Effects of functional electrical stimulation in rehabilitation with hemiparesis patients

Evaluation of Preclinical and Clinical Studies Published in Medical Journals of Bosnia and Herzegovina: Methodology Issues

INTRODUCTION

Results of preclinical and clinical studies in medicine could be trusted only if their design and statistical analysis were appropriate.

AIM

The aim of our study was to investigate whether preclinical and clinical studies published in medical journals of Bosnia and Herzegovina satisfy basic requirements for appropriate design and statistical interpretation of data.

METHODS

Preclinical and clinical studies published in medical journals of Bosnia and Herzegovina were retrieved from the PubMed database, and the sample for analysis was randomly chosen from the retrieved publications. Implementation rate of basic principles of experimental design (local control, randomization and replication) and rate of the most common errors in design of clinical/observational studies was established by careful reading of the sampled publications and their checking against predefined criteria.

RESULTS

Our study showed that only a minority of experimental preclinical studies had basic principles of design completely implemented (7%), while implementation rate of single aspects of appropriate experimental design varied from as low as 12% to as high as 77%. Only one of the clinical/observational studies had none of the errors searched for (2%), and specific errors rates varied from 10% to 89%. Average impact factor of the surveyed studies was around one, and average publication date recent, less than 5 years ago.

CONCLUSION

Prevalence of preclinical studies that did not follow completely basic principles of research design, and that of clinical/observational studies with errors are high, raising suspicion to validity of their results. If incorrect and not protected against bias, results of published studies may adversely influence future research.

Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident

This study aims to investigate the efficacy of early rehabilitation therapy on the movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident (CVA).A total of 86 patients who suffered from acute CVA were selected and divided into 2 groups, according to random number tables: control group, and research group. Patients in the control group received routine primary therapy, while patients in the research group received rehabilitation based on the basic therapy. The recovery of hemiplegic limb movement ability and the improvement of daily living ability before and after treatment were evaluated using the simplified Fugl-Meyer assessment (FMA), neurologic deficit scale (NDS), and Barthel index (BI). After treatment, the clinical efficacy and satisfaction degree for treatment were compared.The FMA, NDS, and BI of patients in these 2 groups were distinctly ameliorated after treatment (P <.05). After treatment, the ameliorated degrees of FMA, NDS, and BI in the research group were obviously superior to those in the control group, and the differences were statistically significant (P <.05). The total efficacy and satisfaction degree in the research group were evidently higher than those in the control group after early rehabilitation therapy, and the differences were statistically significant (P <.05).Early rehabilitation therapy can significantly ameliorate the movement ability of hemiplegic lower extremity in patients with acute CVA. Its therapeutic effect is remarkable. Hence, it is worthy of popularizing in clinical practice.

Assessment of the effects of rehabilitation after cerebrovascular accident in patients with diabetes mellitus and hypertension as risk factors

Aim:

The aim of this study is to evaluate the results of rehabilitation, to determine the prevalence of major risk factors in cerebrovascular accident and their consequences, as well as to propose measures and procedures that will affect the better rehabilitation.

Methods:

The survey analyzed: age, sex, duration of rehabilitation, activities in daily life through the Barthel index at admission and at discharge, presence of risk factors HTA and DM. The study included a total of 116 patients, the majority of patients are older than 61 years. We had 49% of male patients and 51% of female patients and they spent 31-40 days at the rehabilitation.

Results:

The most common risk factor is HTA (83%) and diabetes (33%). Most of the patients at admission had a BI from 0 to 4 (32.7%), and at discharge BI in the range 17-20 (36.2%). Statistical analysis shows that there is a statistically significant correlation between the BI at admission, BI at discharge and risk factors of HTA and diabetes mellitus.

Conclusions:

the rehabilitation results in most patients is good results of rehabilitation. The most important risk factors in patients are HTA, DM and directly affect on results of rehabilitation. For the better results we should have energetic fight against risk factors for HTA and DM through primary and secondary prevention and patient education about early detection and treatment of these risk factors.