Hand function impairment after stroke has become a key and difficult issue in clinical rehabilitation due to complex neural innervation and a long recovery cycle.Biofeedback technology combined with occupational thera...Hand function impairment after stroke has become a key and difficult issue in clinical rehabilitation due to complex neural innervation and a long recovery cycle.Biofeedback technology combined with occupational therapy can make up for the limitations of single therapy and provide a new solution for hand function rehabilitation after stroke.This paper systematically sorts out the theoretical basis and clinical research progress of biofeedback technology combined with occupational therapy in hand function rehabilitation after stroke,and looks forward to the future development direction,aiming to provide reference for clinical rehabilitation practice and scientific research.展开更多
Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral pals...Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy.Methods:A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized,placebo-controlled trial,and were allocated to mono-occupational therapy(OT) group(patients=30),OT combined with real-acupuncture(ORA) group(patients=30),and OT combined with placeboacupuncture(OPA) group(patients=30),respectively.In addition to receiving the conventional OT program as the basic treatment for total 8 weeks,patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks,3 days per week for the next two weeks,2 days per week for another two weeks,and 1 day per week for the last two weeks.Non-communicating children’s pain checklist-revised scale(NCCPC-R) was used for assessing the upper limb pain among patients.Squeeze dynamometry,modified Ashworth scale(MAS),manual muscle testing(MMT),JebsenTaylor hand function test(JTHFT) and box and block test(BBT) were used for assessing various aspects of upper limb and hand functions among patients.Meanwhile,adverse effects were monitored and recorded.Results:After 8-week treatment,NCCPC-R global scores witnessed a dramatic decline in ORA group(P<0.05),but not in either OPA(P> 0.05) or OT group(P> 0.05).Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups(all P <0.05).Furthermore,the increases of ORA group were more significant than those of another two groups(both P <0.05).There were no significant changes in MAS global scores in each group(all P> 0.05).The BBT global scores of all three groups significantly increased(all P <0.05) after treatment.Among them,the increase of the ORA group was more than that of the other two groups(P <0.05).The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group.No significant adverse event was reported.Conclusion:ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.展开更多
This paper proposes an immersive training system for patients with hand dysfunction who can perform rehabilitation training independently. The system uses Leap Motion binocular vision sensors to collect human hand inf...This paper proposes an immersive training system for patients with hand dysfunction who can perform rehabilitation training independently. The system uses Leap Motion binocular vision sensors to collect human hand information, and uses the improved PCA<sub><img src="Edit_d6662636-9073-4fbd-855f-9a36e871d5a4.png" width="10" height="15" alt="" /></sub> (Principal Component Analysis) to perform data fusion on the real-time data collected by the sensor to obtain more hands with fewer principal components, and improve the stability and accuracy of the data. Immediately, the use of improved SVM<sub><img src="Edit_10c78725-e09e-4dcf-ae05-e21205df4acc.png" width="10" height="15" alt="" /></sub> (Support Vector Machine) and KNN<sub><img src="Edit_0ee97f55-2773-4b48-93b3-93f61aa25577.png" width="10" height="15" alt="" /></sub> (K-Nearest Neighbor Algorithm) for gesture recognition and classification is proposed to enable patients to perform rehabilitation training more effectively. Finally, the effective evaluation results of the rehabilitation effect of patients by the idea of AHP<sub><img src="Edit_70dd1964-28be-4137-afa5-9a184704f08e.png" width="10" height="15" alt="" /></sub> (Analytic Hierarchy Process) are taken as necessary reference factors for doctors to follow up treatment. Various experimental results show that the system has achieved the expected results and has a good application prospect.展开更多
Although some patients have successful peripheral nerve regeneration,a poor recovery of hand function often occurs after peripheral nerve injury.It is believed that the capability of brain plasticity is crucial for th...Although some patients have successful peripheral nerve regeneration,a poor recovery of hand function often occurs after peripheral nerve injury.It is believed that the capability of brain plasticity is crucial for the recovery of hand function.The supplementary motor area may play a key role in brain remodeling after peripheral nerve injury.In this study,we explored the activation mode of the supplementary motor area during a motor imagery task.We investigated the plasticity of the central nervous system after brachial plexus injury,using the motor imagery task.Results from functional magnetic resonance imaging showed that after brachial plexus injury,the motor imagery task for the affected limbs of the patients triggered no obvious activation of bilateral supplementary motor areas.This result indicates that it is difficult to excite the supplementary motor areas of brachial plexus injury patients during a motor imagery task,thereby impacting brain remodeling.Deactivation of the supplementary motor area is likely to be a serious problem for brachial plexus injury patients in terms of preparing,initiating and executing certain movements,which may be partly responsible for the unsatisfactory clinical recovery of hand function.展开更多
Background: Carpal Tunnel Syndrome (CTS) is the compression of the median nerve in carpal tunnel of wrist which leads to the typical symptoms of numbness, paresthesia and sometimes pain in the patient’s hand. The sym...Background: Carpal Tunnel Syndrome (CTS) is the compression of the median nerve in carpal tunnel of wrist which leads to the typical symptoms of numbness, paresthesia and sometimes pain in the patient’s hand. The symptoms are usually sensed in the first three radial fingers and the lateral side of the ring finger because these areas are innervated by the median nerve. Objective: To assess hand function among patient with Carpal Tunnel Syndrome (CTS). Methods: This was a descriptive study in which 41 subjects (27 females and 14 males) were included from Ghurki trust teaching hospital, Lahore and Shalamar hospital, Lahore (from August 2018 to October 2018) according to inclusion criteria. Samples were collected according to WHO (World Health Organization) calculator. Hand function was measured with Boston Carpal Tunnel Questionnaire (BCTQ). Results: Majority of the patients with CTS fell into mild functional severity and mild symptom severity. The mean score for functional severity was 2.34 and for symptom severity it was 2.97. Conclusion: Activities of daily living such as grasping, writing, gripping and carrying objects were affected by the symptoms of pain, numbness, tingling and weakness in the patients suffering from CTS.展开更多
Motor function changes in the unaffected hand of stroke patients with hemiplegia. These changes are often ignored by clinicians owing to the extent of motor disability of the affected hand. Finger tapping frequency an...Motor function changes in the unaffected hand of stroke patients with hemiplegia. These changes are often ignored by clinicians owing to the extent of motor disability of the affected hand. Finger tapping frequency and Lind-mark hand function score showed that the motor function of unaffected hands in stroke patients was poorer than that of a healthy control hand. After 2 weeks of rehabilitation treatment, motor function of the unaffected hand of stroke patients was obviously improved. Therefore, attention should also be paid to motor function in the unaffected hand of stroke patients with hemiplegia during rehabilitation.展开更多
There have been no studies reported on the difference in cortical activation during use of volar and dorsal hand splints.We attempted to investigate the difference in cortical activation in the somatosensory cortical ...There have been no studies reported on the difference in cortical activation during use of volar and dorsal hand splints.We attempted to investigate the difference in cortical activation in the somatosensory cortical area during use of volar and dorsal hand splints by functional magnetic resonance imaging（f MRI）.We recruited eight healthy volunteers.f MRI was performed while subjects who were fitted with volar or dorsal hand splints performed grasp-release movements.Regions of interest were placed on the primary motor cortex（M1）,primary somatosensory cortex（S1）,posterior parietal cortex（PPC）,and secondary somatosensory cortex（S2）.Results of group analysis of f MRI data showed that the total numbers of activated voxels in all ROIs were significantly higher during use of volar hand splint（3,376） compared with that（1,416） during use of dorsal hand splint.In each ROI,use of volar hand splint induced greater activation in all ROIs（M1：1,748,S1 ：1,455,PPC：23,and S2：150） compared with use of dorsal hand splint（M1：783,S1：625,PPC：0,and S2：8）.The peak activated value was also higher during use of volar hand splint（t-value：17.29） compared with that during use of dorsal hand splint（t-value：13.11）.Taken together,use of volar hand splint induced greater cortical activation relevant to somatosensory function than use of dorsal hand splint.This result would be important for the physiatrist and therapist to apply appropriate somatosensory input in patients with brain injury.展开更多
Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with isc...Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.展开更多
Embodied semantics theory asserts that the meaning of action-related words is neurally represented through networks that overlap with or are identical to networks involved in sensory-motor processing. While some studi...Embodied semantics theory asserts that the meaning of action-related words is neurally represented through networks that overlap with or are identical to networks involved in sensory-motor processing. While some studies supporting this theory have focused on Chinese characters, less attention has been paid to their semantic radicals. Indeed, there is still disagreement about whether these radicals are processed independently. The present study investigated whether radicals are processed separately and, if so, whether this processing occurs in sensory-motor regions. Materials consisted of 72 high-frequency Chinese characters, with 18 in each of four categories： hand-action verbs with and without hand-radicals, and verbs not related to hand actions, with and without hand-radicals. Twenty-eight participants underwent functional MRI scans while reading the characters. Compared to characters without hand-radicals, reading characters with hand-radicals activated the right medial frontal gyrus. Verbs involving hand-action activated the left inferior parietal lobule, possibly reflecting integration of information in the radical with the semantic meaning of the verb. The findings may be consistent with embodied semantics theory and suggest that neural representation of radicals is indispensable in processing Chinese characters.展开更多
Objective To observe the therapeutic effects of post-stroke hand motor impairment treated with acupuncture at Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5）. Methods Sixty cases of post-stroke hand motor impairment w...Objective To observe the therapeutic effects of post-stroke hand motor impairment treated with acupuncture at Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5）. Methods Sixty cases of post-stroke hand motor impairment were randomly divided into an observation group and a control group, 30 cases in each one. The conventional medication, physical therapy, occupational therapy and other rehabilitation trainings were applied in both groups. In observation group, Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5） were punctured. The assessment was performed with neurologie deficit scoring of the National Institutes of Health Stroke Scale （NIHSS）, hand motor function, walking ability and the modified Barthel index scale of the Activities of Daily Living （ADL） in both groups before and after treatment. Results After treatment, the scores of hand function, walking ability, ADL and NIHSS were improved in both groups as compared with those before treatment （all P〈0.01）. The improvements of hand function, walking ability and ADL ：in observation group were superior to those in control group （all P〈0.05）. Conclusion The conventional medication and rehabilitation trainings combined with acupuncture at Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5） ean obviously improve hand motor function, walking ability, the activities of daily living and rehabilitation efficacy in the patients with post-stroke hand motor impairment.展开更多
目的:基于《国际功能、残疾和健康分类》框架,系统评价不同类型3D打印外骨骼对脑卒中患者手功能康复的临床疗效。方法:检索PubMed、Cochrane Library、Web of Science、Embase、中国知网和中国生物医学文献数据库,收集2015年1月至2024...目的:基于《国际功能、残疾和健康分类》框架,系统评价不同类型3D打印外骨骼对脑卒中患者手功能康复的临床疗效。方法:检索PubMed、Cochrane Library、Web of Science、Embase、中国知网和中国生物医学文献数据库,收集2015年1月至2024年12月发表的3D打印外骨骼干预脑卒中患者手功能的文献。由2名研究者独立筛选文献、提取资料并进行方法学质量评价,遵循PRISMA指南规范系统综述流程。结果:最终纳入13篇文献,涉及美国、中国、荷兰、意大利、新加坡和土耳其6个国家,共62例脑卒中患者。根据Brunnstrom分期将外骨骼分为辅助型(Ⅰ期)、矫正型(Ⅱ-Ⅲ期)、训练型(Ⅳ-Ⅵ期)和代偿型(Ⅳ-Ⅵ期)4类,干预方式包括机构康复、家庭康复和机构-家庭康复,干预方案为每次15-90 min,每周3-7次,持续5-8周。研究结果显示:辅助型外骨骼改善精细手使用能力以及自我照顾能力;矫正型外骨骼改善关节活动功能、肌张力、握力以及精细手使用能力;训练型外骨骼改善关节活动功能、上肢肌肉力量以及自我照顾能力;代偿型外骨骼提升精细手使用能力及手和手臂使用能力。结论:基于《国际功能、残疾和健康分类》框架的证据表明,3D打印外骨骼改善脑卒中患者手部功能以及活动和参与能力。建议根据Brunnstrom分期选择匹配的外骨骼类型,并制定个体化干预方案,以实现康复的最佳效果。展开更多
目的:探讨一款便携式柔性手部康复机器人在脑卒中患者临床与居家上肢康复中的可用性。方法:招募13例脑卒中偏瘫患者进行手部康复机器的可用性测试。患者首先在医院接受为期2周的学习与训练,随后将设备带回家进行为期6周的居家自主康复训...目的:探讨一款便携式柔性手部康复机器人在脑卒中患者临床与居家上肢康复中的可用性。方法:招募13例脑卒中偏瘫患者进行手部康复机器的可用性测试。患者首先在医院接受为期2周的学习与训练,随后将设备带回家进行为期6周的居家自主康复训练,每次33 min,每天2次。训练结束后采用系统可用性量表(system usability scale,SUS)及半结构式访谈评估机器的可用性。此外,在干预前后及训练期间通过Fugl-Meyer运动功能量表上肢部分(Fugl-Meyer assessment upper extremity,FMA-UE)、行动研究手臂测试(action research arm test,ARAT)、日常生活活动量表(activities of daily living,ADL)评估患者的上肢运动功能和日常生活自理能力。结果:13例患者SUS为(85.8±10.5)分,处于“Excellent”水平。半结构式访谈结果显示,该设备操作简便、便于携带,但在连接、硬件稳定性及训练内容丰富度等方面仍有改进空间。干预结束后,部分患者FMA-UE、ARAT、ADL评分较前有所改善,达到最小临床重要差异(mini clinical important difference,MCID)。结论:柔性手部康复机器人在脑卒中偏瘫患者的临床及居家康复中具有良好的可用性和安全性,可作为脑卒中手部康复的一种潜在有效手段。展开更多
目的:腕手矫形器是一种常见的上肢功能障碍康复辅具,对脑卒中后手功能障碍患者的疗效存在争议。该文系统评价腕手矫形器对脑卒中患者手功能障碍的康复效果。方法:系统检索中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Scienc...目的:腕手矫形器是一种常见的上肢功能障碍康复辅具,对脑卒中后手功能障碍患者的疗效存在争议。该文系统评价腕手矫形器对脑卒中患者手功能障碍的康复效果。方法:系统检索中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Science、Cochrane Library等数据库公开发表的腕手矫形器在脑卒中患者手功能康复中应用的随机对照试验,其中试验组采用腕手矫形器和常规康复治疗,对照组采用常规康复治疗,检索时限为各数据库建库到2024年7月。由2位研究者独立开展文献筛选、提取资料,并依据Cochrane风险偏倚评估工具评价文献质量,使用RevMan 5.4软件进行Meta分析。结果:最终纳入8篇文献,共305例患者。Meta分析结果显示:试验组改良Ashworth评分低于对照组[MD=-0.24,95%CI(-0.36,-0.12),P<0.0001],Fugl-Meyer上肢运动功能评分和改良Barthel评分[SMD=0.97,95%CI(0.51,1.43),P<0.0001;SMD=1.00,95%CI(0.05,1.94),P=0.04]均高于对照组,两组握力比较差异无显著性意义[MD=-0.89,95%CI(-5.37,3.58),P=0.70]。结论:腕手矫形器能够降低脑卒中患者腕手关节肌张力,提高患者手运动功能与日常生活活动能力,但对患者握力无明显改善。需注意的是,研究总样本量仅305例,且部分指标(如握力)仅纳入2篇文献,统计效力不足,未来需更多大样本、高质量的随机对照试验进行验证。展开更多
目的比较超声引导下远端周围神经阻滞(DPNB)与不同浓度罗哌卡因腋路臂丛神经阻滞(ABPB)对手部手术患者上肢运动功能保留及术后恢复的影响。方法将90例行择期或急诊手部手术患者随机分为3组:D组(行DPNB,0.25%罗哌卡因)、L组(行低浓度ABPB...目的比较超声引导下远端周围神经阻滞(DPNB)与不同浓度罗哌卡因腋路臂丛神经阻滞(ABPB)对手部手术患者上肢运动功能保留及术后恢复的影响。方法将90例行择期或急诊手部手术患者随机分为3组:D组(行DPNB,0.25%罗哌卡因)、L组(行低浓度ABPB,0.125%罗哌卡因)和N组(行常规浓度ABPB,0.25%罗哌卡因),每组30例。比较3组麻醉操作时间、起效时间、局麻药用量、改良Bromage评分(麻醉起效后)、Barthel指数(入院时、术后6 h、出院时)、15条目恢复质量量表(QoR-15)评分(术前24 h、术后24 h、术后48 h)、术后镇痛维持时间及手术日至出院时间。结果每组各脱落3例,最终纳入81例患者。D组与L组改良Bromage评分显著优于N组(P<0.05)。D组与L组术后6 h Barthel指数及术后24 h QoR-15评分均显著高于N组(P<0.05)。D组手术日至出院时间显著短于N组(P<0.05)。与L组和N组比较,D组的麻醉操作时间及起效时间显著缩短(P<0.05)。D组与L组局麻药用量显著少于N组(P<0.05)。结论超声引导下DPNB能更好地保留上肢运动功能,有利于患者术后早期生活自理与快速康复,并缩短住院时间。展开更多
文摘Hand function impairment after stroke has become a key and difficult issue in clinical rehabilitation due to complex neural innervation and a long recovery cycle.Biofeedback technology combined with occupational therapy can make up for the limitations of single therapy and provide a new solution for hand function rehabilitation after stroke.This paper systematically sorts out the theoretical basis and clinical research progress of biofeedback technology combined with occupational therapy in hand function rehabilitation after stroke,and looks forward to the future development direction,aiming to provide reference for clinical rehabilitation practice and scientific research.
基金Supported by University’s Scientific Research ProjectShanghai Sanda University:No.2021zz02-yj+1 种基金Special Project for Clinical ResearchShanghai Municipal Health Commission:No.20174Y0009.
文摘Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy.Methods:A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized,placebo-controlled trial,and were allocated to mono-occupational therapy(OT) group(patients=30),OT combined with real-acupuncture(ORA) group(patients=30),and OT combined with placeboacupuncture(OPA) group(patients=30),respectively.In addition to receiving the conventional OT program as the basic treatment for total 8 weeks,patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks,3 days per week for the next two weeks,2 days per week for another two weeks,and 1 day per week for the last two weeks.Non-communicating children’s pain checklist-revised scale(NCCPC-R) was used for assessing the upper limb pain among patients.Squeeze dynamometry,modified Ashworth scale(MAS),manual muscle testing(MMT),JebsenTaylor hand function test(JTHFT) and box and block test(BBT) were used for assessing various aspects of upper limb and hand functions among patients.Meanwhile,adverse effects were monitored and recorded.Results:After 8-week treatment,NCCPC-R global scores witnessed a dramatic decline in ORA group(P<0.05),but not in either OPA(P> 0.05) or OT group(P> 0.05).Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups(all P <0.05).Furthermore,the increases of ORA group were more significant than those of another two groups(both P <0.05).There were no significant changes in MAS global scores in each group(all P> 0.05).The BBT global scores of all three groups significantly increased(all P <0.05) after treatment.Among them,the increase of the ORA group was more than that of the other two groups(P <0.05).The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group.No significant adverse event was reported.Conclusion:ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.
文摘This paper proposes an immersive training system for patients with hand dysfunction who can perform rehabilitation training independently. The system uses Leap Motion binocular vision sensors to collect human hand information, and uses the improved PCA<sub><img src="Edit_d6662636-9073-4fbd-855f-9a36e871d5a4.png" width="10" height="15" alt="" /></sub> (Principal Component Analysis) to perform data fusion on the real-time data collected by the sensor to obtain more hands with fewer principal components, and improve the stability and accuracy of the data. Immediately, the use of improved SVM<sub><img src="Edit_10c78725-e09e-4dcf-ae05-e21205df4acc.png" width="10" height="15" alt="" /></sub> (Support Vector Machine) and KNN<sub><img src="Edit_0ee97f55-2773-4b48-93b3-93f61aa25577.png" width="10" height="15" alt="" /></sub> (K-Nearest Neighbor Algorithm) for gesture recognition and classification is proposed to enable patients to perform rehabilitation training more effectively. Finally, the effective evaluation results of the rehabilitation effect of patients by the idea of AHP<sub><img src="Edit_70dd1964-28be-4137-afa5-9a184704f08e.png" width="10" height="15" alt="" /></sub> (Analytic Hierarchy Process) are taken as necessary reference factors for doctors to follow up treatment. Various experimental results show that the system has achieved the expected results and has a good application prospect.
基金supported by the Youth Researcher Foundation of Shanghai Health Development Planning Commission,No.20124319
文摘Although some patients have successful peripheral nerve regeneration,a poor recovery of hand function often occurs after peripheral nerve injury.It is believed that the capability of brain plasticity is crucial for the recovery of hand function.The supplementary motor area may play a key role in brain remodeling after peripheral nerve injury.In this study,we explored the activation mode of the supplementary motor area during a motor imagery task.We investigated the plasticity of the central nervous system after brachial plexus injury,using the motor imagery task.Results from functional magnetic resonance imaging showed that after brachial plexus injury,the motor imagery task for the affected limbs of the patients triggered no obvious activation of bilateral supplementary motor areas.This result indicates that it is difficult to excite the supplementary motor areas of brachial plexus injury patients during a motor imagery task,thereby impacting brain remodeling.Deactivation of the supplementary motor area is likely to be a serious problem for brachial plexus injury patients in terms of preparing,initiating and executing certain movements,which may be partly responsible for the unsatisfactory clinical recovery of hand function.
文摘Background: Carpal Tunnel Syndrome (CTS) is the compression of the median nerve in carpal tunnel of wrist which leads to the typical symptoms of numbness, paresthesia and sometimes pain in the patient’s hand. The symptoms are usually sensed in the first three radial fingers and the lateral side of the ring finger because these areas are innervated by the median nerve. Objective: To assess hand function among patient with Carpal Tunnel Syndrome (CTS). Methods: This was a descriptive study in which 41 subjects (27 females and 14 males) were included from Ghurki trust teaching hospital, Lahore and Shalamar hospital, Lahore (from August 2018 to October 2018) according to inclusion criteria. Samples were collected according to WHO (World Health Organization) calculator. Hand function was measured with Boston Carpal Tunnel Questionnaire (BCTQ). Results: Majority of the patients with CTS fell into mild functional severity and mild symptom severity. The mean score for functional severity was 2.34 and for symptom severity it was 2.97. Conclusion: Activities of daily living such as grasping, writing, gripping and carrying objects were affected by the symptoms of pain, numbness, tingling and weakness in the patients suffering from CTS.
文摘Motor function changes in the unaffected hand of stroke patients with hemiplegia. These changes are often ignored by clinicians owing to the extent of motor disability of the affected hand. Finger tapping frequency and Lind-mark hand function score showed that the motor function of unaffected hands in stroke patients was poorer than that of a healthy control hand. After 2 weeks of rehabilitation treatment, motor function of the unaffected hand of stroke patients was obviously improved. Therefore, attention should also be paid to motor function in the unaffected hand of stroke patients with hemiplegia during rehabilitation.
基金supported by the National Research Foundation(NRF) of Korea Grant funded by the Korean Government(MSIP),No.2015R1A2A2A01004073
文摘There have been no studies reported on the difference in cortical activation during use of volar and dorsal hand splints.We attempted to investigate the difference in cortical activation in the somatosensory cortical area during use of volar and dorsal hand splints by functional magnetic resonance imaging（f MRI）.We recruited eight healthy volunteers.f MRI was performed while subjects who were fitted with volar or dorsal hand splints performed grasp-release movements.Regions of interest were placed on the primary motor cortex（M1）,primary somatosensory cortex（S1）,posterior parietal cortex（PPC）,and secondary somatosensory cortex（S2）.Results of group analysis of f MRI data showed that the total numbers of activated voxels in all ROIs were significantly higher during use of volar hand splint（3,376） compared with that（1,416） during use of dorsal hand splint.In each ROI,use of volar hand splint induced greater activation in all ROIs（M1：1,748,S1 ：1,455,PPC：23,and S2：150） compared with use of dorsal hand splint（M1：783,S1：625,PPC：0,and S2：8）.The peak activated value was also higher during use of volar hand splint（t-value：17.29） compared with that during use of dorsal hand splint（t-value：13.11）.Taken together,use of volar hand splint induced greater cortical activation relevant to somatosensory function than use of dorsal hand splint.This result would be important for the physiatrist and therapist to apply appropriate somatosensory input in patients with brain injury.
基金Shandong Province Traditional Chinese Medicine Technology Development Program。
文摘Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.
基金supported by a grant from Ministry of Education,Taiwan,China under the Aiming for the Top University Plan at Taiwan Normal University,China
文摘Embodied semantics theory asserts that the meaning of action-related words is neurally represented through networks that overlap with or are identical to networks involved in sensory-motor processing. While some studies supporting this theory have focused on Chinese characters, less attention has been paid to their semantic radicals. Indeed, there is still disagreement about whether these radicals are processed independently. The present study investigated whether radicals are processed separately and, if so, whether this processing occurs in sensory-motor regions. Materials consisted of 72 high-frequency Chinese characters, with 18 in each of four categories： hand-action verbs with and without hand-radicals, and verbs not related to hand actions, with and without hand-radicals. Twenty-eight participants underwent functional MRI scans while reading the characters. Compared to characters without hand-radicals, reading characters with hand-radicals activated the right medial frontal gyrus. Verbs involving hand-action activated the left inferior parietal lobule, possibly reflecting integration of information in the radical with the semantic meaning of the verb. The findings may be consistent with embodied semantics theory and suggest that neural representation of radicals is indispensable in processing Chinese characters.
文摘Objective To observe the therapeutic effects of post-stroke hand motor impairment treated with acupuncture at Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5）. Methods Sixty cases of post-stroke hand motor impairment were randomly divided into an observation group and a control group, 30 cases in each one. The conventional medication, physical therapy, occupational therapy and other rehabilitation trainings were applied in both groups. In observation group, Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5） were punctured. The assessment was performed with neurologie deficit scoring of the National Institutes of Health Stroke Scale （NIHSS）, hand motor function, walking ability and the modified Barthel index scale of the Activities of Daily Living （ADL） in both groups before and after treatment. Results After treatment, the scores of hand function, walking ability, ADL and NIHSS were improved in both groups as compared with those before treatment （all P〈0.01）. The improvements of hand function, walking ability and ADL ：in observation group were superior to those in control group （all P〈0.05）. Conclusion The conventional medication and rehabilitation trainings combined with acupuncture at Zhongzhu （中渚 TE 3） and Waiguan （外关TE 5） ean obviously improve hand motor function, walking ability, the activities of daily living and rehabilitation efficacy in the patients with post-stroke hand motor impairment.
文摘目的:基于《国际功能、残疾和健康分类》框架,系统评价不同类型3D打印外骨骼对脑卒中患者手功能康复的临床疗效。方法:检索PubMed、Cochrane Library、Web of Science、Embase、中国知网和中国生物医学文献数据库,收集2015年1月至2024年12月发表的3D打印外骨骼干预脑卒中患者手功能的文献。由2名研究者独立筛选文献、提取资料并进行方法学质量评价,遵循PRISMA指南规范系统综述流程。结果:最终纳入13篇文献,涉及美国、中国、荷兰、意大利、新加坡和土耳其6个国家,共62例脑卒中患者。根据Brunnstrom分期将外骨骼分为辅助型(Ⅰ期)、矫正型(Ⅱ-Ⅲ期)、训练型(Ⅳ-Ⅵ期)和代偿型(Ⅳ-Ⅵ期)4类,干预方式包括机构康复、家庭康复和机构-家庭康复,干预方案为每次15-90 min,每周3-7次,持续5-8周。研究结果显示:辅助型外骨骼改善精细手使用能力以及自我照顾能力;矫正型外骨骼改善关节活动功能、肌张力、握力以及精细手使用能力;训练型外骨骼改善关节活动功能、上肢肌肉力量以及自我照顾能力;代偿型外骨骼提升精细手使用能力及手和手臂使用能力。结论:基于《国际功能、残疾和健康分类》框架的证据表明,3D打印外骨骼改善脑卒中患者手部功能以及活动和参与能力。建议根据Brunnstrom分期选择匹配的外骨骼类型,并制定个体化干预方案,以实现康复的最佳效果。
文摘目的:探讨一款便携式柔性手部康复机器人在脑卒中患者临床与居家上肢康复中的可用性。方法:招募13例脑卒中偏瘫患者进行手部康复机器的可用性测试。患者首先在医院接受为期2周的学习与训练,随后将设备带回家进行为期6周的居家自主康复训练,每次33 min,每天2次。训练结束后采用系统可用性量表(system usability scale,SUS)及半结构式访谈评估机器的可用性。此外,在干预前后及训练期间通过Fugl-Meyer运动功能量表上肢部分(Fugl-Meyer assessment upper extremity,FMA-UE)、行动研究手臂测试(action research arm test,ARAT)、日常生活活动量表(activities of daily living,ADL)评估患者的上肢运动功能和日常生活自理能力。结果:13例患者SUS为(85.8±10.5)分,处于“Excellent”水平。半结构式访谈结果显示,该设备操作简便、便于携带,但在连接、硬件稳定性及训练内容丰富度等方面仍有改进空间。干预结束后,部分患者FMA-UE、ARAT、ADL评分较前有所改善,达到最小临床重要差异(mini clinical important difference,MCID)。结论:柔性手部康复机器人在脑卒中偏瘫患者的临床及居家康复中具有良好的可用性和安全性,可作为脑卒中手部康复的一种潜在有效手段。
文摘目的:腕手矫形器是一种常见的上肢功能障碍康复辅具,对脑卒中后手功能障碍患者的疗效存在争议。该文系统评价腕手矫形器对脑卒中患者手功能障碍的康复效果。方法:系统检索中国知网、万方、维普、SinoMed、PubMed、Embase、Web of Science、Cochrane Library等数据库公开发表的腕手矫形器在脑卒中患者手功能康复中应用的随机对照试验,其中试验组采用腕手矫形器和常规康复治疗,对照组采用常规康复治疗,检索时限为各数据库建库到2024年7月。由2位研究者独立开展文献筛选、提取资料,并依据Cochrane风险偏倚评估工具评价文献质量,使用RevMan 5.4软件进行Meta分析。结果:最终纳入8篇文献,共305例患者。Meta分析结果显示:试验组改良Ashworth评分低于对照组[MD=-0.24,95%CI(-0.36,-0.12),P<0.0001],Fugl-Meyer上肢运动功能评分和改良Barthel评分[SMD=0.97,95%CI(0.51,1.43),P<0.0001;SMD=1.00,95%CI(0.05,1.94),P=0.04]均高于对照组,两组握力比较差异无显著性意义[MD=-0.89,95%CI(-5.37,3.58),P=0.70]。结论:腕手矫形器能够降低脑卒中患者腕手关节肌张力,提高患者手运动功能与日常生活活动能力,但对患者握力无明显改善。需注意的是,研究总样本量仅305例,且部分指标(如握力)仅纳入2篇文献,统计效力不足,未来需更多大样本、高质量的随机对照试验进行验证。
文摘目的比较超声引导下远端周围神经阻滞(DPNB)与不同浓度罗哌卡因腋路臂丛神经阻滞(ABPB)对手部手术患者上肢运动功能保留及术后恢复的影响。方法将90例行择期或急诊手部手术患者随机分为3组:D组(行DPNB,0.25%罗哌卡因)、L组(行低浓度ABPB,0.125%罗哌卡因)和N组(行常规浓度ABPB,0.25%罗哌卡因),每组30例。比较3组麻醉操作时间、起效时间、局麻药用量、改良Bromage评分(麻醉起效后)、Barthel指数(入院时、术后6 h、出院时)、15条目恢复质量量表(QoR-15)评分(术前24 h、术后24 h、术后48 h)、术后镇痛维持时间及手术日至出院时间。结果每组各脱落3例,最终纳入81例患者。D组与L组改良Bromage评分显著优于N组(P<0.05)。D组与L组术后6 h Barthel指数及术后24 h QoR-15评分均显著高于N组(P<0.05)。D组手术日至出院时间显著短于N组(P<0.05)。与L组和N组比较,D组的麻醉操作时间及起效时间显著缩短(P<0.05)。D组与L组局麻药用量显著少于N组(P<0.05)。结论超声引导下DPNB能更好地保留上肢运动功能,有利于患者术后早期生活自理与快速康复,并缩短住院时间。
