听障儿童青少年焦虑或抑郁情绪心理干预效果的系统综述

目的 系统综述心理干预对听障儿童青少年焦虑和抑郁情绪的效果。方法 采用主题词方法，在PubMed、Web of Science、Embase、中国知网和万方数据库检索听障儿童青少年焦虑、抑郁情绪问题心理干预的相关文献，时间为建库至2023年7月。筛选文献并提取作者、国家、研究对象、研究设计、干预方式、结局指标、测量工具。结果 最终纳入8篇文献，来自3个国家，包含8项随机对照试验，涉及404例被试，发表日期主要集中在2013年至2023年。心理干预方式包括家庭支持教育、情绪智力训练、认知行为疗法、自信团体训练和游戏治疗等。干预效果包括有效改善社交焦虑情绪，降低听障儿童青少年的焦虑和抑郁水平。结论 心理干预可以有效缓解听障儿童青少年的焦虑和抑郁情绪。     

肺癌患者术前呼吸训练管理的最佳证据总结

目的检索和分析肺癌患者术前呼吸训练的相关证据,并对最佳证据进行总结,为临床医护人员对肺癌患者术前呼吸训练的管理提供参考。方法计算机检索UpToDate、Cochrane Library、PubMed等数据库中关于肺癌患者术前呼吸训练的所有证据,包括指南、专家共识、证据总结、系统评价及与证据密切相关的原始研究。检索时间为建库至2019年2月1日。结果共纳入证据8篇,包括临床决策1篇,指南1篇,专家共识3篇,系统评价2篇,原始研究1篇。肺癌患者术前呼吸训练的证据主要为呼吸训练的方法、强度及频率等。结论所有纳入研究的证据均显示肺癌患者术前呼吸训练是有益的,医护人员应基于循证及临床情境制定合理的呼吸训练方案,以使肺癌患者术前的呼吸训练管理更科学、有效。     

慢性意识障碍患者结局预测模型的系统综述北大核心CSCD

目的系统评价慢性意识障碍患者结局预测模型的组成因子和准确率。方法采用主题词检索方式,检索PubMed、Web of Science、中国知网、万方数据建库至2021年9月30日慢性意识障碍患者结局预测模型的相关文献,提取内容为作者、出版年份、研究对象、监测项目、主要结局指标和结论。结果共返回文献4313篇,最终纳入37篇,文献类型包括随机对照试验、队列研究,发表时间主要集中在2012年至2021年,研究对象为慢性意识障碍患者,预测模型的组成因子包括临床量表、神经影像学检查、神经电生理学检查和实验室指标。结论预测模型对慢性意识障碍患者的远期结局有一定的参考价值。目前的预测模型大多数只由有限的一项或几项技术手段构成,准确率参差不齐,其中昏迷恢复量表修订版、默认网络、联合多种诱发电位的脑电图分析相关的预测模型具有较高准确率,但尚未建立统一的适配标准。     

经颅直流电刺激改善卒中后失语的系统综述北大核心CSCD

目的系统评价经颅直流电刺激(tDCS)对卒中后失语症(PSA)的治疗作用。方法在PubMed、Web of Science、Cochrane Library、Embase、中国知网和万方数据库中检索tDCS治疗卒中后失语的相关文献,检索时间为建库至2021年12月。提取相关内容进行系统综述。结果共返回文献1026篇,最终纳入45篇,发表时间为2010年至2021年,研究对象为卒中后失语患者,主要结局指标为言语量表和各子项。大部分研究治疗组治疗后言语量表评分高于对照组,少数波士顿失语症检查中未见改善,或仅复杂语言任务有改善。tDCS能改善卒中后失语患者的复述、命名、拼写、言语流畅度等。影响患者恢复的因素可能有电极位置、电流、持续时间、强度和左侧皮质完整性。结论tDCS治疗PSA对不同语言子项均有效果;不同tDCS方案对不同语言功能的效果有所差异。     

物理治疗翻转课堂教学应用效果的系统综述

目的 系统评价翻转课堂教学模式在物理治疗学教学中的应用效果。方法 计算机检索CENTRAL、MEDLINE、EMBASE、CINAHL Plus、Academic Search Premier、Teacher Reference Center、ERIC以及Education Research,纳入翻转课堂教学模式应用于物理治疗学教学的原始研究。检索时限为建库至2021年6月。由2名研究人员独立完成文献筛选、数据提取、质量评价,对翻转课堂教学模式对比传统教学模式在物理治疗学教学中的效果进行综述。结果与结论 共检索文献1 307篇,最终纳入7篇,包括至少770名学生。发表时间集中在2013年至2019年,研究对象为物理治疗学专业学生,主要结局指标为考试成绩。翻转课堂教学模式总体说来可提高学生的笔试成绩,增强高阶思维能力,得到了学生和教师的积极评价。     

身心锻炼对睡眠质量影响的系统综述

目的 系统综述身心锻炼对睡眠质量的影响,梳理身心锻炼干预方案的影响因素。方法 采用主题词检索方法,在PubMed、Web of Science、Science Direct、Cochrane Library、中国知网、维普和万方数据库,检索身心锻炼影响睡眠的相关文献,检索时间为建库至2022年6月1日。经筛后从文献中提取作者、国家、发表时间、研究对象、研究方法、干预过程、测量工具和结局指标,并采用物理治疗证据数据库(PEDro)量表进行方法学质量评价。结果 最终纳入英文文献14篇,均为随机对照试验,整体研究质量较好。身心锻炼方式包括太极拳、气功和八段锦,研究被试多为老年人、患病人群。身心锻炼干预时长10～12周、单次时间为60 min且每周至少2～3次的方案可最大程度改善睡眠质量,被试健康状态是影响干预效果的重要因素。结论 身心锻炼改善睡眠质量,且可以缓解焦虑、减轻抑郁、促进心理健康水平提高。     

电子游戏在恶性肿瘤患者健康教育中应用的范围综述

目的 ：对电子游戏在恶性肿瘤患者健康教育中的文章进行范围审查,为其临床推广应用和相关研究提供参考。方法 ：以JBI范围综述指南为指导,使用检索词在8个中英文数据库中进行文献检索,检索时限为建库至2021年11月1日,对纳入文献进行汇总和分析。结果 ：共纳入10篇文献,均为英文文献,发表时间为2006年—2020年;纳入研究的8个不同的电子游戏主要基于移动应用程序和网页,为患者提供健康教育内容。电子游戏的效果评价主要包括电子游戏内容的可接受性、患者满意度和患者结局指标。结论 ：电子游戏在恶性肿瘤患者健康教育中具有显著的优势,但目前在临床应用中也存在一定的局限性,以健康教育为目的的电子游戏是未来临床健康教育发展的重点。     

数值计算方法在生物电磁学中的应用

目的:介绍现有数值计算方法的特点,总结目前主流生物电磁仿真软件的不同侧重方向,并探讨生物电磁计算平台的发展趋势.资料来源:由作者检索万方数据库、Sciencedirect(Elsevier)数据库及IEEE数据库.资料检索时间为1999/2009.检索关键词包括"生物电磁,仿真,数值计算,FDTD".共检索到83篇文献,其中中文28篇,英文55篇.手动检索资料包括软件的介绍和使用手册资料4份.资料选择:通过标题和摘要阅读进行初筛,选择最近发表的同种仿真方法的相关研究文献.结局评价指标:排除研究目的与课题无关的文献25篇,内容重复和陈旧的文献27篇,保留31篇中英文文献进一步分析.符合纳入标准的31篇文献中,综述、述评8篇,研究论文23篇.结果:常用的电磁场数值计算方法包括时域有限差分法、矩量法、有限元法.目前应用于电磁照射对生物体影响研究的仿真软件主要有SEMCAD-X,FEKO,XFDTD,HFSS及GEMS等多种.结论:未来生物电磁计算平台的发展趋势将融合多种数值计算方法,以增强对仿真对象的多种研究需要.此外,仿真界面人性化和建模流程便捷化也是未来改进的重点.     

节律性听觉刺激对脑性瘫痪患者步态改善的系统综述

目的 分析节律性听觉刺激对脑瘫患者步态改善的效果。方法 采取主题词检索方式,在Web of Science、PubMed、EBSCO、中国知网、万方数据库中检索节律性听觉刺激对脑瘫患者步态改善的相关文献,自建库至2022年12月。采用物理治疗证据数据库(PEDro)量表对纳入文献进行方法学质量评估,提取相关数据进行系统综述。结果 共检索出文献1 339篇,最终纳入10篇,研究对象主要来源于美国、埃及、以色列、韩国和希腊,干预地点主要在医院和社区,部分患者居家干预,发表时间主要在2010年后。在常规物理治疗训练的基础上加入节律性听觉刺激,可以增加脑瘫患者的关节活动度,提高步速、步长和步幅,改善运动模式,增强步态训练的干预效果。结论 节律性听觉刺激可以增加脑瘫患者关节活动度,提高步速、步频和步长,改善步态。     

预康复在肺癌术前患者中应用研究的范围综述

目的 系统分析预康复在肺癌术前患者中的应用研究,总结预康复的具体内容、结局指标和应用效果,以期为医护人员开展相关干预提供参考。方法 根据范围综述的研究方法,检索Cochrane Library、PubMed、Embase、Web of Science、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普中文科技期刊数据库等国内外数据库,检索时限为建库至2023年8月1日。对纳入文献进行筛选、提炼汇总和分析。结果 共纳入29篇文献,其中15篇随机对照试验,9篇类试验研究,4篇自身前后对照试验,1篇回顾性队列研究。预康复内容包括有氧运动训练、抗阻训练、耐力训练和肺功能训练等,强度多为轻中度,锻炼时间为30～90 min/次,频率为2～5次/周。预康复对改善肺癌手术患者的肺功能和运动耐力、降低术后并发症发生率以及提高生活质量等会产生一定程度的影响。结论 预康复方案应体现出整体性、动态性,以保证干预结局的安全性和有效性。在今后的研究中还应注重探索最佳的预康复策略、制订统一规范的评价标准及指标,依据等待肺癌手术患者的病情和身体状态,制订科学、适用性强、规范的预康复方案。     

慢性阻塞性肺疾病稳定期病人的康复治疗

[目的 ]提高慢性阻塞性肺疾病 (COPD )病人呼吸肌的肌力和耐力。 [方法 ]将 10 0例COPD病人随机分为两组 ,观察组 5 0例 ,进行抗阻力深慢腹式呼吸训练 ,对照组 5 0例 ,进行单纯深慢腹式呼吸训练 ,于训练前和训练后 1个月、2个月、3个月分别测定肺功能、12min步行距离和生活质量 ,并对比训练前后的变化。[结果 ]观察组经训练后呼吸肌的肌力、耐力和各项指标的改善程度明显优于对照组。 [结论 ]抗阻力深慢腹式呼吸训练可改善COPD病人的肺功能和生活质量。     

Effects of mental relaxation and slow breathing in essential hypertension

OBJECTIVES: To compare mental relaxation and slow breathing as adjunctive treatment in patients of essential hypertension by observing their effects on blood pressure and other autonomic parameters like heart rate, respiratory rate, peripheral skin temperature, electromyographic activity of the frontalis muscle and skin conductance. METHODS: One hundred patients of essential hypertension either receiving antihypertensive drugs or unmedicated were selected randomly. Various parameters were recorded during the resting state and then during mental relaxation and slow breathing for 10 min each, separated by a quiet period of 15 min. All parameters were recorded again after mental relaxation and slow breathing. Changes in various parameters observed after mental relaxation and slow breathing were analyzed and compared. RESULTS: Both mental relaxation and slow breathing resulted in a fall in systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate and electromyographic activity with increase in peripheral skin temperature and skin conductance. Slow breathing caused a significantly higher fall in heart rate (p<0.05), respiratory rate (p<0.001), systolic blood pressure (p<0.05) and diastolic blood pressure (p<0.01). Increase in peripheral skin temperature (p<0.05) and reduction in electromyographic activity (p<0.05) occurred more with mental relaxation. No significant differences were seen between increases in skin conductance (p>0.2) observed with both the modalities. CONCLUSIONS: Even a single session of mental relaxation or slow breathing can result in a temporary fall in blood pressure. Both the modalities increase the parasympathetic tone but have effects of different intensity on different autonomic parameters.     

The influence of breathing type, expiration and cervical posture on the performance of the cranio-cervical flexion test in healthy subjects

The cranio-cervical flexion test (CCF-T) is used as a clinical evaluation tool for the deep cervical flexors (DCF). The influence of breathing type, expiration and cervical posture on the performance of the test is evaluated in asymptomatic subjects. Thirty volunteers participated in the study and were classified according to their breathing type: costo-diaphragmatic breathing type and upper costal breathing type. Sternocleidomastoid (SCM) electromyographic (EMG) activity was recorded during five incremental levels of CCF during normal breathing as well as during expiration. The cranio-vertebral angle of each subject was measured to quantify cervical posture. During normal inspiration, higher EMG activity of the SCM muscles was observed in subjects with an upper costal breathing pattern compared to costo-diaphragmatic breathing subjects. This difference was statistically significant (P< 0.05) at the three lowest stages of the test. In the upper costal breathing group a significantly lower EMG activity of the SCM muscles was observed while performing the CCF-T during slow expiration compared to normal breathing. No significant correlation was found between the cranio-vertebral angle and the EMG activity of the SCM muscles. Performing the CCF-T during slow expiration diminishes the activity of the SCM muscles in subjects with a predominantly upper costal breathing pattern. Using a costo-diaphragmatic breathing pattern while performing the test will optimize the performance. Studies on neck pain patients are required to further clarify this issue.     

Respiratory rate extraction from pulse oximeter and electrocardiographic recordings

We present an algorithm of respiratory rate extraction using particle filter (PF), which is applicable to both photoplethysmogram (PPG) and electrocardiogram (ECG) signals. For the respiratory rate estimation, 1 min data are analyzed with combination of a PF method and an autoregressive model where among the resultant coefficients, the corresponding pole angle with the highest magnitude is searched since this reflects the closest approximation of the true breathing rate. The PPG data were collected from 15 subjects with the metronome breathing rate ranging from 24 to 36 breaths per minute in the supine and upright positions. The ECG data were collected from 11 subjects with spontaneous breathing ranging from 36 to 60 breaths per minute during treadmill exercises. Our method was able to accurately extract respiratory rates for both metronome and spontaneous breathing even during strenuous exercises. More importantly, despite slow increases in breathing rates concomitant with greater exercise vigor with time, our method was able to accurately track these progressive increases in respiratory rates. We quantified the accuracy of our method by using the mean, standard deviation and interquartile range of the error rates which all reflected high accuracy in estimating the true breathing rates. We are not aware of any other algorithms that are able to provide accurate respiratory rates directly from either ECG signals or PPG signals with spontaneous breathing during strenuous exercises. Our method is near real-time realizable because the computational time on 1 min data segment takes only 10 ms on a 2.66 GHz Intel Core2 microprocessor; the data are subsequently shifted every 10 s to obtain near-continuous breathing rates. This is an attractive feature since most other techniques require offline data analyses to estimate breathing rates.     

Device and non-device-guided slow breathing to reduce blood pressure: A systematic review and meta-analysis

ObjectivesInterest is increasing in nonpharmacological interventions to treat blood pressure in hypertensive and prehypertensive patients at low cardiac risk. This meta-analysis of randomized controlled trials assesses the impact of device-guided and non-device-guided (pranayama) slow breathing on blood pressure reduction in these patient populations.MethodsWe searched PubMed, EMBASE, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Web of Science, BIOSIS (Biological Abstracts) Citation Index and Alt HealthWatch for studies meeting these inclusion criteria: randomized controlled trial or first phase of a randomized cross-over study; subjects with hypertension, prehypertension or on antihypertensive medication; intervention consisting of slow breathing at ≤10 breaths/minute for ≥5 min on ≥3 days/week; total intervention duration of ≥4 weeks; follow-up for ≥4 weeks; and a control group. Data were extracted by two authors independently, the Cochrane Risk of Bias Tool assessed bias risk, and data were pooled using the DerSimonian and Laird random effects model. Main outcomes included changes in systolic (SBP) and/or diastolic blood pressure (DBP), heart rate (HR), and/or decreased antihypertensive medication.ResultsOf 103 citations eligible for full-text review, 17 studies were included in the meta-analysis. Overall, slow breathing decreased SBP by -5.62 mmHg [-7.86, -3.38] and DBP by -2.97 mmHg [-4.28, -1.66]. Heterogeneity was high for all analyses.ConclusionsSlow breathing showed a modest reduction in blood pressure. It may be a reasonable first treatment for low-risk hypertensive and prehypertensive patients who are reluctant to start medication.     

Does respiration perturb body balance more in chronic low back pain subjects than in healthy subjects?

OBJECTIVE: To determine whether body balance is perturbed more in low back pain patients than in healthy subjects, under the concept of posturo-kinetic capacity. DESIGN: Comparison of posturographic and respiratory parameters between low back pain and healthy subjects. BACKGROUND: It has been demonstrated that respiratory movements constitute a perturbation to posture, compensated by movements of the spine and of the hips, and that low back pain is frequently associated with a loss of back mobility. METHOD: Ten low back pain patients and ten healthy subjects performed five posturographic tests under three different respiratory rate conditions: quiet breathing (spontaneous), slow breathing (0.1 Hz) and fast breathing (0.5 Hz). RESULTS: Intergroup comparison showed that the mean displacements of the center of pressure were greater for the low back pain group, especially along the antero-posterior axis, where respiratory perturbation is primarily exerted. Inter-condition comparison showed that in slow and fast breathing relatively to quiet breathing, the mean displacement of the center of pressure along the antero-posterior axis was significantly increased only for the low back pain group. CONCLUSION: According to the results, respiration presented a greater disturbing effect on body balance in low back pain subjects. RELEVANCE: This study provides information on the causes of the impaired body balance associated with chronic low back pain, which could be used to improve treatment strategy.     

Electromyographic feedback for learning to activate thoracic inspiratory muscles

The utility of EMG feedback for modifying the muscular pattern of breathing was investigated in twenty-four subjects divided into two groups (feedback, no feedback. Each took part in three 20-min training sessions, 24 h apart. All the subjects were instructed to increase the thoracic contribution of inspired gas. The feedback subjects were shown an EMG signal of the inspiratory muscles of the upper thorax and a signal indicating their current breathing phase (inspiration or expiration). The no feedback subjects only saw the breathing phase signal. The subjects' ability to control muscular activity was assessed as the relative increase in EMG from expiration to the subsequent inspiration. Analysis of variance with group and session as factors showed that feedback subjects performed significantly better, although the improvement in performance over the sessions by the two groups was not significantly different. These results lend some support to the clinical use of EMG feedback in breathing therapy aimed at changing the thoracoabdominal distribution of ventilation. However, further research for improving learning is necessary.     

呼吸功能训练对开胸手术病人康复的研究

目的探讨术前呼吸功能训练对开胸手术病人康复的影响。方法选自我科2005年1月～12月在我科开胸手术患者100例为观察对象，随机分为实验组50例，对照组50例，对照组按临床常规护理进行指导，实验组行深慢呼吸、缩唇呼吸、咳嗽训练、吹气球训练等呼吸训练，观察比较2组患者术后并发症、胸管留置时间、住院天数，并用进行统计分析。结果实验组明显优于对照组。结论术前呼吸功能训练可减少开胸手术病人术后呼吸系统并发症的发生，促进病人早日康复。     

Biofeedback training for reduced respiratory rate in chronic obstructive pulmonary disease: a preliminary study

The overall objective of this preliminary investigation was to determine whether breathing patterns of patients with chronic obstructive pulmonary disease could be altered by training patients to voluntarily change their breathing, using techniques of biofeedback training. The specific aims were (1) to develop a method of monitoring respiratory rate and tidal volume with a device that was both accurate and usable without discomfort or inconvenience to the patient; (2) to use the method with patients having chronic obstructive pulmonary disease to determine whether respiratory rate could be slowed by voluntary controls; and (3) to determine whether patients who could slow their breathing rate would increase their tidal volume and demonstrate other respiratory changes.     

心脑血管及急诊护士对急诊高血压知识的认知现状

目的了解心脑血管及急诊护士对急诊高血压的认知现状,并分析其影响因素。方法2019年2-3月,便利抽样法选取某三级甲等医院心脑血管及急诊的150名护士为研究对象,采用自制调查问卷对其一般资料、急诊高血压相关知识、接受培训意愿进行调查。结果护士急诊高血压认知现状总分为(63.27±12.92)分。不同年龄、本科室工作年限、现学历、职称、能级的护士,其对急诊高血压认知差异均有统计学意义(均P<0.05)。结论护士急诊高血压总体认知水平整体偏低,医院应尽快完善急诊高血压相关培训体系,以提高护士的认知水平。