physiotherapy rehabilitation

  • 文章类型: Case Reports
    脊髓病表现在儿童时期,可以根据损伤部位(可能导致脊柱综合征)或来源(可能是非创伤性或广泛创伤性)进行临床分类。非创伤性脊髓病可以由炎症引起,传染性,营养,新陈代谢,或缺血因素。它也可能与全身性疾病有关,如脱髓鞘疾病,多发性硬化症,或者系统性狼疮.非故意伤害是创伤性脊髓病的一个重要因素,这通常与额外的伤害有关。MRI和CT摄片有助于识别压迫性脊髓病。我们介绍了一个12岁女孩的情况,她是右手占主导地位。六个月前,她的健康状况良好,但最近开始出现双下肢无力的情况。脑部MRI显示基底内陷伴大孔狭窄,在头椎交界处引起压迫性脊髓病.病人接受了手术,其次是物理治疗康复,以提高功能独立性和生活质量。
    Myelopathy manifests in childhood and can be clinically categorized according to the site of injury (which may result in spinal syndrome) or the source (which may be nontraumatic or widely traumatic). Nontraumatic myelopathy can be caused by inflammatory, infectious, nutritional, metabolic, or ischemic factors. It may also be associated with systemic illnesses such as demyelinating disease, multiple sclerosis, or systemic lupus. Nonintentional harm is a significant factor to take into account in instances of traumatic myelopathy, which can frequently be linked to additional injuries. MRI and CT radiography help identify compressive myelopathy. We present the case of a 12-year-old girl who is right-hand dominant. She was in good health six months ago but recently began experiencing weakness in both of her lower limbs. An MRI of the brain revealed basilar invagination with stenosis of the foramen magnum, causing compressive myelopathy at the cranio-vertebral junction. The patient was operated on, followed by physiotherapy rehabilitation to improve functional independence and quality of life.
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  • 文章类型: Case Reports
    影响大脑后动脉(PCA)的急性缺血性卒中(AIS)代表了独特的临床挑战,需要采取多方面的康复方法。这篇综述旨在全面概述专门为涉及PCA领域的AIS患者量身定制的物理治疗干预措施。PCA提供负责视觉处理的大脑关键区域,记忆,和感觉统合。因此,PCA梗死患者通常表现出一组明显的神经功能缺损,包括视野干扰,认知障碍,和感觉异常。本病例报告重点介绍了基于证据的物理治疗策略,包括一系列干预措施,从早期动员和运动训练到感觉重新融合和认知康复。及早动员,包括卧床活动和直立活动,对于预防与不动相关的并发症至关重要。运动训练干预措施的目标是恢复功能性运动模式,解决偏瘫和平衡障碍。
    Acute ischemic stroke (AIS) affecting the posterior cerebral artery (PCA) represents a unique clinical challenge, necessitating a multifaceted approach to rehabilitation. This review aims to provide a comprehensive overview of physiotherapeutic interventions tailored specifically for individuals with AIS involving the PCA territory. The PCA supplies critical areas of the brain responsible for visual processing, memory, and sensory integration. Consequently, patients with PCA infarcts often exhibit a distinct set of neurological deficits, including visual field disturbances, cognitive impairments, and sensory abnormalities. This case report highlights evidence-based physiotherapy strategies that encompass a spectrum of interventions, ranging from early mobilization and motor training to sensory reintegration and cognitive rehabilitation. Early mobilization, including bed mobility exercises and upright activities, is crucial to prevent complications associated with immobility. Motor training interventions target the restoration of functional movement patterns, addressing hemiparesis and balance impairments.
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  • 文章类型: Case Reports
    在印度,称为抗胆碱酯酶的有机磷(OP)化学物质会导致大量疾病和死亡。虽然没有确切的数字,来自医院的数据表明,约50%的急性中毒事件归因于有机磷。抗胆碱酯酶,当意外或自杀暴露时,导致三种不同的神经系统疾病。第一种是急性胆碱能危象,可能是致命的,需要在重症监护病房给药;第二种是中间综合征,经常导致颅神经麻痹,近端和呼吸肌无力,和患者的呼吸支持;第三是迟发性有机磷引起的多发性神经病。一起,这些神经行为改变已被确认,被称为"慢性有机磷引起的神经精神障碍"(COPIND).一名40岁的男性患者试图通过吞咽大量OP杀虫剂来自杀。他呼吸沉重,喘气的空气,嘴唇起泡,当他被带到一家私人医院时,他闻到了强烈的农药味。进行了神经传导速度(NCV)等调查,显示了运动性轴索多发性神经病。
    In India, organophosphorus (OP) chemicals known as anticholinesterases cause a considerable amount of disease and mortality. While precise figures are unavailable, data from hospitals indicates that about 50% of acute poisoning episodes are attributed to organophosphates. Anticholinesterases, when accidentally or suicidally exposed, cause three different neurological disorders. The first is an acute cholinergic crisis that can be fatal and necessitates administration in an intensive care unit; the second is an intermediate syndrome that frequently results in cranial nerve palsies, proximal and respiratory muscle weakness, and respiratory support for patients; and the third is a delayed organophosphate-induced polyneuropathy. Together, these neurobehavioral alterations have been identified and are referred to as \"chronic organophosphate-induced neuropsychiatric disorders\" (COPIND). A 40-year-old male patient tried suicide by swallowing a significant dose of OP pesticide. He was breathing heavily, gasping for air, foaming at the lips, and smelled intensely of pesticide when he was brought to a private hospital. Investigations like nerve conduction velocity (NCV) were done, which revealed motor axonal polyneuropathy.
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  • 文章类型: Journal Article
    背景与目的屈肌腱损伤的发生率估计为每100,000人中7-14人。在印度,这种损伤很常见,其中约5%的损伤需要修复屈肌腱。在本研究中,我们在印度西部的三级护理中心分享我们手屈肌腱修复的经验。材料和方法在三年内,45例患者入院接受肌腱修复。在进行了适当的评估后,患者接受肌腱修复。在三个月结束时评估主要结果和次要结果参数。在有运动限制的患者中,物理治疗持续更长的时间。在每个阶段汇编数据。结果患者的平均年龄为28.84岁(范围:13-68岁),其中大多数病例属于15-60岁年龄组。大部分手部受伤是意外(由工伤事故造成,机器受伤,或动物咬伤)占80%(n=36),其次是袭击案件(11%,n=5)和自我伤害,即,自杀未遂(约9%,n=4)。在所有的伤害中,大多数在V区(60%,n=27),其次是II区的24.4%(n=11)的病例。一些案件在一区,III,和IV(2.2%,11.2%,和2.2%)。原发性损伤的Buck-Gramcko评分非常出色,恢复率为57.78%。结论屈指肌腱损伤的修复应以恢复强度和活动性为目标。为了获得最佳结果,完全主动运动方案应在手术修复后立即开始.然而,可能需要长期物理治疗才能获得预期的益处。
    Background and objective The incidence of flexor tendon injury is estimated to be 7-14 per 100,000 population. In India, such injuries are common and about 5% of these injuries require repair of the flexor tendon. In the present study, we share our experience of hand flexor tendon repair at a tertiary care center in western India. Material and methods Over a period of three years, 45 patients were admitted for tendon repair. After performing a proper evaluation, patients were taken for tendon repair. Primary outcome and secondary outcome parameters were assessed at the end of three months. Physiotherapy was continued for a longer duration in patients with movement restrictions. Data were compiled at each stage. Results The mean age of the patients was 28.84 years (range: 13-68 years) with a majority of the cases belonging to the age group 15-60 years. The majority of hand injuries were accidental (caused by work-related accidents, machine injuries, or animal bites) amounting to 80% (n=36), followed by assault cases (11%, n=5) and self-inflicted injuries, i.e., attempted suicides (around 9%, n=4). Among all injuries, the majority were in zone V (60%, n=27) followed by 24.4% (n=11) of cases in zone II. A few cases were in zone I, III, and IV (2.2%, 11.2%, and 2.2% respectively). The Buck-Gramcko scoring for primary injury was excellent with a recovery rate of 57.78%. Conclusion Flexor tendon injuries should be repaired with the aim of recovering strength as well as mobility. For optimal outcomes, total active motion protocol should be commenced immediately after the surgical repair. However, long-term physiotherapy may be required for attaining desired benefits.
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  • 文章类型: Journal Article
    背景:许多康复诊所采用严肃的游戏来支持他们的物理治疗。严肃的游戏可以监控并提供有关锻炼的反馈,并有望改善治疗并帮助专业人员处理更多患者。然而,对于严肃游戏对物理治疗师实际工作的影响知之甚少。
    目的:本研究旨在了解基于肌电图的严肃游戏对物理治疗师实际工作的影响。
    方法:这项研究使用了门诊康复诊所的观察课程,该诊所最近开始使用基于肌电图传感器的严肃游戏。总的来说,进行了44次观察,涉及3名物理治疗师和22名患者。观察会议通过录音或现场笔记记录,并通过主题分析对主题进行分析。
    结果:这项研究的结果表明,物理治疗师在使严肃的游戏发挥作用方面发挥了重要作用。物理治疗师向病人介绍情况,校准系统,规定的练习,在病人玩严肃游戏的时候支持他们,所有这些都相当于相关的劳动。
    结论:这项工作的结果挑战了一个观点,即严肃的游戏减少了物理治疗师的工作,并要求对严肃的游戏可能产生的不同影响进行全面分析。采用严肃的游戏来创造更多的工作是完全可以接受的,提供的临床结果或其他优势,使严重的游戏是强大的;然而,这些影响必须逐案评估。此外,这项工作激励技术发展社区更好地调查物理治疗师及其背景,为技术设计提供启示。
    BACKGROUND: Many rehabilitation clinics adopted serious games to support their physiotherapy sessions. Serious games can monitor and provide feedback on exercises and are expected to improve therapy and help professionals deal with more patients. However, there is little understanding of the impacts of serious games on the actual work of physiotherapists.
    OBJECTIVE: This study aimed to understand the impact of an electromyography-based serious game on the practical work of physiotherapists.
    METHODS: This study used observation sessions in an outpatient rehabilitation clinic that recently started using a serious game based on electromyography sensors. In total, 44 observation sessions were performed, involving 3 physiotherapists and 22 patients. Observation sessions were documented by audio recordings or fieldnotes and were analyzed for themes with thematic analysis.
    RESULTS: The findings of this study showed that physiotherapists played an important role in enabling the serious game to work. Physiotherapists briefed patients, calibrated the system, prescribed exercises, and supported patients while they played the serious game, all of which amounted to relevant labor.
    CONCLUSIONS: The results of this work challenge the idea that serious games reduce the work of physiotherapists and call for an overall analysis of the different impacts a serious game can have. Adopting a serious game that creates more work can be entirely acceptable, provided the clinical outcomes or other advantages enabled by the serious game are strong; however, those impacts will have to be assessed on a case-by-case basis. Moreover, this work motivates the technology development community to better investigate physiotherapists and their context, offering implications for technology design.
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  • 文章类型: Journal Article
    OBJECTIVE: Rehabilitation has been reported to improve pain and disability for patients after lumbar surgery. However, studies to investigate the rehabilitation intervention for lumbar decompression surgery during hospitalization are scarce. The aim of this study was to examine outcomes of perioperative rehabilitation intervention for patients who underwent lumbar decompression surgery (LDS).
    METHODS: Patients aged 18-65 years old who received their first LDS were randomized into the perioperative rehabilitation group (PG) or control group (CG). The PG received rehabilitation intervention during hospitalization for lumbar decompression surgery. Pain, functional capacity, Roland-Morris Disability Questionnaire (RMDQ), and Short-Form Health Survey (SF-12) were assessed on admission, at discharge, and at follow-ups one month, three months, and six months after surgery. Two-way repeated measures ANOVAs were used for statistical analysis.
    RESULTS: A total of 60 patients scheduled for decompression surgery for lumbar stenosis were enrolled into the study. After surgery, the PG showed significant pain relief and improvement of disability as well as quality of life, but there were no significant functional improvements compared with the CG.
    CONCLUSIONS: The findings of this study indicate that the rehabilitation intervention during hospitalization improves pain intensity as well as disability and quality of life, yet has limited effects on the functional performance over time up to six months post-surgery in patients who received LDS. The study suggest that rehabilitation interventions during hospitalization must include regular support for patient adherence to the intervention program and focus on task-oriented programs for lower extremities such as closed-chain exercises in functional postures.
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