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Study and Assessment of Motor Abilities of Older Children of Pre-school Age With Speech Disorders 学龄前言语障碍大龄儿童运动能力的研究与评价
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1695.1
K. E. Panasenko, L. Shinkareva, Tatiana A. Altukhova, E. A. Nikolaeva, Elena V. Shatalova
Objectives: The urgency of the given study is in the lack of knowledge of various types of motor abilities of older pre-school children with speech disorders and the need to realize an individually differentiated approach to provide the environment for their development. In the current study, it was tried to identify and assess the level of development of motor abilities in older pre-school children with speech disorders. Methods: The study included 200 older pre-school children, 100 children with a healthy level of speech development, and 100 with a speech disorder in the Belgorod and Belgorod region (Russian Federation). The study looked at scientific sources using motor abilities testing (motor coordination, speed, strength, strength, plasticity, and stamina). Methods of mathematical statistics (student's t-test) using the SPSS software, version 26 were used to calculate the statistic problems. Results: The study and assessment of motor abilities of older pre-school children showed the predominance of an insufficient level of development of motor and coordination abilities in both neurotypical children and those with a language disorder. In both groups, children performed the worse left-hand task (the insufficient level was noted in children with speech disorders in 100% of boys and girls; in the group of children with a healthy level of speech development – in 84.1% of boys and 81.5 % of girls). When performing the right task hand, an insufficient level was noticed in children with speech disorders in 95.5% of boys and 96.4% of girls; in the group of children with a healthy level of speech development–in 77.3% of boys and 74.1% of girls. Diagnosis of other motor abilities states the dominance of the insufficient level only in children with speech disorders: strength abilities (70.5% of boys and 72.3% of girls), speed and strength abilities (68.2 % of boys and 67.9 % of girls), stamina (77.3% of boys and 75% of girls), and plasticity (65.9% of boys and 62.5% of girls). The veracity of the results was confirmed through the student's t-test. The observed differences were statistically significant. Discussion: The obtained findings and assessment of motor abilities confirm developmental lag in older pre-school children with speech disorders. In children, low indicators in the level of development of motor-coordination abilities and stamina prevailed.
目标:本研究的紧迫性在于缺乏对患有言语障碍的学龄前大龄儿童各种类型运动能力的了解,并且需要实现一种个体差异化的方法来为他们的发展提供环境。在目前的研究中,试图确定和评估患有言语障碍的学龄前儿童的运动能力发展水平。方法:该研究纳入了别尔哥罗德和别尔哥罗地区(俄罗斯联邦)的200名年龄较大的学龄前儿童、100名言语发育水平健康的儿童和100名言语障碍儿童。这项研究使用运动能力测试(运动协调性、速度、力量、力量、可塑性和耐力)来寻找科学来源。使用SPSS软件26版的数理统计方法(学生t检验)计算统计问题。结果:对年龄较大的学龄前儿童运动能力的研究和评估表明,神经正常儿童和语言障碍儿童的运动和协调能力发展水平不足。在这两组中,儿童的左手任务表现较差(在患有言语障碍的儿童中,100%的男孩和女孩表现出水平不足;在言语发育水平健康的儿童组中,84.1%的男孩和81.5%的女孩表现出不足)。在执行右手任务时,95.5%的男孩和96.4%的女孩的言语障碍儿童的水平不足;在言语发育水平健康的儿童组中,77.3%的男孩和74.1%的女孩。其他运动能力的诊断表明,不足水平仅在言语障碍儿童中占主导地位:力量能力(70.5%的男孩和72.3%的女孩)、速度和力量能力(68.2%的男孩和67.9%的女孩),耐力(77.3%的男孩和75%的女孩)和可塑性(65.9%的男孩和62.5%的女孩)。学生的t检验证实了结果的准确性。观察到的差异具有统计学意义。讨论:所获得的研究结果和对运动能力的评估证实了患有言语障碍的学龄前儿童的发育滞后。在儿童中,运动协调能力和耐力的发展水平指标普遍较低。
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引用次数: 0
Factors Associated With Resilience Among People With Spinal Cord Injury in the Community Setting 社区环境中脊髓损伤患者恢复力的相关因素
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1808.1
Meenakshi Mohan, R. Deb
Objectives: The present cross-sectional study was done to acknowledge the level of resilience, its association with quality of life (QoL), community integration, and demographic/injury-related variables, and identify the determinants that affect resilience among spinal cord injury individuals living in the community. Methods: The data were collected from 108 participants using the convenience sampling method. A demographic/injury-related questionnaire was used to identify the characteristics of the participants. The CD-RISC10, World Health Organization quality of life-BREF (WHOQOL-BREF), and community integration questionnaire-revised (CIQ-R) were used to measure resilience, QoL, and community integration. Association between resilience and independent variables was examined through Pearson’s correlation and Point-Biserial correlation, whereas, univariate and multivariate linear regression analyses were applied to identify the influence of the demographic/injury-related factors that contribute to resilience, and independent t-test and ANOVA were employed to identify the determinants that affect resilience. Results: Almost 78% of participants had a moderate-to-high level of resilience. In multivariate analysis, gender, marital status, and profession were found to be statistically significant. Among these predictors, employment had a higher beta value (β=0.684, P=0.026), which signifies its importance in evaluating resilience. Significant associations were established between resilience, QoL domains, community integration, and demographic variables, which included marital status, duration since the injury, and frequency of going out. Discussion: The present research brings attention to the significance of using appropriate interventions, such as vocational rehabilitation support as well as awareness about the injury to help strengthen resilience and reintegration amongst SCI individuals into their communities. A further longitudinal study is recommended to determine predictive factors of the dynamic nature of resilience over time.
目的:本横断面研究旨在了解脊髓损伤患者的恢复力水平及其与生活质量(QoL)、社区整合和人口统计学/损伤相关变量的关系,并确定影响社区生活中脊髓损伤患者恢复力的决定因素。方法:采用方便抽样法对108名调查对象进行调查。使用人口统计学/伤害相关问卷来确定参与者的特征。采用CD-RISC10、世界卫生组织生活质量量表(WHOQOL-BREF)和修订后的社区整合问卷(CIQ-R)来测量恢复力、生活质量和社区整合。通过Pearson相关和点双列相关检验心理弹性与自变量之间的关系,采用单变量和多变量线性回归分析确定人口统计学/伤害相关因素对心理弹性的影响,采用独立t检验和方差分析确定影响心理弹性的决定因素。结果:近78%的参与者具有中高水平的弹性。在多变量分析中,性别、婚姻状况和职业具有统计学意义。其中,就业具有较高的β值(β=0.684, P=0.026),说明就业对心理弹性的评价具有重要意义。复原力、生活质量域、社区整合和人口统计变量(包括婚姻状况、受伤后持续时间和外出频率)之间存在显著关联。讨论:目前的研究关注了使用适当干预措施的重要性,例如职业康复支持以及对损伤的认识,以帮助增强脊髓损伤患者的恢复力和重新融入社区。建议进行进一步的纵向研究,以确定弹性随时间变化的动态特性的预测因素。
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引用次数: 0
Women, Sexual Harassment, and Coping Strategies: A Descriptive Analysis 女性、性骚扰与应对策略:一项描述性分析
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1797.1
Z. Mirhosseini, P. Pakdel, Marzieh Ebrahimi
Objectives: Sexual harassment is one of the most common workplace issues that female employees may experience. The issue is especially severe for women working in a healthcare setting due to factors, such as unequal hierarchical power, night shifts, and a significant volume of visitors, etc. This study sought to characterize and categorize responses to and causes of acute sexual harassment. Methods: Thirty-nine hospital employees who had experienced sexual harassment were selected for in-depth interviews as part of a qualitative study designed to collect data. Results: The responses were categorized chronologically as pre-, during-, and post-harassment. Preventive strategies were the most notable pre-harassment responses, whereas, during harassment, diffusion, denial, avoidance, and behavioral changes were the most significant responses. Nonetheless, since diffusion, avoidance, non-disclosure, and non-reporting could result in the persistence of the harassment, the post-harassment strategies shed light on the factors that determined the victims' failure to disclose sexual harassment. Discussion: Although women experience sexual harassment in healthcare settings, they typically refrain from reporting it and respond passively to such situations. Formal and informal organizational support for the harassed women can empower them to resist harassers and report their conduct in hospital settings.
目标:性骚扰是女性员工可能遇到的最常见的工作场所问题之一。由于等级权力不平等、夜班和大量访客等因素,在医疗机构工作的女性面临的问题尤为严重。这项研究试图对急性性骚扰的反应和原因进行定性和分类。方法:选择39名经历过性骚扰的医院员工进行深入访谈,作为旨在收集数据的定性研究的一部分。结果:这些反应按时间顺序分为骚扰前、骚扰中和骚扰后。预防策略是骚扰前最显著的反应,而在骚扰期间,扩散、否认、回避和行为改变是最显著的回应。尽管如此,由于传播、回避、不披露和不报告可能导致骚扰的持续存在,骚扰后策略揭示了决定受害者未披露性骚扰的因素。讨论:尽管女性在医疗环境中经历过性骚扰,但她们通常不会报告,并对这种情况做出被动反应。对被骚扰妇女的正式和非正式组织支持可以使她们有能力抵制骚扰者,并报告她们在医院的行为。
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引用次数: 1
Effects of Pre-operative Physical Therapy on Functional Capacity, Kinesiophobia, and Post-operative ICU Stay in Coronary Artery Bypass Grafting Candidates 术前物理治疗对冠状动脉搭桥术患者功能能力、运动恐惧症和术后ICU住院时间的影响
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1673.1
Kiran Khushnood, N. Sultan, Malik Muhammad Ali Awan, Shafaq Altaf, Riafat Mehmood, S. Qureshi
Objectives: This study was done to find out the impact of a pre-operative physical therapy plan with inspiratory muscle training on functional capacity, kinesiophobia, and post-operative intensive care unit (ICU) stay in subjects with coronary artery disease (CAD) candidates for coronary artery bypass grafting (CABG). Methods: Fifty subjects who fulfilled the inclusion criteria were recruited and randomly distributed into the intervention and control group by concealed envelop method. Participants in the experimental group were provided with inspiratory muscle training (IMT) with breathing exercises and chest clearance techniques, while the control group received breathing exercises and chest clearance techniques. Both groups received three treatment sessions before their scheduled surgery. The assessment was done at three-time intervals: At baseline, after three sessions, and after surgery. The outcome measures were oxygen saturation, heart rate, respiratory rate, Borg scale of perceived exertion (Borg PRE), Tampa scale of kinesiophobia for the heart (TSKH), and days spent at ICU after CABG. Results: Oxygen saturation, respiratory rate, functional capacity, and pulmonary endurance improved significantly among the treatment groups with a P<0.001 and a large effect size. The pulse rate showed no significant improvement; P and effect size were 0.38 and 0.60, respectively. Kinesiophobia and ICU stay also showed significant changes with a P<0.001. The effect size was large for both kinesiophobia and ICU stay. Discussion: IMT as a component of a pre-operative physical therapy plan can improve oxygen saturation, respiratory rate, functional capacity, and pulmonary endurance in CAD patients going for CABG. IMT reduces the level of kinesiophobia and duration of ICU stay after CABG.
目的:本研究旨在了解术前吸气肌训练物理治疗计划对冠状动脉疾病(CAD)候选冠状动脉搭桥术(CABG)受试者的功能能力、运动恐惧症和术后重症监护室(ICU)停留的影响。方法:选择符合入选标准的50名受试者,采用隐蔽包络法随机分为干预组和对照组。实验组的参与者接受了吸气肌训练(IMT),包括呼吸练习和清胸技术,而对照组则接受了呼吸练习和清胸技术。两组患者在预定手术前均接受了三次治疗。评估分三个时间间隔进行:基线时、三次治疗后和手术后。结果指标包括血氧饱和度、心率、呼吸频率、Borg感觉用力量表(Borg PRE)、Tampa心脏运动恐惧症量表(TSKH)以及冠状动脉搭桥术后在ICU的天数。结果:治疗组的血氧饱和度、呼吸频率、肺活量和肺耐力均有显著改善,P<0.001,疗效显著。脉率无明显改善;P和效应大小分别为0.38和0.60。运动恐惧症和ICU住院时间也有显著变化,P<0.001。运动恐惧症和ICU住院的效果都很大。讨论:IMT作为术前物理治疗计划的一个组成部分,可以改善接受CABG的CAD患者的血氧饱和度、呼吸频率、功能能力和肺耐力。IMT可降低CABG术后的运动恐惧症水平和ICU住院时间。
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引用次数: 0
Psychometric Features of the Patient Evaluation Measure in Iranian Individuals With Wrist Disorders 伊朗腕关节疾病患者评估措施的心理测量特征
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1800.1
Mahsa Meimandi, A. Azad, Golara Niketeghad, Laleh Lajevardi
Objectives: The patient evaluation measure (PEM) evaluates the hand health profile. Having an appropriate measurement tool for the assessment of hand outcomes in Iranian individuals with wrist disorders is essential for clinical and research settings. The objective of the present study was to examine the psychometric features of the PEM in Iranian individuals with wrist disorders. Methods: Ninety individuals with wrist disorders were recruited. Hand outcome was evaluated with the PEM, quick-disabilities of the arm, shoulder, and hand (Q-DASH), visual analogue scale-pain (VAS-P), and JAMAR hand-grip dynamometer. The PEM was translated into Persian. Face, content, and convergent validity was examined. Also, acceptability, internal consistency, test-retest reliability, and absolute reliability were calculated. Results: All questions had an item impact score and CVR score of >1.5 and >0.42, respectively. All questions except for question 1 (CVI=0.76) and 10 (CVI=0.73) of section B had a CVI score of <0.79. After changes were applied, the CVI score for these questions (question 1=0.83; question 10=0.87) reached acceptable criteria. The total score of the PEM showed a significant moderate correlation with Q-DASH (ρ=0.51; P<0.001) and VAS-P (ρ=0.55; P<0.001) and an insignificant weak correlation with grip strength (ρ=-0.11; P>0.05). Floor and ceiling effects were 0% for the total PEM score. The Cronbach’s α and intra-class correlation values were 0.72-0.87 and 0.96-0.98, respectively. Discussion: The present study suggests that the PEM has acceptable validity and reliability for measuring performance and satisfaction in individuals with wrist disorders. This measure might contribute as an outcome measure in research and routine assessments in clinical practice.
目的:患者评估量表(PEM)评估手部健康状况。拥有一个合适的测量工具来评估伊朗手腕疾病患者的手部结果对临床和研究环境至关重要。本研究的目的是检查伊朗手腕疾病患者PEM的心理测量特征。方法:90名腕关节疾病患者被招募。用PEM、手臂、肩膀和手的快速残疾(Q-DASH)、视觉模拟量表疼痛(VAS-P)和JAMAR握力计评估手部结果。PEM被翻译成波斯语。检验了面孔、内容和收敛有效性。此外,还计算了可接受性、内部一致性、重测可靠性和绝对可靠性。结果:所有问题的项目影响得分和CVR得分分别为>1.5和>0.42。除B部分的问题1(CVI=0.76)和问题10(CVI=0.73)外,所有问题的CVI得分均为0.05。PEM总分的下限和上限效应为0%。Cronbachα和类内相关值分别为0.72-0.87和0.96-0.98。讨论:本研究表明,PEM在测量手腕疾病患者的表现和满意度方面具有可接受的有效性和可靠性。这项测量可能有助于作为研究和临床实践中常规评估的结果测量。
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引用次数: 0
Assessment of Anxiety Among Pregnant Mothers 孕妇焦虑的评估
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1621.5
Maha Ahmed Kadim, Zainab Abdulameer Abdulrasol, Ali Fadhil Obaid, Huda Ahmed Hamid, Nada Hamid Hamdi, Noor Ali Mousa
Objectives: We aimed to assess anxiety in pregnant women. We also investigated the probably associated factors in anxiety in pregnant women. Methods: This research is a descriptive correlational study. The samples (209 pregnant women) were recruited by non-probability (purposive) sampling, and the study instrument consisted of the Hamilton anxiety rating scale and interviews with mothers. The obtained data were analyzed by SPSS softwer, version 25. Results: Most respondents were 17-26 years old, and around half were satisfied with their income. Studies show a significant positive correlation between anxiety and gestational age, watching TV, sleeping, and drinking tea. Discussion: Anxiety increased with mothers working and with mothers with low socioeconomic status. About 26.3% of pregnant mothers had severe anxiety. Some habits like drinking tea, sleeping, and watching TV increase when anxiety increases.
目的:我们旨在评估孕妇的焦虑。我们还调查了孕妇焦虑的可能相关因素。方法:采用描述性相关研究。采用非概率(有目的)抽样法,采用汉密尔顿焦虑量表和母亲访谈法,选取209名孕妇作为研究对象。所得数据采用SPSS软件25进行分析。结果:大多数受访者年龄在17-26岁之间,约一半的受访者对自己的收入感到满意。研究表明,焦虑与胎龄、看电视、睡眠和喝茶之间存在显著的正相关。讨论:母亲工作和社会经济地位低的母亲的焦虑增加。约26.3%的孕妇有严重的焦虑。当焦虑增加时,一些习惯,如喝茶、睡觉和看电视也会增加。
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引用次数: 0
Goal Attainment Scale (GAS) Administration Workshop and Its Effects on Job Motivation and Burnout of Pediatric Occupational Therapists 目标达成量表管理工作坊及其对儿科职业治疗师工作动机和倦怠的影响
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.417.2
Yalda Sadeghi, N. Hatamizadeh, S. Shahshahani, S. Hosseinzadeh
Objectives: The presence of skilled, motivated therapists is critical to meet the rehabilitation needs of children with disability. This study aimed to determine whether on-the-job training on applying goal attainment scaling (GAS) affects pediatric occupational therapists' burnout and job motivation. Methods: This study was quasi-experimental with a pre-test-post-test design. After signing the informed consent, 35 pediatric occupational therapists at a child rehabilitation center attended a course of five 1.5-2 h workshop sessions during 5 consequent weeks on applying GAS in their workplace. Through the workshop, the trainees practiced setting goals and making 5-point scales to measure the degree of reaching those goals. The participant asked to bring some of their client's descriptions (anonymous) to the workshop as samples to talk about them. Afterward, they were asked to fill in the GAS documentation form as part of their rehabilitation records. Participants' job motivation and burnout scores were measured by the Maslach questionnaire and Loudahel Kitchener's Job Motivation Scale, respectively, before the workshop and 30 and 60 days later. The paired t-test and Wilcoxon test were used for comparisons. Results: The Mean±SD job motivation scores, which were 42.37±6.73 before the intervention, rose to 52.82±8.51 and 56±7.59 at the end of the workshop (day 30) and on follow-up measurement (day 60), respectively (P<0.001). The effect size was 0.556. The burnout scores slightly decreased from 58±12.86 before the intervention to 55.37±12.07, with an effect size of 0.117 on day 60 measurements. Discussion: A short on-the-job training workshop on applying GAS in the formal assessment of achievements in different aspects of child life by rehabilitation practices could help in enhancing therapists' job motivation. Positive effects of GAS administration on motivation and burnout in therapists should take into account along with the client benefits for judging the usefulness of the GAS.
目的:熟练、积极的治疗师的存在对于满足残疾儿童的康复需求至关重要。本研究旨在探讨目标达成量表(GAS)在职培训对儿童职业治疗师职业倦怠和工作动机的影响。方法:本研究采用准实验设计,采用前测后测设计。在签署知情同意书后,一家儿童康复中心的35名儿科职业治疗师在随后的5周内参加了5次1.5-2小时的研讨会,内容是在他们的工作场所应用GAS。通过研讨会,学员们练习了设定目标和制作5分制量表来衡量达到目标的程度。参与者要求将其客户的一些描述(匿名)作为样本带到研讨会上讨论。之后,他们被要求填写GAS文件表格,作为他们康复记录的一部分。采用Maslach问卷和Loudahel Kitchener工作动机量表分别在研讨会开始前和研讨会结束后30天和60天测量参与者的工作动机和倦怠得分。采用配对t检验和Wilcoxon检验进行比较。结果:干预前的Mean±SD工作动机得分为42.37±6.73,干预结束(第30天)和随访(第60天)时分别上升至52.82±8.51和56±7.59,差异有统计学意义(P<0.001)。效应量为0.556。倦怠得分由干预前的58±12.86分降至55.37±12.07分,60天的效应量为0.117。讨论:举办短期在职培训工作坊,探讨如何应用GAS正式评估康复治疗在儿童生活各方面的成就,有助提高治疗师的工作动机。在判断GAS的有用性时,治疗师应考虑到GAS管理对动机和倦怠的积极影响以及客户的利益。
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引用次数: 0
Optimal Duration for Supervised Pelvic Floor Muscle Training in Stress Urinary Incontinence Women: A Prospective Study 压力性尿失禁妇女盆底肌监督训练的最佳时间:一项前瞻性研究
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1774.1
S. Hakim, I. Mistivani, David Tambunan, B. Santoso, Sushkan Djusad, Tyas Priyatini, F. Moegni, A. Meutia, Andrew Pratama Kurniawan
Objectives: We evaluated the optimal duration of pelvic floor muscle training (PFMT) in stress urinary incontinence (SUI) patients. Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2018 to June 2019. We recruited 55 subjects diagnosed with SUI based on the questionnaire for urinary incontinence diagnosis (QUID) score >4 and more than 2 grams of 1-hour pad test. Considering the inclusion and exclusion criteria, we taught and supervised them for PFMT and evaluated them every four weeks to observe the urogenital distress inventory-6 (UDI-6), incontinence impact questionnaire-7 (IIQ-7), 1-hour pad test, and perineometer score. We used the Wilcoxon test to evaluate the improvement at a significance level of P<0.05. Results: Our subjects were mostly obese (65%), 30-55 years old (60%), and had >2 children (90%). There were improvements in UDI-6 and IIQ-7 for every four weeks up to 12 weeks of PFMT (P<0.05, 95% CI). Pelvic floor muscle strength only improved significantly (P=0.001 and P=0.006, respectively) after eight weeks of PFMT. Also, the 1-hour pad test score decreased significantly after four weeks of training (P<0.001). Discussion: SUI distress and symptoms decrease after four weeks of Kegel exercises and continue to improve until 12 weeks of therapy. However, the 1-hour pad test reaches clinical and statistical significance during the first month of exercise with no further improvement clinically. Pelvic floor muscle strength increased significantly after eight weeks of training.
目的:我们评估压力性尿失禁(SUI)患者盆底肌肉训练(PFMT)的最佳持续时间。方法:本横断面研究于2018年11月至2019年6月在Cipto Mangunkusumo医院进行。根据尿失禁诊断问卷(QUID)评分bbbb40分和1小时尿垫试验大于2克,我们招募了55名诊断为SUI的受试者。考虑纳入和排除标准,我们对患者进行PFMT的指导和监督,并每4周对患者进行评估,观察泌尿生殖窘迫量表-6 (UDI-6)、尿失禁影响问卷-7 (IIQ-7)、1小时尿垫试验和会阴计评分。我们使用Wilcoxon检验来评估P2儿童(90%)在显著水平上的改善。在PFMT治疗12周之前,UDI-6和IIQ-7每4周有改善(P<0.05, 95% CI)。盆底肌力仅在PFMT治疗8周后得到显著改善(P=0.001和P=0.006)。训练4周后,1小时尿垫测试得分显著下降(P<0.001)。讨论:经过四周的凯格尔运动后,SUI的痛苦和症状减轻,并持续改善,直到治疗12周。然而,1小时尿垫试验在运动的第一个月达到了临床和统计学意义,临床没有进一步改善。经过8周的训练,骨盆底肌肉力量显著增加。
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引用次数: 0
Iatrogenic-induced Peripheral Gangrene: From Multiple Limb Amputations to Prosthetic Restoration 医源性外周坏疽:从多肢截肢到假肢修复
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.900.2
Linda Joehari, Fatimah Ahmedy, Vanessa Chua, Farhana Harzila Mohd Bahar, Jamie Joseph, Syahiskandar Sybil Shah, Kang Bee Lee
Objectives: Multiple limb amputations are an uncommon complication from inotrope-induced peripheral gangrene. Case Presentation: A 20-year-old lady with valvular heart disease had septic shock secondary to infective endocarditis and required prolonged cardiopulmonary resuscitation. Despite aggressive fluid resuscitation, the patient had triple strength intravenous noradrenaline to maintain hemodynamic stability. On day 5 of post-shock, dry gangrene occurred in distal parts of all limbs, and inotrope was stopped. Although the gangrenous changes were non-progressive, she required a significant degree of assistance with mobility and daily function performance. The patient was counseled for multiple limb amputations to promote walking and hand function through prosthetic restoration. Five months after the event, she had a right transtibial amputation, left Chopart amputation, left wrist disarticulation, and right second, third, fourth, and fifth fingers amputation. Three specific goals for inpatient rehabilitation were independent short-distance ambulation with prostheses, performing basic activities of daily living with adaptive devices, and independent wheelchair propulsion for long-distance mobility using a right-sided transtibial prosthesis, left-sided Syme's prosthesis with Kingsley's foot, right-sided silicone-based cosmetic glove and left-sided body-powered transradial prosthesis. Discussion: Although an uncommon complication, inotrope may lead to multiple limb amputations secondary to peripheral gangrene. Following amputation, the ultimate rehabilitative goal is to restore the mobility and capacity to perform daily functions through prosthetic restoration, whether walking for lower amputees or functioning hand for upper limb amputees. Prescribing prosthesis in a single limb loss is relatively straightforward, but restoring multiple limb amputations bears many challenges toward successful recovery of walking and functions.
目的:多肢截肢是一种少见的由肌力性周围坏疽引起的并发症。病例介绍:一名20岁的女性瓣膜性心脏病,感染性心内膜炎继发感染性休克,需要延长心肺复苏时间。尽管进行了积极的液体复苏,患者仍接受了三倍强度的去甲肾上腺素静脉注射以维持血流动力学的稳定。休克后第5天,所有肢体远端发生干性坏疽,停止肌力运动。虽然坏疽性改变是非进行性的,但她在活动和日常活动方面需要很大程度的帮助。建议患者多肢截肢,通过义肢修复促进行走和手部功能。事件发生5个月后,她接受了右胫骨截肢,左Chopart截肢,左腕关节脱臼,右二、三、四、五指截肢。住院患者康复的三个具体目标是使用假肢进行独立的短距离行走,使用自适应装置进行基本的日常生活活动,以及使用右侧经胫假体、左侧赛姆假体(Kingsley's foot)、右侧硅胶美容手套和左侧身体动力经桡骨假体进行独立的轮椅推进进行长距离活动。讨论:虽然是一种罕见的并发症,但肌力变性可能导致继发于周围坏疽的多肢截肢。截肢后,最终的康复目标是通过假肢修复恢复活动能力和日常功能,无论是下肢截肢者的行走还是上肢截肢者的功能手。在单侧肢体缺失的情况下使用假肢相对简单,但在多侧肢体截肢的情况下,要成功恢复行走和功能,还面临许多挑战。
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引用次数: 0
The Association Between Cervical Radiculopathy and Quality of Life in Patients With Cervical Spondylosis 颈椎病患者颈神经根病与生活质量的关系
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.32598/irj.21.1.1548.1
Rafia Sultana, Zohaib Shahid, Faryal Safdar, Hafiz Sheraz Arshad
Objectives: To determine the association between cervical radiculopathy and quality of life (QoL) in patients with cervical spondylosis. Methods: This analytical cross-sectional study was conducted on 273 patients in five hospitals in Lahore within 3 months from April to June 2021. The Spurling test was used to measure cervical radiculopathy. The participants were selected according to the inclusion criteria. The Spurling test was used to measure cervical radiculopathy and its symptoms. The World Health Organization quality of life scale (WHOQoL) was used to evaluate the QoL of patients suffering from cervical spondylosis. Results: Of 273 patients, 42.9% were male and 57.1% female. Their Mean±SD age was 42±11.9 years. Also, 70.3% had positive Spurling test, and 29.7% had negative results. Their Mean±SD physical health score was 11.70±1.74 (out of a total of 20), and their Mean±SD psychological health score was 11.75±1.78 (out of a total of 20). The Mean±SD social relationships score was 11.19±2.98 (out of a total of 20), and their Mean±SD environment health score was 11.13±3.08 out of a total of 20. P indicates a significant difference in the QoL between patients with positive and negative Spurling tests. Patients with negative Spurling tests had higher QoL scores. Greater scores denote a higher QoL Discussion: There is a significant association between cervical radiculopathy and QoL in patients with cervical spondylosis. These results will help us in the future to design educational programs or modify the lifestyle of those patients with cervical radiculopathy. This research concluded that there is a significant difference in the QoL among patients with positive and negative Spurling tests. Patients with negative Spurling tests have higher QoL scores. Hence there is a significant association between diagnosed cervical radiculopathy and QoL.
目的:探讨神经根型颈椎病与颈椎病患者生活质量(QoL)的关系。方法:本分析性横断面研究于2021年4月至6月对拉合尔五家医院的273名患者进行。Spurling试验用于测量神经根型颈椎病。参与者是根据入选标准选择的。Spurling试验用于测量神经根型颈椎病及其症状。采用世界卫生组织生活质量量表(WHOQoL)对颈椎病患者的生活质量进行评价。结果:273例患者中,男性42.9%,女性57.1%。平均±SD年龄为42±11.9岁。Spurling试验阳性率为70.3%,阴性率为29.7%。他们的平均±SD身体健康评分为11.70±1.74(共20分),平均±SD心理健康评分为1175±1.78(共20)。平均值±SD社会关系评分为11.19±2.98(共20分),平均值±标准差环境健康评分为11.13±3.08(共10分)。P表示Spurling测试阳性和阴性患者的生活质量存在显著差异。Spurling测试呈阴性的患者生活质量得分较高。得分越高,生活质量越高讨论:颈椎病患者的神经根病与生活质量之间存在显著相关性。这些结果将有助于我们在未来设计教育计划或改变神经根型颈椎病患者的生活方式。本研究得出结论,Spurling测试阳性和阴性患者的生活质量存在显著差异。Spurling测试呈阴性的患者生活质量得分较高。因此,诊断出的神经根型颈椎病与生活质量之间存在显著关联。
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引用次数: 0
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Iranian Rehabilitation Journal
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