Rehabilitation exercise on the quality of life in anal sphincter-preserving surgery.

BACKGROUND/AIMS: In the recent years, there have been more and more patients with low rectal cancer who have received anal sphincter preserving surgery (ASPS). The defecation function greatly affects patient's postoperative social activity and quality of life. This study aimed to examine the effects of Kegel's exercise on postoperative anal defecation and quality of life of patients following sphincter preserving surgery. METHODOLOGY: A total of 34 patients received sphincter preserving surgery. 17 patients received instruction for Kegel's exercise postoperatively and 17 patients did not. Defecation function and quality of life were compared between the two groups by FACT-C questionnaire. RESULTS: The response rate of FACT-C questionnaire was 64.7% (22 in 34 patients). These 22 patients were divided into two groups: exercise group (n=11) and the non-exercise group (n=11). No significant differences were found in the demographic data between the two groups. Although the defecation frequency of the exercise group was better than the non-exercise group, no statistical difference was found. The total scores of the quality of life of the exercise group were significantly higher than those in the non-exercise group (p=0.038). CONCLUSIONS: This preliminary study found that Kegel's exercises may have a positive impact on the quality of life in patients undergoing anal sphincter preserving surgery.

[Regaining dignity: the experience and process of reconstructing normal defecation functions through an anal sphincter-saving operation].

BACKGROUND: Resection through an anal sphincter-saving (ASS) operation may affect a low rectal cancer patient'snormal defecation function. The long and complex reconstruction process following such a procedure makes understanding the patient rehabilitation experience necessary in order to develop an effective educational strategy that addresses patient needs. PURPOSE: This study investigated the defecation reconstruction experience of low rectal cancer patients after ASS. METHODS: Researchers used a case study method and purposive sampling. Participants were followed for a period of 6 to 8 months and interviewed between 5 and 7 times. RESULTS: Eleven themes emerged from content analysis. Before temporary colostomy take-down: anal leakage and discomfort, dignity impairment, struggling to locate the contracting muscle, restoring anal strength. After colostomy take-down: loss of defecating control again and damage to peri-anal skin, perceived effects and insistence on persisting with training, faith in effectiveness, trying to comply, trying to restrict medication use, maintaining a hygienic self-image and dignity, promoting quality of life, and a chance to regain a normal life. CONCLUSIONS / IMPLICATIONS: Participants described the rehabilitation exercise as beneficial to controlling the defecation and expressed their intent to continue such. Participant experiences can assist stoma nurses to provide better physical and psychological care to ASS patients.

Spatiotemporal integration of visual stimuli and its relevance to the use of a divisional power supply scheme for retinal prosthesis.

A wireless photovoltaic retinal prosthesis is currently being studied with the aim of providing prosthetic vision to patients with retinitis pigmentosa (RP) and age-related macular degeneration (AMD). The major challenge of a photovoltaic device is its limited power efficiency. Our retinal prosthetic design implements a unique divisional power supply scheme (DPSS) system that provides the electrical power generated by all of the solar cells to only a subset of electrodes at any moment in time. The aim of the present study was to systematically characterize the spatiotemporal integration performance of the system under various DPSS conditions using human subjects and a psychophysical approach. A 16x16 pixels LED array controlled by Arduino was used to simulate the output signal of the DPSS design, and human performance under different visual stimulations at various update frequencies was then used to assess the spatiotemporal capability of retinal prostheses. The results showed that the contrast polarity of the image, image brightness, and division number influenced the lower limit of the update frequency of the DPSS system, while, on the other hand, visual angle, ambient light level, and stimulation order did not affect performance significantly. Pattern recognition by visual persistence with spatiotemporal integration of multiple frames of sparse dots is a feasible approach in retinal prosthesis design. These findings provide an insight into how to optimize a photovoltaic retinal prosthesis using a DPSS design with an appropriate update frequency for reliable pattern recognition. This will help the development of a wireless device able to restore vision to RP and AMD patients in the future.