Along with the illness progresses of maintenance hemodialysis (MHD) patients, their functional limitations such as decreased cardiopulmonary endurance, muscle loss, dysfunction of arteriovenous fistula, fatigue, and sleep disorders are increasingly prominent and urgently need to be resolved. Modern physiotherapy as a non-invasive and non-pharmacological therapy which can reduce the functional limitations of MHD patients, improves the patients’ exercise capacity and quality of life. Physical therapy techniques suitable for MHD patients include active and passive exercise therapy such as aerobic exercise, resistance exercise, breathing training, and muscle stretching, as well as physical agents therapy such as neuromuscular electrical stimulation, infrared, and low-frequency pulsed electromagnetic field. Choosing appropriate physical agents and exercise prescription can reduce the treatment risk and improve the efficacy.
目的 探讨康复治疗结合盐酸氨基葡萄糖治疗肩关节周围炎的临床疗效。 方法 将2009年3月－2011年11月在成都军区总医院康复医学科门诊和住院的90例肩关节周围炎患者随机分为两组，治疗组45例，采用运动疗法结合口服盐酸氨基葡萄糖治疗90 d；对照组45例，仅采用运动疗法治疗90 d。 结果 治疗90 d后，在临床疗效方面，治疗组总有效率86.7%；对照组总有效率66.7%，差异有统计学意义（P＜0.05）。在康复疗效方面，两组患者肩关节疾患治疗成绩判定标准中疼痛、肌力、关节活动度（ROM）、日常生活能力（ADL）和关节稳定性5个方面均有明显改善（P＜0.01）；和对照组相比，治疗组在疼痛、ROM、ADL 3个方面改善更明显（P＜0.05）。 结论 康复治疗结合盐酸氨基葡萄糖治疗肩关节周围炎疗效比单独采用康复治疗要好。
ObjectiveTo systematically review the efficacy of aerobic training, resistance training and aerobic training combined with resistance training on non-dialysis patients with chronic kidney diseases. MethodsPubMed, The Cochrane Library, EMbase, EBSCO, Web of Science, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of three types of exercise therapy on patients with chronic kidney disease from January 2012 to January 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using RevMan 5.4 software and R software. ResultsA total of 22 RCTs involving 1 633 patients were included. The results of network meta-analysis showed that: compared with the control group, aerobic training, and resistance training reduced resting systolic blood pressure; aerobic training, resistance training reduced resting diastolic blood pressure; aerobic training reduced total cholesterol levels; aerobic training improved peak oxygen uptake; aerobic training combined with resistance training improved six-minute walking test. Aerobic training, resistance training, and aerobic training combined with resistance training improved glomerular filtration rate. The probability sorting results showed that aerobic training had the most significant effect on the improvement of peak oxygen uptake, C-reactive protein, total cholesterol, low-density lipoproteins, and high-density lipoproteins; resistance training had the most significant effect on the improvement of systolic blood pressure, diastolic blood pressure and glomerular filtration rate; aerobic exercise combined with resistance training had the most significant effect on the improvement of body mass index, triglycerides, and six-minute walking test. ConclusionCurrent evidence shows that aerobic training has an advantage in reducing total cholesterol levels and increasing peak oxygen uptake, resistance training has an advantage in improving blood pressure and glomerular filtration rate and aerobic training combined with resistance training has an advantage in improving walking ability of patients with non-dialysis chronic kidney disease.
Objective To review the up-to-date development of overseas cl inical study on exercise therapy for patients with knee osteoarthritis. Methods The cl inical researches of exercise therapy for knee osteoarthritis were summarized by reviewing l iterature concerned in recent years. Results Exercise therapy was extensively used in the treatment of knee osteoarthritis not only in hospital but also in community rehabil itation abroad. The main patterns of exercise therapy included muscle strengthening exercise, aerobic exercise and underwater exercise. It was capable of effectively improving patient’s independent l iving abil ity and l ive qual ity, and postproning the time of surgical intervention. But the long-term efficacy of exercise therapy was still under debate. Conclusion Exercise therapy is an effect method to treat knee osteoarthritis.
ObjectiveTo study the clinical effect of the combination of glucosamine hydrochloride with exercise therapy and traditional Chinese medicine hot compress in the treatment of early patellofemoral osteoarthritis. MethodsA total of 126 patients with early patellofemoral osteoarthritis treated between June 2013 and April 2015 were divided into group A (n=43), B (n=42) and C (n=41) with the method of random number table. Oral administration of glucosamine hydrochloride tablets, exercise therapy of knee joints and traditional Chinese medicine hot compress were applied for the 43 patients in group A. Oral administration of glucosamine hydrochloride tablets and exercise therapy of knee joints were applied for the 42 patients in group B. Exercise therapy of knee joints and traditional Chinese medicine hot compress were applied for the 41 patients in group C. Chen's Scoring was applied before the treatment and 2, 4, 12 and 24 weeks after the treatment. ResultsThe differences of Chen's scores at the time points after treatment and those before treatment of the same group had statistical significance (P<0.05). The differences of Chen's scores at the time points after treatment in group A and those in group B and C had statistical significance (P<0.05). There were no obvious adverse effects due to administration of glucosamine hydrochloride tablets in group A and B. Five patients in group A and 4 patients in group C suffered from the symptoms of local erythema, light cutaneous pruritus and other contact dermatitis after traditional Chinese medicine hot compress. Those symptoms disappeared automatically several hours later without any special treatment. ConclusionThe treatment of early patellofemoral osteoarthritis by the combination of glucosamine hydrochloride tablets with exercise therapy and traditional Chinese medicine hot compress can rapidly relieve joint pain, and maintain efficacy for a long time.
ObjectiveTo systematically review the efficacy of exercise therapy for patients with chronic low back pain (CLBP) by network meta-analysis (NMA).MethodsThe PubMed, EBSCO, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCT) on exercise for patients with CLBP from inception to May, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, NMA was performed by Stata 15.1 software.ResultsA total of 79 RCTs involving 5 782 CLBP patients were included. The effect of exercise therapy on pain in patients with CLBP were in the following rankings: yoga (SMD=−1.25, 95%CI −1.87 to −0.64, P<0.000 1), health Qigong/Taichi (SMD=−1.12, 95%CI −1.87 to −0.64, P=0.002), sling exercise (SMD=−1.07, 95%CI −1.64 to −0.50, P<0.000 1), Mackenzie therapy (SMD=−1.05, 95%CI −1.68 to −0.42, P=0.001), pilates (SMD=−0.96, 95%CI −1.74 to −1.78, P=0.016), multimodal training (SMD=−0.80, 95%CI −1.33 to −0.27, P=0.003) and stabilisation/motor control (SMD=−0.62, 95%CI −1.03 to −0.21, P=0.003). The effect of exercise therapy on function in patients with CLBP were in the following rankings: Mackenzie therapy (SMD=−0.62, 95%CI −1.03 to −0.21, P=0.003), and yoga (SMD=−0.88, 95%CI −1.51 to −0.25, P=0.007). Clusterank results showed that Mackenzie therapy, yoga, pilates, sling exercise and multimodal training were similar in improving pain and physical function in patients with CLBP.ConclusionsThe current study shows that yoga, Mackenzie therapy, pilates, sling exercise and multimodal training constitute the optimal group for improving CLBP symptoms. Health Qigong/Taichi is second only to yoga in improving pain in patients with CLBP, which has great promotional value.
ObjectivesTo systematically review the efficacy of exercise therapy on functional and activity recovery after anterior cruciate ligament reconstruction (ACL).MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise therapy on functional and activity recovery after ACL from inception to May 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 602 patients were included. The results of meta-analysis showed that: 1 week (MD=3.07, 95%CI 1.37 to 4.77, P=0.000 4) and 3 weeks (MD=4.53, 95%CI 2.34 to 6.71, P<0.000 1) conventional exercise training rehabilitation effects were better than natural recovery under orthopedic routine care in promoting knee joint function recovery. The recovery effects of over 6 months neuromuscular training was significantly increased compared with conventional rehabilitation (MD=11.48, 95%CI 8.25 to 14.71, P<0.000 01). In addition, there was significant difference between open and closed chain exercise rehabilitation after more than 6 months rehabilitation training (MD=6.77, 95%CI 0.86 to 12.68, P=0.02).ConclusionsThe current evidence shows that over 6 months neuromuscular training significantly enhance the recovery of motor function after anterior cruciate ligament reconstruction. According to different reconstruction methods, individualized rehabilitation program is developed to maximize the recovery of knee joint function. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
ObjectiveTo systematically review the efficacy of early physical rehabilitation for patients with stroke-induced hemiplegia. MethodsDatabases including PubMed, Web of Knowledge, The Cochrane Library (Issue 7, 2014), EMbase, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about early physical rehabilitation for patients with stroke-induced hemiplegia from inception to 1st August 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, metaanalysis was performed using RevMan 5.2 software. ResultsA total of 6 RCTs were included. The results of metaanalysis showed that, after 1 month of treatment, the Fugl-Meyer scores (MD=18.02, 95%CI 6.24 to 29.80, P=0.003) and BI scores (MD=32.32, 95%CI 24.28 to 40.36, P<0.000 01) in the early physical rehabilitation group were higher than that in the conventional rehabilitation group. But after 3 months of treatment, there were no statistical differences between two groups in the proportion of patients with 0-2 MRS scores, mortality and the incidence of complications. ConclusionCurrent evidence shows that early physical rehabilitation can effectively improve the limb motor function and daily living ability in patients with stroke-induced hemiplegia. However, due to the limited quantity and quality of the include studies, more large-scale, high quality RCTs are needed to verify the above conclusion.
Most patients with end-stage renal disease choose maintenance hemodialysis to prolong survival. The clinical application of exercise therapy has a definite effect on maintenance hemodialysis patients, and can effectively improve their quality of life and promote rehabilitation. Individualized exercise therapy under the guidance of medical professionals has positive effects on patients’ physical and mental rehabilitation. This paper mainly summarizes the status of exercise, factors affecting exercise, exercise therapy, exercise and rehabilitation of maintenance hemodialysis patients, and reviews the impact of exercise therapy on the physical and mental health of maintenance hemodialysis patients, in order to provide some references for clinical intervention and prognosis studies.