The Role of 6-Minute Walk Test Guided by Impedance Cardiography in the Rehabilitation Following Knee Arthroplasty: A Randomized Controlled Trial

Objective: To explore the effect of the 6-minute walk test (6MWT) guided by non-invasive cardiac output on the rehabilitation of patients with knee osteoarthritis following artificial total knee arthroplasty.Methods: About 66 patients with knee osteoarthritis planned to undergo artificial total knee arthroplasty were included from March 2019 to October 2019, and randomly assigned to the intervention group or control group. Under the guidance of a clinical rehabilitation physician, orthopedic physician, and cardiologist, a home rehabilitation exercise program based on 6MWT and non-invasive cardiac output was formulated for patients with knee osteoarthritis. The participants of the intervention group conducted full rehabilitation training supervision and guidance through the WeChat platform to ensure their rehabilitation pieces of training were completed safely and effectively. As for the control group, patients were just given rehabilitation training manuals at the time of discharge and completed the training by themselves.Results: At 6 months post-operatively, 6-minute walk distance (413.88 ± 44.61 vs. 375.00 ± 40.53 m, P < 0.05), active metabolic equivalent (4.13 ± 0.29 vs. 3.88 ± 0.27, P < 0.05), stroke volume after 6MWT (114.97 ± 12.05 vs. 98.38 ± 16.43 ml, P < 0.05), and cardiac output (11.92 ± 1.68 vs. 9.79 ± 1.82 l/min, P < 0.05) of the intervention group were significantly higher than those of the control group. The symptom evaluation scores of the intervention group were also better than those of the control group.Conclusions: The multidisciplinary post-operative rehabilitation exercise training program is beneficial to the recovery of lower limb function and the improvement of exercise capacity after knee replacement, and it also helps to improve the non-invasive hemodynamic indicators related to the cardiac function of the patient.Clinical Trial Registration:http://www.chictr.org.cn/index.aspx.

Case Report: Unusual Presentation of Myositis Ossificans of the Elbow in a Child Who Underwent Excessive Postoperative Rehabilitation Exercise

Traumatic myositis ossificans (MO) is an unusual complication after muscle injury and is predominantly seen in young adults and adolescents. Pediatric MO cases are even rarer. We report an 8-year-old girl who was diagnosed with a lateral humeral condyle fracture. She was treated surgically, and her elbow joint was fixed with plaster. Rehabilitation exercise was administered 1 month after the operation. Due to the wrong exercise method, a palpable bony mass appeared around the elbow 1 month later. The clinical radiological diagnosis showed MO, and conservative treatment was administered. After 3 years of follow-up, the affected limb functioned well, with no sign of recurrence. Here, we report this long-term follow-up case of MO resulting from excessive rehabilitation exercise.

Application Value of Rehabilitation Nursing in Patients with Stroke Based on the Theory of Interactive Standard: A Randomized Controlled Study

Objective. To explore the application value of rehabilitation nursing based on the theory of interactive standards in stroke patients. Methods. A total of 120 stroke patients who were treated in our hospital from December 2018 to September 2020 were selected as the research objects, and the patients were divided into a control group (60 cases) and an observation group (60 cases) according to the random number table method. The control group used routine nursing care, and the observation group used interactive rehabilitation care based on the control group. The Barthel Index, National Institute of Health Stroke Scale (NIHSS) score, Specific Quality Of Life Scale (SS-QOL) score, rehabilitation standard rate, nursing satisfaction, improvement time of limb function, and compliance with rehabilitation exercise were compared between the two groups of patients. Results. After intervention, the Barthel Index of the two groups increased, and the Barthel Index of the observation group was comparatively higher ( P < 0.05); the NIHSS scores of the two groups of patients reduced, and the NIHSS scores of the observation group were significantly lower than those of the control group ( P < 0.05); the SS-QOL scores of the two groups of patients improved, and the increase in SS-QOL scores in the observation group was found to be significantly higher than those in the control group ( P < 0.05); the compliance rate was found to be in favor of the observation group (83.33 (50/60) vs 63.33 (38/60)) (χ2 = 6.136, P ˂0.05); the total satisfaction of nursing care of patients in the observation group was superior to the control group (96.67% vs 78.33%) (χ2 = 9.219, P ˂0.05); the limb function improvement time of the observation group was significantly shorter ( P < 0.05); the observation group had significantly higher rehabilitation exercise compliance scores ( P < 0.05). Conclusion. The rehabilitation nursing based on the interactive standard theory can promote the stroke patients to complete the rehabilitation goals, improve the neurological and limb functions, and enhance the patients’ daily living ability, quality of life, and nursing satisfaction, which is worthy of clinical promotion and application.

Kinematic Analysis During Straight Line Free Swimming in Horses: Part 1 - Forelimbs

Background: Swimming is used for rehabilitation and conditioning purposes in equine sports medicine despite the lack of understanding of equine swimming kinematics. The aim of this study was to assess forelimb joints kinematics (elbow, carpus, and fetlock) in swimming horses. The specific objectives were 1- to calculate and compare joint angles in swimming vs. passive mobilizations (PM), 2- to determine joint angular velocities during a swimming stride cycle.Methods: Eleven elite endurance horses swam in a 100-m straight pool. Underwater (swimming) and overground (PM) videos were recorded from the horses' left side. Joint markers were applied on the lateral hoof wall, lateral metacarpal epicondyle, ulnar carpal bone, lateral humeral epicondyle, and the greater tubercle of humerus, from which elbow, carpus and fetlock angles, and angular velocities were obtained. As a reference, maximal fetlock, carpus, and elbow flexion/extension angles were determined during PM overground. Differences between angle extrema, angular velocities and range of motion (ROM) were compared.Results: Carpus and fetlock ROM were significantly smaller (p &lt; 0.001) during swimming when compared with PM, while there was no difference in elbow ROM between both situations. The carpus had the greatest ROM of all joints during swimming. Absolute angular velocities values of all joints during swimming were greater during retraction than protraction (p &lt; 0.001). When compared to other joints during protraction, the carpus joint reached the highest angular velocity.Conclusion: Swimming, as a rehabilitation exercise, has the potential to benefit horses where great elbow ROM with a moderate carpus and fetlock extension are wanted.

Delivering Cardiac Rehabilitation Exercise Virtually Using a Digital Health Platform (ECME-CR): Protocol for a Pilot Trial

Background Exercise-based cardiac rehabilitation is recognized as a core component of cardiovascular disease management and has been shown to reduce all-cause and cardiovascular mortality and reduce the risk of hospital readmission following a cardiac event. However, despite this, the uptake of and long-term adherence to cardiac rehabilitation exercise is poor. Delivering cardiac rehabilitation exercise virtually (ie, allowing patients to participate from their own homes) may be an alternative approach that could enhance uptake and increase adherence. Objective The aim of this study is to assess the feasibility of delivering a virtual cardiac rehabilitation exercise program supported by the Eastern Corridor Medical Engineering – Cardiac Rehabilitation (ECME-CR) platform. Methods A convenience sample (n=20) of participants eligible to participate in community-based cardiac rehabilitation exercise will be recruited. Participants will be randomized to one of two study groups. Both study groups will perform the same exercise program, consisting of twice-weekly sessions of 60 minutes each, over an 8-week intervention period. Participants in the intervention group will partake in virtually delivered cardiac rehabilitation exercise classes in their own home. The virtual exercise classes will be delivered to participants using a videoconferencing platform. Participants in the control group will attend the research center for their cardiac rehabilitation exercise classes. Intervention group participants will receive the ECME-CR digital health platform for monitoring during the class and during the intervention period. Outcomes will be assessed at baseline and following the 8-week intervention period. The primary outcome will be exercise capacity as assessed using the 6-minute walk test. Other outcome measures will include heart rate, blood pressure, weight, percentage body fat, muscle strength, and self-reported quality of life. Semistructured interviews will also be conducted with a subset of participants to explore their experiences of using the digital platform. Results Participant recruitment and data collection will begin in July 2021, and it is anticipated that the study results will be available for dissemination in spring 2022. Conclusions This pilot trial will inform the design of a randomized controlled trial that will assess the clinical effectiveness of the ECME-CR digital health platform. International Registered Report Identifier (IRRID) PRR1-10.2196/31855