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ABSTRACT Objective: To examine the physical function and respiratory muscle strength of patients - who recovered from critical COVID-19 - after intensive care unit discharge to the ward on Days one (D1) and seven (D7), and to investigate variables associated with functional impairment. Methods: This was a prospective cohort study of adult patients with COVID-19 who needed invasive mechanical ventilation, non-invasive ventilation or high-flow nasal cannula and were discharged from the intensive care unit to the ward. Participants were submitted to Medical Research Council sum-score, handgrip strength, maximal inspiratory pressure, maximal expiratory pressure, and short physical performance battery tests. Participants were grouped into two groups according to their need for invasive ventilation: the Invasive Mechanical Ventilation Group (IMV Group) and the Non-Invasive Mechanical Ventilation Group (Non-IMV Group). Results: Patients in the IMV Group (n = 31) were younger and had higher Sequential Organ Failure Assessment scores than those in the Non-IMV Group (n = 33). The short physical performance battery scores (range 0 - 12) on D1 and D7 were 6.1 ± 4.3 and 7.3 ± 3.8, respectively for the Non-Invasive Mechanical Ventilation Group, and 1.3 ± 2.5 and 2.6 ± 3.7, respectively for the IMV Group. The prevalence of intensive care unit-acquired weakness on D7 was 13% for the Non-IMV Group and 72% for the IMV Group. The maximal inspiratory pressure, maximal expiratory pressure, and handgrip strength increased on D7 in both groups, but the maximal expiratory pressure and handgrip strength were still weak. Only maximal inspiratory pressure was recovered (i.e., > 80% of the predicted value) in the Non-IMV Group. Female sex, and the need and duration of invasive mechanical were independently and negatively associated with the short physical performance battery score and handgrip strength. Conclusion: Patients who recovered from critical COVID-19 and who received invasive mechanical ventilation presented greater disability than those who were not invasively ventilated. However, they both showed marginal functional improvement during early recovery, regardless of the need for invasive mechanical ventilation. This might highlight the severity of disability caused by SARS-CoV-2.
RESUMO Objetivo: Examinar a função física e a força muscular respiratória de pacientes que se recuperaram da COVID-19 grave após a alta da unidade de terapia intensiva para a enfermaria nos Dias 1 e 7 e investigar as variáveis associadas ao comprometimento funcional. Métodos: Trata-se de estudo de coorte prospectivo de pacientes adultos com COVID-19 que necessitaram de ventilação mecânica invasiva, ventilação mecânica não invasiva ou cânula nasal de alto fluxo e tiveram alta da unidade de terapia intensiva para a enfermaria. Os participantes foram submetidos aos testes Medical Research Council sum-score, força de preensão manual, pressão inspiratória máxima, pressão expiratória máxima e short physical performance battery. Os participantes foram agrupados em dois grupos conforme a necessidade de ventilação mecânica invasiva: o Grupo Ventilação Mecânica Invasiva (Grupo VMI) e o Grupo Não Ventilação Mecânica Invasiva (Grupo Não VMI). Resultados: Os pacientes do Grupo VMI (n = 31) eram mais jovens e tinham pontuações do Sequential Organ Failure Assessment mais altas do que os do Grupo VMI (n = 33). As pontuações do short physical performance battery (intervalo de zero a 12) nos Dias 1 e 7 foram 6,1 ± 4,3 e 7,3 ± 3,8, respectivamente para o Grupo Não VMI, e 1,3 ± 2,5 e 2,6 ± 3,7, respectivamente para o Grupo VMI. A prevalência de fraqueza adquirida na unidade de terapia intensiva no Dia 7 foi de 13% para o Grupo Não VMI e de 72% para o Grupo VMI. A pressão inspiratória máxima, a pressão expiratória máxima e a força de preensão manual aumentaram no Dia 7 em ambos os grupos, porém a pressão expiratória máxima e a força de preensão manual ainda eram fracas. Apenas a pressão inspiratória máxima foi recuperada (ou seja, > 80% do valor previsto) no Grupo Não VMI. As variáveis sexo feminino, e necessidade e duração da ventilação mecânica invasiva foram associadas de forma independente e negativa à pontuação do short physical performance battery e à força de preensão manual. Conclusão: Os pacientes que se recuperaram da COVID-19 grave e receberam ventilação mecânica invasiva apresentaram maior incapacidade do que aqueles que não foram ventilados invasivamente. No entanto, os dois grupos de pacientes apresentaram melhora funcional marginal durante a fase inicial de recuperação, independentemente da necessidade de ventilação mecânica invasiva. Esse resultado pode evidenciar a gravidade da incapacidade causada pelo SARS-CoV-2.
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Abstract Objective The present study aimed to compare the cure rate recovery time and Merle d'Aubigné-Postel functional (MAPF) score after single-stage surgery (C1T) or two-stage surgery (C2T) to treat prosthetic infections of the hip considering sociodemographic and clinical features of the patients. Materials and Methods The present retrospective study occurred in a single center from 2011 to 2014 with 37 studied cases including 26 treated with C1T and 11 with C2T. We compared the cure rate recovery time and MAPF score in the two groups as well as the sociodemographic and clinical features of the patients. We also considered surgical complications and the most common infectious agents. Results The C1T group had a faster functional recovery than the C2T group but there were no significant differences in the cure rate surgical complications or MAPF score. However C1T group patients were significantly younger which may have influenced the outcomes. Staphylococcus spp. was the most common infectious agent (62%). Conclusion Although C2T appears superior regarding infection cure C1T may be preferable for faster functional recovery. However it is critical to consider individual patient characteristics when choosing treatment. Further research with a larger sample size is required to confirm these results.
Resumo Objetivo Comparar a taxa de cura, o tempo de recuperação e a pontuação na escala funcional de Merle d'Aubigné-Postel (EFMA) entre a cirurgia em tempo único (C1T) e a cirurgia em dois tempos (C2T) no tratamento de infecções protéticas do quadril, considerando as características sociodemográficas e clínicas dos pacientes. Materiais e Métodos Foi realizado um estudo retrospectivo num único centro, entre 2011 e 2014, com um total de 37 casos estudados, sendo 26 tratados com C1T e 11 com C2T. Foram comparadas a taxa de cura, o tempo de recuperação e a pontuação EFMA entre os dois grupos, bem como as características sociodemográficas e clínicas dos pacientes. Foram também consideradas as complicações cirúrgicas e o agente infeccioso mais comum. Resultados O grupo C1T teve uma recuperação funcional mais rápida do que o grupo C2T, mas não houve diferenças significativas na taxa de cura, nas complicações cirúrgicas ou na pontuação EFMA. No entanto, o grupo C1T era significativamente mais jovem, o que pode ter influenciado os resultados. Staphylococcus spp. foi o agente infeccioso mais comum (62%). Conclusão Embora a C2T pareça ser superior em termos de cura de infecção, a C1T pode ser preferível para uma recuperação funcional mais rápida. No entanto, as características individuais dos pacientes devem ser consideradas na escolha do tratamento. São necessárias mais pesquisas com um tamanho de amostra maior para confirmar estes resultados.
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Humans , Reoperation , Arthroplasty, Replacement, Hip , Hip Prosthesis , InfectionsABSTRACT
Objective:To investigate the prevalence and predictors of delayed function independence (DFI) in patients with acute vertebrobasilar artery occlusion (VBAO) achieved successful recanalization after endovascular therapy.Methods:Patients with acute VBAO received endovascular treatment in the Departments of Neurology, the First Affiliated Hospital of University of Science and Technology and General Hospital of Eastern Theater Command, PLA from December 2015 to December 2018 were retrospectively enrolled. The demographic, clinical, laboratory and imaging data were collected. Early functional independence (EFI) was defined as the modified Rankin Scale score 0-2 at discharge, and DFI was defined as the modified Rankin Scale score 0-2 at 90 d after discharge for non-EFI patients. Multivariate logistic regression analysis was used to determine the independent predictors of DFI. Results:A total of 122 patients with acute VBAO were included. Their age was 61.8±11.9 years old and 91 (74.6%) were male. The median Glasgow Coma Scale (GCS) score was 7, the median National Institutes of Health Stroke Scale (NIHSS) score was 26.5, and the median posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) score was 9. Twenty-four patients (20.0%) had EFI; of the 98 patients with non-EFI, 18 (18.4%) had DFI. Multivariate logistic regression analysis showed that male (odds ratio [ OR] 0.038, 95% confidence interval [ CI] 0.002-0.658; P=0.025), cardiogenic embolism ( OR 0.116, 95% CI 0.023-0.579; P=0.009), baseline NIHSS score ( OR 1.136, 95% CI 1.040-1.242; P=0.005) and lung infection ( OR 6.089, 95% CI 1.451-25.562; P=0.014) were the independent predictors of DFI. Conclusions:Nearly 1/5 of the non-EFI patients have DFI. Male, cardiogenic embolism, lower baseline NIHSS score and without pulmonary infection are the independent predictors of DFI.
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Objective:To investigate the effect of acupressure combined with repetitive transcranial magnetic stimulation (rTMS) on the motor function recovery after stroke.Methods:Patients with post-stroke hemiplegia treated with rehabilitation in Beijing Tongzhou District Integrated Traditional Chinese and Western Medicine Hospital from February 2020 to May 2022 were enrolled prospectively. They were randomly divided into acupressure + rTMS group and rTMS group according to the random number table method. All patients were given routine rehabilitation training and drug intervention after admission. The rTMS group was treated with high-frequency rTMS on the dorsolateral prefrontal cortex of the affected sides, and the acupressure + rTMS group conducted acupressure on the basis of the rTMS group. The treatment time was 6 weeks for both groups. Before and after treatment, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test Scale (WMFT) were used to evaluate motor function.Results:A total of 112 patients were enrolled in the study, including 56 patients in the acupressure + rTMS group and 56 patients in the rTMS group. The BBS score, FMA score and WMFT score in both groups after treatment were significantly improved than those before treatment ( P<0.001), but the BBS score, FMA score and WMFT score in the acupressure + rTMS group after treatment were significantly higher than those in the rTMS group ( P<0.001). Conclusion:The application of acupressure combined with rTMS can promote the recovery of motor function after stroke, and the treatment effect is significant.
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Objective:To explore the mediating effect of psychological resilience on self-efficacy and knee functional recovery of patients after artificial total knee arthroplasty, and to provide theoretical basis for promoting functional recovery after artificial total knee arthroplasty.Methods:This was a cross-sectional survey study. A total of 250 patients undergoing artificial total knee arthroplasty at the Orthopedics Department of Beijing Jishuitan Hospital Affiliated to Capital Medical University were set as the research objects from September 2021 to March 2022, self-designed demographic questionnaire, General Self-Efficacy Scale (GSES), Connor Davidson Resilience Scale (CD-RISC) and Hospital for Special Surgery (HSS) scale were used to evaluate postoperative self-efficacy, psychological reselience and knee function.Results:A total of 225 valid questionnaires were recovered. The GSES score, CD-RISC score and knee function score of 225 patients were (26.45 ± 3.75), (68.01 ± 2.85) and (71.76 ± 4.53) points, respectively. Psychological resilience was positively correlated with self-efficacy and knee function score ( r=0.535, 0.675, both P<0.05), and self-efficacy was positively correlated with knee function score ( r=0.688, both P<0.05). Stratified regression analysis in showed that self-efficacy, tenacity, strength, optimism, and psychological resilience were included in the equation, adjusted for R2=0.812, indicating good fit of the model. The mediation model showed that psychological resilience was partially mediated between self-efficacy and functional recovery, with its mediation effects accounting for 25.49% of the total effect. Conclusions:The recovery of knee function in patients after artificial total knee arthroplasty is at a moderate level, and improving psychological resilience and self-efficacy may probably promote the recovery of knee function.
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Objective:To analyze the clinical efficacy of bone transport with unilateral external fixation in the treatment of massive tibial bone defects.Methods:A retrospective study was conducted to review the 21 patients with massive tibial bone defects who had been treated by bone transport with unilateral external fixation from February 2017 to January 2022 at Department of Trauma Orthopedics, Ganzhou People's Hospital. There were 14 males and 7 females with a mean age of (46.3 ± 11.3) years. Causes for bone defects: trauma ( n=5), resection of bone non-union ( n=9), resection of infected bone ( n=6) and resection of bone tumor ( n=1). The mean bone defect length was (8.3 ± 1.7) cm. Bone transport started from 10 to 12 days after operation, with a speed of 1 mm/d, and was completed in 4 times. X-ray films were reviewed every 2 weeks. The bone union time, external fixation time (EFT), external fixation index (EFI), docking site situation and complications were recorded. The clinical efficacy was assessed by Paley score. Results:All patients were followed-up for a mean time of (13.5 ± 5.5) months. The mineralization of regenerated bone was good. The bone union time was (9.6 ± 2.2) months, the EFT (10.3 ± 4.0) months, and the EFI (1.3 ± 0.4) months/cm. All docking sites got united. The docking sites were cleaned in 14 patients, of whom simple compression with external fixation was performed in 5 and bone grafts at the docking sites in 9. Postoperative nail tract infection was observed in 6 cases, tibial alignment deviation in 1 case, foot drop deformity in 5 cases, horseshoe varus foot deformity in 1 case, toe flexion deformity in 3 cases, and refracture after removing the external fixation in 1 case. By the Paley score, the bony outcomes were rated as excellent in 16 and as good in 5 cases. The functional outcomes were excellent in 10, good in 7, and acceptable in 4.Conclusion:Bone transport with unilateral external fixation is an effective treatment for massive tibial bone defects, showing advantages of easy operation and convenient carry.
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ABSTRACT Introduction Traumatic injury to the knee joints and their adjacent muscles is common among athletes, and their organizational characteristics require thorough analysis. Objective Investigate the motor organization of muscles in the lower limbs of athletes with traumatic knee injuries. Methods A systematic survey of the peculiarities of motor organization in the muscles of physically healthy athletes was preceded by an analytical survey of the peculiarities of this organization among athletes with traumatic knee injuries interested in medical treatment to restore the functional condition of the knee joints and perform active sports activities. Results The characteristics of muscle motor organization in traumatic injuries and their recovery methods were determined, as well as the formation of a sequential understanding of the recovery process of knee joint injuries for athletes representing various sports. Conclusion The results of this scientific study and the conclusions formulated based on them are of great importance for athletes concerned with restoring functional status after knee joint injuries sustained during the competition and in the training process. Evidence level II; Therapeutic studies - outcomes research.
RESUMO Introdução A lesão traumática nas articulações do joelho e seus músculos adjacentes é comum entre atletas e suas características organizacionais exigem uma análise minuciosa. Objetivo Investigar a organização motora dos músculos nos membros inferiores de atletas com lesões traumáticas no joelho. Métodos Uma pesquisa sistemática sobre as peculiaridades da organização motora na musculatura de atletas fisicamente saudáveis foi precedida a uma pesquisa analítica das peculiaridades desta organização entre atletas com lesões traumáticas no joelho, interessados no tratamento médico a fim de restaurar a condição funcional das articulações do joelho e realizar atividades esportivas ativas. Resultados Foram determinadas as características de organização motora muscular nas lesões traumáticas e seus métodos de recuperação, bem como a formação de uma compreensão sequencial no processo de recuperação das lesões das articulações do joelho para os atletas que representam diversos esportes. Conclusão Os resultados deste estudo científico e as conclusões formuladas com base neles são de grande importância para atletas preocupados com o restauro do estado funcional após as lesões nas articulações do joelho sofridas durante o período de competição e no processo de treinamento. Evidência nível II; Estudos terapêuticos - pesquisa de resultados.
RESUMEN Introducción Las lesiones traumáticas de las articulaciones de la rodilla y sus músculos adyacentes son frecuentes entre los deportistas y sus características organizativas requieren un análisis exhaustivo. Objetivo Investigar la organización motora de los músculos de las extremidades inferiores de atletas con lesiones traumáticas de rodilla. Métodos Una investigación sistemática sobre las peculiaridades de la organización motora en los músculos de los atletas físicamente sanos fue precedida por una investigación analítica de las peculiaridades de esta organización entre los atletas con lesiones traumáticas de la rodilla, interesados en el tratamiento médico para restaurar la condición funcional de las articulaciones de la rodilla y realizar actividades deportivas activas. Resultados Se determinaron las características de la organización motora del músculo en las lesiones traumáticas y sus métodos de recuperación, así como la formación de una comprensión secuencial en el proceso de recuperación de las lesiones de la articulación de la rodilla para los atletas que representan varios deportes. Conclusión Los resultados de este estudio científico y las conclusiones formuladas a partir de ellos son de gran importancia para los deportistas preocupados por el restablecimiento del estado funcional tras las lesiones de la articulación de la rodilla sufridas durante el periodo de competición y en el proceso de entrenamiento. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados.
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ABSTRACT Objective: To verify the impact of renal recovery on mortality in non-critically ill patients with acute kidney injury. Method: A prospective cohort study was carried out in a public hospital in the Federal District with patients with acute kidney injury admitted to a non-critical care unit. Renal recovery was assessed based on the ratio of serum creatinine to baseline creatinine and the patient was followed up for 6 months. Mortality was assessed during hospitalization and after discharge. Results: Of the 90 patients with hospital-acquired kidney injury, renal recovery was identified in 34.1% to 75% of cases, depending on the time of assessment, considering a follow-up period of up to 6 months. Recovery of renal function during follow-up had an impact on in-hospital mortality [95% CI 0.15 (0.003 - 0.73; p = 0019). Conclusion: Recovery of renal function has been shown to be a protective factor for mortality in patients admitted to the non-critical care unit. Early identification of kidney damage and monitoring of physiological and laboratory variables proved to be fundamental in identifying the severity of the disease and reducing mortality.
RESUMEN Objetivo: Verificar el impacto de la recuperación renal en la mortalidad en pacientes no críticos con lesión renal aguda. Método: Cohorte prospectiva, realizada en un hospital público del Distrito Federal con pacientes con daño renal agudo ingresados en una unidad de cuidados no críticos. La recuperación renal se evaluó según la relación entre la creatinina sérica y la creatinina inicial y se siguió al paciente durante 6 meses. La mortalidad se evaluó durante la hospitalización y después del alta hospitalaria. Resultados: De los 90 pacientes con daño renal intrahospitalario, se identificó recuperación renal entre el 34,1% y el 75% de los casos, dependiendo del momento de la evaluación, considerando un período de seguimiento de hasta 6 meses. La recuperación de la función renal durante el seguimiento tuvo impacto en la mortalidad hospitalaria [IC 95% 0,15 (0,003 - 0,73; p = 0019). Conclusión: La recuperación de la función renal demostró ser un factor protector de la mortalidad en pacientes ingresados en la unidad de cuidados no críticos. La identificación temprana de la lesión renal y el seguimiento de variables fisiológicas y de laboratorio resultaron esenciales para identificar la gravedad de la enfermedad y reducir la mortalidad.
RESUMO Objetivo: Verificar o impacto da recuperação renal na mortalidade de pacientes não críticos com injúria renal aguda. Método: Coorte prospectiva, realizado em um hospital público do Distrito Federal com pacientes diagnosticados com injúria renal aguda internados em uma unidade de cuidados não críticos. A recuperação renal foi avaliada a partir da razão da creatinina sérica em relação à creatinina basal e o paciente foi acompanhado por 6 meses. A mortalidade foi avaliada durante internação e após alta hospitalar. Resultados: Dos 90 pacientes com injúria renal adquirida no hospital, identificou-se a recuperação renal em 34,1% a 75% dos casos, a depender do momento de avaliação, considerando o período de acompanhamento de até 6 meses. A recuperação da função renal durante o acompanhamento impactou na mortalidade intra-hospitalar [IC 95% 0,15 (0,003-0,73; p = 0019). Conclusão: A recuperação da função renal demonstrou-se como um fator protetor para mortalidade em pacientes internados na unidade de cuidados não críticos. A identificação precoce da injúria renal e o monitoramento de variáveis fisiológicas e laboratoriais mostraram-se fundamentais para identificação da gravidade da doença e redução da mortalidade.
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Humans , Mortality , Acute Kidney Injury , Recovery of FunctionABSTRACT
ABSTRACT Introduction: The athletes' physiological capacity and psychological level are raised to the limit during the competition, which is necessary for adequate recovery after the dispute. Objective: Study the effect of sports training associated with nutritional intervention on athletes' post-competition recovery. Methods: In the first two weeks of the experiment, training was done in slow aerobic exercise, aerobics, and running. Strength training and a small amount of anaerobic training were added to the training with the gradual practice of the experiment. Results: The proportion of breakfast, lunch, and dinner was 25.33%, 42.55%, and 32.12%, respectively; protein intake decreased from 34.23% to 20.13%, and the proportion of fat intake decreased from 15. 56% to 12.3%, and IgG content changed from 7.654 ± 0.283 (mmol/L) at the end to 8.586 ± 0.651 (mmol/L); IgM content changed from 3.382 ± 0.875 (g/L) at the end to 3.169 ± 1.002 (g/L). Conclusion: Athletes can effectively, through sports training and nutritional intervention, adjust body changes caused by competition while maintaining a good exercise level. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: A capacidade fisiológica e o nível psicológico dos atletas são elevados ao limite durante a competição, sendo necessária uma recuperação adequada após a disputa. Objetivo: Estudar o efeito do treinamento esportivo associado à intervenção nutricional para a recuperação dos atletas após a competição. Métodos: Nas duas primeiras semanas da experiência, realizou-se o treinamento na forma de exercício aeróbico lento, aeróbica e corrida. O treinamento de força e uma pequena quantidade de treinamento anaeróbico foram adicionados ao treinamento com a prática gradual do experimento. Resultados: A proporção de café da manhã, almoço e jantar foi de 25,33%, 42,55% e 32,12% respectivamente, a proporção de ingestão de proteínas diminuiu de 34,23% para 20,13%, a proporção de ingestão de gordura diminuiu de 15,56% para 12,3%, e o conteúdo de IgG mudou de 7,654 ± 0,283 (mmol/L) no final para 8,586 ± 0,651 (mmol/L); o conteúdo de IgM mudou de 3,382 ± 0,875 (g/L) no final para 3,169 ± 1,002 (g/L). Conclusão: Os atletas podem de maneira eficaz, através de treinamento esportivo e intervenção nutricional, ajustar as alterações corporais ocasionadas pela competição, mantendo um bom nível de exercício. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: La capacidad fisiológica y el nivel psicológico de los atletas se elevan al límite durante la competición, siendo necesaria una adecuada recuperación tras la disputa. Objetivo: Estudiar el efecto del entrenamiento deportivo asociado a la intervención nutricional para la recuperación de los deportistas tras la competición. Métodos: En las dos primeras semanas del experimento, el entrenamiento se realizó en forma de ejercicio aeróbico lento, aeróbic y carrera. El entrenamiento de fuerza y una pequeña cantidad de entrenamiento anaeróbico se añadieron al entrenamiento con la práctica gradual del experimento. Resultados: La proporción de desayuno, comida y cena fue del 25,33%, 42,55% y 32,12% respectivamente, la proporción de ingesta de proteínas descendió del 34,23% al 20,13%, la proporción de ingesta de grasas descendió del 15. 56% a 12,3%, y el contenido de IgG pasó de 7,654 ± 0,283 (mmol/L) al final a 8,586 ± 0,651 (mmol/L); el contenido de IgM pasó de 3,382 ± 0,875 (g/L) al final a 3,169 ± 1,002 (g/L). Conclusión: Los atletas pueden ajustar eficazmente, mediante el entrenamiento deportivo y la intervención nutricional, los cambios corporales provocados por la competición, manteniendo un buen nivel de ejercicio. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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ABSTRACT Introduction: With the continuous development of running, great changes have occurred in training media, equipment, and training concepts. Running fatigue and recovery have increasingly become the direction of research by scientists worldwide. Objective: In this paper, the mechanism, causes, and measures of biological recovery in athletes during training are discussed. Method: The effects of different interventions on athletes' recovery after training were analyzed through protocoled experiments. Effective methods of fatigue recovery were presented. The study compared the variables of the sprinter's morning heart rate, blood pressure, body temperature, CK, BUN, RPE, and other indicators to understand the recovery of middle and long-distance runners after training. Results: Recovery measures are effective when combined with exercise training based on the fatigue mechanism. Conclusion: Subjective sensory, physiological, and biochemical indicators are used to judge the intensity of fatigue in exercise training, and the fatigue recovery phase of exercise training is an important item to consider during training activities. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: Com o desenvolvimento contínuo da corrida, grandes mudanças ocorreram nos meios de treinamento, nos equipamentos e conceitos de treinamento. A fadiga e a recuperação da corrida têm se tornado cada vez mais a direção da pesquisa de cientistas em todo o mundo. Objetivo: Neste artigo, são discutidos o mecanismo, as causas e suas medidas de recuperação biológica nos atletas durante o treinamento. Método: Através de experimentos protocolados, foram analisados os efeitos de diferentes intervenções sobre a recuperação dos atletas após o treinamento. Métodos eficazes de recuperação da fadiga foram apresentados. O estudo comparou as variáveis da frequência cardíaca matinal do velocista, pressão arterial, temperatura corporal, CK, BUN, RPE e outros indicadores para entender a recuperação dos corredores de média e longa distância após o treinamento. Resultados: As medidas de recuperação são efetivas quando combinadas ao treinamento de exercício baseado no mecanismo de fadiga. Conclusão: Os indicadores sensoriais subjetivos, fisiológicos e bioquímicos são usados para julgar a intensidade da fadiga no treinamento físico, sendo a fase de recuperação da fadiga do treinamento físico um item importante a ser considerado durante as atividades de treinamento. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: Con el continuo desarrollo de las carreras, se han producido grandes cambios en los medios de entrenamiento, el equipamiento y los conceptos de entrenamiento. La fatiga y la recuperación en la carrera se han convertido cada vez más en objeto de investigación por parte de científicos de todo el mundo. Objetivo: En este artículo, se discute el mecanismo, las causas y las medidas de la recuperación biológica en los atletas durante el entrenamiento. Método: Mediante experimentos protocolizados, se analizaron los efectos de diferentes intervenciones en la recuperación de los atletas después del entrenamiento. Se presentaron métodos eficaces de recuperación de la fatiga. El estudio comparó las variables de la frecuencia cardíaca matutina de los velocistas, la presión arterial, la temperatura corporal, la CK, el BUN, el RPE y otros indicadores para comprender la recuperación de los corredores de media y larga distancia después del entrenamiento. Resultados: Las medidas de recuperación son eficaces cuando se combinan con el entrenamiento del ejercicio basado en el mecanismo de la fatiga. Conclusión: Los indicadores subjetivos sensoriales, fisiológicos y bioquímicos se utilizan para juzgar la intensidad de la fatiga en el entrenamiento con ejercicios, y la fase de recuperación de la fatiga del entrenamiento con ejercicios es un elemento importante que debe tenerse en cuenta durante las actividades de entrenamiento. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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ABSTRACT Introduction: A new research direction to strengthen basketball, improve physical function and enhance the immunity of athletes during the epidemic situation of COVID-19 is requested. Objective: Explore the specific methods of basketball fatigue and physical recovery under the outlook of COVID-19. Methods: 36 college volunteers without significant differences in height, weight, or age were randomly selected for the research. Divided into two groups, the intervention mode of the experimental group was vibration foam roller intervention, while the control group adopted the traditional walking and stretching method. The subjective assessment data of lactic acid change and exercise fatigue were collected and analyzed. Results: One hour after exercise, the rate, and decrease of lactic acid in the experimental group were statistically higher. Before the beginning of the experiment, the subjective assessment of fatigue in the control group was (16.031 ± 2.4438) points, and that in the experimental group was (16.139 ± 2.7043) points. After the end of the ninth week, the subjective assessment of fatigue in the control group was (14.646 ± 2.7453) points, while in the experimental group, it was (11.576 ± 3.2552). Conclusion: The vibrating foam roller massage method can recover athletes from muscle fatigue more efficiently while respecting the limitations imposed by the epidemic situation. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: Uma nova direção de pesquisa para fortalecer o basquetebol, melhorar o nível da função física e aumentar a imunidade dos atletas sob a situação epidêmica da COVID-19 é requisitada. Objetivo: Explorar os métodos específicos de fadiga do basquetebol e recuperação física sob o panorama da COVID-19. Métodos: Foram selecionados aleatoriamente 36 universitários voluntários sem diferenças significativas de altura, peso ou idade para a pesquisa. Divididos em dois grupos, o modo de intervenção do grupo experimental foi a intervenção com rolo de espuma vibratória, enquanto o grupo de controle adotou o método tradicional de caminhada e alongamento. Os dados da avaliação subjetiva da mudança do ácido lático e da fadiga do exercício foram coletados e analisados. Resultados: Em uma hora após o exercício, a taxa e a diminuição do ácido láctico no grupo experimental foram estatisticamente superiores. Antes do início do experimento, a avaliação subjetiva da fadiga no grupo controle foi de (16.031 ± 2.4438) pontos, e a do grupo experimental foi de (16.139 ± 2.7043) pontos. Após o final da nona semana, a avaliação subjetiva da fadiga no grupo controle foi de (14.646 ± 2.7453) pontos, enquanto no experimental foi de (11.576 ± 3.2552) pontos. Conclusão: O método de massagem por rolo de espuma vibratória pode recuperar os atletas da fadiga muscular de forma mais eficiente, respeitando as limitações impostas pela situação epidêmica. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: Se solicita una nueva dirección de investigación para fortalecer el baloncesto, mejorar el nivel de la función física y aumentar la inmunidad de los atletas bajo la situación epidémica de COVID-19. Objetivo: Explorar los métodos específicos de fatiga y recuperación física en baloncesto bajo la perspectiva de COVID-19. Métodos: Para la investigación se seleccionaron aleatoriamente 36 estudiantes universitarios voluntarios sin diferencias significativas de estatura, peso o edad. Divididos en dos grupos, el modo de intervención del grupo experimental fue la intervención con rodillo de espuma vibratoria, mientras que el grupo de control adoptó el método tradicional de caminar y estirar. Se recogieron y analizaron los datos de la evaluación subjetiva del cambio del ácido láctico y la fatiga del ejercicio. Resultados: Una hora después del ejercicio, la tasa y la disminución de ácido láctico en el grupo experimental fueron estadísticamente superiores. Antes del inicio del experimento, la evaluación subjetiva de la fatiga en el grupo de control fue de (16,031 ± 2,4438) puntos, y la del grupo experimental fue de (16,139 ± 2,7043) puntos. Al final de la novena semana, la evaluación subjetiva de la fatiga en el grupo de control fue de (14,646 ± 2,7453) puntos, mientras que en el grupo experimental fue de (11,576 ± 3,2552) puntos. Conclusión: El método de masaje con rodillo de espuma vibratorio puede recuperar a los deportistas de la fatiga muscular de forma más eficaz, respetando las limitaciones impuestas por la situación epidémica. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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ABSTRACT Introduction Running has become one of the most popular sports and fitness methods for low cost, convenience, and easy adherence. This has made the characteristics and rules of running-related sports injuries a key research issue in sports medicine and public health. Objective Evaluate the effects of moderate running on sports injuries rehabilitation. Methods This paper uses mathematical statistics to study some groups that have been running for a long time (n=369). The causes of sports injuries analyses and risks are performed by questionnaire. Results Relaxation after exercise is a protective factor for sports injuries. The time of maintenance of the running habit and the previous sport's history are factors influencing the risk for a sport's injury. Conclusion Amateur runners have a high rate of running injuries. The knee is the area with the highest injury incidence. Weight-loss running increases the risk of injury. An individually moderate running training plan can reduce the risk of running injuries. Evidence level II; Therapeutic Studies - Investigating the results.
RESUMO Introdução A corrida tornou-se um dos esportes e métodos de aptidão física mais populares devido ao seu baixo custo, conveniência e fácil adesão. Isso fez com que as características e regras das lesões esportivas relacionadas à corrida tornaram-se uma questão-chave de pesquisa em medicina esportiva e saúde pública. Objetivo Avaliar os efeitos da corrida moderada sobre a reabilitação de lesões esportivas. Métodos Este artigo utiliza a estatística matemática para estudar alguns grupos que já praticam corrida há muito tempo (n=369). A análise das causas de lesões e riscos desportivos é feita por questionário. Resultados O relaxamento após o exercício é um fator de proteção para lesões esportivas. O tempo de manutenção do hábito da corrida bem como o histórico esportivo pregresso são fatores que influenciam no risco para uma lesão esportiva. Conclusão Corredores amadores têm uma alta taxa de lesões na corrida. O joelho é a área de maior incidência das lesões. Correr para perder peso aumenta o risco de lesões. Um plano de treinamento de corrida moderado planejado individualmente pode reduzir os riscos das lesões durante as corridas. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.
RESUMEN Introducción La corrida se ha convertido en uno de los deportes y métodos de acondicionamiento físico más populares debido a su bajo coste, comodidad y fácil adherencia. Esto ha hecho que las características y las reglas de las lesiones deportivas relacionadas con la corrida sean un tema de investigación clave en la medicina deportiva y la salud pública. Objetivo Evaluar los efectos de la corrida moderada en la rehabilitación de las lesiones deportivas. Métodos Este trabajo utiliza la estadística matemática para estudiar algunos grupos que llevan mucho tiempo corriendo (n=369). El análisis de las causas de las lesiones deportivas y los riesgos se realiza mediante un cuestionario. Resultados La relajación después del ejercicio es un factor de protección para las lesiones deportivas. El tiempo de mantenimiento del hábito de correr, así como el historial deportivo previo son factores que influyen en el riesgo de sufrir una lesión deportiva. Conclusión Los corredores aficionados tienen un alto índice de lesiones al correr. La rodilla es la zona de mayor incidencia de lesiones. Correr para perder peso aumenta el riesgo de lesiones. Un plan de entrenamiento moderado para correr, planificado individualmente, puede reducir el riesgo de lesiones al correr. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.
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ABSTRACT Objective: To evaluate the effects of hydrotherapy on post-training recovery of basketball players. Methods: 60 basketball players from the sports representative team were divided equally into test and control group for evaluation according to the Partridge method. The experimental group received hydrotherapy for 15 minutes after intense winter training. Pain degrees in joint flexion and extension, adduction, external rotation, and internal rotation were evaluated. Results: The HL value of blood immediately after 800m hydrotherapy swimming was not significantly different between the experimental group and the control group by t-test (P>0.05). Before treatment, there was no significant difference in the Partridge score between the two groups (P<0.01). The improvement of the Partridge score in the two groups of patients was significantly reduced after treatment (P<0.01), and the improvement of the experimental group was significantly better than that of the control group (P<0.01). Before treatment, there was no significant difference between the two groups (P<0.01). After treatment, it was significantly reduced (P<0.01), but the experimental group's improvement was significantly better than the control group (P<0.01). Conclusion: The method of introducing hydrotherapy as post-workout swimming has a significant effect on relieving swelling of the brachial and quadriceps muscles. However, intense swimming may affect the effect of muscle recovery. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Objetivo: Avaliar os efeitos da hidroterapia sobre a recuperação pós-treinamento dos jogadores de basquete. Método: 60 jogadores de basquetebol da equipe de representantes esportivos foram divididos igualmente em grupo teste e controle para avaliação de acordo com o método Partridge. O grupo experimental recebeu hidroterapia por 15 minutos após o treino intenso de inverno. Foram avaliados os graus de dor em flexão e extensão das articulações, adução, rotação externa e rotação interna. Resultados: O valor de HL do sangue imediatamente após a natação hidroterápica de 800m não foi significativamente diferente entre o grupo experimental e o grupo controle por teste t (P>0,05). Antes do tratamento, não houve diferença significativa na pontuação de Partridge entre os dois grupos (P<0,01). A melhora da pontuação de Partridge nos dois grupos de pacientes foi significativamente reduzida após o tratamento (P<0,01), e o desenvolvimento do grupo experimental foi significativamente melhor que a do grupo controle (P<0,01). Antes do tratamento, não houve diferença significativa entre os dois grupos (P<0,01). Após o tratamento, foi significativamente reduzido (P<0.01), mas o desenvolvimento do grupo experimental foi significativamente melhor que a do grupo controle (P<0.01). Conclusão: O método de introduzir a hidroterapia como natação pós-treino tem um efeito significativo no alívio do inchaço dos músculos braquial e quadríceps. No entanto, a natação intensa pode afetar o efeito de recuperação muscular. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.
RESUMEN Objetivo: Evaluar los efectos de la hidroterapia en la recuperación post-entrenamiento de los jugadores de baloncesto. Método: 60 jugadores de baloncesto del equipo de representación deportiva fueron divididos equitativamente en grupo de prueba y grupo de control para su evaluación según el método Partridge. El grupo experimental recibió hidroterapia durante 15 minutos después de un entrenamiento invernal intenso. Se evaluaron los grados de dolor en la flexión y extensión de la articulación, la aducción, la rotación externa y la rotación interna. Resultados: EL valor de HL de la sangre inmediatamente después de 800 m de natación con hidroterapia no fue significativamente diferente entre el grupo experimental y el grupo de control mediante la prueba t (P>0,05). Antes del tratamiento, no hubo diferencias significativas en la puntuación Partridge entre los dos grupos (P<0,01). La mejora de la puntuación Partridge en ambos grupos de pacientes se redujo significativamente después del tratamiento (P<0,01), y la mejora del grupo experimental fue significativamente mejor que la del grupo de control (P<0,01). Antes del tratamiento, no hubo diferencias significativas entre los dos grupos (P<0,01). Después del tratamiento, se redujo significativamente (P<0,01), pero el desarrollo del grupo experimental fue significativamente mejor que la del grupo de control (P<0,01). Conclusión: El método de introducción de la hidroterapia como natación post-entrenamiento tiene un efecto significativo en el alivio de la hinchazón de los músculos braquiales y del cuádriceps. Sin embargo, la natación intensa puede perjudicar el efecto de recuperación muscular. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.
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RESUMO O estudo analisou o perfil de atuação dos fisioterapeutas do Rio de Janeiro (RJ) e do Rio Grande do Sul (RS) no manejo da pessoa com doença de Alzheimer (DA). Foram obtidas 256 respostas a um questionário enviado via endereço eletrônico dos Conselhos Regionais de Fisioterapia e Terapia Ocupacional das regiões 2 (RJ) e 5 (RS) - CREFITOS 2 e 5 -, entre março e dezembro de 2020. O questionário tinha 36 perguntas fechadas, cujas variáveis foram agrupadas em: (1) caracterização da amostra; (2) dados específicos sobre a profissão de fisioterapeuta; e (3) questões relacionadas à DA. Neste artigo serão analisadas apenas as questões relacionadas à DA. Todas as questões eram de múltipla escolha, com 2 até 15 opções de resposta. A maioria dos respondentes (88,3%) já atendeu paciente com DA, mas 50,8% fariam uma revisão de literatura para atender novamente esses pacientes. O principal objetivo relatado no manejo do indivíduo com DA foi "retardar a progressão das perdas motoras". As condutas foram significativamente diferentes conforme a fase da doença (p<0,001). Mais de 85% citaram como benefício que a fisioterapia "retarda a dependência física". Este estudo deixa evidente a necessidade de mais pesquisas que abordem especificamente as fases intermediária e avançada da DA, pois, até o momento, a literatura se mostra inconclusiva e com pouca evidência em relação à fisioterapia no manejo dessas pessoas, impossibilitando a criação de manuais e/ou padronização de condutas específicas a cada estágio da doença.
RESUMEN Este estudio analizó el perfil de actuación de los fisioterapeutas de Rio de Janeiro (RJ) y de Rio Grande do Sul (RS) en el manejo de personas con enfermedad de Alzheimer (EA). Un total de 256 respuestas se obtuvo de un cuestionario enviado electrónicamente a los Consejos Regionales de Fisioterapia y Terapia Ocupacional de las regiones 2 (RJ) y 5 (RS) -CREFITOS 2 y 5-, en el período de marzo a diciembre de 2020. El cuestionario constaba de 36 preguntas cerradas, con variables que se agruparon en: (1) caracterización de la muestra; (2) datos específicos sobre la profesión de fisioterapeuta; y (3) preguntas relacionadas con EA. Este artículo solo analizó los problemas relacionados con la EA. Todas las preguntas eran de opción múltiple, con 2 a 15 opciones de respuesta. La mayoría de los encuestados (88,3%) ya había asistido a pacientes con EA, pero el 50,8% haría una revisión de la literatura para asistir nuevamente a estos pacientes. El principal objetivo informado en el manejo del individuo con EA fue "retrasar la progresión de las pérdidas motoras". Las conductas fueron significativamente diferentes según el estadio de la enfermedad (p<0,001). Más del 85% citó como beneficio que la fisioterapia "retrasa la dependencia física". Este estudio apunta la necesidad de más investigaciones que aborden específicamente las etapas intermedias y avanzadas de la EA, ya que la literatura existente es poco concluyente y con poca evidencia respecto a la fisioterapia en el manejo de estas personas con la enfermedad, lo que impide la elaboración de manuales y/o estandarización de conductas específicas para cada estadio de la enfermedad.
ABSTRACT This study analyzes the working profile of physical therapists from the states of Rio de Janeiro (RJ) and Rio Grande do Sul (RS) in the management of people with Alzheimer's disease (AD). A total of 256 responses were obtained to a questionnaire sent via the electronic address of the Regional Councils of Physical Therapy and Occupational Therapy (CREFITOS) 2 (RJ) and 5 (RS), from March to December 2020. The questionnaire comprises 36 closed questions, the variables of which were grouped into: (1) sample characterization; (2) specific data on the profession of physical therapist; and (3) issues related to AD. In this article, only issues related to AD will be analyzed. All questions were multiple choice with 2 to 15 options of answer. Most respondents (88.3%) had already treated patients with AD, but 50.8% needed to review the literature to assist these patients. The main objective reported in the management of the individual with AD was to "delay the progression of motor losses." The practices were significantly different according to the stage of the disease (p<0.001). More than 85% of the participants cited as a benefit that physical therapy "delays physical dependence." This study shows the need for further studies that specifically address the intermediate and advanced stages of AD since the current literature is inconclusive and with little evidence regarding physical therapy in the management of this population, making it impossible to create manuals and /or standardization of specific practices for each stage.
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RESUMO Objetivo: Realizar a tradução, a adaptação transcultural e a avaliação das propriedades clinimétricas da Critical Care Functional Rehabilitation Outcome Measure para avaliação da funcionalidade de pacientes internados em unidades de terapia intensiva no Brasil. Métodos: O processo de tradução e adaptação transcultural seguiu as seguintes etapas: tradução inicial, síntese, retrotradução, revisão por comitê de especialistas e pré-teste. Foram analisadas a confiabilidade intra e interavaliador e a concordância, com dados gerados a partir da avaliação de dois fisioterapeutas no mesmo grupo de pacientes (n = 35). As avaliações foram feitas de forma independente e cega quanto ao escore atribuído pelo outro profissional. A análise qualitativa foi realizada pelo comitê de revisão, e os especialistas adaptaram e sintetizaram a tradução da escala Critical Care Functional Rehabilitation Outcome Measure na língua portuguesa. Resultados: Observou-se concordância entre as traduções da escala Critical Care Functional Rehabilitation Outcome Measure para versão brasileira. As equivalências conceitual, idiomática, semântica e experimental entre a versão original e a traduzida foram obtidas, resultando na versão brasileira, denominada Medida de Resultado da Reabilitação Funcional em Cuidados Intensivos. A avaliação das propriedades clinimétricas demonstrou evidências de alto grau de concordância e de confiabilidade, visto que todos tiveram Coeficiente de Correlação Intraclasse acima de 0,75. O Coeficiente de Correlação Intraclasse total foi de 0,89. Conclusão: A versão da escala Critical Care Functional Rehabilitation Outcome Measure para avaliação da funcionalidade de pacientes internados em unidade de terapia intensiva pode ser utilizada de forma confiável no Brasil, pois foi traduzida e adaptada transculturamente para o português brasileiro e apresenta evidências de excelentes propriedades
ABSTRACT Objective: To translate, crossculturally adapt and evaluate the clinimetric properties of the Critical Care Functional Rehabilitation Outcome Measure for evaluating the functionality of patients admitted to intensive care units in Brazil. Methods: The process of translation and cross-cultural adaptation involved the following steps: initial translation, synthesis, back-translation, expert committee review and pretesting. The intra- and interrater reliability and agreement were analyzed between two physical therapists who evaluated the same group of patients (n = 35). The evaluations were performed by each therapist independently and blinded to the score assigned by the other professional. The qualitative analysis was performed by the review committee, and the experts adapted and synthesized the Portuguese translation of the Critical Care Functional Rehabilitation Outcome Measure. Results: There was agreement between the initial Brazilian translations of the Critical Care Functional Rehabilitation Outcome Measure scale. The conceptual, idiomatic, semantic and experimental equivalences between the original and translated versions were assessed, resulting in the final Brazilian version of the scale, called the Medida de Resultado da Reabilitação Funcional em Cuidados Intensivos. The evaluation of the clinimetric properties showed evidence of a high degree of agreement and reliability, as all had an intraclass correlation coefficient above 0.75. The overall intraclass correlation coefficient was 0.89. Conclusion: The translated version of the Critical Care Functional Rehabilitation Outcome Measure scale for assessing the functionality of patients admitted to an intensive care unit can be used reliably in Brazil following translation and cross-cultural adaptation to Brazilian Portuguese and presents evidence of excellent interrater reliability.
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Objective:To explore the effects of small-incision carpal tunnel release on postoperative functional recovery and electrophysiological indexes in carpal tunnel syndrome (CTS).Methods:A total of 75 patients with CTS treated in Shulan (Hangzhou) Hospital were enrolled as the research objects between April 2016 and April 2021. According to different surgical methods, they were divided into group A (34 cases, small-incision carpal tunnel release) and group B (41 cases, traditional carpal tunnel release). The operation time, hospitalization time, time to resume work, electrophysiological indexesbefore and after surgery, and postoperative complications were compared between the two groups.Results:Compared with group B, operation time, hospitalization time and time to resume work were shorter in group A: (12.32 ± 3.26) min vs. (34.65 ± 7.49) min, (5.15 ± 1.68) d vs. (7.83 ± 2.24) d, (18.22 ± 2.03) d vs. (37.35 ± 3.16) d ( P<0.05). After surgery, electrophysiological indexes in both groups were improved ( P<0.05), but there was no significant difference between the two groups ( P>0.05). The incidence rates of scar pain, decreased grip strength and hand piercing pain in group A were lower than those in group B: 2.94%(1/34) vs. 19.51%(8/41), 0 vs. 21.95%(9/41), 0 vs. 12.20%(5/41) ( P<0.05). Conclusions:Compared with traditional carpal tunnel release, clinical curative effect of small-incision carpal tunnel release is comparable on CTS patients. However, it can shorten operation time, hospitalization time and time to resume work, reduce incidence of postoperative complications.
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Objective:To explore application of the mixed reality (MR) technique in the surgery for complex pilon fractures.Methods:A retrospective analysis was conducted of the 22 patients with pilon fracture of Rüedi-Allg?wer type Ⅲ who had been treated at the Department of Orthopedics, Nanjing Tongren Hospital from May 2018 to October 2020. They were divided into 2 groups according to their treatment procedures. In the MR group of 9 cases, there were 8 males and one female, with an age of (39.2 ± 15.1) years. In addition to calcaneal traction plus open reduction and internal fixation, the MR technique was used to assist doctor-patient communication, preoperative planning, surgical guidance and rehabilitation exercises. In the control group of 13 male cases with an age of (33.7 ± 9.6) years, only conventional calcaneal traction plus open reduction and internal fixation were carried out. The communication efficiency, operation time, intraoperative blood loss, fluoroscopy frequency, fracture reduction, post-operative complications and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at one year postoperatively were recorded and compared between the 2 groups.Results:There was no significant difference in the general data between the MR group and the control group, showing they were comparable ( P > 0.05). The questionnaire score of patients' surgical awareness [(77.8 ± 19.2) points] in the MR group was significantly higher than that in the control group [(50.0 ± 30.6) points] ( P = 0.017). The fluoroscopy frequency [(7.3 ± 2.6) times] in the MR group was significantly lower than that in the control group [(9.5 ± 2.3) times] ( P = 0.043). No significant differences were observed between the 2 groups in either the operation time [(98.3 ± 14.4) min versus (110.4 ± 20.4) min] or the intraoperative blood loss [(118.9 ± 36.5) mL versus (128.8 ± 35.2) mL] ( P = 0.142, P = 0.527). In the MR group, 8 cases achieved anatomical reduction and one case good reduction; in the control group, 4 cases achieved anatomical reduction, 8 cases good reduction and one case poor reduction. The anatomical reduction in the MR group was significantly better than that in the control group ( P = 0.011). There were one case of delayed wound healing, one case of nonunion, and one case of traumatic osteoarthritis in the MR group while there were 2 cases of delayed wound healing, one case of superficial soft tissue infection, one case of nonunion, and 2 cases of traumatic osteoarthritis in the control group. The average AOFSA ankle-hindfoot score at one year postoperatively in the MR group [(83.8 ± 9.0) points] was significantly higher than that in the control group [(73.3 ± 11.8) points] ( P = 0.035). However, there was no significant difference between the MR group and the control group in the good to excellent rate by the AOFSA ankle-hindfoot score at one year postoperatively (6 excellent cases, one good case, and 2 fair cases in the former versus 6 excellent cases, 2 good cases, 4 fair cases, and one poor case in the latter) ( P = 0.648). Conclusions:In the surgery for complex pilon fractures, MR technique can increase the efficiency of doctor-patient communication, reduce intraoperative fluoroscopy frequency, and improve reduction quality and ankle function, but fails to significantly reduce operation time and intraoperative blood loss.
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Objective:To investigate the effect of everting resection natural orifice specimen extraction surgery (NOSES) on postoperative function in patients with colorectal cancer.Methods:The clinical data of 78 patients with colorectal cancer treated in Chongqing Bishan District People's Hospital from June 2019 to June 2020 were retrospectively analyzed. According to the selected surgical methods, they were divided into the study group (45 cases) and the control group (33 cases). The control group underwent traditional laparoscopic radical resection of colorectal cancer, and the study group underwent everting resection NOSES. Perioperative indicators such as intraoperative bleeding, operation time, postoperative exhaust time and hospitalization time were observed in the two groups. Anal function indicators [anal constriction pressure, fecal incontinence severity score (Wexner score)], coagulation function indicators [activated partial thromboplastin time (APTT), prothrombin time (PT)], the levels of inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP)] and pain factors [nerve growth factor (NGF), prostaglandin E2 (PGE2), neuropeptide Y (NPY)] before and after operation were compared between the two groups.Results:There were no significant differences in intraoperative bleeding and operation time between the two groups ( t values were 1.30 and 0.56, both P > 0.05); the postoperative exhaust time and hospitalization time of the study group were shorter than those of the control group ( t values were 26.88 and 7.42, both P < 0.05). At 3 months after operation, the anal constriction pressure in the two groups was lower than that before operation [study group: (177±10) mmHg (1 mmHg = 0.133 kPa) vs. (184±10) mmHg, t = 3.22, P < 0.001; control group: (178±10) mmHg vs. (184±10) mmHg, t = 2.36, P = 0.020]; the Wexner score was higher than that before operation [study group: (9.0±1.2) points vs. (7.9±1.2) points, t = 4.26, P < 0.001; control group: (10.3±1.2) points vs. (7.9±1.2) points, t = 7.80, P < 0.001], and the Wexner score in the study group was lower than that in the control group ( t = 4.57, P < 0.001). At 1 day after operation, APTT and PT in the two groups were shorter than those before operation (all P < 0.05), and APTT and PT in the study group were shorter than those in the control group [APTT: (26.2±2.2) s vs. (28.3±2.2) s, t = 4.23, P < 0.001; PT: (9.34±0.17) s vs.(11.03±0.41) s, t = 24.93, P < 0.001]. At 1 day after operation, the levels of IL-6 and CRP in the two groups were higher than those before operation (all P < 0.05); the levels of IL-6 and CRP in the study group were lower than those in the control group [IL-6: (8.6± 2.2) ng/L vs. (17.2±3.1) ng/L, t = 14.26, P < 0.001; CRP: (2.16±0.22) mg/L vs. (2.99±0.24) mg/L, t = 15.84, P < 0.001]. At 1 day after operation, the levels of NGF, PGE2 and NPY in the two groups were higher than those before operation (all P < 0.05), and the levels of NGF, PGE2 and NPY in the study group were lower than those in the control group [NGF: (302±7) pg/ml vs. (319±8) pg/ml, t = 9.76, P < 0.001; PGE2: (189±4) ng/L vs. (196±5) ng/L, t = 6.56, P < 0.001; NPY: (164±10) ng/L vs. (177±11) ng/L, t = 5.36, P < 0.001]. Conclusions:Everting resection NOSES can effectively shorten the postoperative exhaust time and hospitalization time of patients with colorectal cancer, have less impact on coagulation function and anal function, reduce the inflammatory reaction and the level of pain factors.
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Objective:To analyze the factors influencing functional recovery after surgery of calcaneal fracture.Methods:A retrospective analysis was performed in 1,080 eligible patients with calcaneal fracture who had been admitted to The Third Hospital of Hebei Medical University from January 1, 2018 to December 31, 2020. They were 931 males and 149 females with a mean age of 43.0 years. By the Sanders classification, there were 107 cases of type Ⅰ, 343 cases of type Ⅱ, 471 cases of type Ⅲ and 159 cases of type Ⅳ. Multiple linear regression model was used to screen out the main relevant factors affecting the postoperative functional recovery by analyzing the 18 factors which might influence the postoperative functional recovery like gender, age, Sanders type, occupation, body mass index, season, cause, hospital stay, operation method, internal fixation, preoperative combined injury, preoperative complication, anesthesia, attendance to rehabilitation institution, incision selection, waiting time, preoperative blister and reduction quality.Results:All the 1,080 patients were followed up for 17.5 months on average. The mean Creighton-Nebraska score at the last follow-up was 88.4. The univariate analyses showed statistically significant differences in the Creighton-Nebraska score among patients with different gender, age group, Sanders type, occupation, injury cause, surgical method, preoperative combined injury, incision selection and reduction quality ( P<0.05). Multiple linear regression model analysis resulted in the following regression equation: Y=107.408-4.013×gender-7.101×age-1.214×Sanders type-1.606×incision selection. Conclusions:The factors which influence the functional recovery after surgery of calcaneal fracture may be gender, age, fracture type and incision selection; the functional recovery score after surgery of calcaneal fracture may be low for female senior patients with type Ⅳ fracture and a large L-shaped incision.