Rehabilitation nurse after temporomandibular arthroplasty

Background:Femoral subtrochanteric fracture means fractures happened 5 cm away from inferior margin level of samll trochanter.Most of this kind of fracure in unstable fractures caused by trauma mostly and characterized with large malposition,splintered and difficult to be treated.It will lead to a series of severe complications if treated improperly.Objective:To evaluate the clinical effect of the remoral interlocking intramedullary nailing for the treatment of subtrochanteric fracture.Unit:Department of Orthopedics,First Hospital of Suzhou Univerisyt Subjects:2 cases combined with fracture of shaft of femur in 10 cases of subtrochanteric fracture,including 7 males and 3 females,age 22-48 years,average age 32.8 years,4 cases suffered left side,6 cases suffered right side.8 cases of road accident,1 case of falling trauma and 1 case of crash trauma.All the cases were treated with closes reduction except 2 cases combined with fracture of shaft of femur.According to Seinsheimer classification:2 cses of ⅡB type,3 cases of ⅡC type,3 cases of Ⅲ A type,2 cases of Ⅳtype,all these 10 cases were closure trauma.Intervention:Patients received traction 5-7 days afte hos pitalization to relieve pain and maintain length of suffered limb.We took full-length X-ray of other side femur to estimate length and diameter of intramedullary pin,After lateral position,we mede 6-8cm incision along near end of femoral larger trochanter to near lateral side obliquely,cut fasciae of gluteus maximus muscle longitudinally along incision,identified level of inferior fasciae of gluteus maximus muscle,touched inside pyriform recess,pored at pyriform recess along longitudinal axis of shaft of femur,pore localizing in the middle of femur,reduced fracture under X-ray,inserted guide to distal end and dilated marrow tp 13cm.Then we put intramedullary pin with proper lentth and diameter at level of the top of larger trochanter,locked distal and approximate ends with interlocked pin.Incision need to be extended to needed length to distal end along larger trochanter,borke partly the starting point of vastus lateralis if patients received incisive reduction,expose fracture and reduce under direct,look.Patients received CPM knee joint function exercises after operation;patients load weight completely after fracture healed.Patients received routine X-ray exams 6 and 12 weeks after operation,if only few callus formed around the fracture,we suggest removing distal interlocked pin.Result:All the patients were followed up for 12-25 months,average 16.3 months.All the fractures were healed.Conclusiong:Femoral interlocked intrameduallary pin treating sbutrochanteric fracture is an ideal nternal fixation method.     

“Rehabilitation Research Framework for Patients With COVID-19” Defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme

The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of research activity. Since its outset, efforts have been made to guide the rapid generation of research in medicine. There are gaps in some areas of rehabilitation research for patients with COVID-19. The development of a specific research framework might serve to help monitor the status of research (mapping), shape and strengthen research by pointing to under-investigated areas, and promote rehabilitation research in this context. This article introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development.The questions have been developed among the World Health Organization (WHO) Rehabilitation Programme, Cochrane Rehabilitation, and the experts of its Rehabilitation–COVID-19 Evidence-based Response Action International Multiprofessional Steering Committee. The framework is divided into 2 parts and includes 20 questions organized in 4 groups: epidemiology, and evidence at the micro- (individual), meso- (health services), and macro- (health systems) levels.The CRRF offers a comprehensive view of the research areas relevant to COVID-19 and rehabilitation that are necessary to inform best practice and ensure rehabilitation services and health systems can best serve the population with COVID-19. The collaboration between Cochrane Rehabilitation and the WHO Rehabilitation Programme in establishing the CRRF brought together perspectives from the health systems, health management, and clinical evidence. The authors encourage researchers to use the CRRF when planning studies on rehabilitation in the context of COVID-19.     

Stroke Rehabilitation In The United States

Stroke rehabilitation currently is a very exciting area in which to be involved.There is much going on with regard to clinical research,and much more to come.     

Rehabilitation nursing experience for acute lumbar sprain

TREATMENTEXPERIENCEFORLUMBARSPRAINMassageandtractionareoftenusedintreatmentoflumbarspraintoalleviateadhesionofmuscleandligament,enlargeintervertebralspace.Atthesametime,localdialysis,physicaltherapymightbeused,alsoacupuncturemoxibustion.Tomassagetreatment,painpointsatlumbodorsalorlumbosacralpartaremassagedfor15minutes,thereafterpressedfor10minutestopromotelumbosacralbloodcirculationandexcitelumbosacralnerves.Afterpain,spasmarerelieved,localcompressionoftraditionalChinesemedicinei…     

Rehabilitation trainging of ankle fractures afteropen reduction

Background：Anklejointisaweightcarryingone，whichtreatmentfocusesonanatomicalreductionofarticularsurface．Theultimateaimiscompletelyrecoveryofjointfunction．Itismuchbenefitforopenreductionwithrationalrehabilitationtrainingofpostoperationtofunctionrecoveryofanklejoint．Objective：Toexplorethetreatmenteffectofrehabilitationtrainingofopenreductiononanklefracture．Unit：FirstHospitalofZiboCity．Subject：５９patientswithanklefracturewererecruitedfromJuly１９９７toJuly１９９９，３７menand２２wom…     

Rehabilitation training of children with mental retardation

INTRODUCTION５３mentallyretardedchildren（MRC）receivedrehabilitationsince１９８２，significanteffectwasobservedsuggestingthesechildrenre－habilitationpotential．MATERIALSANDMETHODSMaterial５３MRCfromourhospitalparticipatedinourstudy，including１４boysand３９girls，amongwhich，３９haddisabilitiesofotherkinds．５３childrenweredividedaccordingtoIQgroupingproposedbyWUTianming，PekingUniversity．１２childrenhadmildmentalretardation（IQ：５１－７０），１７hadmoderatementalretardati…     

Rehabilitation guidance after total hip joint replacement

BACKGROUND: Total hip joint replacement ia commonly applied in clinic, and rehabilitation guidance after operation plays an important role in postoperative recovery.OBJECTIVE: To observe the effect of rehabilitation guidance on operation after total hip joint replacement.UNIT: Orthopedics centre, Tangdu Hospital, Fourth Military Medical UniversitySUBJECTS: 20 patients, including 6 males, 14 females, age 62 - 78 years old, average 71.5 years. Old fracture 14 cases, aseptic necrosis of head of femur 2 cases, congenital dysplasia of hip joint 4     

HealthSouth's Inpatient Rehabilitation Facilities: How Does Their Performance Compare With Other For-Profit and Nonprofit Inpatient Rehabilitation Facilities?

McCue MJ, Thompson JM. HealthSouth's inpatient rehabilitation facilities: how does their performance compare with other for-profit and nonprofit inpatient rehabilitation facilities?

Objectives

To assess the financial and operational differences in freestanding inpatient rehabilitation facilities (IRFs) that are operated by HealthSouth Corporation relative to other for-profit and nonprofit system-affiliated ownership groups. Since 2003, when it faced fraud charges and financial penalties, HealthSouth has experienced new management and refocused its business strategy. Because HealthSouth is the largest provider of freestanding IRF services, it is important to understand how their performance may differ relative to other ownership groups.

Design

We used the Mann-Whitney U test to assess differences in median values for financial and operational variables of HealthSouth-owned IRFs compared with other for-profit system IRFs and nonprofit system IRFs.

Setting

System-affiliated freestanding IRFs in the United States.

Participants

Sixty-four HealthSouth IRFs, 18 nonprofit system-affiliated IRFs, and 18 for-profit system-affiliated IRFs.

Interventions

Not applicable.

Main Outcome Measures

Net patient revenue per adjusted discharge, operating expense per adjusted discharge, salary expense per full-time equivalent, and cash flow margin.

Results

HealthSouth IRFs had significantly lower net patient revenue per adjusted discharge and operating expense per adjusted discharge; however, its cash flow margin was significantly higher than other comparison groups. HealthSouth IRFs treated a higher case mix of patients relative to these comparison groups.

Conclusions

The financial and operating performance of HealthSouth IRFs is stronger than other ownership groups. Strong cash flow will enable HealthSouth to pay down long-term debt.     

Kardiologische Rehabilitation in Österreich. Eine Bedarfsanalyse

The aim of this analysis is to survey the general demand and current supply of cardiac rehabilitation in Austria on the basis of best evidence practice and to produce recommendations for a cost-effective structure of the entire cardiac rehabilitation system. Following the standards of indication of the Austrian Society of Cardiology an analysis of demand of cardiac rehabilitation has been carried out and juxtaposed with the current supply of facilities for cardiac rehabilitation. According to hospitalizations in the year 2000, 11,630 patients per annum would require inpatient phase II rehabilitation, 6,270 patients institutional based outpatient phase II rehabilitation and 14,319 patients institutional based phase III rehabilitation. In the year 2000, 14,746 patients received treatment in the 9 Austrian inpatient cardiac rehabilitation centres. This number is compared with an annual demand of 11,630 admissions for phase-II treatment. It follows that an equilibrium can be argued for the supply of and demand for inpatient cardiac rehabilitation in Austria. At present, 10 approved institutions in Austria offer outpatient cardiac rehabilitation services. The maximum number of positions for treatment per institution is currently 200-250. Consequently, maximally 2,000-2,500 patients per annum can be treated. In comparison, there exists a calculated demand for 6,270 patients in institutional based outpatient phase II rehabilitation and 14,319 patients in institutional based phase III rehabilitation. Altogether this amounts to a demand for 20,588 positions for treatment per annum. In Austria, the expenditures for inpatient phase II rehabilitation of a patient given an average duration of stay of 28 days, are [symbol: see text] 4,774.-. Presuming 100% compliance, the institutional based outpatient phase II rehabilitation program costs [symbol: see text] 2,760.- per patient. The costs for institutional based phase III rehabilitation services are [symbol: see text] 2,990.- per patient. This number is accompanied by a potential effective reduction of risks for the patients and a potential effective reduction of costs for the carrier as the number of rehospitalizations and recurrent procedures would decrease significantly. At present, the supply of cardiac rehabilitation in Austria is sufficient for inpatient phase II, but insufficient for the institutional based outpatient phase II and mainly phase III. Thus, a striking asymmetry exists between supply and demand. In view of the enduring effects of institutional based phase III rehabilitation, the individual and social use and finally the expected efficiency in terms of costs, this program should at least be offered without limits to all eligible patients.     

Rehabilitation therapy of cerebral hemorrhage in acute phase

Background:Acutephaseincerebralhemorrhagereferstothefirsttwoweeksandinthisperiodpatient'sconditionisunstable.Incidenceofdisabilityincerebralhemorrhageisveryhighandhowtoreducetheincidenceinmaximumandimprovepatent'slivingqualityhasbecomeanimportantclinicproblem.Objective:Toinvestigatetheeffectofrehabilitationtherapyonlivingqualityofpatientswithcerebralhemorrhageinacutephase.Subjects:147casesofcerebralhemorrhagefromMay1999toAugust2001wereinvestigatedincluding84males,63females,aged38-87(mean:57.…     

Rehabilitation nursing of unstable lumbar vertabrae in bed

Background:clinical rehabilitation of unstable lumbar vertebrae in an important part of mordern rehabilitation medicine.Because of its plentiful contents,rapid developing,comprehensive using of methods,it has been paid more and more attention to.Objective:To investigate effect of rehabilitation nursing on prognosis of unstable lumbar vertabrae in bed.Unit:people‘s Hospital of Anyang City.Subjects:112 cases of unstable lumbar vertebrae were investigated,including 70 cases of spinal injury(62.5%),most of which were incomplete injury,38 cases of retrograde affection (34.0%),others 4 cases (3.5%).Interventions:(1)rehabilitation of muscle:Grouped exercises were directed to shoulder,elbow,wrist,hip,knee and ankle joints.Both active and passive exercises of each group took 200 times of flexing and extending,3-4 groups each day and increased successively;If patients couldn‘t coordinate or needed a larger amount,CPM and special OT,PT rehabilitation were given suplementarily:①upper part of body and head were elevated with both arms bracing and hip on bed.②both lower limbs extended backward in turn,with knee joint extending.③upper part of body and head were elevated without upper limbs bracing.④both lower limbs stable.⑤“swallow”movement.⑥upper and lower part turned over at the same time,combined with abdominal muscles exercise.Exercises varied with each individual,amount increased gradually.(3) Rehabilitation training of detrusor urinae and sphinctor of anus:before defectation,massaging of abdomen for 5-10min,hot water was drunk 15 min before defectation.Actively contracting detrusor usinae and sphinctor of anus,100 times pergroup,3-4groups every day.Rubbing anus sliphtly,15-30s,1-2 times every day.(4)Rehabilitation of complications:turning over once every 2h.Massage of sacrococcygeal region,sacroiliac region and calcaneus,15-20 min.Irrigation of bladder with furacilin(1:5000).Cleaning of perineum with bromogeramine.Results: In 2 cases of panplegia,patients could do simple activities with the help of wheel-chair;In 77 cases of incomplete pletia,muscle strength recovered to grade Ⅳ-Ⅴ.Besides 2 cases of panplegia,all cases achieved self-dependence of daily living.Conclusion:Rehabilitation nursing of nustable lumbar vertebrae in bed could accelerate the clinical rehabilitation and shorten therapeutic course.     

How To Become A Model Center of Medical Rehabilitation——The Experience of the Kessler Institute for Rehabilitation

In this article I will describe a model medical rehabilitation center in the United States based on my experience as the Medical Director of the Kessler Institute for Rehabilitation (KIR) located in West Orange,New Jersey.KIR has three integrated distinct missions:patient care,education,and research.It is a 336-inpatient bed facility (three separate locations) that runs at approximately 95％occupancy.In 2012,6896 individuals were admitted for care.The patient ages are from 18 to 109 with an average age of 69.Forty five percent of the patients were male and 55％ were female.KIR,West Orange,is a freestanding hospital that owns and operates its own X-ray and laboratory facilities.     

Rehabilitation of mental disturbance in patients with stroke

It is considered now that early rehabilitation interventional mechanism is related to the plasticity of brain that means after injury of neural function,cental nervous system has the ability of compensation and functional recombination.OBJECTIVE：To explore the effects of early rehabilitation on paralysis after cerebral infarction.