
文摘Objective To investigate the clinical implications of early rehabilitative treatment for uncomplete dislocation of shoulder after stroke.Method 420 patients received the anti－ spasticity treatment of upper limb,protecting techniques and sling were also used for all patients.Result The recovery of uncomplete dislocation of shoulder after stroke was satisfying.Conclusion Early rehabilitative treatment was beneficial for the improvement of uncomplete dislocation of shoulder after stroke.
文摘Objective:To explore the effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction (ACI).Methods: A total of 150 patients with ACI who were admitted in our hospital from October, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group. The patients in the two groups were given anti-coagulation, anti-platelet aggregation, cerebral circulation improving, and brain cell activators. The patients in the control group were given routine neurological nursing, while the patients in the observation group were given early comprehensive rehabilitation training on the basis of stable vital signs and no disease progression within 48 h. The morning fasting peripheral venous blood before treatment, 2 and 4 weeks after treatment in the two groups was collected. The serum NGF, NSE, BDNF, IL-6, hs-CRP, and TNF-α were detected. The activities of daily living and motor function before treatment, 2 and 4 weeks after treatment in the two groups were evaluated.Results:IL-6, hs-CRP, and TNF-α levels 2 and 4 weeks after treatment in the observation group were significantly lower than those in the control group (P<0.05). NGF and BDNF levels 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05), while NSE level was significantly lower than that in the control group (P<0.05). MBI and FMA scores 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions: The early rehabilitation training can effectively reduce the inflammatory reaction of nervous system in patients with ACI, regulate NGF, BDNF, and NSE levels, and play the cerebral function remodeling in order to promote the neural function recovery, and improve the motor function.
文摘Objective To explore the effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia.Methods Divided the 96 patients with acute stroke hemiplegia into group A and B randomly (group B as control). Evaluate the rehabilitation before and after therapy, and deal with the data in statistics. The courses are 26 to 28 days. In group A, stab negative channel and points of upper limb as well as positive channel and points of lower limb of paralysis side in flaccid paralysis stage. After the muscular tension resumed, stab positive points of upper limb and negative points of lower limb, and try to recover the balance of muscular tension, and avoid muscular spasm to establish normal moving pattern. Results Compared with control group, group A had prominent difference on the process of muscular tension resuming, incidence rate of muscular spasm, the ratio of reducing of neurologic impairment scores and increasing of motor function integral (FMA), MBI of the ability of daily life (ADL) as well as index of quality of life (QLI), P<0.01. Conclusion Acuppuncture and balance facillitation of muscular tension are useful in the early rehabilitation in hemiplegia.
基金supported by Nanjing Medical Science and Technology Development Project(No.YKK13138).
文摘Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.
基金by the State Key Laboratory of Trauma,Burn and Combined Injury,No.SKL11201802Chongqing Basic Research and Frontier Exploration Project,No.cstc2017jcyjAX0242.
文摘BACKGROUND Hands are one of the most common burn sites in children.Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion(ROM),motility,and fine motor activities.Rehabilitation can improve the function of hands.But the optimal time of rehabilitation intervention is still unclear.Therefore,this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention.AIM To investigate the effects of early rehabilitation management of paediatric burnt hands.METHODS A total of 52 children with burnt hands were allocated into the early intervention group(≤1 mo from onset)and a late intervention group(>1 mo from onset)between January 2016 and December 2017.The children received the same rehabilitation programme including skin care,scar massage,passive ROM exercises,active ROM exercises,compression therapy,orthotic devices wearing and game or music therapy.Rehabilitation assessments were performed before and after the rehabilitation treatment.RESULTS In the early intervention group,the ROM of the hands was significantly improved after rehabilitation(P=0.001).But in the late group the effect was not significant statistically(P=0.142).In the early group,38.5%of the patients showed significant improvement,while in the late group,69.2%of the patients showed no significant improvement.The time from onset to posttraumatic rehabilitation(P=0.0007)and length of hospital stay(P=0.003)were negatively correlated with the hand function improvement.The length of rehabilitation stay was positively correlated with the hand function improvement(P=0.005).CONCLUSION These findings suggest that early rehabilitation might show better results in terms of ROM.
基金the Science and Technology Foundation of Shanghai Railway Bureau of China, No. B340406052
文摘Sixty elderly patients, who suffered from acute stroke and were admitted within a 1-year period to the Department of Geriatrics in the First Affiliated Hospital of School of Medicine, Zhejiang University, China, underwent early rehabilitation in combination with neuroprotective drug therapy. Limb movement, cognitive functions and daily life self-care ability in elderly patients upon admission and discharge were assessed using the Hunt-Hess scale, functional independence measures and mini-mental state examination. The mean duration of hospital stay among the 60 patients was 35 days. Upon discharge, 42 (75%) of the patients exhibited cognitive impairment to varying degrees, and 25 (45%) of the 56 stroke patients who underwent rehabilitation evaluation attained independence in daily living activities, 11 (20%) required intermittent supervision, and 20 (36%) required 24-hour constant supervision during performance of these activities. Results demonstrated that early rehabilitation treatment in combination with neuroprotective therapy for acute stroke was effective.
文摘Objective: To study the effect of early rehabilitation training combined with edaravone on oxygen free radical generation and nerve injury in patients with cerebral hemorrhage. Methods: A total of 56 patients with acute cerebral hemorrhage who were treated in Zigong Third People's Hospital between July 2014 and March 2017 were selected and randomly divided into early rehabilitation group and routine rehabilitation group, the early rehabilitation group began the rehabilitation training 2 d after cerebral hemorrhage condition was stabilized, and routine rehabilitation group began the rehabilitation training 14 d after cerebral hemorrhage. Serum contents of oxygen free radicals, nerve injury markers and neurotrophic molecules were detected 28 d and 56 d after cerebral hemorrhage. Results: 28 d and 56 d after cerebral hemorrhage, serum MDA, AOPP, 8-OHdG, GFAP, NSE, Tf, Ft and S100B levels of early rehabilitation group were significantly lower than those of routine rehabilitation group while BDNF, NGF, NTF-α and IGF-I levels were significantly higher than those of routine rehabilitation group. Conclusion: Early rehabilitation training combined with edaravone for cerebral hemorrhage can inhibit the oxygen free radical generation, reduce the degree of nerve injury and improve the neurotrophic state.
文摘To investigate the effect of early rehabilitation on neurofunctional outcome after surgery in children with spinal tumors, this study reviewed the medical charts and radiographic records of 70 pediatric patients(1–17 years old) who received spinal tumor surgical removal. The peddiatric patients received rahabilitation treatment at 4(range, 2–7) days after surgery for 10(range, 7–23) days. Results from the Modified McCormick Scale, Functional Independence Measure for Children, American Spinal Injury Association Impairment Scale and Karnofsky Performance Status Scale demonstrated that the sensory function, motor function and activity of daily living of pediatric children who received early rehabilitation were significantly improved. Results also showed that tumor setting and level localization as well as patients' s clinical symptoms have no influences on neurofunctional outcomes.
文摘Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related to the nature of asthma. In some specific industries, such as workers who are exposed to asthmatic isocyanates for a long time, the incidence of occupational asthma can reach 5%-10%, and the incidence of occupational asthma can even reach 50% or higher among workers engaged in the detergent industry who are in contact with proteolytic enzymes for a long time. Objective To analyze the clinical value of early comprehensive rehabilitation nursing for patients with occupational asthma, methods a total of 48 patients with occupational asthma who were admitted from January 2020 to December 2022 were divided into control group and study group by random number table method The disappearance time of chest tightness and shortness of breath, the disappearance time of wheezing and cough, and the FEV1, forced vital capacity (FVC) and peak expiratory flow (PEF) indexes before and after treatment were compared between the two groups after nursing, the disappearance time of clinical symptoms in the study group was shorter than that in the control group, and the levels of FEV1, FVC and PEF were higher than those in the control group, and the P < 0.05 was significantly improved.
文摘BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with sepsis.METHODS A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment regimen.Cardiac function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after treatment.RESULTS After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.
文摘Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were randomly selected and divided into two groups:Group A(68 cases,receiving early enteral nutrition)and Group B(71 cases,receiving sequential early enteral nutrition),using computer randomization.The effects of the interventions on both groups were compared.Results:Seven days post-operation,the levels of nutritional indicators in Group B were significantly higher than those in Group A(P<0.05).Group B showed significantly better levels of inflammatory factors and immune factors compared to Group A seven days post-operation(P<0.05).The postoperative complication rate in Group B was 4.23%,2 significantly lower than that in Group A,which was 16.18%(χ=5.477,P=0.019).Conclusion:The utilization of sequential early enteral nutrition in gastric cancer patients after surgery demonstrated notable improvements in nutritional status and inflammation markers,along with enhanced immunity,effectively reducing postoperative complications.
文摘Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.
文摘Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.
文摘[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were searched.Literature screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this review.The results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),P<0.01],with statistically significant differences.Furthermore,there were significant reductions in ICU length of stay[SMD=-0.70,95%CI(-0.90,-0.50),P<0.01],duration of mechanical ventilation[SMD=-1.15,95%CI(-1.36,-0.94),P<0.01],and occurrence of complications[OR=0.16,95%CI(0.10,0.26),P<0.01],all of which were statistically significant.[Conclusions]Early-stage phased pulmonary rehabilitation training for ARDS patients effectively improves the oxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces complications.These findings support the clinical application and promotion of early-stage phased rehabilitation training.
