临床护理路径在腰椎间盘突出症术后康复中的应用

目的：探讨腰椎间盘突出症手术后实施临床护理路径对患者的康复效果.方法：将120例腰椎间盘突出症手术患者随机分为试验组和对照组各60例,试验组实施临床护理路径管理,进行术后康复训练;对照组实施整体护理和常规健康指导.比较两组患者术后功能恢复程度、健康知识掌握程度及满意度.结果：试验组术后功能恢复程度、健康知识掌握程度、患者满意度均高于对照组（P＜0.05）.结论：对腰椎间盘突出症患者术后实施临床护理路径管理,可以提高患者功能康复效果、健康知识掌握程度和综合满意度.     

达标理论在腰椎间盘突出症术后康复训练中的应用效果

目的探讨达标理论指导构建的腰椎间盘突出症术后康复训练程序的效果。方法将手术治疗的腰椎间盘突出症患者214例分为对照组和观察组各107例,对照组术后给予常规康复训练程序,观察组术后给予以达标理论指导构建的康复训练程序,并观察两组患者康复训练效果。结果观察组患者掌握训练动作优于对照组,出院后1年疗效评定优于对照组(P0.01)。结论达标理论可较好地构建腰椎间盘突出症患者术后康复训练的主动参与意识,提高其训练技能,保障康复训练的效果。     

健康教育小处方在腰椎间盘突出症介入术后康复训练指导中的应用

目的:研究健康教育小处方在腰椎间盘突出症介入术后康复训练指导中的应用效果.方法:74例腰椎间盘突出症介入术后患者,分为常规讲解示范指导组(对照组)和使用健康教育小处方指导组(实验组),术后分别运用两种不同方式进行康复功能训练指导,以患者能掌握并能正确进行训练为标准,每次计算护士“一对一”指导所耗时间及在第二天再次评价患者对康复训练掌握情况进行比较.结果:对照组35例患者,平均每人每次耗时30.14min,第二天复查掌握患者占74.3％.实验组39例患者,平均每人每次耗时20.62min,第二天复查掌握患者占92.3％,两组训练指导时间及掌握比例比较差异均有显著性意义(P＜0.05).结论:使用健康教育小处方进行康复训练指导,能使不同文化层次的患者易于理解和记忆,能有效提高患者对康复训练技巧及训练要点的掌握程度,并大大提高医护人员对患者的康复训练指导工作效率,节约人力成本.     

健康教育路径在人工膝关节置换术康复训练中的应用

目的探讨健康教育路径在人工膝关节置换术(total knee arthroplasty,TKA)康复训练中的应用效果。方法将患者入院先后顺序编号,单号是对照组,双号是实验组,每组各90例,对照组采用常规锻炼方法,实验组按照临床路径表制订的要求指导患者进行康复训练。比较两组患者功能锻炼的正确率、康复知识的掌握程度、护理满意度和术后12个月功能锻炼效果。结果实验组患者功能锻炼的正确率、康复知识的掌握程度、护理满意度和术后12个月功能锻炼效果均优于对照组,均P0.05,差异具有统计学意义。结论健康教育路径应用于TKA患者康复训练中,能提高患者术后功能锻炼效果,从而提高康复率。     

针灸、中药熏洗联合康复训练对腰椎间盘突出症手术患者术后腰椎功能的影响

目的探讨针灸、中药熏洗联合康复训练对腰椎间盘突出症手术患者术后腰椎功能的改善效果。方法选取2017年3月至2018年9月在某院接受手术治疗的腰椎间盘突出症患者96例,依据随机数表法的分组方法分为两组,对照组48例和观察组48例。对照组患者术后给予康复训练治疗,观察组患者在对照组基础上联合针灸、中药熏洗治疗,观察分析两组疼痛程度及腰椎功能状况。结果干预后,观察组的视觉疼痛模拟评分法(VAS)评分较对照组低,差异有统计学意义(P<0.05);观察组的Oswestry功能障碍指数问卷表(ODI)评分较对照组低,差异有统计学意义(P<0.05)。结论采用针灸、中药熏洗联合康复训练对腰椎间盘突出症术后患者进行干预,能够加快患者的术后恢复,可显著降低患者术后疼痛程度,提高其腰椎活动范围及预后状况。     

两种护理模式对腰椎滑脱症手术患者康复的影响

目的 探讨两种护理模式在腰椎滑脱症手术患者的应用效果.方法 将86例腰椎滑脱症手术患者随机分为对照组和观察组各43例,对照组按常规护理,观察组在此基础上采取循证护理干预,比较两组并发症发生率和腰腿痛残留率.结果 观察组并发症发生率和腰腿痛残留率明显低于对照组(均P＜0.05).结论 腰椎滑脱症围术期实施循证护理干预,能改善腰部活动功能,减少腰腿痛的残留,降低并发症发生率,促进患者康复.     

针灸理疗康复治疗腰椎间盘突出症的临床效果观察

目的:分析针灸结合康复训练对腰椎间盘突出症的治疗效果.方法:选择我院腰椎间盘突出症41例采用针灸结合康复训练方法,设为观察组,与同期41例患者采用针灸治疗的患者,设为对照组.比较二组治疗效果、平均疼痛缓解时间、恢复时间.结果:观察组治愈率75.61％,对照组治愈率为41.46％;观察组平均疼痛缓解时间及恢复时间均较对照组短,二组比较差异具有显著性,有统计学意义P＜0.05.治疗结束后随访3～6个月,观察组无复发病例,对照组复发4例.结论:针灸结合康复训练是治疗腰椎间盘突出症的理想方法,值得临床推广应用.     

医疗体操对腰椎间盘突出症术后病人训练的效果观察

目的探讨医疗体操对腰椎间盘突出症术后病人早期康复训练的临床效果方法1999年1月～2001年10月,112例腰椎间盘突出症术后病人,54例(医疗体操组)采用医疗体操早期介入,进行康复功能训练,58例(常规对照组)采用传统训练方法,经过4周、8周、1年的随访,用以评价训练效果结果医疗体操组中53例手术后训练效果满意,常规对照组49例手术后训练效果满意,两组有显著差异(P＜0.05)结论对于腰椎间盘突出症术后病人,医疗体操早期介入,可提高病人腰背肌功能和生活质量.     

健康教育康复训练路径在胸腰椎结核病人中的应用

[目的]探讨健康教育康复训练路径在胸腰椎结核病人中的研究效果。[方法]将102例胸腰椎结核病人随机分为观察组48例,对照组54例,观察组采用健康教育康复训练路径表进行全程康复训练,对照组实施传统方法进行健康教育及康复训练。[结果]实施健康教育康复训练路径后,观察组病人的平均住院时间、住院费用、术后并发症发生率明显低于对照组(P<0.05);接受健康教育后对健康教育及康复训练内容的掌握程度显著提高(P<0.01),病人对护理的满意度大幅度提高(P<0.01)。[结论]健康教育康复训练路径的应用有助于提高康复训练效果,提高病人对疾病知识的认知度和对护理服务的满意度。     

平衡针灸联合康复训练治疗腰椎间盘突出症的临床效果

目的：探讨腰椎间盘突出症应用平衡针灸联合康复训练治疗的临床效果。方法：选取2018年1月~2020年1月收治的腰椎间盘突出症患者86例为研究对象,随机分为对照组和联合组各43例。对照组给予康复训练治疗,联合组给予平衡针灸联合康复训练治疗。比较两组临床疗效。结果：联合组治疗总有效率高于对照组,差异有统计学意义（P＜0.05）;治疗后联合组日本骨科协会评估治疗分数评分高于对照组,疼痛评分、Oswestry功能障碍指数评分低于对照组,差异有统计学意义（P＜0.05）。结论：腰椎间盘突出症应用平衡针灸联合康复训练治疗效果更确切,患者腰部功能及疼痛均能得到有效恢复或改善。     

关于促进康复护理发展的探讨

在康复医学发展的同时，康复护理正在成为护士职能扩展的一个重要方面，随着整体护理模式的提出，康复与护理这两门学科将有越来越多的联系和相关，不论在临床还是在社区医疗卫生工作中，康复护士的作用会日益受到重视，这个领域将有许多新的课题有待我们去开发，如何促进康复护理的发展是值得研究和探讨的问题。     

Rehabilitation the Health Strategy of the 21st Century,Really?

Rehabilitation is the care needed when a person is experiencing or is likely to experience limitations in everyday functioning due to aging or a health condition, including chronic diseases or disorders, injuries, or traumas. The changing health and demographic trends are contributing to rapid increases globally in numbers of people experiencing declines in functioning. Hence, rehabilitation needs that are already very high will further increase in the years to come.The question is: Is the field of rehabilitation with all its stakeholders ready to address that challenge?I argue that to move things forward and make sure that rehabilitation becomes a political priority under a unified message, rehabilitation stakeholders need to bring together the distinct portraits of rehabilitation under the concept of functioning. Also, the field of rehabilitation is still very fragmented and there is a need of a more unified advocacy by rehabilitation professional groups, by subspecialties and users.Responses to the paper are very welcome before, during, and after the second global Rehabilitation 2030 meeting on July 8 and 9, 2019.     

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。     

Recalibration and Validation of the Cumberland Ankle Instability Tool Cutoff Score for Individuals With Chronic Ankle Instability

Objective

To independently recalibrate and revalidate the Cumberland Ankle Instability Tool (CAIT) cutoff score for discriminating individuals with and without chronic ankle instability (CAI). There are concerns the original cutoff score (≤27) may be suboptimal for use in the CAI population.

Design

Case control.

Setting

Research laboratory.

Participants

Two independent datasets were used (total N=200). Dataset 1 included 61 individuals with a history of ≥1 ankle sprain and ≥2 episodes of giving way in the last year (CAI group) and 57 participants with no history of ankle sprain or instability in their lifetime (uninjured group). Dataset 2 included 27 uninjured participants, 29 participants with CAI, and 26 individuals with a history of a single ankle sprain and no subsequent instability (copers).

Interventions

All participants completed the CAIT during a single session. In dataset 1, a receiver operating characteristic (ROC) curve was calculated using the CAIT score and group membership as test variables. The ideal cutoff score was identified using the Youden index. The recalibrated cutoff score was validated in dataset 2 using the ROC analysis and clinimetric characteristics.

Main Outcome Measures

CAIT cutoff score and clinimetrics.

Results

In dataset 1, the optimal cutoff score was ≤25, which is lower than previously reported. In dataset 2, the recalibrated cutoff score demonstrated a sensitivity of 96.6%, specificity of 86.8%, positive likelihood ratio of 7.318, and negative likelihood ratio of .039. There were 7 false positives and 1 false negative.

Conclusions

The recalibrated CAIT score demonstrated very good clinimetric properties; all properties improved compared with the original cutoff score. Clinicians using the CAIT should use the recalibrated cutoff score to maximize test characteristics. Caution should be taken with copers, who had a high rate of false positives.     

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.