老年慢性阻塞性肺疾病病人远程居家肺康复的研究进展

对远程居家肺康复的概念、远程居家肺康复设备的选择以及远程居家肺康复的方式进行综述,旨在为慢性阻塞性肺疾病的康复护理提供依据。     

移动医疗在慢性阻塞性肺疾病患者肺康复中的应用现状

肺康复作为目前最具成本效益的慢性阻塞性肺疾病治疗策略之一,在全球慢性阻塞性肺疾病控制策略中被强烈推荐。然而,由于患者的身体状况等原因,肺康复的应用率较低。本文综述了国内外移动医疗的概念界定、设备类型、在慢性阻塞性肺疾病患者肺康复中的应用及注意事项,旨在总结经验与不足,从而为国内开展相关的研究提供依据和参考。     

远程康复技术辅助慢性阻塞性肺疾病患者居家肺康复的研究进展

肺康复是慢性阻塞性肺疾病(COPD)的主要疾病管理方式之一,目前居家肺康复的效果已得到证实,但仍受到时间、空间等因素限制。应用远程康复技术可为上述问题提供一种解决方案。本文总结了应用远程康复技术辅助COPD患者居家肺康复的研究进展,主要包括使用的远程康复技术的形式和对COPD患者结局的影响,以期为今后更好地开展COPD患者的居家肺康复提供依据,最终改善患者的临床结局。     

移动医疗在慢性阻塞性肺疾病患者延续护理中的现状与应用

介绍国内外各移动医疗干预方式在慢性阻塞性肺疾病患者延续护理中的应用现状,总结移动医疗在慢性阻塞性肺疾病患者延续护理中的应用效果,分析影响其使用的因素,以期为移动医疗在慢性阻塞性肺疾病患者延续护理中的发展提供参考.     

远程医疗在慢性阻塞性肺疾病病人中的应用现状

介绍了远程医疗的概念和重要意义,分析并总结了远程医疗在慢性阻塞性肺疾病病人中的应用方式、应用效果及应用建议,以期为国内慢性阻塞性肺疾病的临床护理提供借鉴。     

慢性阻塞性肺疾病患者居家运动疗法的研究进展

对慢性阻塞性肺疾病患者居家运动疗法进行综述,运动类型包括呼吸肌运动训练,骨骼肌运动训练;运动方法包含运动强度、运动频率及周期和运动程序.以期为慢性阻塞性肺疾病患者居家运动训练提供参考.     

慢性阻塞性肺疾病患者的康复医疗

慢性阻塞性肺疾病患者的康复医疗叶洪青１潘克勤１慢性阻塞性肺疾病（ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）是我国的常见病、多发病，老年人尤为多见，且反复发作，逐渐加重，甚则严重影响生活，危及生命。临床上多注重于急...     

实施肺康复指导对慢性阻塞性肺疾病患者的效果观察

目的 观察实施肺康复指导对慢性阻塞性肺疾病患者的效果.方法 对32例慢性阻塞性肺疾病患者进行为期3个月的肺康复指导,观察入院时及康复指导3个月后患者日常生活能力评分和6 min步行距离.结果 经过3个月的肺康复指导,患者日常生活能力评分和6 min步行距离均较入院时明显提高.结论 肺康复指导能促进慢性阻塞性肺疾病患者的...     

无创正压通气在稳定期重度慢性阻塞性肺疾病患者肺康复中的应用进展

长期无创正压通气应用于稳定期重度慢性阻塞性肺疾病患者,可有效提高肺康复效果,持续改善患者的呼吸困难症状和运动耐力,稳定患者的肺功能,提高患者的生活质量,还可能改善患者的预后。本文对无创正压通气在稳定期重度慢性阻塞性肺疾病肺康复治疗中的应用进行综述。     

慢性阻塞性肺疾病的康复护理

慢性阻塞性肺疾病的康复护理孟祥荣１牛卫东２慢性阻塞性肺疾病（ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）是严重危害人类健康的常见病、多发病。目前在治疗上还没有特效方法，我们在临床中采用综合医疗措施对３０例ＣＯＰＤ患...     

下肢关节功能康复架在术后膝关节功能康复中的应用

目的：观察关节功能康复架在膝关节功能康复中的作用。方法：应用自己设计制造的下肢关节功能康复架,对膝关节及周围骨折病人术后８～１０ｄ,行膝关节被动活动,每日３～４次,每次伸、屈４０～５０次,伸屈结束时停留于自然位置,并辅以肌肉主动收缩锻炼,以１５ｄ为限。结果：临床应用５０例,在被动活动结束时,关节活动度≥９０度,未见移位、分离、内固定松动等骨折端的并发症。结论：关节功能康复架是膝关节及周围骨折术后膝关节早期被动活动的较理想的辅助器械;早期被动运动对关节功能康复有促进作用。     

Changes in Ankle Mechanical Stability in Those With Knee Osteoarthritis

Hubbard TJ, Hicks-Little C, Cordova M. Changes in ankle mechanical stability in those with knee osteoarthritis.

Objective

To examine ankle joint mechanical stability in patients who had mild to moderate knee osteoarthritis (OA).

Design

Case control study.

Setting

Biodynamics research laboratory.

Participants

Subjects with knee OA (n=15; 5 men and 10 women; mean age ± SD, 60.3±10.2y; mean mass ± SD, 93.9±18.3kg; mean height ± SD, 167.23±9.5cm) were matched to healthy controls (n=15; 5 men and 10 women; mean age ± SD, 59.6±12.6y; mean mass ± SD, 83.5±19.2kg; mean height ± SD, 169.7±12.6cm).

Interventions

Not applicable.

Main Outcome Measures

Mechanical ankle-subtalar joint stability was assessed with an instrumented arthrometer where ankle-subtalar joint motion for anterior/posterior displacement and inversion/eversion rotation was measured. Separate 2 × 2 mixed model analyses of variance were performed.

Results

Significant group × side interactions were observed for anterior and posterior displacement (P<.05) where patients with knee OA had significantly less anterior and posterior ankle displacement compared with the control group, as well as compared with their unaffected extremity. Additionally, patients with knee OA had significantly (P<.05) less inversion/eversion rotation than their respective controls.

Conclusions

These data suggest that altered ankle joint mechanics may be the result of deviations in ankle joint alignment secondary to the structural changes at the knee. Compensatory changes in ankle joint mechanics must also be considered when addressing lower extremity functional deficits in patients with knee OA.     

Hindfoot Flexibility Influences the Biomechanical Effects of Laterally Wedged Insoles and Ankle-Foot Orthoses in Medial Knee Osteoarthritis

ObjectiveTo investigate the relationship of frontal plane ankle mobility with the effects of an ankle-foot orthosis (AFO) and a laterally wedged insole (LWI) on knee adduction moment (KAM) in the treatment of medial knee osteoarthritis.DesignRandomized, nonblinded crossover trial.SettingOutpatient clinic of university hospital.ParticipantsReferred sample of 20 patients (N=20) with medial knee osteoarthritis stage 1-3 (Kellgren and Lawrence), aged 56.4±6.5 years; 58 patients were assessed, 21 were included, and 1 was a dropout. There were 14 healthy reference participants without knee osteoarthritis (convenience sample) who were matched by age.InterventionsPatients received AFO and LWI for 6 weeks each with gait analysis after each 6-week intervention. Patients underwent additional barefoot gait analysis, walking on even ground and on a cross slope of 5° lateral elevation and standing on inclinations of 0°, 5°, 10°, and 20°.Main Outcome MeasuresSpearman correlation between the immediate change in first peak of KAM with each aid and the change in hindfoot varus on the cross slope relative to level ground.ResultsThe KAM reduction with AFO correlated significantly with hindfoot varus reaction to the cross slope during walking: the greater the hindfoot valgization on the cross slope, the greater the KAM reduction with AFO (Spearman ρ=0.53, P=.02).The KAM reduction with LWI correlated moderately negatively with the change in hindfoot varus: the greater the hindfoot valgization on the cross slope, the smaller the KAM reduction with LWI (r=?0.31 P=.18).ConclusionsLWI may be suitable for patients with limited to normal frontal plane ankle mobility. Patients with greater frontal plane ankle mobility benefit most from frontal plane ankle bridging with AFO. Studies with larger samples are necessary.     

Short-Term Effects of Vestibular Rehabilitation in Patients With Chronic Unilateral Vestibular Dysfunction: A Randomized Controlled Study

Giray M, Kirazli Y, Karapolat H, Celebisoy N, Bilgen C, Kirazli T. Short-term effects of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction: a randomized controlled study.

Objective

To evaluate the short-term effects of vestibular rehabilitation on symptom, disability, balance, and postural stability in patients with chronic unilateral vestibular dysfunction.

Design

Randomized controlled trial.

Setting

Department of Physical Medicine and Rehabilitation, University Hospital.

Participants

Patients (N=42) with chronic vestibular dysfunction were divided into either a rehabilitation group (group 1) or a control group (group 2).

Interventions

Patients in group 1 were treated with a customized exercise program for 4 weeks, while the patients in the control group did not receive any treatment.

Main Outcome Measures

Subjects were assessed before and after the rehabilitation program with respect to symptoms (visual analog scale [VAS]), disability (Dizziness Handicap Inventory [DHI]), balance (Berg Balance Scale [BBS]), and postural stability (modified Clinical Test for Sensory Interaction on Balance [mCTSIB]).

Results

Significant improvements in all parameters (VAS, DHI, BBS, mCTSIB) were observed in group 1 (P<.05). When the 2 groups were compared, there were significant improvements in postexercise VAS, DHI (emotional, functional, physical, total), BBS, and mCTSIB (standing on a firm surface with eyes open, standing on a foam surface with eyes open, standing on a foam surface with eyes closed, mCTSIB mean) in favor of group 1 (P<.05). No significant improvements were seen in any parameters in the control group (P>.05).

Conclusions

Significant improvements were seen in symptom, disability, balance, and postural stability in chronic unilateral vestibular dysfunction after an exercise program. Customized exercise programs are beneficial in treatment of chronic unilateral vestibular dysfunction.     

急性心肌梗死患者心脏康复知识与态度的调查研究

目的 调查浙江省7所医院急性心肌梗死患者心脏康复知识与态度的现状。方法 便利抽取浙江省7所三级甲等医院的急性心肌梗死患者195例,采用自行编制的急性心肌梗死患者心脏康复知识与态度调查问卷进行调查。结果 195例患者心脏康复知识的得分为（21.31±5.35）分,心脏康复态度的得分为（40.05±4.36）分。不同文化程度、不同经济负担、是否有支架置入史等对患者心脏康复知识、态度的得分有影响（P<0.05）,路程远、经济负担重、高龄及对康复知识了解不足是患者参加心脏康复的影响因素,差异具有统计学差异（P<0.05）。结论 浙江省急性心肌梗死患者心脏康复知识及态度的得分均处于中低水平。路程远、经济负担重、高龄及对康复知识了解不足是患者参加心脏康复的阻力因素,提示医护人员需加强对急性心肌梗死患者心脏康复知识的传播,开展心脏康复项目时需充分考虑医院、社区、家庭的整体情况。     

Effects of Taping and Exercise on Ankle Joint Movement in Subjects With Chronic Ankle Instability: A Preliminary Investigation

Delahunt E, O'Driscoll J, Moran K. Effects of taping and exercise on ankle joint movement in subjects with chronic ankle instability: a preliminary investigation.

Objective

To examine the effects of ankle joint taping and exercise on ankle joint sagittal plane and rear-foot frontal plane movement in subjects with chronic ankle instability.

Design

Laboratory-based, repeated-measures study.

Setting

University biomechanics laboratory.

Participants

Subjects with chronic ankle instability (N=11) as defined by the Cumberland Ankle Instability Tool.

Interventions

Each participant performed 3 single-leg drop landings onto a forceplate under 3 different conditions. These conditions were: condition 1 (no tape), condition 2 (taped), and condition 3 (postexercise taped).

Main Outcome Measures

Kinematic data were used to identify ankle joint sagittal plane and rear-foot frontal plane positions at 50ms before initial contact (IC) and at IC, under each of the conditions.

Results

There was a significant effect on the angle of ankle joint plantar flexion, both at 50ms before IC (F_2,18=29.4, P<.001) and at IC (F_2,18=16.1, P<.001), as a result of the application of tape. Post hoc analysis revealed that condition 1 (no tape) resulted in significantly greater plantar flexion angle at 50ms before IC than condition 2 (taped) (7.7±3.0°; P=.002) and condition 3 (postexercise taped) (8.3±4.8°; P=.01). Similarly, condition 1 (no tape) resulted in significantly greater plantar flexion at IC than both condition 2 (taped) (5.3±3.2°; P<.001) and condition 3 (postexercise taped) (5.3±4.4°; P=.001). No significant differences were evident between condition 2 (taped) and condition 3 (postexercise taped) (P>.05).

Conclusions

These results indicate that taping acted to reduce the degree of plantar flexion at both 50ms before and at IC with the ground, and that these reductions were retained even after exercise.