语前聋儿多导人工耳蜗植入6例随访观察

目的：探讨多导人工耳蜗植入对重度感音性语前聋儿童的治疗效果。方法：对6例极重度感音性语前聋儿童植入由澳大利亚Cochlear公司生产的Nuelus24型多导人工耳蜗。术后1个月开机。结果：6例语前聋儿童在接受人工耳蜗植入后均获得听力，听阈平均提高到33．33dBHL；双音节词言语辨别率(SDS)术后6个月听平均28．33％，听加唇读平均61．6％；术后12个月(SDS)听平均5l％，听加唇读平均73．8％，比术前有明显改善。结论：多导人工耳蜗植入对恢复极重度感音神经性语前聋儿童的听觉是有效的，植入年龄越小效果越好。     

语前聋患儿行人工耳蜗植入术的围术期护理

介绍语前聋患儿行人工耳蜗植入术的围术期护理,包括术前评估、术中全身麻醉的监护及术后常规护理、常见并发症的观察与护理、心理护理、出院康复指导等。     

人工耳蜗植入术护理

总结了6例接受人工耳蜗植入术患儿的护理体会。分别从术前和术后护理的角度进行阐述。术前应做好心理护理和有关知识指导。术后护理的重点是:乳突区耳蜗接受器皮肤观察;防止电极脱落;并发症的观察和护理;语音康复指导。     

语前聋患儿行人工耳蜗植入术的围术期护理

介绍语前聋患儿行人工耳蜗植入术的围术期护理,包括术前评估、术中全身麻醉的监护及术后常规护理、常见并发症的观察与护理、心理护理、出院康复指导等.     

中国多导人工耳蜗植入概况

人工耳蜗是一种可以帮助聋人恢复听力和言语交流能力的生物医学工程装置，近十几年取得了突破性进展，技术水平日臻完善，临床应用效果明显。我国曾于80年代研制单通道人工耳蜗装置，但由于信息技术与封装工艺上的缺陷而一度停顿，1995年引进国际先进的多导人工耳蜗技术以来，我国人工耳蜗植入的数量和质量有了大幅度提高，越来越多的重度感音神经性耳聋患者得以重新参与社会生活。     

语前聋儿童人工耳蜗植入分析

目的：通过对已植入人工耳蜗的语前聋儿童在手术中，手术后早期和调试中所遇问题的总结，探讨术中术后和调机中的特别注意事项。方法：9例在我院接受人工耳蜗植入，开机至少6月的语前聋儿童被纳入本次分析。采用回顾临床资料和进行自由声场测试纯音，言语察觉率和开放式，闭合式言语分辨率的方法评价人工耳蜗补偿听力的效果。结果：全部患者均被成功地植入了人工耳蜗。手术并发症计有电极滑出耳蜗1例，术中穿破外耳道后壁2例，术后出现术侧面肌抽动2例。自由声场纯音听阈测试，均在30～35dB SPL。言语察觉阈35～40dB SPL；言语分辨率(除3例外)，开放式大于50％，最佳者达到78％；闭合式大于80％。4例植入时间较长的学龄期儿童已进入普通小学学习。结论：人工耳蜗植入术加术后言语训练，能达到改善听力，提高语言能力的目的。并对术中寻找圆窗龛困难，术后出现的电极滑出和面肌抽动的原因及相应的对策进行了探讨。     

耳科新进展——中国多导人工耳蜗植入概况

人工耳蜗是一种可以帮助聋人恢复听力和言语交流能力的生物医学工程装置，近十几年取得了突破性进展，技术水平日臻完善，临床应用效果明显。我国曾于80年代研制单通道人工耳蜗装置，但由于信息技术与封装工艺上的缺陷而一度停顿，1995年引进国际先进的多导人工耳蜗技术以来，我国人工耳蜗植入的数量和质量有了大幅度提高，越来越多的重度感音神经性耳聋患者得以重新参与社会生活。     

多导人工耳蜗植入术后康复训练疗效分析

目的：探讨多导人工耳蜗植入术后康复训练的有效性和影响因素。方法：176例极重度感音性耳聋患，6岁以下104例，接受多导人工耳蜗植入手术，术后进行听觉感知训练。结果：患术后自由声场平均听阈为25－40dBHL(0.5,1.0,2.0kHz)较前有明显提高，经定期的设备调试及听力康复训练均取得满意的效果。结论：多导人工耳蜗植入技术可有效地帮助极重度感音性耳聋患改善听力，有多种因素可影响术后康复效果。     

语前聋患儿电子耳蜗植入术后的康复指导

总结语前聋患儿电子耳蜗植入术后的康复指导.康复指导重点为心理指导、耳蜗保养指导、开机及维护指导、语音指导.45例患儿通过听力训练及语言训练,能正确发音,与他人进行交流.     

语前聋人工耳蜗植入术患儿家属照护体验的质性研究

目的:对语前聋人工耳蜗植入术患儿家属进行访谈,了解其照护体验,便于医护人员有针对性地制定护理方案,促进患儿及家属身心健康。方法:通过立意抽样性采样法,选取15名语前聋人工耳蜗植入术患儿家属作为调查对象,采用半结构化访谈收集数据,并使用现象学七步分析方法对主题进行编码,总结和改进。结果:抽取5个主题,缺乏疾病知识、负性情绪体验、渴望社会支持、对前景的担忧、照顾过程中建立的积极应对。结论:语前聋人工耳蜗植入术患儿家属在照顾过程中经历多重身心体验,需要多方面的帮助与支持,医护人员应及时给予专业指导,保证患儿及其家属身心健康。     

聋儿人工耳蜗植入术31例评价

目的通过评估植入人工耳蜗的语前聋儿童术后的听力、听觉及语言能力及智力情况,初步分析耳蜗植入后听力语言康复的进展。方法31例行人工耳蜗植入的语前聋儿童进行听力测试、双音节词封闭项识别,主题对话测试及智力评估。结果受试者术后平均听力在33dB左右。正确识别率随人工耳蜗使用时间而不断增加,在术后6个月以上的聋儿中扬扬格双音节词识别率大于等于90%的占94.7%。语言能力随植入时间的增长而呈上升趋势,在术后6个月以上的聋儿中主题对话达到三四级的占89.5%。使用人工耳蜗后对患儿的言语发育具有较大帮助,听觉能力≥80%的聋儿语言能力为三四级的占73%。结论对于8岁及以下进行植入手术、智力发育正常,术后及时在康复机构接受科学的康复训练的语前聋耳蜗植入患儿,到术后半年以上大多数患儿的听觉和语言能力的提高是令人满意的。     

人工耳蜗植入后言语康复效果的相关因素

目的：初步分析语前聋儿童耳蜗植入后言语康复效果的相关因素。方法：对多通道人工耳蜗植入的42例语前聋的聋儿，进行重建听阈、听觉能力、言语能力、智力评估，并调查他们的一般情况、家庭情况、术前助听器佩戴和训练情况等。结果：影响聋儿言语能力的因素包括：性别、年龄、植入后时间和开机时间长短及听觉能力。Logistic回归分析结果显示：植入后时间、耳聋到植入人工耳蜗时间、听觉能力情况与言语能力呈正相关，重建听阈与言语能力呈负相关。结论：对语前聋的聋儿，在人工耳蜗植入前佩戴助听器康复训练时间较长，植入后的重建听阈、听觉能力越好，进行科学培训的时间越长，其言语能力康复效果会更好。     

Production of word-initial fricatives of Mandarin Chinese in prelingually deafened children with cochlear implants

Purpose: This study examined the production of fricatives by prelingually deafened Mandarin-speaking children with cochlear implants (CIs).

Method: Fourteen cochlear implant (CI) children (2.9–8.3 years old) and 60 age-matched normal-hearing (NH) children were recorded producing a list of 13 Mandarin words with four fricatives, /f, s, ?, ?/, occurring at the syllable-initial position evoked with a picture-naming task. Two phonetically-trained native Mandarin speakers transcribed the fricative productions. Acoustic analysis was conducted to examine acoustic measures including duration, normalised amplitude, spectral peak location and four spectral moments.

Result: The CI children showed much lower accuracy rates and more diverse error patterns on all four fricatives than their NH peers. Among these four fricatives, both CI and NH children showed the highest rate of mispronunciation of /s/. The acoustic results showed that the speech of the CI children differed from the NH children in spectral peak location, normalised amplitude, spectral mean and spectral skewness. In addition, the fricatives produced by the CI children showed less distinctive patterns of acoustic measures relative to the NH children.

Conclusion: In general, these results indicate that the CI children have not established distinct categories for the Mandarin fricatives in terms of the place of articulation.     

多导人工耳蜗植入术及听觉语言康复效果分析43例

目的总结43例多导人工耳蜗植入术围手术期的处理经验和听觉语言康复效果。方法介绍在多导人工耳蜗植入术围手术期的处理方法,分析比较语前聋与语后聋;学龄前聋儿与学龄聋儿人工耳蜗植入后的听觉语言康复效果。结果43例人工耳蜗植入术后通过1个月以上的调试和听觉训练,声场测听全部达到正常范围。语前聋儿童中,测定13例学龄前的可合作儿童的限定词表言语测听,言语识别率平均达到90%,非限定词表识别率平均达87%。测定9例7岁以上合作儿童的限定词表言语识别率平均达到82%,非限定词表言语识别率平均达78%,与学龄前组比较差异有显著意义。语后聋者经过一两个月的适应,全部能正常方式对话和打电话。结论人工耳蜗植入是治疗全聋患者的最佳选择。对语前聋患者而言,植入年龄最好在7岁前。人工耳蜗植入后,听觉语言康复工作将是一项长期的工作,需要家庭、社会、医生和聋康老师的共同努力。     

13例人工耳蜗植入聋儿术前、术后有关问题的探讨

目的：探讨人工耳蜗植入术前准备和术后康复训练的意义。方法：对在训的１３ 名人工耳蜗植入术后聋儿进行听觉言语评估。结果：不同的术前准备及术后康复训练对聋儿的听觉能力和言语理解、表达能力均有不同的影响。结论：术前准备、术后康复训练的方法对耳蜗植入后的效果有影响     

Strength training in a cardiac rehabilitation program: a six-month follow-up

The effect of circuit training on blood pressure (BP) and strength were evaluated for six months in 16 middle-aged (means = 55.8 years) men in a metropolitan cardiac rehabilitation program. Circuit training consisted of 12 to 20 repetitions at 30% to 40% of one repetition maximum on 12 Nautilus exercises with one-minute rests between exercises. This strength conditioning was supplemental to the patients' aerobic exercise. Five of the patients had myocardial infarctions, six had coronary artery bypass grafts, two had ventricular arrhythmias, one had angioplasty, and two had a complex of other cardiac conditions. Average height, weight, and body fat for the 16 patients were 179.3 cm, 82.4 kg, and 24.6%, respectively. Blood pressure (BP) data indicated no change in mean systolic or diastolic values during actual circuit training sessions (initial = 122/77 mmHg, mid = 124/78 mmHg, end = 122/76 mmHg). These data were compared with corresponding sets of BP at three and six months of training and no significant differences were seen. In no instance did circuit training appear to elevate a patient's BP above clinically acceptable levels for controlled hypertension. In the six months, significant increases in strength were observed with a mean increment of 8.2 kg or 22% for all 12 exercises. No changes occurred in body weight or percentage of fat. For selected patients in cardiac rehabilitation programs, a carefully supervised, long-term program of low-resistance strength training appears to be safe with regard to BP response, and beneficial in terms of strength gain.     

Non-pharmacological rehabilitation interventions for concussion in children: a scoping review

Purpose: To summarise the extent, nature, and quality of current scholarly literature related to non-pharmacological, rehabilitation interventions following concussion, or mild traumatic brain injury in children.

Methods: An electronic search was conducted from 1987 to 24 October 2017. Studies were included if they met the following criteria: (1) full text, peer reviewed, and written in English, (2) original research, (3) diagnosed concussion or mild traumatic brain injury, (4) described the evaluation of an intervention, (5) the outcome was a concussion impairment, and (6) the mean/median age was under 19. Quality assessment using the Down’s and Black criteria was conducted.

Results: Twenty-six studies published between 2001 and 2017 were identified. Interventions included rest, active rehabilitation, exercise, vestibular, oculomotor, cervicospinal therapy, education, early intervention, telephone counselling, mobile health application, Web-based Self-Management program, multimodal physical therapy, cognitive behavioural therapy, transcranial direct current stimulation, and acupuncture. The quality assessments ranged from poor to good.

Conclusions: The literature describing interventions following concussion in children is scarce. While both positive and negative results were obtained, there were methodological concerns in most studies limiting the ability to draw conclusions. Interventions incorporating aerobic exercise show promise as a concussion management strategy.

• Implications for rehabilitation

• Few studies have examined rehabilitation interventions for youth following concussion.

• Research ranging from rest to exercise highlights the uncertainty of the field.

• Low quality research limits the generalizability of results.

• The use of physical activity appears to be an emerging area of interest.

• Individualised, aerobic exercise should be used as part of clinical management.

     

A 6-year follow-up study of 122 patients attending a multiprofessional rehabilitation programme for persistent musculoskeletal-related pain

The aim of the study was to evaluate the outcome 6 years after completing a multiprofessional 8-week rehabilitation programme regarding the following objectives: (1) return to work, (2) level of activity and (3) pain intensity. Of 149 patients attending a rehabilitation programme, 122 were followed up after 6 years, through a structured telephone interview, and their present work situation, level of activity, sleeping habits, their estimated pain intensity and consumption of analgesics were recorded. The questions presented were the same as they had answered before entering the programme. The return-to-work rate was compared to 79 patients in a control group. At the 6-year follow-up, compared to before entering the programme, 52% had returned to work (P<0.001). In the control group the return-to-work rate was 13%. This difference was statistically significant (P<0.001). There was a statistically significant higher level of activity (P=0.037). A pain reduction was experienced by 58% of the patients (P<0.001) and 47% of the patients had decreased their consumption of analgesics (P<0.001). In conclusion, after completing the structured 8-week rehabilitation programme, the return-to-work rate was higher at a 6-year follow-up than in a control group. Furthermore, they had a higher level of activity and lower level of pain intensity than before entering the programme, indicating that the rehabilitation programme had a long-term positive effect on the return-to-work-rate, activity and pain as well as on the analgesic consumption.     

Prosthetic rehabilitation of geriatric amputee patients: a follow-up study

During a four-year period, 116 lower extremity amputee patients older than 65 years were evaluated and treated by our department. Fifty-nine patients with below-knee (BK) amputations, 22 with above-knee (AK) amputations, and 15 with bilateral amputations were fitted with prostheses and trained in their use. A follow-up study on all patients was done at an average of 22 months after they had completed their training program but not earlier than after 6 months. Of all BK amputees who had been fitted with a prosthesis, 73% were using it fulltime and as their main mode of locomotion; 25% were using it part of the time. The results were less favorable for AK and for bilateral amputee patients: 50% of AK amputees and 33% of the bilateral amputees had become fulltime users of their prostheses. Age alone was not a major determining factor in success or failure of prosthetic rehabilitation. Failures usually were due to concurrent medical disease or mental deterioration. The study indicates that the effort and expense of fitting and training geriatric patients with prostheses may be well worthwhile.