Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. How...Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.展开更多
Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarctio...Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the ex...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
Background:Virtual reality(VR)technology is increasingly used in stroke rehabilitation.This study aimed to investigate the effectiveness of using the glasses-free VR training to improve motor function of upper limb in...Background:Virtual reality(VR)technology is increasingly used in stroke rehabilitation.This study aimed to investigate the effectiveness of using the glasses-free VR training to improve motor function of upper limb in patients with stroke.Methods:Twelve patients with stroke were recruited to participate in the intervention of 3 weeks.At the baseline and post intervention,two times of evaluation including Fugl-Meyer upper-extremity scale(FMS-UE),transcranial magnetic stimulation(TMS)measurement and motion evaluation were performed.Results:No significant difference was observed between two groups at baseline evaluation.After the intervention,the FMS-UE scores presented a greater improvement in the VR group compared with the control group.TMS measurement showed that there was significant difference in cortex latency and central motor conduction time between two groups after the intervention,but no significant difference in the amplitude of motor event potential was observed.In addition,there was a significant correlation between game scores and FMS-UE scores.Conclusions:The novel glasses-free VR training was at least as effective as conventional occupational therapy in upper limb motor function,improving nerve conduction time and corticospinal excitability in patient with stroke.展开更多
Objective: to analyze the clinical value of biofeedback training in elderly stroke patients to promote the recovery of their lower extremity motor dysfunction. Methods: from January 2021 to January 2022, 76 cases of s...Objective: to analyze the clinical value of biofeedback training in elderly stroke patients to promote the recovery of their lower extremity motor dysfunction. Methods: from January 2021 to January 2022, 76 cases of senile stroke were diagnosed in our hospital. They were divided into two groups: control group and observation group. There were 38 cases in each group. The control group was treated with conventional drugs and rehabilitation training. The observation group further increased biofeedback training Lower limb motor dysfunction and daily living ability were evaluated and compared. Results: the difference of Fugl-Meyer scale score between the two groups before treatment was small (P>0.05), and the score of Fugl-Meyer scale in the observation group was higher than that in the control group after treatment (P<0.05);The difference of Barthel index between the two groups before treatment was small (P>0.05), and the Barthel index in the observation group was higher than that in the control group after treatment (P<0.05);The difference of NIHSS scores between the two groups before treatment was small (P>0.05), and the NIHSS scores in the observation group were lower than those in the control group after treatment (P<0.05). Conclusion: the combined use of biofeedback training for elderly stroke patients can effectively promote the rehabilitation of patients, improve their neurological function, enhance the motor function of lower limbs and the ability of self-care in life.展开更多
Objective: to analyze the effect of acupuncture combined with rehabilitation technology on upper limb motor dysfunction in the clinical treatment of stroke. Methods: a total of 80 stroke patients admitted to our hospi...Objective: to analyze the effect of acupuncture combined with rehabilitation technology on upper limb motor dysfunction in the clinical treatment of stroke. Methods: a total of 80 stroke patients admitted to our hospital from January 2018 to January 2019 were randomly divided into two groups by odd-even serial number, with 40 patients in the observation group and 40 in the control group. The control group was treated with rehabilitation technology, and the observation group was treated with acupuncture combined with rehabilitation training. After the treatment, the treatment effect of the observation group and the control group was compared, and the scores of daily living ability and limb motor function of the two groups were statistically compared and analyzed. Results: according to data analysis, there were 35 patients in the observation group with significant therapeutic effect (87.5%) and 28 patients in the control group with significant therapeutic effect (70.00%). Comparison of two groups of treatment effect, the observation group was better (P < 0.05). After treatment, the scores of daily living ability and upper limb motor function in observation group were better than those in control group (P < 0.05). Conclusion: according to the experimental results, the motor dysfunction of stroke patients has been significantly improved after acupuncture combined with rehabilitation technology treatment, and the patients' daily living ability and upper limb movement ability have been significantly improved, and the efficacy is accurate, which can be widely promoted in clinical practice.展开更多
Objective:To observe the impacts of the combined treatment of Tongdu Tiaoshen moxibustion(moxibustion for promoting the circulation of the governor vessel and regulating the spirit)and rehabilitation training on the m...Objective:To observe the impacts of the combined treatment of Tongdu Tiaoshen moxibustion(moxibustion for promoting the circulation of the governor vessel and regulating the spirit)and rehabilitation training on the motor function recovery in the patients with apoplectic hemiplegia.Methods:A total of 50 patients with apoplectic hemiplegia and qualified in the trial recruitment criteria were divided into two groups according to random number table,25 cases in each group.In the control group,the simple rehabilitation training was provided.In the observation group,on the base of the treatment as the control group,Tongdu Tiaoshen moxibustion was given.Main acupoints:Baihul(百会GV20),Fengfu(风府GV16)and Dazhui(大椎GV14).The treatment was given once a day,6 treatments a week,4 weeks as one course and two courses of treatment were required.Before and after treatment,the scores of Fugle-Meyer assessment(FMA),the modified Barthel index(MBI)and action research arm test(ARAT)were detected before and after treatment in the two groups separately.Results:After 4 and 8 weeks of treatment,the scores of FMA,MBI and ARAT were all improved obviously as compared with those before treatment respectively in patients of the two groups(all P<0.01).After8 weeks of treatment,the score of each scale in the observation group was more obviously improved as compared with the control group(all P<0.05).The difference in the clinical therapeutic effect was significant statistically between the two groups(P=0.005).Conclusion:The combined treatment of Tongdu Tiaoshen moxibustion and rehabilitation training promotes the recovery of the upper limb motor function and improves the self-ability of living activities in the patients with apoplectic hemiplegia.The long-term effect of this combined therapy is superior to that of simple rehabilitation training.展开更多
BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe...BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.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
BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimu...BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.展开更多
文摘Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.
基金supported by the Guangdong Province Medical Science Research Fund, No. B200258
文摘Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
基金This study was supported by National Natural Science Foundation of China(Nos.31771016,32071316,and 81971224)partly supported by Guangdong Basic and Applied Basic Research Foundation(No.2020A1515011356)+1 种基金Guangzhou Research Collaborative Innovation Projects(No.201907010034)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2020-JKCS005).
文摘Background:Virtual reality(VR)technology is increasingly used in stroke rehabilitation.This study aimed to investigate the effectiveness of using the glasses-free VR training to improve motor function of upper limb in patients with stroke.Methods:Twelve patients with stroke were recruited to participate in the intervention of 3 weeks.At the baseline and post intervention,two times of evaluation including Fugl-Meyer upper-extremity scale(FMS-UE),transcranial magnetic stimulation(TMS)measurement and motion evaluation were performed.Results:No significant difference was observed between two groups at baseline evaluation.After the intervention,the FMS-UE scores presented a greater improvement in the VR group compared with the control group.TMS measurement showed that there was significant difference in cortex latency and central motor conduction time between two groups after the intervention,but no significant difference in the amplitude of motor event potential was observed.In addition,there was a significant correlation between game scores and FMS-UE scores.Conclusions:The novel glasses-free VR training was at least as effective as conventional occupational therapy in upper limb motor function,improving nerve conduction time and corticospinal excitability in patient with stroke.
文摘Objective: to analyze the clinical value of biofeedback training in elderly stroke patients to promote the recovery of their lower extremity motor dysfunction. Methods: from January 2021 to January 2022, 76 cases of senile stroke were diagnosed in our hospital. They were divided into two groups: control group and observation group. There were 38 cases in each group. The control group was treated with conventional drugs and rehabilitation training. The observation group further increased biofeedback training Lower limb motor dysfunction and daily living ability were evaluated and compared. Results: the difference of Fugl-Meyer scale score between the two groups before treatment was small (P>0.05), and the score of Fugl-Meyer scale in the observation group was higher than that in the control group after treatment (P<0.05);The difference of Barthel index between the two groups before treatment was small (P>0.05), and the Barthel index in the observation group was higher than that in the control group after treatment (P<0.05);The difference of NIHSS scores between the two groups before treatment was small (P>0.05), and the NIHSS scores in the observation group were lower than those in the control group after treatment (P<0.05). Conclusion: the combined use of biofeedback training for elderly stroke patients can effectively promote the rehabilitation of patients, improve their neurological function, enhance the motor function of lower limbs and the ability of self-care in life.
文摘Objective: to analyze the effect of acupuncture combined with rehabilitation technology on upper limb motor dysfunction in the clinical treatment of stroke. Methods: a total of 80 stroke patients admitted to our hospital from January 2018 to January 2019 were randomly divided into two groups by odd-even serial number, with 40 patients in the observation group and 40 in the control group. The control group was treated with rehabilitation technology, and the observation group was treated with acupuncture combined with rehabilitation training. After the treatment, the treatment effect of the observation group and the control group was compared, and the scores of daily living ability and limb motor function of the two groups were statistically compared and analyzed. Results: according to data analysis, there were 35 patients in the observation group with significant therapeutic effect (87.5%) and 28 patients in the control group with significant therapeutic effect (70.00%). Comparison of two groups of treatment effect, the observation group was better (P < 0.05). After treatment, the scores of daily living ability and upper limb motor function in observation group were better than those in control group (P < 0.05). Conclusion: according to the experimental results, the motor dysfunction of stroke patients has been significantly improved after acupuncture combined with rehabilitation technology treatment, and the patients' daily living ability and upper limb movement ability have been significantly improved, and the efficacy is accurate, which can be widely promoted in clinical practice.
基金Supported by Research Program of Anhui University of Traditional Chinese Medicine:2019zryb21。
文摘Objective:To observe the impacts of the combined treatment of Tongdu Tiaoshen moxibustion(moxibustion for promoting the circulation of the governor vessel and regulating the spirit)and rehabilitation training on the motor function recovery in the patients with apoplectic hemiplegia.Methods:A total of 50 patients with apoplectic hemiplegia and qualified in the trial recruitment criteria were divided into two groups according to random number table,25 cases in each group.In the control group,the simple rehabilitation training was provided.In the observation group,on the base of the treatment as the control group,Tongdu Tiaoshen moxibustion was given.Main acupoints:Baihul(百会GV20),Fengfu(风府GV16)and Dazhui(大椎GV14).The treatment was given once a day,6 treatments a week,4 weeks as one course and two courses of treatment were required.Before and after treatment,the scores of Fugle-Meyer assessment(FMA),the modified Barthel index(MBI)and action research arm test(ARAT)were detected before and after treatment in the two groups separately.Results:After 4 and 8 weeks of treatment,the scores of FMA,MBI and ARAT were all improved obviously as compared with those before treatment respectively in patients of the two groups(all P<0.01).After8 weeks of treatment,the score of each scale in the observation group was more obviously improved as compared with the control group(all P<0.05).The difference in the clinical therapeutic effect was significant statistically between the two groups(P=0.005).Conclusion:The combined treatment of Tongdu Tiaoshen moxibustion and rehabilitation training promotes the recovery of the upper limb motor function and improves the self-ability of living activities in the patients with apoplectic hemiplegia.The long-term effect of this combined therapy is superior to that of simple rehabilitation training.
基金a grant from the Tackle Key Problem and Planning Projectin Science and Technology of Hebei Province,No.052761224
文摘BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.
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a grant from Military Tenth Five-Year Key Research Project Foundation, No. mymjzyy 010
文摘BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.
