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 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 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 observe the iffectiveness of comprehensive rehabilitationinterventions on stroke patients with unilateral spatial neglect (USN). Methods A total of 245 cases if strijd were examined to diagnose USN. Of the 245 patients,86 cases were diagnosed as being with USN, and divided into a control group(n=43 cases) and a treatment group (n=43 cases) randomly. The control group was treated with Bobath and Rood techniques in addition to routine clinical medical interventions, while the treatment group was treated with a comprehensive rehabilitation protocol for USN in addition to the same interventions for the control group. Both groups were assessed with regard to motor, balance function, walking performance, and USN severity as well as the activities of daily living (ADL) performance. Results After 8 weeks of treatment,both groups improved, but there showed a significantly statistical difference between the 2 groups in terms of Fugl-Meyer motor function scores (P＜0.01), balance function scores (P＜0.01) Holden walding function classifications (P＜0.01), Barthel index(P＜0.001) and USN severity scores(P＜0.01). Conclusion Comprehensive USN rehabilitation intervention could improve motor, balance, walking functions and ADL performance and alleviate the USN severity in stroke patients with USN.

Objective To evaluate and analyze the clinical effect of comprehensive rehabilitation therapy after arthroscopic rotator cuff repair using suture-bridge technique for full-thickness rotator cuff tears.Methods Forty-one patients (20 males,21 females; mean age 52.2 years) with full-thickness rotator cuff tears were treated with arthroscopic rotator cuff repair using suture-bridge technique between June 2010 and January 2012 in our hospital.After arthroscopic rotator cuff repair,the patients were randomly assigned to a treatment group (21 patients) or a control group (20 patients).The treatment group received systematic rehabilitation therapy including rehabilitation education,physical modalities treatment and rehabilitative training additionally,while the control group only accepted the routine rehabilitation therapy including stretching and muscle strength training.The outcome was evaluated at 6 months after surgery,by employing visual analogae scale (VAS),the range of motion (ROM) testing of shoulder joint flexion and rotation,the rating scale of University of California at Los Angeles (UCLA),and the shoulder index of American shoulder and elbow surgeons (ASES).Results The mean follow-up period was 15.6 months (8-24 months).Prior to intervention,there was no significant difference in any parameter between the two groups (P ＞ 0.05).Six months later,all scores of assessments changed:in treatment group VAS (1.7 ± 1.5),ROM [flexion (168.3±31.3)°,rotation (47.2±11.2)°],UCLA(30.7 ±4.13) and ASES (85.1 ±15.67); in control group VAS(3.8±2.2),ROM[flexion (121.2 ±53.6)°,rotation (32.9 ±14.9)°],UCLA(18.3 ±4.94) and ASES (36.4 ± 17.70).Significant changes occurred in both groups in all the parameters after treatment when compare to baseline (P ＜ 0.05).Conclusions Comprehensive rehabilitation therapy is an effective approach for improving motor ability of the shoulder in patients after arthroscopic rotator cuff repair with suture-bridge technique for their full-thickness rotator cuff tears.

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 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.