Systematic Team-Approach Rehabilitation After Knee Fracture Surgery Is Associated With Better Functional Outcomes

Abstract Purpose In Western developed countries, patients commonly receive rehabilitation after orthopedic surgery to improve functional dysfunction. In China, however, rehabilitation is widely neglected. An appropriate perioperative rehabilitation model for early orthopedic rehabilitation is urgently needed in China. We evaluated the outcomes of perioperative rehabilitation patterns and promoted the functional recovery of orthopedic patients in China. Methods 668 patients from 9 centers who underwent internal fixation surgery because of knee joint fracture were assigned to 2 groups: 1) control group: received the standard postoperative treatments, or 2) trial group: received perioperative rehabilitation in team-based approach. The visual analog scale (VAS), Hospital for Special Surgery (HSS) knee and Berg Balance Scale (BBS) scores were assessed 12 and 24 weeks postoperatively. Results The VAS scores at 12 and 24 weeks postoperative showed that the trial group had significantly less pain than control group (P < 0.001). Compared to the control group, the trial group had significantly better HSS knee scores at 12 weeks (P < 0.05) and significantly better BBS scores at both 12 and 24 weeks postoperative (P < 0.05). Conclusions Compared to common postoperative treatments, patients with systematic team-approach rehabilitation had better functional outcomes and pain relief after knee fracture surgery.

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The effect of robot-assisted gait training on cortical activation in stroke patients: A functional near-infrared spectroscopy study

Neurorehabilitation ◽

10.3233/nre-210034 ◽

2021 ◽

pp. 1-9

Author(s):

Kyeong Joo Song ◽

Min Ho Chun ◽

Junekyung Lee ◽

Changmin Lee

Keyword(s):

Gait Speed ◽

Functional Outcomes ◽

Near Infrared ◽

Gait Training ◽

Berg Balance Scale ◽

Cortical Activation ◽

Control Group ◽

Stroke Patients ◽

Robot Assisted ◽

Functional Near Infrared Spectroscopy

OBJECTIVE: To investigate the effects of the robot–assisted gait training on cortical activation and functional outcomes in stroke patients. METHODS: The patients were randomly assigned: training with Morning Walk® (Morning Walk group; n = 30); conventional physiotherapy (control group; n = 30). Rehabilitation was performed five times a week for 3 weeks. The primary outcome was the cortical activation in the Morning Walk group. The secondary outcomes included gait speed, 10-Meter Walk Test (10MWT), FAC, Motricity Index–Lower (MI–Lower), Modified Barthel Index (MBI), Rivermead Mobility Index (RMI), and Berg Balance Scale (BBS). RESULTS: Thirty-six subjects were analyzed, 18 in the Morning Walk group and 18 in the control group. The cortical activation was lower in affected hemisphere than unaffected hemisphere at the beginning of robot rehabilitation. After training, the affected hemisphere achieved a higher increase in cortical activation than the unaffected hemisphere. Consequently, the cortical activation in affected hemisphere was significantly higher than that in unaffected hemisphere (P = 0.036). FAC, MBI, BBS, and RMI scores significantly improved in both groups. The Morning Walk group had significantly greater improvements than the control group in 10MWT (P = 0.017), gait speed (P = 0.043), BBS (P = 0.010), and MI–Lower (P = 0.047) scores. CONCLUSION: Robot-assisted gait training not only improved functional outcomes but also increased cortical activation in stroke patients.

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Effect of combined home-based, overground robotic-assisted gait training and usual physiotherapy on clinical functional outcomes in people with chronic stroke: A randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215520984133 ◽

2020 ◽

pp. 026921552098413

Author(s):

Amy Wright ◽

Keeron Stone ◽

Louis Martinelli ◽

Simon Fryer ◽

Grace Smith ◽

...

Keyword(s):

Physical Activity ◽

Functional Outcomes ◽

Controlled Trial ◽

Gait Training ◽

Berg Balance Scale ◽

Chronic Stroke ◽

Control Group ◽

Robotic Assisted ◽

Home Based ◽

Dynamic Gait Index

Objectives: To assess the effect of a home-based over-ground robotic-assisted gait training program using the AlterG Bionic Leg orthosis on clinical functional outcomes in people with chronic stroke. Design: Randomized controlled trial. Setting: Home. Participants: Thirty-four ambulatory chronic stroke patients who recieve usual physiotherapy. Intervention: Usual physiotherapy plus either (1)10-week over-ground robotic-assisted gait training program ( n = 16), using the device for ⩾30 minutes per day, or (2) control group ( n = 18), 30 minutes of physical activity per day. Measurements: The primary outcome was the Six-Minute Walk Test. Secondary outcomes included: Timed-Up-and-Go, Functional Ambulation Categories, Dynamic Gait Index and Berg Balance Scale. Physical activity and sedentary time were assessed using accelerometry. All measurements were completed at baseline, 10 and 22 weeks after baseline. Results: Significant increases in walking distance were observed for the Six-Minute Walk Test between baseline and 10 weeks for over-ground robotic-assisted gait training (135 ± 81 m vs 158 ± 93 m, respectively; P ⩽ 0.001) but not for control (122 ± 92 m vs 119 ± 84 m, respectively). Findings were similar for Functional Ambulation Categories, Dynamic Gait Index and Berg Balance Scale (all P ⩽ 0.01). For over-ground robotic-assisted gait training, there were increases in time spent stepping, number of steps taken, number of sit-to-stand transitions, and reductions in time spent sitting/supine between baseline and 10 weeks (all P < 0.05). The differences observed in all of the aforementioned outcome measures were maintained at 22 weeks, 12 weeks after completing the intervention (all P > 0.05). Conclusion: Over-ground robotic-assisted gait training combined with physiotherapy in chronic stroke patients led to significant improvements in clinical functional outcomes and physical activity compared to the control group. Improvements were maintained at 22 weeks.

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COMPARISON OF THE QUALITY OF LIFE OF PATIENTS IN THE LOCALY ADVANCED BREAST CANCER FORMS AFTER SYSTEM AND INTRALYMPHATIC POLYCHEMOTHERAPY

EUREKA Health Sciences ◽

10.21303/2504-5679.2018.00693 ◽

2018 ◽

Vol 4 ◽

pp. 3-13

Author(s):

Yuriy Dumanskiy ◽

Oleksandr Bondar ◽

Oleksandr Tkachenko ◽

Evhenii Stoliachuk ◽

Vasilii Ermakov

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Locally Advanced ◽

Developed Countries ◽

Control Group ◽

Preoperative Treatment ◽

Discrete Elements ◽

Important Indicator ◽

Significant Difference

In recent years, breast cancer (BC) is the most common cancer pathology and the most common cause of disability among women in developed countries. Finding the most effective ways of interaction between the patient and the doctor creates the preconditions for the necessary analysis of the treatment process from an objective and subjective point of view. Therefore, an important indicator to be taken into account is the quality of life of a patient. To compare the indicators of a comprehensive assessment of the quality of life of patients to the adverse locally advanced forms (LA) of breast cancer before and after systemic intravenous polychemotherapy (SPCTx) and selective endolymphatic polychemotherapy (ELPCTx) in neoadjuvant mode. The study was conducted on the basis of a random analysis of outpatient cards from 112 patients with LA BC T4A-DN0-3M0 who received a comprehensive antitumor treatment on the basis of the Donetsk regional antitumor center and the University Clinic of the Odessa National Medical University from 2000 to 2017, which was proposed a questionnaire at various stages of preoperative treatment. The first (control) group consisted of 65 patients (58 %) with inoperable forms of LA BC, which was performed in neoadjuvant mode by SPCTx. The second (study group) included 47 patients (42 %) with inoperable forms of LA BC, which was performed as a neoadjuvant course ELPCTx. According to the integral indicators of quality of life and quality of health between patients in the control and study groups, there was no statistically significant difference. In a detailed analysis of the indicators of symptomatic scales, the difference between the groups did not exceed the critical. Based on the results of a study conducted among patients receiving endolymphatic chemotherapy in a neoadjuvant mode, the subjective evaluations of treatment in absolute numbers have better reference values without statistical superiority. The study of the integrative indicator of quality of life and its discrete elements is an ergonomic and economical means of heuristic assessment of the health of patients in order to further develop more rational and convenient ways of solving urgent issues of modern oncology by increasing compliance and finding a compromise between the physician and the patient.

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Effects of Self RehAbilitation Video Exercises (SAVE) on Functional Restorations in Patients with Subacute Stroke

Healthcare ◽

10.3390/healthcare9050565 ◽

2021 ◽

Vol 9 (5) ◽

pp. 565

Author(s):

Seung-Hwan Jung ◽

Eunhee Park ◽

Ju-Hyun Kim ◽

Bi-Ang Park ◽

Ja-Won Yu ◽

...

Keyword(s):

Acute Stroke ◽

Short Form ◽

Intervention Group ◽

Exercise Program ◽

Berg Balance Scale ◽

Control Group ◽

Early Recovery ◽

Subacute Stroke ◽

Sf 36 ◽

State Examination

Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve the functional outcomes and facilitate early recovery by increasing the continuity of rehabilitation therapy after acute stroke. Methods: This study is a non-randomized trial. Eighty-eight patients were included in an intervention group (SAVE group), who received conventional rehabilitation therapies and an additional self-rehabilitation session by watching bedside exercise videos and continued their own exercises in their rooms for 60 min every day for 4 weeks. Ninety-six patients were included in a control group, who received only conventional rehabilitation therapies. After 4 weeks of hospitalization, both groups assessed several outcome measurements, including the Berg Balance Scale (BBS), Modified Barthel Index (MBI), physical component summary (PCS) and the mental component summary of the Short-Form Survey 36 (SF-36), Mini-Mental State Examination, and Beck Depression Inventory. Results: Differences in BBS, MBI, and PCS components in SF-36 were more statistically significant in the SAVE group than that in the control group (p < 0.05). Patients in the SAVE group showed more significant improvement in BBS, MBI, and PCS components in SF-36 as compared to that in the control group. Conclusions: This evidence-based SAVE intervention can optimize patient recovery after a subacute stroke while keeping the available resources in mind.

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Toe Clearance Rehabilitative Slippers for Older Adults With Fall Risk: A Randomized Controlled Trial

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/21514593211029102 ◽

2021 ◽

Vol 12 ◽

pp. 215145932110291

Author(s):

Atsuko Satoh ◽

Yukoh Kudoh ◽

Sangun Lee ◽

Masumi Saitoh ◽

Miwa Miura ◽

...

Keyword(s):

Older Adults ◽

Fall Risk ◽

Controlled Trial ◽

Intervention Group ◽

Berg Balance Scale ◽

Control Group ◽

Mobility Assessment ◽

Before And After ◽

Day Services ◽

And Control

Introduction: To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults. Materials and Methods: This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase. Results: After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores. Discussion: Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported. Conclusions: Rehabilitation training slippers may reduce falls in older adults.

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Does Motor Training of the Nonparetic Side Influences Balance and Function in Chronic Stroke? A Pilot RCT

The Scientific World JOURNAL ◽

10.1155/2014/769726 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Shanta Pandian ◽

Kamal Narayan Arya ◽

Dharmendra Kumar

Keyword(s):

Functional Performance ◽

Berg Balance Scale ◽

Chronic Stroke ◽

The Body ◽

Control Group ◽

Therapy Program ◽

Functional Reach Test ◽

Double Blinded ◽

And Function ◽

Experimental Group

Background. Balance and functional abilities are controlled by both sides of the body. The role of nonparetic side has never been explored for such skills.Objective. The objective of the present study was to examine the effect of a motor therapy program primarily involving the nonparetic side on balance and function in chronic stroke.Method. A randomized controlled, double blinded trial was conducted on 39 poststroke hemiparetic subjects (21, men; mean age, 42 years; mean poststroke duration, 13 months). They were randomly divided into the experimental group(n=20)and control group(n=19). The participants received either motor therapy focusing on the nonparetic side along with the conventional program or conventional program alone for 8 weeks (3 session/week, 60 minutes each). The balance ability was assessed using Berg Balance Scale (BBS) and Functional Reach Test (FRT) while the functional performance was measured by Barthel Index (BI).Result. After intervention, the experimental group exhibited significant(P<0.05)change on BBS (5.65 versus 2.52) and BI (12.75 versus 2.16) scores in comparison to the control group.Conclusion. The motor therapy program incorporating the nonparetic side along with the affected side was found to be effective in enhancing balance and function in stroke.

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The Survey of Effectiveness of Group Counseling with Cognitive – Behavioural Method in Reducing Mother’s Stress of Child with Mental Retardation under 6 Years Old Under Cover of Khorramabad Province Welfare Organization (2012)

Journal of Sociological Research ◽

10.5296/jsr.v4i2.4563 ◽

2013 ◽

Vol 4 (2) ◽

pp. 391

Author(s):

Azarinvand, Abrahim ◽

Gorjee, Yosef ◽

Sadrepooshan, Najmeh ◽

Esmaili, Ghasem

Keyword(s):

Mental Retardation ◽

Group Counseling ◽

Repeated Measurements ◽

Cognitive Behavioral ◽

Control Group ◽

Trial Group ◽

Significant Difference ◽

Group 15 ◽

Behavioral Method ◽

And Control

The aim of this study was to investigate the effectiveness of group counseling with cognitive – behavioral method in reducing mother’s stress of child with mental retardation less than 6 years old covered of Khorramabad province welfare organization (2012). The statistical society of this study consisted of 52 mothers of child with mental retardation who their children had file in the welfare office. 30 persons were selected by simple random sampling and were divided into two groups including trial group (15 persons) and control group (15 persons).The method of study was quasi – experimental way with control group and random trial and data gathering tool such as Friedrich, Greenberg and Crink resources and stress questionnaire. To perform the study; the first step was pretest trial and control group and then 10 group counseling sessions with cognitive- behavioral method had hold among trial group. The control group’s mothers did not receive any counseling. Then, it established post – testing of both group again and another test provided to following – up step for two weeks after test.The result of variance analysis with repeated measurements showed that, there is significant difference in percentage1 level between control and trial groups post – test and follow – up scores, so, the first hypothesis of this study had approved upon group counseling efficacy with cognitive – behavioral method in reducing mother’s stress of child with mental retardation. In addition, these results showed that group counseling with cognitive – behavioral method has been established significant reduction in percentage 1 level physical and emotional symptoms of trial groups’ mothers, but it did not find the significant difference in the cognitive symptoms.

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Lethal Toxic Encephalopathy Due to Childhood Shigellosis in a Developed Country

PEDIATRICS ◽

10.1542/peds.89.6.1189 ◽

1992 ◽

Vol 89 (6) ◽

pp. 1189-1193

Author(s):

Avner Goren ◽

Serem Freier ◽

Justen H. Passwell

Keyword(s):

Cause Of Death ◽

Clinical Signs ◽

Antibiotic Sensitivity ◽

Developed Countries ◽

Toxic Encephalopathy ◽

Control Group ◽

Healthy Children ◽

Developed Country ◽

Patients Âgés ◽

Shigella Species

Shigellosis results in considerable morbidity in endemic areas, but mortality is rare in developed countries. All pediatric deaths (n = 15) in Israel following shigellosis in the past 10 years were reviewed. The patients' ages ranged from 5 months to 11 years; there were eight boys and seven girls. Three were institutionalized mentally retarded patients, 11 were healthy children. Twelve had definite clinical signs of brain death within 48 hours of onset of disease. Cause of death in all patients was consistent with toxic encephalopathy. No other systemic complication was implicated as the cause of death except for one case consistent with a "Reye-like" syndrome. Shigella species were as follows: 8 flexneri, 4 sonnei, 1 dysenteriae, and 2 were not identified. Case-control study of these patients vs surviving, hospitalized patients with shigellosis showed similar severity of fever, diarrhea, vomiting, and dehydration and similar incidence of convulsions. Headache was a prominent feature of patients who died; 5 of 7 verbal patients complained of this symptom as opposed to 2 of 20 in the control group (P < .01). There were no significant differences in the hematological and biochemical profile (except for an increased incidence of hyponatremia in the study group), pattern of shigella species, or antibiotic sensitivity. These findings indicate that mortality from shigellosis in a developed country is due primarily to the toxic encephalopathy syndrome.

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Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215516628616 ◽

2016 ◽

Vol 31 (2) ◽

pp. 217-224 ◽

Cited By ~ 7

Author(s):

Ibolya Mikó ◽

Imre Szerb ◽

Anna Szerb ◽

Gyula Poor

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Balance Training ◽

Training Programme ◽

Exercise Programme ◽

Berg Balance Scale ◽

Control Group ◽

Timed Up And Go ◽

Randomized Controlled

Objective: To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Design: Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. Subjects: A total of 100 osteoporotic women – at least with one osteoporotic fracture – aged 65 years old and above. Main measures: Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Interventions: Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. Results: The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. Conclusion: The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

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Electrical activity in rat retina in a streptozotocin-induced diabetes model

Diabetes Mellitus ◽

10.14341/dm9490 ◽

2018 ◽

Vol 21 (5) ◽

pp. 356-363

Author(s):

Ekaterina M. Klochihina ◽

Aleksey K. Erdyakov ◽

Maria P. Morozova ◽

Svetlana A. Gavrilova ◽

Elena S. Akhapkina ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Wave Amplitude ◽

Developed Countries ◽

Laboratory Animals ◽

Control Group ◽

Oscillatory Potential ◽

Ischaemic Injury ◽

Rhythmic Stimulation ◽

Potential Test ◽

Wave Latency

Objectives: Diabetic retinopathy remains the major cause of blindness among the working-age population of developed countries. Considering this, experimental models of diabetes involving laboratory animals are important for assessing clinically significant methods to determine early pathologic alterations of the retina. The early detection of diabetic retinopathy in combination with a search for new pathogenetic targets will enable focusing on new strategies to limit the development of critical changes in the retina and to prolong retinal functioning during the development of diabetes mellitus. Aim: This study aimed to define parameters of electroretinography test that identifies changes due to retinal impairment in diabetes. Methods: Experimental diabetes was induced in Wistar rats by intraperitoneally injecting streptozocin (65 mg/kg; group DM). The control group (CB) received intraperitoneal injections of the vehicle, i.e. citric buffer. On each consecutive day of the experiment, all rats received insulin detemir (2 u/kg). Ophthalmoscopy and electroretinography were conducted before initiating the experiment and after 50, 58 and 66 days of injectin sptreptozocin. Results: Amid 2u\kg insulin injection the glucose level in venous blood in DM group amounted to 30-40 mM. The ophthalmoscopy showed that the optic nerve disk paled by the 50th day, with its line erasing. During electroretinography, wave amplitude in oscillatory potential test tended to decrease. -wave latency of photopic system increased with -wave latency of photopic system and - and -waves latency of scotopic system not altering. In addition, the amplitude of rhythmic stimulation of 8 and 12 Hz decreased. Conclusion: The most apparent parameters of electroretinography for modelling streptozocin-induced diabetes are wave amplitude during the oscillatory potential test, photopic B-wave latency and the amplitude of rhythmic stimulation. These results suggest that in diabetes, ischaemic injury is an important cause of early dysfunction of inner retinal layers.

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