In recent years, the development of artificial shoulder arthroplasty has been rapid, but postoperative patients often have problems such as joint swelling, pain, activity limitation, muscle strength decline and various complications, which need to be accompanied by standardized and correct rehabilitation treatment. In this paper, we review the postoperative rehabilitation treatment program of artificial shoulder arthroplasty, the selection of the timing of rehabilitation treatment, the continuity treatment of rehabilitation and the rehabilitation strategies to improve the clinical efficacy in the postoperative period, with a view to providing reference and basis for the development of a reasonable rehabilitation program for postoperative patients.
Stroke is a common and frequently-occurring disease, which seriously endangers human health. Rehabilitation treatment can effectively reduce the disability rate of stroke and improve the quality of life. The tertiary rehabilitation treatment system for stroke can effectively improve the motor function of stroke patients and improve the quality of life. This paper focuses on the choices and methods of physical therapy and occupational therapy at all levels of the hospitals and in different periods of the disease. It also aims to summarize the tertiary rehabilitation strategy for motor dysfunction in stroke patients, to provide references for all levels of hospitals and communities, achieve standardization and unification of rehabilitation treatment, as well as the rehabilitation efficacy of homogeneity.
Objective Peri pheral nerve injury is a common cl inical disease, to study the effects of the physical therapy on the regeneration of the injured sciatic nerve, and provide a reference for cl inical treatment. Methods Sixty-four female adult Wistar rats (weighing 252-365 g) were chosen and randomly divided into 4 groups (n=16): group A, group B, groupC, and group D. The experimental model of sciatic nerve defect was establ ished by crushing the right sciatic nerve in groups B, C, and D; group A served as the control group without crushing. At 2 days after injury, no treatment was given in group B, electrical stimulation in group C, and combined physical therapies (decimeter and infrared ray) in group D. At 0, 7, 14, and 30 days after treatment, the sciatic nerve function index (SFI) and the motor nerve conduction velocity (MNCV) were measured, and morphological and transmission electron microscopy (TEM) examinations were done; at 30 days after treatment, the morphological evaluation analysis of axons was performed. Results At 0 and 7 days after treatment, the SFI values of groups B, C, and D were significantly higher than that of group A (P lt; 0.05); at 14 and 30 days after treatment, the SFI value of group D decreased significantly, no significant difference was observed between group D and group A (P gt; 0.05) at 30 days; whereas the SFI values of groups B and C decreased, showing significant difference when compared with the value of group A (P lt; 0.05). At 0, 7, and 14 days after treatment, the MNCV values of groups B, C, and D were significantly lower than that of group A (P lt; 0.05), and there were significantly differences between group B and groups C, D (P lt; 0.05); at 14 days, the MNCV value of group D was significantly higher than that of group C (P lt; 0.05); and at 30 days, the MNCV values of groups B and C were significantly lower than that of group A (P lt; 0.05), but there was no significant difference between group D and group A (P gt; 0.05). At 0 and 7 days, only collagen and l i pid were observed by TEM; at 14 and 30 days, many Schwann cells and perineurial cells in regeneration axon were observed in groups B, C, and D, especially in group D. Automated image analysis of axons showed that there was no significant difference in the number of myelinated nerve fibers, axon diameter, and myelin sheath thickness between group D and group A (P gt; 0.05), and the number of myelinated nerve fibers and axon diameter of group D were significantly higher than those of groups B and C (P lt; 0.05). Conclusion Physical therapy can improve the regeneration of the injured sciatic nerve of rats.
Objective To assess the effects of physiotherapy on pulmonary function in COPD patients with lung cancer after lobectomy or pneumonectomy. Methods Fifty-five COPD patients with lung cancer undergoing lobectomy or pneumonectomy from January 2005 to May 2014 were recruited in the study. They were divided into group A received comprehensive physiotherapy before surgery and group B without comprehensive physiotherapy before surgery. The changes of lung function and tolerance were compared before physiotherapy (T1 time point) and after physiotherapy (T2 time point) in the group A, and between two groups before lung resection (T2 time point) and after lung resection (T3 time point). Results In group A, the forced expiratory volume in one second (FEV1), vital capacity (VC), peak expiratory flow at 50% of vital capacity (FEF50) and FEF25 increased significantly respectively by 16.96%, 14.75%, 20.69% and 13.79% compared with those before physiotherapy. Meanwhile, six-minutes walking distance (6MWD) achieved a significant improvement. After resection of lung, FEV1 and VC appeared to reduce, and pulmonary small airway function, tolerance, and clinical features deteriorated significantly. The differences between T2 and T1 in FEV1, FEF50 and FEF25 in the patients with FEV1%pred ≥80% and 50%-80% were similar with those in the patients with FEV1%pred<50%. The differences between T2 and T3 in FEF50 and FEF25 in the patients with FEV1%pred≥80% and 50%-80% were higher than those with FEV1%pred<50%. For the patients with lobectomy, FEV1 and VC in the group B were lower than those in the group A (FEV1: 10.24% vs. 22.44%; VC: 10.13% vs. 20.87%). For the patients with pulmonary resection, FEV1 and VC had little differences (FEV1: 36.33% vs. 36.78%; VC: 37.23% vs. 38.98%). Conclusion Physiotherapy is very important for the preoperative treatment and postoperative nursing of COPD patients with primary lung cancer.
目的:探讨物理治疗在新生儿经会阴肛门形成术中的治疗效果,提高护理质量。方法:将103例新生儿肛门直肠畸形患儿,随机分为实验组和对照组,对照组实施常规护理治疗。实验组在常规护理治疗基础上,实施物理治疗。结果:物理治疗实验组患儿肛周的局部红肿情况明显低于对照组(P<0.05),实验组患儿的平均住院日较对照组明显缩短(P<0.05)。结论:物理治疗能降低新生儿经会阴肛门成形术术后并发症的发生率,缩短住院天数,降低医疗费用,提高护理质量。
Objective To explore the effectiveness of detailed physiotherapy in perioperative rehabilitation of patients undergoing thyroid cancer surgery with lymph node dissection. Methods A total of 97 patients with thyroid malignancy who underwent surgical treatment in West China Hospital of Sichuan University between February and June 2021 were selected and randomly divided into the trial group (n=50) and the control group (n=47). The patients in the trial group received detailed physiotherapy, and the patients in the control group received routine perioperative rehabilitation. The degree of pain within the operation area and the degree of neck and shoulder discomfort associated with surgery within 4 weeks, and the scores of Neck Dissection Impairment Index 4 weeks after surgery were compared between the two groups. The pain score, which was non-normally distributed, was described by median (lower quartile, upper quartile) and compared by generalized estimation equation; the discomfort score and score of Neck Dissection Impairment Index, which were normally distributed, were described by mean ± standard deviation, and the former was compared by multivariate analysis of variance, and the latter was compared by Student’s t-test. Results In the 1st, 2nd, 3rd, and 4th week after surgery, the pain scores within the operation area were 2.2 (1.7, 3.3), 1.5 (1.0, 2.2), 1.5 (0.0, 2.3), and 0.0 (0.0, 1.2), respectively in the trial group, and 3.4 (2.7, 5.2), 2.6 (1.5, 3.5), 2.4 (1.1, 3.4), and 1.5 (1.1, 2.0), respectively in the control group; the surgery-related neck and shoulder discomfort scores were 8.72±4.14, 5.28±2.98, 5.89±2.78, and 3.57±1.83, respectively in the trial group, and 10.56±5.30, 7.54±4.51, 7.37±3.49, and 5.05±2.59, respectively in the control group. Within 4 weeks after operation, the surgical-area pain scores and surgery-related neck and shoulder discomfort scores in the trial group were lower than those in the control group, and the differences were statistically significant (Wald χ2=28.826, P<0.001; F=7.695, P=0.007). In the post-operative week 4, the Neck Dissection Impairment Index in the trial group was higher than that in the control group, and the difference was statistically significant (75.23±20.40 vs. 63.83±19.52; t=2.809, P=0.006). Conclusion For patients undergoing thyroid cancer surgery with lymph node dissection, detailed physiotherapy intervention is more effective than routine perioperative rehabilitation.
Objective To explore the preventive effectiveness of early physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. Methods A total of 206 patients who underwent modified radical mastectomy for breast cancer in The First Affiliated Hospital of Henan University from June 2014 to June 2016, enrolled in this randomized controlled clinical trial. Then these patients were randomly divided into intervention group and control group equally. Patients in the control group received routine treatment, and the patients in the intervention group began to use the air pressure pump combined with the microwave physiotherapy on the second day after the radical surgery. The incidences of limb lymphedema in 6 months and 1 year after operation between the 2 groups were compared, and the influencing factors of arm lymphedema were explored. Results The clinical data of 195 patients were analyzed at end, including 99 patients of the intervention group and 96 patients of the control group. ① There were statistical significance in the incidences of arm lymphedema in 6 months and 1 year after operation between the 2 groups (P<0.05), that incidences of arm lymphedema in the intervention group were both lower than those of the control group at the2 time points [6 months after operation: 2.0% (2/99)vs. 9.4% (9/96); 1 year after operation: 5.1% (5/99) vs. 17.7% (17/96)]. ② The results of non-conditional logistic regression analysis shown that, age (OR=1.45, P=0.008), tumor location (OR=1.72, P<0.001), TNM stage (OR=2.01, P=0.033), the number of invasive axillary lymph nodes (OR=1.15, P=0.005), and postoperative radiotherapy (OR=1.23, P=0.016) were the influencing factors of arm lymphedema after modified radical mastectomy for breast cancer, patients with age older than 60 years, tumor position at the outside area, stage Ⅲ of TNM, the number of invasive axillary lymph nodes >5, and patients received radiotherapy after operation had high risk of arm lymphedema. Conclusion Early physiotherapy can effectively prevent the occurrence of arm lymphedema after modified radical mastectomy for breast cancer, and early physiotherapy should be performed for patients with high risk of arm lymphedema.
目的:探讨急性胰腺炎(AP)并发胰腺假性囊肿(PPC)的早期诊断、早期治疗方法及疗效观察。方法:急性胰腺炎患者给予常规治疗,每周复查B型超声,必要时复查上腹部CT,一旦检查诊断为胰腺假性囊肿形成,即给予TDP(CQ型特定电磁波治疗器)烤腹部相应囊肿部位皮肤,烤后再以适量黄冰解毒消肿软膏外敷腹部相应囊肿部位皮肤,每周复查B超1次,直致囊肿消失。结果: 63例胰腺假性囊肿56例胰腺假性囊肿经保守治疗后完全消失,有效率8889%(56/63),平均68周时间,最短时间2周,最长时间12周。7例囊肿未消失,其中2例囊肿有缩小,5例无效。结论: 胰腺假性囊肿形成早期诊断,早期联合物理治疗和中药外敷疗效显著,不失为一种安全、有效、经济的治疗方法。