Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replacement(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasin...Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replacement(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasingly older,have comorbidities,and frailty.TAVR cardiac rehabilitation(CR)programs significantly improve both functional capacity and quality of life of patients.However,there are no guidelines on how to carry out them and few elderly patients are referred to CR.Furthermore,mortality in women who undergo TAVR is higher than in men and even fewer are referred to CR programs.Multidisciplinary patient care,including comorbidities and frailty,is essential.It is necessary to ensure exquisite continuity of care during TAVR,CR,and the rest of the patient's life.Telerehabilitation could be an option in some lower-risk patients to include more patients in CR programs after TAVR,given the high demand.This article reviews the evidence on why CR should be performed in post-TAVR patients and proposes a practical and novel approach to the care process and the recommended aspects and components of the CR program.展开更多
In today’s society, the incidence of cardiopulmonary diseases is increasing annually, seriously affecting patients’ quality of life. Therefore, developing a scientific and effective rehabilitation training program i...In today’s society, the incidence of cardiopulmonary diseases is increasing annually, seriously affecting patients’ quality of life. Therefore, developing a scientific and effective rehabilitation training program is of great significance. This study first analyzes the theoretical basis of cardiopulmonary rehabilitation training, including the effects of aerobic exercise, interval training, and strength training on cardiopulmonary function. Based on this, a comprehensive rehabilitation training program is designed, which includes personalized training plans, comprehensive interventions, multidisciplinary collaboration, patient education, and regular follow-up visits. The cardiopulmonary rehabilitation training plan developed in this study has certain scientific practicability, which provides a theoretical basis for cardiopulmonary rehabilitation training, and also provides a reference for medical institutions, rehabilitation centers and communities, which is helpful for promotion and application to a wider range of patients with cardiopulmonary diseases.展开更多
AIM To investigate factors predicting treatment completion and treatment outcome of the Reasoning and Rehabilitation Mental Health Programme(R&R2MHP)cognitive skills programme for mentally disordered offenders.MET...AIM To investigate factors predicting treatment completion and treatment outcome of the Reasoning and Rehabilitation Mental Health Programme(R&R2MHP)cognitive skills programme for mentally disordered offenders.METHODS Secondary analysis of data previously obtained from 97 male patients who were sectioned and detained under the United Kingdom Mental Health Act in low,medium and high security hospitals and who had completed R&R2MHP.Predictors of treatment completion included background variables and five outcome measures:Four self-reported measures of violent attitudes,social problem-solving skills,reactive anger and locus of control and an objective measure of behaviour on theward that was completed by staff.Completion of the 16 session programme,which was delivered on a weekly basis,was classified as≥12 sessions.RESULTS It was found that the R&R2MHP is appropriate for delivery to participants of different ages,ethnic background,and at different levels of security without the completion rate or treatment effectiveness being compromised.Participants taking oral typical psychotropic medication were over seven times more likely to complete the programme than other participants.Behavioural disturbance on the ward prior to commencing the programme predicted non-completion(medium effect size).As far as treatment completion was concerned,none of the background factors predicted treatment effectiveness(age,ethnic background,level of security,number of previous convictions and number of previous hospital admissions).The best predictor of treatment effectiveness was attitude towards violence suggesting that this should be the primary outcome measure in future research evaluating outcomes of the R&R2MHP cognitive skills program.CONCLUSION The findings suggest that a stable mental state is a key factor that predicts treatment completion.展开更多
In view of the uncertainty and complexity,the intelligent model of rehabilitation training program for stroke was proposed,combining with the case-based reasoning(CBR) and interval type-2 fuzzy reasoning(IT2FR).The mo...In view of the uncertainty and complexity,the intelligent model of rehabilitation training program for stroke was proposed,combining with the case-based reasoning(CBR) and interval type-2 fuzzy reasoning(IT2FR).The model consists of two parts:the setting model based on CBR and the feedback compensation model based on IT2FR.The former presets the value of rehabilitation training program,and the latter carries on the feedback compensation of the preset value.Experimental results show that the average percentage error of two rehabilitation training programs is 0.074%.The two programs are made by the intelligent model and rehabilitation physician.That is,the two different programs are nearly identical.It means that the intelligent model can make a rehabilitation training program effectively and improve the rehabilitation efficiency.展开更多
Objective Patients suffered a lot from decompensated vestibular vertigo.Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation.Routine rehabilitati...Objective Patients suffered a lot from decompensated vestibular vertigo.Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation.Routine rehabilitation training is faced with the challenges of patients’compliance,completion,the average recuperation time and so on.This study is aimed to investigate advantages of short-term personalized vestibular rehabihitation at home guided by professional therapist.Methods A short-term personalized vestibular rehabilitation program(ST-PVR)was designed for patients with decompensated vestibular vertigo in this study.Results Patients experiencing the ST-PVR program showed significant improvement of Self-Rating Anxiety Scale(SAS),Dizziness Handicap Inventory(DHI),Activities-Specific Balance Confidence Scale(ABC)scores by the second follow-up(at 2nd week after treatment,P<0.05).However-improvement in the medication group occurred slightly later,DHI for 1 month and SAS for 2 months after treatment(P<0.05).Also,the improvement in the onset time of unilateral weakness(UW)at 2nd week after treatment in the personalized vestibular rehabilitation(PVR)group was faster than that in the medication group.Conclusion In general,the short-term PVR program showed great advantages by prompting vestibular compensation quickly and putting forward future direction for clinical treatment on decompensated vestibular vertigo.展开更多
Background The benefits of exercise-based cardiac rehabilitation(EBCR)programs in post-acute myocardial infarction(AMI)patients have been demonstrated.Our aim was to assess the impact of EBCR in³70-years-old vs.y...Background The benefits of exercise-based cardiac rehabilitation(EBCR)programs in post-acute myocardial infarction(AMI)patients have been demonstrated.Our aim was to assess the impact of EBCR in³70-years-old vs.younger post-AMI patients.Methods We retrospectively evaluated patients who underwent a supervised EBCR protocol,twice a week during 6-12 weeks.We evaluated changes in several outcomes based on pre-and post-CRP assessments.Results Of a total of 1607 patients,333(21%)were³70-years-old.After the EBCR,an overall improvement on functional capacity,daily physical activity,lipid profile,body mass index,glycated hemoglobin(HbA1c),N-terminal pro-brain natriuretic peptide(NT-pro-BNP)and C-reactive protein was observed in both younger and older patients(P<0.05).Older patients showed a smaller benefit on the increment of daily physical activity and lipid profile improvement,but a larger reduction in NT-pro-BNP.In the multivariate analysis,only improvements on daily physical activity and HbA1c were dependent on age.Conclusion As their younger counterparts,older patients,significantly improved functional capacity,metabolic parameters and level of daily physical activity after EBCR.展开更多
AIM: To identify baseline characteristics that independently predict pulmonary rehabilitation non-completion and compare these findings against the participant's reasons for non-completion. METHODS: Participants w...AIM: To identify baseline characteristics that independently predict pulmonary rehabilitation non-completion and compare these findings against the participant's reasons for non-completion. METHODS: Participants with chronic obstructive pulmonary disease(COPD) who attended a standardised twice weekly, eight week pulmonary rehabilitation program(located in the sub-tropics, latitude 27°29' South) between 2010 and 2012 were recruited. Thebaseline characteristics of program completers and non-completers were compared in a case-controlled design. Participants who attended < 12/16 sessions were classified as a non-completer. Non-completers(those who missed > 4 session of the program) were asked by one independent investigator to participate in a survey about their pulmonary rehabilitation experience. Baseline characteristics were assessed for differences between program completers and non-completers. The baseline characteristics included disease severity, exercise capacity, smoking history, participant's social support and the season when each participant commenced rehabilitation. Non-completers that agreed to participate in the survey were asked to indicate what personal factors or external factors contributed to their program non-completion. Comparisons of completers and non-completers baseline characteristics were performed using cross-tabulations and t-tests, with significant measures analysed in a multivariate binary logistic regression model. Non-completers survey responses were compared to the identified independent predictors using cross-tabulations.RESULTS: Twenty-six participants(23.4%) of the 111 participants with COPD [(mean ± SD) age was 67.4 ± 9.2 years and FEV1 54.6% ± 22.3%)], were classified as non-completers. Forty-five participants(40.5%) commenced pulmonary rehabilitation during winter. Thirty-six participants(32.4%) were living alone at program commencement. In the multivariate analysis(n = 111), only programs that commenced in winter(Exp B: 0.255, 95%CI: 0.090-0.727, P = 0.011) and participants that lived alone(Exp B: 2.925, 95%CI: 1.039-8.229, P = 0.042) were identified as independent predictors of program non-completion. Twenty participants of the twenty-six non-completers agreed to participate in the survey about their pulmonary rehabilitation experience. The reasons given for non-completion were grouped into: medical reasons(75%), other personal reasons(30%) and external barriers(45%), with ten non-completers reporting more than one reason.No participant reported living alone or that the program commenced during winter as a reason for noncompletion. There was no relationship between illness being the participant's reason for non-completion and the programs that commenced in winter(P = 0.135). CONCLUSION: Despite winter commencing programs and participants who lived alone being independent predictors of program non-completion, neither measure was reported by participants as a reason for noncompletion.展开更多
Peripheral vascular disease is the main reason for lower limb amputation, mostly present in old persons. The number of lower limb amputations due to cancer is small, but affects all age groups. Surgery is the primary ...Peripheral vascular disease is the main reason for lower limb amputation, mostly present in old persons. The number of lower limb amputations due to cancer is small, but affects all age groups. Surgery is the primary （main） treatment for most bone tumors, the main goal is to remove all of the tumor. Sometimes limb amputation is the only possible solution, resulting in severe impairment of body function and activity limitations. The final goal of rehabilitation is to enable patients to re-integrate to the highest possible level into their previous social life and work. The article presents the functional outcome of patients with lower limb amputation due to oncological disease--cancer of bone or soft tissue admitted for rehabilitation to the University Rehabilitation Institute So^a in the period from 2002 to 2012. During this period 67 amputees were admitted and 60 of them were fitted with appropriate lower limb prosthesis. Younger age and transtibial level of amputation were of better functional outcome than in transfemoral or hip disarticulation amputees.展开更多
文摘Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replacement(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasingly older,have comorbidities,and frailty.TAVR cardiac rehabilitation(CR)programs significantly improve both functional capacity and quality of life of patients.However,there are no guidelines on how to carry out them and few elderly patients are referred to CR.Furthermore,mortality in women who undergo TAVR is higher than in men and even fewer are referred to CR programs.Multidisciplinary patient care,including comorbidities and frailty,is essential.It is necessary to ensure exquisite continuity of care during TAVR,CR,and the rest of the patient's life.Telerehabilitation could be an option in some lower-risk patients to include more patients in CR programs after TAVR,given the high demand.This article reviews the evidence on why CR should be performed in post-TAVR patients and proposes a practical and novel approach to the care process and the recommended aspects and components of the CR program.
文摘In today’s society, the incidence of cardiopulmonary diseases is increasing annually, seriously affecting patients’ quality of life. Therefore, developing a scientific and effective rehabilitation training program is of great significance. This study first analyzes the theoretical basis of cardiopulmonary rehabilitation training, including the effects of aerobic exercise, interval training, and strength training on cardiopulmonary function. Based on this, a comprehensive rehabilitation training program is designed, which includes personalized training plans, comprehensive interventions, multidisciplinary collaboration, patient education, and regular follow-up visits. The cardiopulmonary rehabilitation training plan developed in this study has certain scientific practicability, which provides a theoretical basis for cardiopulmonary rehabilitation training, and also provides a reference for medical institutions, rehabilitation centers and communities, which is helpful for promotion and application to a wider range of patients with cardiopulmonary diseases.
基金supported by the National Institute for Health Research(NIHR)Imperial Biomedical Research Centre
文摘AIM To investigate factors predicting treatment completion and treatment outcome of the Reasoning and Rehabilitation Mental Health Programme(R&R2MHP)cognitive skills programme for mentally disordered offenders.METHODS Secondary analysis of data previously obtained from 97 male patients who were sectioned and detained under the United Kingdom Mental Health Act in low,medium and high security hospitals and who had completed R&R2MHP.Predictors of treatment completion included background variables and five outcome measures:Four self-reported measures of violent attitudes,social problem-solving skills,reactive anger and locus of control and an objective measure of behaviour on theward that was completed by staff.Completion of the 16 session programme,which was delivered on a weekly basis,was classified as≥12 sessions.RESULTS It was found that the R&R2MHP is appropriate for delivery to participants of different ages,ethnic background,and at different levels of security without the completion rate or treatment effectiveness being compromised.Participants taking oral typical psychotropic medication were over seven times more likely to complete the programme than other participants.Behavioural disturbance on the ward prior to commencing the programme predicted non-completion(medium effect size).As far as treatment completion was concerned,none of the background factors predicted treatment effectiveness(age,ethnic background,level of security,number of previous convictions and number of previous hospital admissions).The best predictor of treatment effectiveness was attitude towards violence suggesting that this should be the primary outcome measure in future research evaluating outcomes of the R&R2MHP cognitive skills program.CONCLUSION The findings suggest that a stable mental state is a key factor that predicts treatment completion.
基金Project(2010020176-301)supported by Liaoning Science and Technology Program,ChinaProject(F10-2D5-1-57)supported by Shenyang Municipal Fund,China
文摘In view of the uncertainty and complexity,the intelligent model of rehabilitation training program for stroke was proposed,combining with the case-based reasoning(CBR) and interval type-2 fuzzy reasoning(IT2FR).The model consists of two parts:the setting model based on CBR and the feedback compensation model based on IT2FR.The former presets the value of rehabilitation training program,and the latter carries on the feedback compensation of the preset value.Experimental results show that the average percentage error of two rehabilitation training programs is 0.074%.The two programs are made by the intelligent model and rehabilitation physician.That is,the two different programs are nearly identical.It means that the intelligent model can make a rehabilitation training program effectively and improve the rehabilitation efficiency.
基金supported by grants from the General Program of National Natural Science Foundation of China(No.81870724)the Innovation Project of Shanghai Municipal Science and Technology Commission(No.19441900400)the Shanghai Municipal Health Commission(No.201740018).
文摘Objective Patients suffered a lot from decompensated vestibular vertigo.Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation.Routine rehabilitation training is faced with the challenges of patients’compliance,completion,the average recuperation time and so on.This study is aimed to investigate advantages of short-term personalized vestibular rehabihitation at home guided by professional therapist.Methods A short-term personalized vestibular rehabilitation program(ST-PVR)was designed for patients with decompensated vestibular vertigo in this study.Results Patients experiencing the ST-PVR program showed significant improvement of Self-Rating Anxiety Scale(SAS),Dizziness Handicap Inventory(DHI),Activities-Specific Balance Confidence Scale(ABC)scores by the second follow-up(at 2nd week after treatment,P<0.05).However-improvement in the medication group occurred slightly later,DHI for 1 month and SAS for 2 months after treatment(P<0.05).Also,the improvement in the onset time of unilateral weakness(UW)at 2nd week after treatment in the personalized vestibular rehabilitation(PVR)group was faster than that in the medication group.Conclusion In general,the short-term PVR program showed great advantages by prompting vestibular compensation quickly and putting forward future direction for clinical treatment on decompensated vestibular vertigo.
文摘Background The benefits of exercise-based cardiac rehabilitation(EBCR)programs in post-acute myocardial infarction(AMI)patients have been demonstrated.Our aim was to assess the impact of EBCR in³70-years-old vs.younger post-AMI patients.Methods We retrospectively evaluated patients who underwent a supervised EBCR protocol,twice a week during 6-12 weeks.We evaluated changes in several outcomes based on pre-and post-CRP assessments.Results Of a total of 1607 patients,333(21%)were³70-years-old.After the EBCR,an overall improvement on functional capacity,daily physical activity,lipid profile,body mass index,glycated hemoglobin(HbA1c),N-terminal pro-brain natriuretic peptide(NT-pro-BNP)and C-reactive protein was observed in both younger and older patients(P<0.05).Older patients showed a smaller benefit on the increment of daily physical activity and lipid profile improvement,but a larger reduction in NT-pro-BNP.In the multivariate analysis,only improvements on daily physical activity and HbA1c were dependent on age.Conclusion As their younger counterparts,older patients,significantly improved functional capacity,metabolic parameters and level of daily physical activity after EBCR.
基金Supported by The Prince Charles Hospital Foundationthe Queensland Health’s Health Practitioner Research Scheme
文摘AIM: To identify baseline characteristics that independently predict pulmonary rehabilitation non-completion and compare these findings against the participant's reasons for non-completion. METHODS: Participants with chronic obstructive pulmonary disease(COPD) who attended a standardised twice weekly, eight week pulmonary rehabilitation program(located in the sub-tropics, latitude 27°29' South) between 2010 and 2012 were recruited. Thebaseline characteristics of program completers and non-completers were compared in a case-controlled design. Participants who attended < 12/16 sessions were classified as a non-completer. Non-completers(those who missed > 4 session of the program) were asked by one independent investigator to participate in a survey about their pulmonary rehabilitation experience. Baseline characteristics were assessed for differences between program completers and non-completers. The baseline characteristics included disease severity, exercise capacity, smoking history, participant's social support and the season when each participant commenced rehabilitation. Non-completers that agreed to participate in the survey were asked to indicate what personal factors or external factors contributed to their program non-completion. Comparisons of completers and non-completers baseline characteristics were performed using cross-tabulations and t-tests, with significant measures analysed in a multivariate binary logistic regression model. Non-completers survey responses were compared to the identified independent predictors using cross-tabulations.RESULTS: Twenty-six participants(23.4%) of the 111 participants with COPD [(mean ± SD) age was 67.4 ± 9.2 years and FEV1 54.6% ± 22.3%)], were classified as non-completers. Forty-five participants(40.5%) commenced pulmonary rehabilitation during winter. Thirty-six participants(32.4%) were living alone at program commencement. In the multivariate analysis(n = 111), only programs that commenced in winter(Exp B: 0.255, 95%CI: 0.090-0.727, P = 0.011) and participants that lived alone(Exp B: 2.925, 95%CI: 1.039-8.229, P = 0.042) were identified as independent predictors of program non-completion. Twenty participants of the twenty-six non-completers agreed to participate in the survey about their pulmonary rehabilitation experience. The reasons given for non-completion were grouped into: medical reasons(75%), other personal reasons(30%) and external barriers(45%), with ten non-completers reporting more than one reason.No participant reported living alone or that the program commenced during winter as a reason for noncompletion. There was no relationship between illness being the participant's reason for non-completion and the programs that commenced in winter(P = 0.135). CONCLUSION: Despite winter commencing programs and participants who lived alone being independent predictors of program non-completion, neither measure was reported by participants as a reason for noncompletion.
文摘Peripheral vascular disease is the main reason for lower limb amputation, mostly present in old persons. The number of lower limb amputations due to cancer is small, but affects all age groups. Surgery is the primary （main） treatment for most bone tumors, the main goal is to remove all of the tumor. Sometimes limb amputation is the only possible solution, resulting in severe impairment of body function and activity limitations. The final goal of rehabilitation is to enable patients to re-integrate to the highest possible level into their previous social life and work. The article presents the functional outcome of patients with lower limb amputation due to oncological disease--cancer of bone or soft tissue admitted for rehabilitation to the University Rehabilitation Institute So^a in the period from 2002 to 2012. During this period 67 amputees were admitted and 60 of them were fitted with appropriate lower limb prosthesis. Younger age and transtibial level of amputation were of better functional outcome than in transfemoral or hip disarticulation amputees.
