OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.
Activities of Daily Living ; Brain Neoplasms ; Brain ; Caregivers ; Cognition ; Follow-Up Studies ; Humans ; Medical Records ; Neurological Rehabilitation ; Pilot Projects ; Recovery of Function ; Rehabilitation ; Retrospective Studies ; Stroke ; Treatment Outcome

Virtual reality (VR) therapy has many benefits to promote neurological and functional recovery in the field of neurorehabilitation after brain injury. VR-assisted neurorehabilitation can be applied in motor, sensori-motor, cognitive, activities of daily living (ADL), and telerehabilitation. Recent reports found that VR therapy appears to be a safe intervention that is effective at improving arm function and ADL function following stroke. Greater improvements were seen at a higher VR therapeutic dose. There has been insufficient evidence that VR therapy improved lower extremity gait speed, balance, and cognitive function after brain injury. As a result, the number of commercially available devices have increased and large-scale controlled trials have reported positive effects recently. Interface devices, various feedback methods, and the advancement of augmented reality technology are quickly developing, therefore, the potential value of VR therapy in neurorehabilitation will be high and its clinical application will be diversified.
Activities of Daily Living ; Arm ; Brain Injuries ; Cognition ; Gait ; Lower Extremity ; Neurological Rehabilitation* ; Rehabilitation ; Stroke ; Telerehabilitation

INTRODUCTIONPhysiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA).

METHODS50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months.

RESULTSBoth groups showed a significant difference in all algofunctional KOOS subscales (p < 0.001). The mean score difference at six weeks and three months was not significant in the sports and recreational activities subscale for both groups (p > 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928).

CONCLUSIONSix-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA.

Activities of Daily Living ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; physiopathology ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; therapy ; Physical Therapy Modalities ; Preoperative Care ; methods ; Range of Motion, Articular ; physiology ; Recovery of Function ; Retrospective Studies ; Time Factors ; Treatment Outcome

This study identified the explanatory power of the Korean rehabilitation patient group (KRPG) v1.1 for acquired brain injury (ABI) on medical expenses in the rehabilitation hospitals and the correlation of functional outcomes with the expenses. Here, the design is a retrospective analysis from the claim data of the designated rehabilitation hospitals. Data including KRPG information with functional status and medical expenses were collected from 1 January and 31 August 2018. Reduction of variance (R2) was statistically analyzed for the explanation power of the KRPG. Association between functional status and the medical expenses was carried out using the Spearman's rank order correlation (rho). From the claim data of 365 patients with ABI, the KRPG v1.1 explained 8.6% of variance for the total medical expenses and also explained 9.8% of variance for the rehabilitation therapy costs. Cognitive function and spasticity showed very weak correlation with the total medical expenses (rho = −0.17 and −0.14, respectively). Motor power and performance of activities of daily living were associated weakly (rho = −0.27 and −0.30, respectively). The KRPG and related functional status in ABI reflects the total medical expenses and rehabilitation therapy costs insufficiently in the designated rehabilitation hospitals. Thus, the current KRPG algorithm and variables for ABI may need to be ameliorated in the future.
Activities of Daily Living ; Brain Diseases ; Brain Injuries ; Brain ; Cognition ; Diagnosis-Related Groups ; Fee-for-Service Plans ; Humans ; Muscle Spasticity ; Neurological Rehabilitation ; Rehabilitation ; Retrospective Studies

OBJECTIVETo study the biological effects of 585 nm pulsed dye laser (FLPDL) in the treatment of congestive scar.

METHODSBy histological study, collagen VG staining and microvascular staining, we investigated the changes of collagen fibers and the density of microvessels in the congestive scars after FLPDL treatment.

RESULTSHistological and immunohistochemistry examinations showed that FLPDL achieved normal vascularity in the scar after over 3 times of treatment.

CONCLUSIONSPDL treatment can change fundamentally the physiology of wound healing if applied in the early phases.

Adolescent ; Adult ; Cicatrix ; therapy ; Female ; Humans ; Lasers, Dye ; Low-Level Light Therapy ; methods ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome ; Wound Healing ; Young Adult

OBJECTIVE: To observe the effect of staged acupuncture on serum irisin level, neurological deficit, balance ability and spasticity in patients with ischemic stroke. METHODS: Sixty patients with ischemic stroke were randomly divided into a staged acupuncture group and a routine acupuncture group, 30 cases in each group; another 30 healthy subjects were selected as a normal group. The patients with ischemic stroke were treated with aspirin (100 mg each time, once a day, changing to 50 mg for prophylactic dose after 4 weeks). The patients in the staged acupuncture group were treated with staged acupuncture (acupoints were selected according to the soft paralysis period, spasticity period and recovery period, sequelae period) and rehabilitation treatment, while the patients in the routine acupuncture group were treated with acupuncture of soft paralysis-period as the staged acupuncture group and rehabilitation treatment. All the treatment was given once a day, 5 times a week, 2 weeks as a course of treatment, and 4 consecutive courses of treatment were provided. Before treatment and at 2 weeks, 4 weeks, 6 weeks and 8 weeks into treatment, the serum irisin level was measured, and the scores of National Institutes of Health stroke scale (NIHSS), Fugl-Meyer assessment scale-balance (FM-B) and comprehensive spasticity scale (CSS) were compared, and the correlation between the serum irisin level and NIHSS and FM-B scores in the two groups was analyzed. RESULTS: Before treatment, the serum irisin levels in the two groups were lower than those in the normal group (P<0.01). Compared before treatment, the serum irisin levels and FM-B scores were increased (P<0.01), and the NIHSS scores were decreased at 2, 4, 6 and 8 weeks into treatment in the two groups (P<0.01). At 4, 6 and 8 weeks into treatment, in the staged acupuncture group, the serum irisin levels and FM-B scores were higher than those in the routine acupuncture group (P<0.01, P<0.05), and the NIHSS scores were lower than those in the routine acupuncture group (P<0.01). After treatment, the CSS scores in the two groups were increased first and then decreased. Compared before treatment, the CSS scores were increased at 2, 4, 6 and 8 weeks into treatment in the two groups (P<0.01). At 4, 6 and 8 weeks into treatment, the CSS scores in the staged acupuncture group were lower than those in the routine acupuncture group (P<0.01). The serum irisin level was negatively correlated with NIHSS score (r =-0.772, P =0.000), and positively correlated with FM-B score (r =0.675, P =0.000). CONCLUSION The severity of neurological deficit and balance ability are related to serum irisin level in patients with ischemic stroke. The staged acupuncture could increase the serum irisin level, improve the neurological function, balance ability and spasticity in patients with ischemic stroke.
Acupuncture Therapy ; Fibronectins ; Humans ; Ischemic Stroke ; Muscle Spasticity ; Neurological Rehabilitation ; Paralysis/complications* ; Stroke/therapy* ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of low-energy QS Nd : YAG and QS alexandrite laser for melsasma.

METHODSWe treated 32 patients with melasma using the low-energy QS Nd : YAG and QS alexandrite laser. Pigment subsided by > or = 90% was regarded as "cured", by 60% -89% as "remarkably improved", by 30% -59% as "effective", and by < 30% as "ineffective" .

RESULTSAmong the 32 patients, 21 patients (65.6%) were cured after (10.2 +/- 3.5) times (range: 4-15 times) of treatments, 11 patients (34.4%) were remarkably improved after (11.4 +/- 2.5) times (range: 10-14 times) of treatment. The rates of "cured" and "remarkably improved" were 81.3% and 18.7% among patients with light brown melasma and 50.0% and 50.0% among patients with dark brown melasma (P < 0.05). In patients with a disease history of less than 2 years, the rates of " cured" and "remarkably improved" were 87.5% and 12.5%, which was significantly better than the treatment results of patients with a disease history of more than 2 years (the rates of "cured" and "remarkably improved" were 58.3% and 41.7%) (P < 0.05). No hyperpigment and scarring was observed and only one patient experienced a transient pigment loss.

CONCLUSIONSLower-energy QS Nd : YAG and QS Alexandrite Laser can be used to treat patients with melasma safely and effectively. The color and disease course of melasma were factors that may affect the treatment results.

Adult ; Female ; Humans ; Lasers, Solid-State ; therapeutic use ; Low-Level Light Therapy ; methods ; Male ; Melanosis ; radiotherapy ; Middle Aged ; Risk Assessment ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of the 308 nm excimer laser for the treatment of vitiligo.

METHODSWe treated 170 patients with stable vitiligo by using the 308 nm excimer laser. The lesions of vitiligo were treated one to two times per week for 10-30 times. Efficacies were evaluated every 7 days and 3 days after the treatments were completed. Patients were followed up for two months.

RESULTSThe rates of "remarkably improved" and "cured" were 67.97% and 32.03% in faces, 54.55% and 27.27% in necks, 63.26% and 26.53% in trunks, 38.84% and 15.70% in limbs, and 0 and 0 in hands and feet. The areas of faces had a better response than those of necks, trunks, or limbs (P < 0.01), and the areas of trunks or limbs had better response than that of hands and feet (P < 0.01).

CONCLUSIONThe 308 nm excimer laser is safe and effective in treating stable vitiligo and the efficacy varies in different lesion sites.

Adolescent ; Adult ; Child ; Female ; Humans ; Lasers, Excimer ; therapeutic use ; Low-Level Light Therapy ; instrumentation ; methods ; Male ; Middle Aged ; Risk Assessment ; Treatment Outcome ; Vitiligo ; radiotherapy ; Young Adult

OBJECTIVETo evaluate the effectiveness and safety of long-pulsed Alexandrite laser for hair removal.

METHODSHair removal was performed in 1702 hirsute patients with long-pulsed Alexandrite laser. Among them 1603 patients received two or more operations.

RESULTSIn patients who received 2, 3, 4, 5, and > or =6 operations, the effectiveness rates were 9.79%, 18.33%, 29.10%, 37.64%, and 82.68%, respectively. The number of operation correlated with the effectiveness, and > or =6 operations resulted in superior outcomes. Pigmentation occurred in 0.94% of the patients (16/1702).

CONCLUSIONThe long-pulsed Alexandrite laser system is effective and safe in removing hair.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hair Removal ; methods ; Hirsutism ; radiotherapy ; Humans ; Low-Level Light Therapy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To compare the effect of floating needle therapy on myofascial trigger point (MTrP) and conventional electroacupuncture on the recovery of shoulder joint function after surgical neck fracture of humerus on the basis of drugs and rehabilitation training. METHODS: A total of 72 patients with unilateral surgical neck fracture of humerus were randomly divided into a floating needle group (35 cases) and an electroacupuncture group (37 cases). At the same time of the basic treatment, both groups were intervened on the 2nd day after operation. Touched the MTrP at the affected limb, and the floating needle was used to sweep around it in the floating needle group. In the electroacupuncture group, electroacupuncture was applied at Hegu (LI 4), Quchi (LI 11), Waiguan (TE 5) on the affected side, the dilatational wave (4 Hz/20 Hz) was selected. The treatment was given once every day for 2 weeks. Pain visual analogue scales (VAS) score, constant shoulder joint score, and changes in the number of MTrP were used to evaluate the pain and functional status of the shoulder joints before, after treatment, and 3 months after treatment. RESULTS: Compared with that before treatment, the VAS scores were decreased, the constant scores were increased, and the numbers of MTrP were decreased in the two groups after treatment and 3 months after treatment (<0.05), but the improvement in the floating needle group was better than that in the electroacupuncture group (<0.05). Compared with that after treatment, the VAS scores were decreased and the constant scores were increased 3 months after treatment in the floating needle group (<0.05), and the VAS scores in the electroacupuncture group were decreased (<0.05). CONCLUSION Floating needle therapy is helpful for the rehabilitation of shoulder joint function after surgical neck fracture of the humerus, and its curative effect is better than conventional electroacupuncture.
Acupuncture Points ; Electroacupuncture ; Humans ; Humerus ; Physical Therapy Modalities ; Treatment Outcome