This study has been attempted to set up the strategies of the nursing which can promote the activity performance for early rehabilitation for the patients by examining the effect of the structured patient education on the early rehabilitation knowledge and activity performance of the C.V.A patients. The study method has been done by investigating the experiment group and control group in advance through the question papers and interview and observation on 65 patients who had been hospitalized at oriental medicine hospital of K Medical Center from July 1st 1995 to the end of Sep, 1995. The analysis of the collected material had been done for the homogeneity test in which general characters of experiment group and control group had been tested by X²and the homogeneity test of ADL by t-test. To test the hypothesis the t-test had been given for the difference of the early rehabilitation knowledge and activity performance between the two groups and the correlation between early rehabilitation knowledge and activity performance had been tested by Pearson's Correlation Coefficient. The result of the test of the hypothesis is as the below. 1 The 1st hypothesis “The experiment group which had received the structured education should be higher in the early rehabilitation knowledge than the control group” was supported(t=4.45. p=.000). 2. The 2nd hypothesis “The experiment group which received the structured education should be higher in the early rehabilitation activity performance than the control group”was supported(t=2.11, p=.036). 3. The 3rd hypothesis “The higher the early rehabilitation knowledge of the patient the higher the activity performance degree” was rejected (r=.1546, p=.219). In conclusion, the patients who received the structured education showed the increase in the degree of early rehabilitation knowledge and activity performance, so it has been judged that education has been prerequisite in increasing the knowledge and activity performance of early rehabilitation.
Purpose: To investigate the effect of an augmented reality (AR) system on muscle strength and function level of the paretic lower limb and the balance ability in the early rehabilitation program of acute stroke patients. Methods: The participants (30 or fewer days after stroke) were randomly assigned to receive intervention with an early rehabilitation program using an AR system (n=1) or an early rehabilitation program consisting of functional electrical stimulation and tilt table use (n=1). Patients in both subjects received interventions 4-5 times a week for 3 weeks. Results: In the paretic limb muscle strength, AR subject was increased from 15 to 39.6 Nm and Control subject was increased from 5 to 30.2 Nm. The paretic limb function of AR subject motor function was increased from 8 to 28 score and Control subject motor function was increased from 6 to 14 score. But sensory function was very little difference between the two subjects (AR subject: from 4 to 10 score, Control subject: from 3 to 10 score). In the balance ability, AR subject had more difference after intervention than control subject (AR subject: 33 score, Control subject: 22 score). Conclusion: The early rehabilitation program using the AR system showed a slightly higher improvement in the motor function of the paretic lower limb and balance ability measurement than the general early rehabilitation program. The AR system, which can provide more active, task-oriented, and motivational environment, may provide a meaningful environment for the initial rehabilitation process after stroke.
We propose a new early rehabilitation training system for postural control using a tilting bed and a force plate. The conventional rehabilitation systems for postural control cannot be applied to the patients lying in bed because the rehabilitation training using those systems is possible only when the patient can stand up by himself or herself. Moreover, there has not existed any device that could provide the sense of balance or the sensation of walking to the patients in bed. By using a tilting bed, a visual display, and a force plate, we have developed a new rehabilitation training system for balance control of the patients in bed providing sense of balance and the sensation of walking to the patient. Through the experiments with real people, we verified the effectiveness of the new early rehabilitation training system. The results showed that this system is an effective system for the early rehabilitation training and that our system might be useful as clinical equipment.
Objective : To study the effect of early intervention and rehabilitation in the expression of aquaporin-4 and ultrastructure changes on cerebral palsy pups model induced by intrauterine infection. Methods : 20 pregnant Wistar rats were consecutively injected with lipopolysaccharide intraperitoneally. 60 Pups born from lipopolysaccharide group were randomly divided into intervention group (n=30) and non-intervention group (n=30); intervention group further divided into early intervention and rehabilitation group (n=10), acupuncture group (n=10) and consolidate group (n=10). Another 5 pregnant rats were injected with normal saline intraperitoneally; 30 pups born from the normal saline group were taken as control group. The intervention group received early intervention, rehabilitation and acupuncture treatment. The motor functions of all pups were assessed via suspension test and modified BBB locomotor score. Aquaporin-4 expression in brain tissue was studied through immunohistochemical and western-blot analysis. Ultrastructure changes in damaged brain and control group were studied electron-microscopically. Results : The scores of suspension test and modified BBB locomotor test were significantly higher in the control group than the intervention and non intervention group (p<0.01); higher in the intervention group than the non-intervention group (p<0.01). The expression of Aquaporin-4 was lower in intervention and non intervention group than in the control group (p<0.01); also lower in non-intervention group than the intervention group (p<0.01). Marked changes were observed in ultrastructure of cortex and hippocampus CAI in brain damaged group. Conclusion : Early intervention and rehabilitation training can improve the motor function in offspring with brain injury and reduce the expression of aquaporin-4 in damaged brain.
The purpose of this study was to investigate factors influencing on the early treatment of children with developmental disability. Data was collected from 102 mothers of children with developmental disability who were treated at 4 rehabilitation facilities in Kyunggi-Do and Kangwon-Do. The results were as follows: 1) Of a total of 102, 63 children began to receive rehabilitation therapy during the period 0~12 months (early treatment group), 38 children after 1 year of age (delayed early treatment group). 2) There were statistically significant differences between the early treatment group and delayed early treatment group for prematurity, low birth weight, the time to discover developmental abnormalities, the time of first diagnosis, and first treatment (p<0.05). 3) There were no statistically significant differences in the two groups for level of education, economic status, risk factors (except prematurity and birth weight), home care, family's cooperation and commuting time (p>0.05). Based on this study, the important factors for early treatment were early detection, early diagnosis and constant follow-up for high-risk babies.
Choi, Sungwook;Seo, Kyu Bum;Shim, Seungjae;Shin, Ju Yeon;Kang, Hyunseong
Clinics in Shoulder and Elbow
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제22권4호
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pp.190-194
/
2019
Background: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation. Methods: Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suturebridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery. Results: No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0-88.0; delayed: 66.9-91.0; p<0.001) and the UCLA shoulder score (early: 20.3-32.3; delayed: 20.4-32.4; p<0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6-15 months; average, 10.4 months). Conclusions: Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.
Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients' high motivation and committed participation. Patients' motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients' participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients' level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients' participation at early intervention were important determinants of functional outcome. These findings suggest that patients' participation should be encouraged in order to achieve successful stroke recovery.
Byunghoon Lee;Yong Beom Shin;Kwangha Lee;Myung Hun Jang
Physical Therapy Rehabilitation Science
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제12권1호
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pp.43-47
/
2023
Objective: To present a case study of a 69-year-old woman with COVID-19 who developed neurological complications due to Extracorporeal Membrane Oxygenation (ECMO) therapy and highlight the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU. Design: A case report Methods: The patient received ECMO therapy, followed by neurological monitoring and rehabilitation in an isolation ICU. Daily neurological examinations were conducted to monitor the patient's neurological symptoms. Computed tomography was performed to confirm the presence of a hematoma in the left hamstring, which was identified as the cause of the neurological complication. Ultrasound-guided aspiration was immediately performed, and sciatic neuropathy predominantly involving the peroneal division was identified after aspiration. Results: Successful recovery was made possible by the early detection of neurological complications and rehabilitation in an isolation ICU. Although electrodiagnostic tests were not performed due to limited access to the isolation ICU, the appropriate intervention time could be determined through daily neurological examinations and rehabilitation, thereby minimizing neurological sequelae. Conclusions: ECMO-related neurological complications are well known, and their recognition in the ICU can be challenging. The presented case highlights the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU, which can minimize neurological sequelae.
Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.
Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.
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