EFFECT OF EXERCISE ON EARLY REHABILITATION OF PATIENTS WITH NEUROLOGICAL DISORDERS

ABSTRACT Introduction: Acute cerebral infarction refers to the deficiency of the blood supply to the brain and the damage of tissue function. Objective: To study the effect of exercise training in early rehabilitation of patients with hemiplegia treated in the neurology department. Methods: Ninety-six patients with acute cerebral infarction hemiplegia were studied. According to the order of admission, 96 patients were divided into a control group and an early recovery group, with 48 patients in each group. Results: Before early rehabilitation, there was no statistical significance in NIHSS and FUGL-Meyer scores between the two groups (P > 0.05). After early rehabilitation,the NIHSS score of early rehabilitation group was lower than both its pre-early-rehab score and the control group score, while the FUGL-Meyer score was higher than both its pre-early-rehab and the control group score (P<0.05). Before early rehabilitation, there was no significant difference in the GQOLI-74 score between the two groups (P > 0.05). After early rehabilitation, the GQOLI-74 score was higher in the early rehabilitation group than both its pre-early-rehab score and the control group score (P<0.05). Conclusions: The clinical effect of early rehabilitation training in acute cerebral infarction patients with hemiplegia is significant and can further improve the clinical treatment of patients and their quality of life. Level of evidence II; Therapeutic studies - investigation of treatment results.

EARLY REHABILITATION OF CRITICAL TESTICULAR ISCHEMIA WITH ACUTE TORSION IN CHILDREN

Introduction. Acute testicular torsion is an urgent condition characterized by chorda spermatica turn and torsion with its vessels along vertical or horizontal axis. This condition results in testicular ischemia and loss of organ in case of lack of timely medical care. If a child is operated on within 6-12 hours their chance for complete recovery is decreased to 70 %. The timeline of 12-24 hours leaves only a 20% chance to keep a testicle. After 24 hours since the beginning of the condition there is virtually no chance to keep organ’s viability. The goal of the research is an optimization of early rehabilitation of critical testicular ischemia in children with acute testicular torsion. Material and methods. Over the period of the years 2010 – 2021 54 children with testicular torsion were observed and treated. Eight children got to a hospital as in-patients within first six hours from condition establishment, eight patients turned to a hospital within the period of 6.1-12 hours, 11 patients addressed hospital after 12.1-16 hours, 16 patients did so after 16.1-24 hours, and 11 patients addressed hospital after more than 24 hours since condition had been established. All patients with testicular torsion were admitted to a hospital in an urgent manner, their general condition was assessed as "moderate". Time before surgery was limited (up to 1 hour from the moment of hospitalization). Therefore, the examination of patients was minimized by a general blood test, a general urine test (83.3 %), determination of blood group and Rh-factor, measuring arterial pressure. A testicle was verified as viable in 12 children (22.2 %). Genital gland necrosis was diagnosed in 22 patients (40.8 %), they underwent orchophuniculectomia. Critical testicle ischemia was diagnosed in 20 boys (37 %). All patients were operated on. In all cases operation started not later than an hour after hospitalization. For 45 children operation was performed via inguinal access (83.3 %), transscrotal access was used in 9 patients (16.7 %). In all cases when a testicle was viable invasive detorsion with further orchiopexy was used. All children who underwent testiculectomy were hospitalized later than 16 hours after the onset of the disease. All boys with critical testicle ischemia underwent rehabilitation measures during operation. Results. Among children with genital gland critical ischemia 10 patients (52.6 %) recovered completely. Children who had been hospitalized during 6-12 hours after the onset of the disease were discharged from a hospital ward on the 5-7 day after operation. Two children (25 %) in this group had further testicle autolysis. Among children who addressed for healthcare support within 12–16 hours after the condition establishment, two patients (18.2 %) recovered completely. Five patients (50 %) had testicle autolysis in the postoperative period. Conclusions. 1. Critical testicular ischemia is observed in 35.2 % children with acute testicular torsion. 2. Early rehabilitation measures include a complex of conservative and operational approaches implemented in pre-operational, intra-operational and early post-operational periods. 3. Timely and full-fledged rehabilitation measures implementation allows to improve results of operational treatment and save affected genital gland with critical ischemia in 50 % of patients.

Weaning in der neurologischen Frührehabilitation (NFR)

Weaning in neurological early rehabilitation represents an important participation goal that can be achieved in up to 90% of cases after an average of two to three weeks of weaning through a combination of intensive care and rehabilitative interventions. The weaning process should be based on a standardized weaning protocol, with which a gradual expansion of spontaneous breathing phases can be achieved. The German Society for Neurorehabilitation (DGNR) has taken the special features of prolonged weaning in NFR into account in a separate guideline.

Rechtliche Rahmenbedingungen, Qualitätssicherungsprogramme, Zertifizierungen, DRGs, OPS, Pflege als Therapie

The establishment of structural and minimum features within the DRG system by the operations and procedure key (OPS) gave the neurological early rehabilitation phase B a definitional framework and ensured standardization. In the field of nursing, it has given rise to a new self-image and a boost to interdisciplinarity. The assignment of patients at the interface between acute inpatient treatment and rehabilitation remains problematic. The article gives an overview of the regulatory framework

Early Rehabilitation Nursing for Stroke Patients with Hemiplegia in Neurology Department

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.