目的探讨加强康复指导对提高患者运动功能和日常生活能力(ADL)的意义。方法选择脊髓损伤患者59例,随机分两组,1组在康复治疗过程中开展康复指导(以下简称康复指导组) ;1组常规康复治疗(以下简称对照组)。康复指导组由专人负责制订实施康复训练,并对患者及家属、陪护人员进行指导。对照组不设专人,由主管医师负责康复训练并提供随机指导。治疗前及治疗后两组患者均采用Barthel指数进行评定。结果康复指导组在患者运动功能、ADL方面明显优于对照组,差异有显著性(P<0.01)。结论脊髓损伤康复中加强康复指导,有助于提高患者运动功能和生活自理能力。

Objective To observe the effect of psychological intervention on dysphagia after stroke complicated with depression. Methods 60 cases with dysphagia complicated with depression were divided into treatment and control groups. Based on the nountine nursing and swallowing function training, the treatment group received psychological intervention. They were assessed with multimodel approach to diagnosis of post stroke depression (MMADD) and drinking test before and after treatments. Results The scores of drinking test and MMADD inside symptom in treatment group were lower than that of control （P＜0.05）. Conclusion The psychological intervention at early stage can facilitate the recovery of swallowing dysfunction and depresson after stroke.

Objective To observe the effects of action observation therapy based on mirror neuron theory on upper-extremity motor function and performance in activities of daily living(ADL) after stroke.Methods Eightyone stroke patients were randomly assigned to an observational group (41 cases) or a control group (40cases).Both groups received conventional rehabilitation,and the observational group also received action observation therapy for 16 weeks,10 times per week.Upper-extremity motor function and ADL performance were assessed before treatment using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) and then again after 4,8 and 16 weeks of treatment.Results The average FMA scores and BI scores in the observational group at the 4th week (32.50 ± 9.32 and 67.41 ± 16.81),the 8th week (36.35 ± 8.32 and 78.74 ± 15.63) and the 16 th week (41.32 ± 13.45 and 93.85 ± 13.45) had increased significantly compared with the pre-treatment assessment and were significantly better than at the same time point for the control group (P ＜ 0.05).Conclusion Action observation therapy based on mirror neuron theory can promote the recovery of upper-extremity motor function and ADL performance after stroke.

OBJECTIVE To investigate the influence of intermittent catheterization methods and indwelling catheterization methods on the urinary tract infection in patients with spinal cord injury.METHODS After eighty cases of spinal cord injury,the urine retention patients caused by bladder dysfunction were respectively used intermittent catheterization and indwelling catheterization.The urinary tract infection rates of regucally urine culture were compared.By use of intermittent catheterization,the bladder function was trained.Bacteria culture and identification of the urine from the patients were conducted after 15 or 30 days of intermittent catheterization and indwelling catheterization respectively.RESULTS The rates of urinary tract infection(colony count≥1?10 CFU/ml) after 15 or 30 days of intermittent catheterization were 32.6% and 31.5%,respectively.Which were significantly lower than those of indwelling catheterization(100%)(P

Objective To explore the effect of rehabilitation training combined with rational-emotive therapy on post-stroke depression (PSD).Methods 51 PSD patients were randomly divided into the treatment group (n=25) and control group (n=26). All patients received routine rehabilitation training, simultaneously took 20 mg of fluoxetine hydrochloride dispersible tablets per day. Based on above, the treatment group was given physiological rehabilitation treatment with rational-emotive therapy in early stage, 30 min each time, continuously 6 weeks. The two groups were assessed with Zung Self-rating Depression Scale and Fugl-Meyer Motor Scale before and after treatment.Results Afer treatment, the scoers of Zung Self-rating Depression Scale and Fugl-Meyer Motor Scale of the treatment group was higher than that of the control group ( P<0.05).Conclusion The rational-emotive therapy might improve the depression condition of post-stroke, enhance patients' motor function.

Objective To explore the nursing after free great toe fibular flap transplant to repair finger pulp defects. Methods 12 cases with finger pulp defect accepted the free great toe fibular flap were reviewed. Results All flaps survived and no vascular crisis occurred. The flap shaped well, and the skin sweated and the two point discrimination was 4-6 mm. Conclusion Close monitoring and appropriate is important after free great toe fibular flap transplant to repair finger pulp defects.

Objective To explore the effects of virtual reality (VR) combined with motor imagery therapy on the upper limb function of hemiplegic stroke survivors.Methods Thirty-nine hemiplegic stroke patients were divided randomly into a treatment group (n =20) and a control group (n =19).Both groups were treated with motor imagery therapy,but the treatment group also received VR training lasting 20 min/day,6 days/week for 8 weeks.All of the patients were assessed with the Fugl-Meyer (FMA) upper limb assessment,the modified Barthel index (MBI) and electromyography at the beginning and after eight weeks of treatment.Results Before the intervention there was no significant difference between the groups in any of the assessments.After eight weeks of treatment,all the assessment results in the treatment group were significantly better than those in the control group.Conclusion Virtual reality combined with motor imagery therapy can distinctly improve the upper limb motor function of hemiplegic stroke survivors and their ability in the activities of daily living.

Objective To observe the effect of early occupational therapy intervention on unilateral spatial neglect caused by stroke.Methods A total of 92 patients with unilateral spatial neglect caused by stroke were ran- domly divided into a treatment group(46 cases)and a control group(46 cases).The cases of the control group were treated by routine clinical treatment plus positioning on the bed,passive joint motion,bridging movement,facilitation techniques,balance training in sitting and standing positions,gait training immediately after the patients' conditions got stable.The patients in the treatment group were treated with activities of daily living(ADL)training in addition to the interventions employed in the control group.Results Effect of the treatment group are superior to that of the control group as reflected by the scores with Fug1-Meyer scale and Barthel Index(P

Objective To explore the effectiveness of a respiratory function training instrument with stable chronic obstructive pulmonary disease (COPD) patients.Methods Sixty-seven COPD patients in the stable period were randomly divided into a treatment group of 36 and a control group of 31 using a random number table.Both groups were given conventional pulmonary rehabilitation,including half-closed lip respiration,abdominal respiration and upper limb training.The treatment group was additionally provided with 30 minutes of respiratory training using a respiration function training instrument 5 times per week for 6 months.Both groups were assessed for their mobility,life quality and pulmonary function using the 6-minute walk test (6 MWT),a COPD assessment test (CAT),the BODE index,forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and surface electromyography (SEMG) of the respiratory muscles before and after the 6-month intervention.Results Before the treatment there were no significant differences between the two groups in terms of any of the measurements.After the treatment,significant improvement was observed in the average 6 MWT,CAT,BODE index and SEMG results in both groups,but with significantly greater improvement in the treatment group.The average FVC and FEV1 results did not improve significantly,so after the intervention there was still no significant difference between the groups.Conclusions Respiratory training using the pulmonary function training instrument can improve the mobility,life quality and the functioning of the respiratory muscles of COPD patients in the stable period.

Objective To explore the effects of action observation therapy on upper-extremity motor function after ischemic stroke and on the motor cortex using functional magnetic resonance imaging (fMRI).Methods Forty patients with ischemic stroke were randomly assigned to an observational group (n =20) or a control group (n =20).Both groups received conventional rehabilitation,while the observational group was additionally provided with action observation therapy for 8 weeks.Both groups were assessed using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) before and after the 8 weeks of treatment and functional magnetic resonance imaging was performed before treatment.Two months after the treatment,nine patients of the experimental group and 8 of the control group who continued to receive their respective treatments after discharge were again assessed using functional magnetic resonance imaging.Results After the treatment the average FMA score and BI score of both the observational group and the control group had increased significantly.The increase in the average FMA score of the observational group was significantly greater than that of the control group.However,there was no significant difference between the two groups in the increases in BI score after 8 weeks of treatment.The fMRI results showed that there was a significantly greater rise in activity in the bilateral precentral gyrus,parietal lobe and the supplementary motor area of the patients in the observational group after the treatment compared with the control group.Conclusion Action observation therapy can improve upper extremity motor function and performance in the activities of daily living after ischemic stroke and induce changes in the excitability of the cerebral motor cortex.