Fuck, we don't need pulmonary rehabilitation you blithering idiots, solve the problem of preventing that pneumonia in the first place. I'd have you all fired.
You've known about this problem for a long time. GET THERE!
Just maybe this vaccine!
Pneumonia Vaccine (3 posts to July 2020)
11% Stroke-associated pneumonia (2 posts to October 2020)
Reducing stroke-associated pneumonia through pulmonary rehabilitation in moderate-to-severe acute ischemic stroke
European Journal of Medical Research volume 30, Article number: 208 (2025)
Abstract
Objectives
This study investigated the effect of a comprehensive pulmonary rehabilitation (CPR) program on stroke-associated pneumonia (SAP) in patients with moderate-to-severe acute ischemic stroke (AIS) after thrombolysis.
Methods
This study was a prospective randomized controlled intervention study. Eighty patients with moderate-to-severe AIS were divided into the conventional rehabilitation (CR) and CPR groups. Demographic and general clinical data were collected. Patients were evaluated by the Fatigue Severity Scale (FSS), Fugl–Meyer Assessment (FMA), and Fugl–Meyer balance (FMB). The incidence of pneumonia in the acute phase and the treatment efficacy were compared.
Results
FSS scores at T1 and T2 (2 weeks and 4 weeks after treatment), FMA scores, and FMB scores were higher than those at T0 (first day of admission). FSS scores in the CPR group were lower, while FMA and FMB scores were higher than those in the CR group at T1 and T2. The incidence of pneumonia was 10.00% in the CPR group and 25.00% in the CR group. The rehabilitation effective rate was 92.50% in the CPR group and 80.00% in the CR group, but the proportion of rehabilitation effect in the CPR group was higher than that in the CR group.
Conclusions
CPR program improves fatigue and motor function and reduces the occurrence of SAP in AIS patients.(Preventing SAP would make much more sense, why the hell aren't you working on that? Your mentors and senior researchers are that fucking incompetent?)
Introduction
Stroke is a clinical syndrome in which there is a sudden loss of brain function, either focal or global, that lasts for more than 24 h or results in death [1]. Stroke is now the second leading cause of death, characterized by high morbidity, mortality, and disability [2]. The incidence of acute cerebral infarction (ACI) is about 60–70% of all stroke patients [3]. Intravenous thrombolysis has become a common treatment for ACI [4,5,6]. After intravenous thrombolysis, rehabilitation aids patients in slowly recovering the functions of the affected limbs, such as muscle strength, coordination, and balance. Moreover, systematic rehabilitation can reduce the incidence of disability after stroke [7]. Pulmonary rehabilitation has been increasingly recognized and applied by healthcare professionals, since it was introduced in 1994. In 2016, the American Stroke Association recommended early intervention for post-stroke patients through pulmonary rehabilitation exercises, such as vibration expectoration, active exercises, and respiratory muscle training [8]. However, there are few studies that apply comprehensive pulmonary rehabilitation to patients with moderate-to-severe acute ischemic stroke (AIS).
Post-stroke fatigue (PSF) is the subjective feeling of extreme fatigue due to lack of mental and/or physical energy, which appears suddenly after a stroke event [9]. PSF is a common and long-lasting sequela of stroke, which affects the patient's recovery and increases disability and mortality rates [10,11,12]. Fatigue not only manifests itself in physical weakness, but also in mental lethargy, making it difficult for patients to adhere to the necessary rehabilitation treatments, which in turn hinders the process of neurological recovery [13]. Physical activity after stroke improves physical fitness and stimulates cortical excitability, which may help reduce fatigue [13]. Meanwhile, motor dysfunction is also a key problem for patients with moderate-to-severe AIS. Due to the damage of motor neurons caused by cerebral ischemia, patients often suffer from paralysis of limbs, loss of muscle strength, and poor motor coordination. This not only restricts the patient's ability to move independently, making it impossible for the patient to perform basic life actions, but also may lead to a series of complications, such as muscle atrophy, joint contracture, etc., which will further aggravate disability of the patient. In addition, stroke-associated pneumonia (SAP) is a common cause of death in clinical practice, and the incidence of SAP ranges from 3.0 to 56.6% [14]. Patients with moderate-to-severe AIS are highly susceptible to aspiration due to swallowing dysfunction, weakened cough reflex, and impaired consciousness, which can lead to lung infection [15]. Once SAP occurs, the patient's hospitalization time is prolonged, medical costs increase, and the prognosis becomes significantly worse [16]. The focus on preventing and controlling SAP in stroke treatment has increased, with research and guidelines worldwide showing that pulmonary rehabilitation can improve pulmonary function and daily activities in patients with stroke [17].
In recent years, comprehensive pulmonary rehabilitation (CPR) programs have gradually gained attention and been applied in clinical practice. Pulmonary rehabilitation aims to improve respiratory function, exercise capacity, and overall health through a series of planned and targeted interventions, including respiratory training, physical therapy, exercise training, nutritional support, and psychological counseling [18]. For patients with moderate-to-severe AIS, the implementation of a CPR program after thrombolysis is potentially important. On the one hand, respiratory training and physical therapy can improve patients' respiratory function, enhance the ability to cough up sputum, and reduce the risk of aspiration, thereby reducing the incidence of SAP [19]. On the other hand, systematic exercise training can promote the recovery of patients' motor function, improve muscle strength and motor coordination, reduce fatigue symptoms, and enhance patients' daily self-care ability and quality of life [20].
Although some studies have explored the application of pulmonary rehabilitation in stroke patients, there are still relatively few studies on the effects of CPR program on fatigue, motor function, and the incidence of SAP after thrombolysis in patients with moderate-to-severe AIS. It is of great theoretical and practical significance to conduct such studies to clarify the role and value of CPR programs in the treatment of patients with moderate-to-severe AIS to optimize the clinical treatment strategy and improve the rehabilitation effect and quality of life of patients. The aim of this study was to investigate the effects of a post-thrombolysis CPR program on fatigue, motor function, and the incidence of SAP in patients with moderate-to-severe AIS through rigorous clinical observation and data analysis, and to provide a reference for the implementation of integrated pulmonary rehabilitation in clinical practice.
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