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Objective:To observe any effect of endoscopic evaluation of swallowing (FEES) on the functional outcomes of post-stroke patients in the subacute phase.Methods:A retrospective case-control study was conducted of 52 patients who had received an FEES assessment (the FEES group) and 51 who had not (the control group). Both groups received swallowing rehabilitation and intake training based on the results of the FEES assessment and those of a modified volume-viscosity swallowing test. The primary outcome indicator was the incidence of pneumonia. Secondary outcome indicators were the rate of removal of the nasal feeding tube, the length of indwelling of the nasal feeding tube, functional oral intake assessment scale (FOIS) scores, eating technique at discharge, and the length of hospital stay.Results:Compared with the control group, the incidence of pneumonia in the FEES group was significantly lower (7.7% vs. 39.2%). The removal rate of the nasal feeding tube was significantly greater (75.0% vs. 41.0%). The FEES group showed a significant improvement in its average FOIS score. And the proportion of patients who could try partial oral eating or complete oral eating at discharge was significantly higher in the FEES group. Regression analysis indicated that the risk of pneumonia in the FEES group was positively related to the time from onset to the first FEES examination.Conclusion:Early FEES examination after a stroke could reduce the incidence of pneumonia, increase chances of removing the nasal feeding tube and improve the swallowing function and outcome of stroke survivors.
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Objective To explore the effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia. Methods Sixty patients with schizophrenia were randomly assigned into Valpar therapy group ( experiment group, n=30) and traditional rehabilitation therapy group ( control group, n=30) according to the order number. The duration of the treatment was six weeks. The brief assess?ment of cognition in schizophrenia ( BACS) and Wisconsin card sorting test ( WCST) were conducted as pre?and post?treatment assessment. Results There were significant differences between scores of BASC in pre?and post?treatment assessment in experiment group. More specifically, the BASC scores in symbol coding (37.50±6.50, t=-4.60, P<0.01),token movement(60.80±8.72, t=-2.54, P=0.017),verbal memory (44.40±11.29, t=-2.19, P=0.037)),and word fluency(14.23±4.35, t=-3.39, P=0.002) were signifi?cantly different when comparing pre?and post?treatment assessment outcomes. In control group,the only sig?nificant difference was found in word fluency (14.23±4.35, t=-3.39, P=0.002).In addition,response errors (57.80±10.35, t=-3.06, P=0.005) and repeat errors (34.67±6.96, t=3.41, P=0.002) in WCST in exper?iment group were significantly different in pre?and post?treatment assessment while only repeat errors (34.30 ±7.01, t=4.36, P=0.000) was different in control group. It was further discovered that scores in in symbol cod?ing( t=2.010, P=0.048),token movement ( t=2.124, P=0.038),response errors ( t=2.413, P=0.020) and repeat errors( t=2.009, P=0.047) in WCST were different between two groups. Conclusion Valpar professional evaluation train?ing system can significantly improve the cognitive function of people with schizophrenia.
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Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.