Objective Using a rat model, we investigated the effect of multidisciplinary rehabilitation, including aerobic training and ointment, on the ROM, vWF, VEGF content, and femoral artery hemodynamics in rats with joint contracture. Methods A total of 44 Wistar rats were divided into the normal control group (NC, eight rats) and the experimental group (EG). A joint contracture model was established for the rats in the EG group by an external fixator. After fixator removal, 32 rats are further divided into the MC, SC, RE, and SR groups ( n = 8). Before and after the 42 day intervention, the ROM, vWF, VEGF, PS, ED, and RI were measured using X-ray imaging, ELISA, and color Doppler ultrasound, respectively. Results After fixator removal, ROM for EG group was lower than that of the NC group ( p < .01). After the intervention, ROM for the SR, RE, and SC groups was improved. The ROM for the SR group reached a similar value for NC group. vWF and VEGF levels in SR group were lower than in the MC, SC, and RE groups ( p < .05), and had a similar value to the NC groups. PS value for SR and RE groups was higher than the MC and SC groups. The RI value for SR group was higher than that of NC and MC groups. Conclusion Multidisciplinary rehabilitation used in this study can treat joint contracture synergistically. It improves the ROM of the joint, reduces the content of vWF and VEGF, and improves the femoral artery hemodynamics.

目的 了解废用性膝关节挛缩患者日常活动能力现状,并分析其影响因素.方法 采用日常活动能力评定量表、徒手肌力评定量表、下肢运动功能评定量表和步行功能评定量表对新疆乌鲁木齐市某三级甲等医院康复科的 126 例废用性膝关节挛缩患者进行调查,采用多元线性回归分析废用性膝关节挛缩患者日常活动能力的影响因素.结果 废用性膝关节挛缩患者的日常活动能力得分为 52.50(25.00,80.00)分,不同性别、年龄、病程、医疗费用支付方式的废用性膝关节挛缩患者日常活动能力得分差异有统计学意义(P＜0.05);废用性膝关节挛缩患者日常活动能力与肌力、下肢运动功能及步行能力均成正相关(P＜0.001);多元线性回归分析结果显示,肌力、运动功能及步行能力是废用性膝关节挛缩患者日常活动能力的影响因素.结论 废用性膝关节挛缩患者的日常活动能力处于中度残疾水平,临床康复工作者可从其影响因素入手,根据患者的自身特点强化其肌力、运动功能及步行能力,以期提高患者的日常活动能力.

Joint contracture causes a decrease in range of motion (ROM), which severely affects activities of daily living of patients. We have investigated the effectiveness of a multidisciplinary rehabilitation on joint contracture by rat model. We used 60 Wistar rats in this study. The rats were divided into five groups as follows: group 1 was the normal control group; except the group 1, we created left hind limb knee joint contracture using Nagai method for other four groups. The joint contracture modeling group 2 was the model control group for monitoring the spontaneous recovery, and other three groups were given different rehabilitation treatments; for example, group 3 was treadmill running group; group 4 was medication group; group 5 was treadmill running plus medication group. The left hind limbs knee joint ROM and the femoral blood flow indicators (FBFI) including PS, ED, RI, and PI were measured right before and after the 4 weeks of rehabilitation. After 4 weeks of rehabilitation treatments, the measured values of ROM and FBFI are compared with the corresponding values of group 2. Firstly, we did not see clear difference in the values of ROM and FBFI for group 2 before and after 4 weeks spontaneous recovery. The improvement of left lower limb ROM for group 4 and group 5 as compared to the group 2 was statistically significant (p < 0.05), whereas a less recovery for group 3 was observed. However as compared to the group 1, we did not observe full recovery in ROM of group 4 and group 5 after 4 weeks of rehabilitation. The PS and ED level for rehabilitation treatment groups was significantly higher than those modeling ones (Tables 2, 3, Figs. 4, 5), while the RI and PI values show the contrary trends (Tables 4, 5, Figs. 6, 7). Our results indicate that multidisciplinary rehabilitation treatments had a curative effect on both contracture of joints and the abnormal femoral circulations.

目的 探讨中药松弛膏联合跑台运动康复干预方案对关节挛缩大鼠关节纤维化中ROM、IL-6、IL-17和TGF-β1表达的影响.方法 44只Wistar大鼠,随机取8只大鼠为正常对照组(NC组),其余36只大鼠建立关节挛缩模型.将32只造模成功的大鼠分为模型对照组(MC组)、中药松弛膏干预组(SC组)、跑台运动康复干预组(RE组)、中药松弛膏+跑台运动康复干预组(SR组),每组8只.MC组不进行任何干预;SC组给予药物涂抹按摩;RE组给予跑台训练;SR组给予跑台训练后再进行药物涂抹按摩,干预均为每天1次,每周6 d.于干预前、干预42 d后测量所有大鼠ROM;干预42 d后采用ELISA法检测大鼠IL-6、IL-17含量及TGF-β1含量.结果 干预前模型组大鼠ROM与NC组相比显著降低(P<0.05);干预42 d后,与MC组ROM相比,SR组ROM和SC组ROM显著增加,差异均具有统计学意义(P<0.05).干预后与MC组比,SC组、RE组及SR组IL-6、IL-17含量显著降低,其中SR组显著低于SC组及RE组(P<0.05);SR组TGF-β1含量均较MC组、SC组及RE组显著降低(P<0.05).结论 中药松弛膏联合跑台运动康复干预能协同改善关节挛缩大鼠的关节活动度,减轻炎症因子释放,减少与纤维化有关的TGF-β1的分泌,从而改善关节挛缩大鼠关节纤维化的程度.

目的 探讨跌倒效能及步行能力在脑卒中足下垂患者平衡功能与活动能力之间的中介效应.方法 采用方便抽样法,以新疆医科大学第一附属医院康复科收治的脑卒中足下垂患者为调查对象,在2020年12月至2021年10月共选取159例患者,评估其跌倒效能、步行、平衡及日常生活活动能力.采用Pearson相关分析,采用SPSS软件进行统计分析.结果 平衡功能与步行能力、活动能力呈正相关(r=0.819、0.789,P＜0.01),与跌倒效能呈负相关(r=-0.712,P＜0.01);步行能力与活动能力呈正相关(r=0.722,P＜0.01);跌倒效能与活动能力呈负相关(r=-0.621,P＜0.01).脑卒中足下垂患者跌倒效能及步行能力在平衡功能与活动能力之间起中介效应,中介效应占总效应的37.58％.结论 跌倒效能及步行能力在平衡功能与活动能力之间起到部分中介效应.

目的 探讨综合康复护理对脑卒中足下垂患者跌倒相关危险因素的影响.方法 选取乌鲁木齐市某三甲医院康复医学科脑卒中足下垂住院患者90例,按照入院先后顺序随机分为3组:常规组、情志护理组和综合康复护理组,各30例,分别采用简明国际跌倒效能感量表、Holden步行功能分级、Berg平衡量表及改良Barthel指数评估患者的跌倒效能、步行能力、平衡功能以及日常生活活动能力.结果 与干预前比较,3组患者的简明国际跌倒效能感量表得分均降低(P＜0.05),综合康复护理组下降程度明显高于常规组及情志护理组,差异有统计学意义(P＜0.05);与干预前比较,3组患者的Berg平衡量表及日常生活活动能力评分均提高(P＜0.05),综合康复护理组与常规组、情志护理组比较,差异均有统计学意义(P＜0.05).脑卒中足下垂患者平衡功能与步行能力(r=0.851,P＜0.01)、日常生活活动能力(r=0.749,P＜0.01)均呈正相关(P＜0.01)、与跌倒效能得分呈负相关(r=-0.550,P＜0.01).多元线性回归分析显示,步行能力、跌倒效能及日常生活活动能力是脑卒中足下垂患者平衡功能的主要影响因素(P＜0.05).结论 综合康复护理能有效改善患者跌倒效能、平衡功能及日常生活活动能力与跌倒相关的危险因素,改善效果优于常规组及情志护理组.

目的 调查脑卒中足下垂患者日常生活活动能力现状,并分析其影响因素.方法 采用便利抽样法,于2020年12月—2021年10月选取乌鲁木齐市某三级甲等医院康复医学科159例脑卒中足下垂住院患者作为研究对象,使用一般情况调查表、简明国际跌倒效能感量表、Holden步行能力分级、Berg平衡量表以及改良Barthel指数进行调查,采用多元线性回归分析脑卒中足下垂患者日常生活活动能力的影响因素.结果 脑卒中足下垂患者的日常生活活动能力得分为(58.74±19.16)分.多元线性回归分析结果显示:平衡功能、步行能力及跌倒效能进入回归方程(F=95.361,P<0.001),共解释日常生活活动能力总变异的64.2％.结论 脑卒中足下垂患者日常生活活动能力处于中等水平,平衡功能、步行能力及跌倒效能是日常生活活动能力的主要影响因素.临床康复计划中不仅要加强患者平衡功能及步行能力的训练,也要重视对患者跌倒恐惧心理的干预,以更好地恢复患者的日常生活活动能力.

Objective:To observe any effect of supplementing treadmill training with applications of the traditional Chinese Songchi ointment in the rehabilitation of gastrocnemius muscles atrophied through disuse.Methods:Forty-five Wistar rats were randomly divided into a normal control group ( n=8) and a model group ( n=37). The rats in the model group had their left hind limbs immobilized by the Nagai method to induce disused muscle atrophy (DMA). That group was then randomly subdivided into a model control (MC) group, a treadmill training group (the EX group), a Songchi ointment group (SC group) and a comprehensive rehabilitation group (the CR group), each of 8. The EX and SC groups were given treadmill training at 18m/min or topical application of Songchi ointment once a day, 6 days a week for 6 weeks. The CR group was given both treatments. After the 6 weeks, hematoxylin and eosin staining was used to evaluate the pathological changes in the gastrocnemius of each rat′s left hind limb. Serum levels of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β) and interleukin-10 (IL-10) were detected using enzyme-linked immunosorbent assays. PI3K, Akt and mTOR mRNA and protein were assayed using real-time quantitative PCR and western blotting. Results:The arrangement of muscle fibers in the MC group was disordered and there was a large number of infiltrated inflammatory cells. Such conditions were significantly relieved in the CR group. After the intervention the levels of inflammatory factors TNF-α and IL-1β in the CR group were, on average, significantly lower than those observed in the MC group, the EX group or the SC group, while the level of anti-inflammatory factor IL-10 was significantly higher. The average PI3K, Akt and mTOR mRNA and protein levels of group CR were significantly higher than those of the MC and EX groups.Conclusions:The traditional Chinese Songchi ointment can usefully supplement treadmill training to relieve DMA. It upregulates IL-10, activates the PI3K Akt/mTOR signaling pathway and promotes the synthesis of muscle fiber protein while down-regulating TNF-α and IL-1β and muscle fiber inflammatory response.

目的 探究出院随访在乳腺癌患者化疗后延续性护理中的影响价值,从而增强患者对自身、医院及社会的满意.方法 选择本科室150例化疗患者,将其随机分为对照组和观察组各75例.两组患者住院期间均给与常规化护理,观察组在此基础上对患者出院后进行定期电话随访并进行干预.比较两组出院后患者服药依从性、疾病相关知识知晓情况及患者满意度.结果 观察组患者出院后服药依从性、疾病相关知识知晓情况及患者满意度均高于对照组(P<0.05).结论 出院随访在乳腺癌化疗后出院患者延伸性护理中,可有效提高患者服药依从性、疾病相关知识知晓情况及患者满意度.有利于降低乳腺癌的复发和转移,促进患者健康,从而延长患者生存期,提高患者生活质量.