Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery ...Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor ...BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.展开更多
Objective: To investigate the effect of a self-developed balance rhythm dance program on the rehabilitation of motor function and the reduction of fall risk in elderly women with diminished balance function. Methods: ...Objective: To investigate the effect of a self-developed balance rhythm dance program on the rehabilitation of motor function and the reduction of fall risk in elderly women with diminished balance function. Methods: Fifty elderly women with reduced balance function, admitted to the Qingbar Elderly Care Center of Chongqing Medical University from December 2022 to December 2023, were randomly selected and divided into two groups. The aerobic exercise group (25 patients) received traditional treatment and rehabilitation nursing, while the balance rhythm dance intervention group (25 patients) received the balance rhythm dance intervention in addition to traditional treatment and rehabilitation nursing. The Unified Parkinson’s Disease Rating Scale (UPDRS) and Berg Balance Scale (BBS) were used as evaluation indicators to compare the intervention effects between the two groups. Results: The data revealed that the balance rhythm dance intervention significantly improved the motor ability and balance function of elderly women in the intervention group (P < 0.01), with statistically significant differences observed. Conclusion: The balance rhythm dance program plays a critical role in promoting the rehabilitation of motor function and balance ability in elderly women, effectively enhancing their quality of life.展开更多
Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City f...Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.展开更多
Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functio...Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.展开更多
Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patien...Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.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
Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial ...Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.展开更多
Objective To investigate the effects of combined transplantation of neural stem cells （NSC） and olfactory ensheathing cells （OEC） on the motor function of rats with intracerebral hemorrhage. Methods In three days ...Objective To investigate the effects of combined transplantation of neural stem cells （NSC） and olfactory ensheathing cells （OEC） on the motor function of rats with intracerebral hemorrhage. Methods In three days after a rat model of caudate nucleus hemorrhage was established, NSCs and OEC, NSC, OEC （from embryos of Wistar rats） or normal saline were injected into bematomas of rats in combined transplantation group, NSC group, OEC group, and control group, respectively. Damage of neural function was scored before and in 3, 7, 14, 30 days after operation. Tissue after transplantation was observed by immunocytochemistry staining. Results The scores for the NSC, OEC and co-transplantation groups were significantly lower in 14 and 30 days after operation than in 3 days after operation （P〈0.05）. The scores for the NSC and OEC groups were significantly lower than those for the control group only in 30 days after operation （P〈0.05）, while the difference for the NSC-OEC group was significant in 14 days after operation （P〈0.05）. Immunocytochemistry staining revealed that the transplanted OEC and NSC could survive, migrate and differentiate into neurons, astrocytes, and oligodendrocytes. The number of neural precursor cells was greater in the NSC and combined transplantation groups than in the control group. The number of neurons differentiated from NSC was significantly greater in the co-transplantation group than in the NSC group. Conclusion Co-transplantation of NSC and OEC can promote the repair of injured tissue and improve the motor fimction of rats with intracerebral hemorrhage.展开更多
Electroacupuncture(EA)has been widely used for functional restoration after stroke.However,its role in post-stroke rehabilitation and the associated regulatory mechanisms remain poorly understood.In this study,we appl...Electroacupuncture(EA)has been widely used for functional restoration after stroke.However,its role in post-stroke rehabilitation and the associated regulatory mechanisms remain poorly understood.In this study,we applied EA to the Zusanli(ST36)and Quchi(LI11)acupoints in rats with middle cerebral artery occlusion and reperfusion.We found that EA effectively increased the expression of brain-derived neurotrophic factor and its receptor tyrosine kinase B,synapsin-1,postsynaptic dense protein 95,and microtubule-associated protein 2 in the ischemic penumbra of rats with middle cerebral artery occlusion and reperfusion.Moreover,EA greatly reduced the expression of myelin-related inhibitors Nogo-A and NgR in the ischemic penumbra.Tyrosine kinase B inhibitor ANA-12 weakened the therapeutic effects of EA.These findings suggest that EA can improve neurological function after middle cerebral artery occlusion and reperfusion,possibly through regulating the activity of the brain-derived neurotrophic factor/tyrosine kinase B signal pathway.All procedures and experiments were approved by the Animal Research Committee of Shanghai University of Traditional Chinese Medicine,China(approval No.PZSHUTCM200110002)on January 10,2020.展开更多
Previous studies have shown that transcranial pulse current stimulation(tPCS) can increase cerebral neural plasticity and improve patients' locomotor function.However, the precise mechanisms underlying this effect...Previous studies have shown that transcranial pulse current stimulation(tPCS) can increase cerebral neural plasticity and improve patients' locomotor function.However, the precise mechanisms underlying this effect remain unclear.In the present study, rat models of stroke established by occlusion of the right cerebral middle artery were subjected to tPCS, 20 minutes per day for 7 successive days.tPCS significantly reduced the Bederson score, increased the foot print area of the affected limbs, and reduced the standing time of affected limbs of rats with stroke compared with that before intervention.Immunofluorescence staining and western blot assay revealed that tPCS significantly increased the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.This finding suggests that tPCS can improve the locomotor function of rats with stroke by regulating the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.These findings may provide a new method for the clinical treatment of poststroke motor dysfunction and a theoretical basis for clinical application of tPCS.The study was approved by the Animal Use and Management Committee of Shanghai University of Traditional Chinese Medicine of China(approval No.PZSHUTCM190315003) on February 22, 2019.展开更多
Flavonoids have been reported to have therapeutic potential for spinal cord injury.Hawthorn leaves have abundant content and species of total flavonoids,and studies of the effects of the total flavonoids of hawthorn l...Flavonoids have been reported to have therapeutic potential for spinal cord injury.Hawthorn leaves have abundant content and species of total flavonoids,and studies of the effects of the total flavonoids of hawthorn leaves on spinal cord injury have not been published in or outside China.Therefore,Sprague-Dawley rats were used to establish a spinal cord injury model by Allen's method.Rats were intraperitoneally injected with 0.2 m L of different concentrations of total flavonoids of hawthorn leaves(5,10,and 20 mg/kg)after spinal cord injury.Injections were administered once every 6 hours,three times a day,for 14 days.After treatment with various concentrations of total flavonoids of hawthorn leaves,the Basso,Beattie,and Bresnahan scores and histological staining indicated decreases in the lesion cavity and number of apoptotic cells of the injured spinal cord tissue;the morphological arrangement of the myelin sheath and nerve cells tended to be regular;and the Nissl bodies in neurons increased.The Basso,Beattie,and Bresnahan scores of treated spinal cord injury rats were increased.Western blot assays showed that the expression levels of pro-apoptotic Bax and cleaved caspase-3 were decreased,but the expression level of the anti-apoptotic Bcl-2 protein was increased.The improvement of the above physiological indicators showed a dose-dependent relationship with the concentration of total flavonoids of hawthorn leaves.The above findings confirm that total flavonoids of hawthorn leaves can reduce apoptosis and exert neuroprotective effects to promote the recovery of the motor function of rats with spinal cord injury.This study was approved by the Ethics Committee of the Guangxi Medical University of China(approval No.201810042)in October 2018.展开更多
Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. Functional electrical stimulation applied to the affe...Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. Functional electrical stimulation applied to the affected limb based on myoelectric signal from the unaffected limb is a promising therapy for hemiplegia. In this study, we developed a prototype system for evaluating this novel functional electrical stimulation-control strategy. Based on surface electromyography and a vector machine model, a self-administered, muki-movement, force-modulation functional electrical stimulation-prototype system for hemiplegia was implemented. This paper discusses the hardware design, the algorithm of the system, and key points of the self-oscillation-prone system. The experimental results demonstrate the feasibility of the prototype system for further clinical trials, which is being conducted to evaluate the efficacy of the proposed rehabilitation technique.展开更多
Multi-target neural circuit-magnetic stimulation has been clinically shown to improve rehabilitation of lower limb motor function after spinal cord injury. However, the precise underlying mechanism remains unclear. In...Multi-target neural circuit-magnetic stimulation has been clinically shown to improve rehabilitation of lower limb motor function after spinal cord injury. However, the precise underlying mechanism remains unclear. In this study, we performed double-target neural circuit-magnetic stimulation on the left motor cortex and bilateral L5 nerve root for 3 successive weeks in a rat model of incomplete spinal cord injury caused by compression at T10. Results showed that in the injured spinal cord, the expression of the astrocyte marker glial fibrillary acidic protein and inflammatory factors interleukin 1β, interleukin-6, and tumor necrosis factor-α had decreased, whereas that of neuronal survival marker microtubule-associated protein 2 and synaptic plasticity markers postsynaptic densification protein 95 and synaptophysin protein had increased. Additionally, neural signaling of the descending corticospinal tract was markedly improved and rat locomotor function recovered significantly. These findings suggest that double-target neural circuit-magnetic stimulation improves rat motor function by attenuating astrocyte activation, thus providing a theoretical basis for application of double-target neural circuit-magnetic stimulation in the clinical treatment of spinal cord injury.展开更多
OBJECTIVE:To evaluate the efficacy of meridian massage on motor function after a stroke.METHODS:This systematic review and Meta-analysis of randomised(RCTs)and quasi-randomised controlled trials(q RCTs)was performed t...OBJECTIVE:To evaluate the efficacy of meridian massage on motor function after a stroke.METHODS:This systematic review and Meta-analysis of randomised(RCTs)and quasi-randomised controlled trials(q RCTs)was performed to determine the effects of meridian massage on motor dysfunction following a stroke.Articles published until December 2020 related to stroke and meridian massage from National Library of Medicine,Cochrane Central Register of Controlled Trials,Embase,Korea Med,Japan science and Technology Agency,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Biomedical Literature Database and China Science and Technology Journal Database were searched.The primary outcomes included Fugl-Mayer Assessment(FMA),modified Barthel Index(m BI)and clinical efficiency,while the secondary outcomes included modified Ashworth(m AS)and Berg Balance Scale(BBS).Two authors independently selected the literature,extracted the data and assessed the risk of bias,after which Meta-analysis with subgroups and sensitivity analysis was conducted.RESULTS:A total of 16 RCTs and 3 q-RCTs involved 1556 patients satisfied the inclusion.Meta-analysis showed that compared to conventional rehabilitation,meridian massage had significantly better FMA[mean difference(MD)=1.16,95%confidence interval(CI):0.43,1.89,P=0.002],FMA-L(MD=3.21,95%CI:1.97,4.45,P=0.00001),m BI(MD=8.87,95%CI:4.24,13.49,P=0.00002),clinical efficiency[relative risk(RR)=1.37,95%CI:1.24,1.51,P<0.00001],m AS(MD=-0.69,95%CI:-1.26,-0.11,P=0.02)and BBS(MD=5.07,95%CI:2.22,7.93,P=0.0005).Subgroup analysis indicated no significant difference between meridian massage and control group when the intervention duration was>8 weeks(MD=0.89,95%CI:-0.64,2.42,P=0.25)but improving motor function in the meridian massage when the intervention duration was≤8 weeks(<4 weeks intervention duration MD=0.84,95%CI:0.59,1.10,P<0.00001;4–8 weeks MD=2.41,95%CI:0.80,4.01,P=0.003).CONCLUSIONS:Meridian massage as an alternative and complementary therapy seems to have short-term benefits in improving post-stroke motor function(particularly in the lower limbs),quality of life,clinical efficiency,and balance stability and muscle spasms.The high heterogeneity of the included studies and the low methodological quality certainly limits the confidence placed in this systematic review and Meta-analysis,warranting future well-designed studies.展开更多
OBJECTIVE： To evaluate feasibility of biofeedback therapy in China Medical Institutions to improve dysfunction following stroke. DATA SOURCE： A computer-based online search of publications was conducted using the Vi...OBJECTIVE： To evaluate feasibility of biofeedback therapy in China Medical Institutions to improve dysfunction following stroke. DATA SOURCE： A computer-based online search of publications was conducted using the Vip and PubMed Databases to identify publications that addressed biofeedback. The search key words included ＂electromyogram＂, ＂biofeedback＂, and ＂stroke＂. In total, 81 articles were retrieved. DATA SELECTION： Studies closely related to biofeedback, or studies with contents recently published in the same study field or in authorized journals, were included. Duplicated articles were excluded. Following full-text retrieval of selected articles, a total of 14 articles were collected, which addressed randomized, controlled trials of biofeedback therapy for dysfunction after stroke. Methodological quality was assessed for randomized, controlled trials using criteria from Cochrane reviewers＇ handbook. Results were analyzed using Revman 4.2 software. MAIN OUTCOME MEASURES： Outcomes and evaluation indices were expressed by odds ratio （OR）, weighted mean difference （WMD）, and 95% confidence interval （95% CO. Potential publication bias was presented using the funnel plot. RESULTS： The study included 14 randomized, controlled trials of 1 147 patients. Following biofeedback therapy, meta-analysis results demonstrated that： （1） The total effective rate was significantly greater in the biofeedback therapy group compared with the control group [OR = 3.46, 95% Cl （2.09, 5.73）, P = 0.62]. （2） Electromyogram changes were better in biofeedback therapy patients compared to the control group [WMD= 22.31, 95% C/（17.19, 27.43）, P〈 0.001]. （3） Motor function was better in biofeedback therapy patients compared with the control group [WMD = 12.43, 95% CI （6.71, 18.16）, P 〈 0.001]. （4） Daily living activities were better in biofeedback therapy patients compared with the control group [WMD= 18.11, 95% C/（15.77, 20.44）, P= 0.36]. （5） Joint range of motion was better in biofeedback therapy patients compared with the control group [WMD = 6.43, 95% Cl （4.44, 8.41）, P = 0.77]. Sensitivity analysis also demonstrated similar results after eliminating articles that described unknown diagnostic criteria and statistical methods. CONCLUSION： Following stroke, biofeedback therapy for dysfunction was shown to result in significant and valid outcomes, increased motor function and electromyogram values, improved joint range of motion, and improved daily living activities.展开更多
BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor...BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.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
Fine motor skills are thought to rely on the integrity of ascending sensory pathways in the spinal dorsal column as well as descending motor pathways that have a neocortical origin.However, the neurophysiological proc...Fine motor skills are thought to rely on the integrity of ascending sensory pathways in the spinal dorsal column as well as descending motor pathways that have a neocortical origin.However, the neurophysiological processes underlying communication between the somatosensory and motor pathways that regulate fine motor skills during spontaneous recovery after spinal cord contusion injury remain unclear.Here, we established a rat model of cervical hemicontusive injury using C5 laminectomy followed by contusional displacement of 1.2 mm(mild injury) or 2.0 mm(severe injury) to the C5 spinal cord.Electrophysiological recordings were performed on the brachial muscles up to 12 weeks after injury to investigate the mechanisms by which spinal cord pathways participate in motor function.After spinal cord contusion injury, the amplitudes of somatosensory and motor-evoked potentials were reduced, and the latencies were increased.The forelimb open field locomotion test, grooming test, rearing test and Montoya staircase test revealed improvement in functions.With increasing time after injury, the amplitudes of somatosensory and motor-evoked potentials in rats with mild spinal cord injury increased gradually, and the latencies gradually shortened.In comparison, the recovery times of somatosensory and motor-evoked potential amplitudes and latencies were longer, and the recovery of motor function was delayed in rats with severe spinal cord injury.Correlation analysis revealed that somatosensoryevoked potential and motor-evoked potential parameters were correlated with gross and fine motor function in rats with mild spinal cord contusion injury.In contrast, only somatosensory-evoked potential amplitude was correlated with fine motor skills in rats with severe spinal cord injury.Our results show that changes in both somatosensory and motor-evoked potentials can reflect the changes in gross and fine motor functions after mild spinal cord contusion injury, and that the change in somatosensory-evoked potential amplitude can also reflect the change in fine motor function after severe spinal cord contusion injury.This study was approved by the Animal Ethics Committee of Nanfang Hospital, Southern Medical University, China(approval No.NFYY-2017-67) on June 11, 2017.展开更多
基金supported by the NIH (R01NS103481, R01NS111776, and R01NS131489)Indiana Department of Health (ISDH58180)(all to WW)。
文摘Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2023ZL460Zhejiang Province Traditional Chinese Medicine Modernization Special Project,No.2021ZX011。
文摘BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.
基金Chongqing Sports Scientific Research Project“Research and Development of Balance Rhythm Dance and Its Application in Reducing Fall Risk in Older Women”(Project No.D202209)Chongqing Nursing Vocational College College-level Project“Research on the Talent Training Model of Field Engineers in the Intelligent Health Care Sector Based on Rehabilitation Assistive Devices under the‘Integration of Science and Education’Approach”(Project No.Y202307)+1 种基金Chongqing Science and Technology Bureau Research Project“Investigating the Impact of Electro-acupuncture Applied to Antagonist Muscles on Walking Ability in Stroke Patients with Hemiplegia Based on the Principle of Reciprocal Inhibition”(Project No.CSTC2019JXJL130019)Chongqing Traditional Chinese Medicine Hospital Research Project“The Alterations in the Pelvic Floor Muscle Group Following Acupuncture Treatment for Postpartum Stress Urinary Incontinence Were Evaluated Using SWE Technology”(Project No.jxyn2021-2-23)。
文摘Objective: To investigate the effect of a self-developed balance rhythm dance program on the rehabilitation of motor function and the reduction of fall risk in elderly women with diminished balance function. Methods: Fifty elderly women with reduced balance function, admitted to the Qingbar Elderly Care Center of Chongqing Medical University from December 2022 to December 2023, were randomly selected and divided into two groups. The aerobic exercise group (25 patients) received traditional treatment and rehabilitation nursing, while the balance rhythm dance intervention group (25 patients) received the balance rhythm dance intervention in addition to traditional treatment and rehabilitation nursing. The Unified Parkinson’s Disease Rating Scale (UPDRS) and Berg Balance Scale (BBS) were used as evaluation indicators to compare the intervention effects between the two groups. Results: The data revealed that the balance rhythm dance intervention significantly improved the motor ability and balance function of elderly women in the intervention group (P < 0.01), with statistically significant differences observed. Conclusion: The balance rhythm dance program plays a critical role in promoting the rehabilitation of motor function and balance ability in elderly women, effectively enhancing their quality of life.
文摘Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.
基金supported by the National Natural Science Foundation of China,No.81371663,61534003the Top-notch Academic Programs Project of Jiangsu Higher Education Institutions of China,No.PPZY2015B135
文摘Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.
基金supported by the Sub-Project under National "Twelfth Five-Year" Plan for Science&Technology Support Project in China,No.2011BAI08B11the Research Project of China Rehabilitation Research Center,No.2014-3
文摘Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.
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supported by the 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University,China,No.2020HXFH051(to QG).
文摘Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.
基金supported by the National Natural Science Foundation of China (30570628 & 30770751)
文摘Objective To investigate the effects of combined transplantation of neural stem cells （NSC） and olfactory ensheathing cells （OEC） on the motor function of rats with intracerebral hemorrhage. Methods In three days after a rat model of caudate nucleus hemorrhage was established, NSCs and OEC, NSC, OEC （from embryos of Wistar rats） or normal saline were injected into bematomas of rats in combined transplantation group, NSC group, OEC group, and control group, respectively. Damage of neural function was scored before and in 3, 7, 14, 30 days after operation. Tissue after transplantation was observed by immunocytochemistry staining. Results The scores for the NSC, OEC and co-transplantation groups were significantly lower in 14 and 30 days after operation than in 3 days after operation （P〈0.05）. The scores for the NSC and OEC groups were significantly lower than those for the control group only in 30 days after operation （P〈0.05）, while the difference for the NSC-OEC group was significant in 14 days after operation （P〈0.05）. Immunocytochemistry staining revealed that the transplanted OEC and NSC could survive, migrate and differentiate into neurons, astrocytes, and oligodendrocytes. The number of neural precursor cells was greater in the NSC and combined transplantation groups than in the control group. The number of neurons differentiated from NSC was significantly greater in the co-transplantation group than in the NSC group. Conclusion Co-transplantation of NSC and OEC can promote the repair of injured tissue and improve the motor fimction of rats with intracerebral hemorrhage.
基金supported by the National Key R&D Program of China,No.2018YFC2001600(to JGX)the National Natural Science Foundation of China,No.81902301(to JJW)+3 种基金Budgetary Project of Shanghai University of Traditional Chinese Medicine of China,No.2019LK024(to JJW)Intelligent Medical Program of Shanghai(Municipal)Health Commission of China,No.2018ZHYL0216(to CLS)Clinical Science and Technology Innovation Project of Shanghai Shen Kang Hospital Development Center of China,No.SHDC12018126(to CLS)Accelerated the Development of Traditional Chinese Medicine Three-Year Action Plan Project(of Shanghai Health Commission)of China,Nos.ZY(2018-2020)-CCCX-2001-06(to JGX and CLS)and ZY(2018-2020)-CCCX-2004-05(to JGX and CLS)。
文摘Electroacupuncture(EA)has been widely used for functional restoration after stroke.However,its role in post-stroke rehabilitation and the associated regulatory mechanisms remain poorly understood.In this study,we applied EA to the Zusanli(ST36)and Quchi(LI11)acupoints in rats with middle cerebral artery occlusion and reperfusion.We found that EA effectively increased the expression of brain-derived neurotrophic factor and its receptor tyrosine kinase B,synapsin-1,postsynaptic dense protein 95,and microtubule-associated protein 2 in the ischemic penumbra of rats with middle cerebral artery occlusion and reperfusion.Moreover,EA greatly reduced the expression of myelin-related inhibitors Nogo-A and NgR in the ischemic penumbra.Tyrosine kinase B inhibitor ANA-12 weakened the therapeutic effects of EA.These findings suggest that EA can improve neurological function after middle cerebral artery occlusion and reperfusion,possibly through regulating the activity of the brain-derived neurotrophic factor/tyrosine kinase B signal pathway.All procedures and experiments were approved by the Animal Research Committee of Shanghai University of Traditional Chinese Medicine,China(approval No.PZSHUTCM200110002)on January 10,2020.
基金supported by the National Key R&D Program of China, No.2018 YFC2001600(to CLS)the Shanghai Health Commission Accelerated the Development of Traditional Chinese Medicine Three-Year Action Plan Project, No.ZY(2018-2020)-CCCX-2001-06/2004-05(to CLS)+1 种基金the Program of Shanghai Academic Research Leader, No.19 XD1403600(to CLS)the National Natural Science Foundation of China for the Youth Project, No.81704163(to JJZ)。
文摘Previous studies have shown that transcranial pulse current stimulation(tPCS) can increase cerebral neural plasticity and improve patients' locomotor function.However, the precise mechanisms underlying this effect remain unclear.In the present study, rat models of stroke established by occlusion of the right cerebral middle artery were subjected to tPCS, 20 minutes per day for 7 successive days.tPCS significantly reduced the Bederson score, increased the foot print area of the affected limbs, and reduced the standing time of affected limbs of rats with stroke compared with that before intervention.Immunofluorescence staining and western blot assay revealed that tPCS significantly increased the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.This finding suggests that tPCS can improve the locomotor function of rats with stroke by regulating the expression of microtubule-associated protein-2 and growth-associated protein-43 around the ischemic penumbra.These findings may provide a new method for the clinical treatment of poststroke motor dysfunction and a theoretical basis for clinical application of tPCS.The study was approved by the Animal Use and Management Committee of Shanghai University of Traditional Chinese Medicine of China(approval No.PZSHUTCM190315003) on February 22, 2019.
基金the National Natural Science Foundation of China,No.81860391(to GFZ)the Natural Science Foundation of Guangxi Zhuang Autonomous Region of China,No.2018GXNSFAA281144(to GFZ)the Key Research and Development Project of Guangxi Zhuang Autonomous Region of China,No.guike AB18221021(to SHZ)。
文摘Flavonoids have been reported to have therapeutic potential for spinal cord injury.Hawthorn leaves have abundant content and species of total flavonoids,and studies of the effects of the total flavonoids of hawthorn leaves on spinal cord injury have not been published in or outside China.Therefore,Sprague-Dawley rats were used to establish a spinal cord injury model by Allen's method.Rats were intraperitoneally injected with 0.2 m L of different concentrations of total flavonoids of hawthorn leaves(5,10,and 20 mg/kg)after spinal cord injury.Injections were administered once every 6 hours,three times a day,for 14 days.After treatment with various concentrations of total flavonoids of hawthorn leaves,the Basso,Beattie,and Bresnahan scores and histological staining indicated decreases in the lesion cavity and number of apoptotic cells of the injured spinal cord tissue;the morphological arrangement of the myelin sheath and nerve cells tended to be regular;and the Nissl bodies in neurons increased.The Basso,Beattie,and Bresnahan scores of treated spinal cord injury rats were increased.Western blot assays showed that the expression levels of pro-apoptotic Bax and cleaved caspase-3 were decreased,but the expression level of the anti-apoptotic Bcl-2 protein was increased.The improvement of the above physiological indicators showed a dose-dependent relationship with the concentration of total flavonoids of hawthorn leaves.The above findings confirm that total flavonoids of hawthorn leaves can reduce apoptosis and exert neuroprotective effects to promote the recovery of the motor function of rats with spinal cord injury.This study was approved by the Ethics Committee of the Guangxi Medical University of China(approval No.201810042)in October 2018.
基金supported by the National Natural Science Foundation of China,No.90307013,90707005a grant from the Science&Technology Pillar Program of Jiangsu Province in China,No.BE2013706
文摘Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. Functional electrical stimulation applied to the affected limb based on myoelectric signal from the unaffected limb is a promising therapy for hemiplegia. In this study, we developed a prototype system for evaluating this novel functional electrical stimulation-control strategy. Based on surface electromyography and a vector machine model, a self-administered, muki-movement, force-modulation functional electrical stimulation-prototype system for hemiplegia was implemented. This paper discusses the hardware design, the algorithm of the system, and key points of the self-oscillation-prone system. The experimental results demonstrate the feasibility of the prototype system for further clinical trials, which is being conducted to evaluate the efficacy of the proposed rehabilitation technique.
基金supported by the National Natural Science Foundation of China,Nos. 81772453 and 81974358 (both to DSX)Shanghai Municipal Key Clinical Specialty Program,No. shslczdzk02701 (to QX)。
文摘Multi-target neural circuit-magnetic stimulation has been clinically shown to improve rehabilitation of lower limb motor function after spinal cord injury. However, the precise underlying mechanism remains unclear. In this study, we performed double-target neural circuit-magnetic stimulation on the left motor cortex and bilateral L5 nerve root for 3 successive weeks in a rat model of incomplete spinal cord injury caused by compression at T10. Results showed that in the injured spinal cord, the expression of the astrocyte marker glial fibrillary acidic protein and inflammatory factors interleukin 1β, interleukin-6, and tumor necrosis factor-α had decreased, whereas that of neuronal survival marker microtubule-associated protein 2 and synaptic plasticity markers postsynaptic densification protein 95 and synaptophysin protein had increased. Additionally, neural signaling of the descending corticospinal tract was markedly improved and rat locomotor function recovered significantly. These findings suggest that double-target neural circuit-magnetic stimulation improves rat motor function by attenuating astrocyte activation, thus providing a theoretical basis for application of double-target neural circuit-magnetic stimulation in the clinical treatment of spinal cord injury.
基金Supported by the National Natural Science Foundation of China(Based on the Regulation of MIR-206 on BDNF,to Explore the Mechanism of Meridian Massage on Motor Function Reconstruction in rats with Cerebral Infarction,No.8166150430)
文摘OBJECTIVE:To evaluate the efficacy of meridian massage on motor function after a stroke.METHODS:This systematic review and Meta-analysis of randomised(RCTs)and quasi-randomised controlled trials(q RCTs)was performed to determine the effects of meridian massage on motor dysfunction following a stroke.Articles published until December 2020 related to stroke and meridian massage from National Library of Medicine,Cochrane Central Register of Controlled Trials,Embase,Korea Med,Japan science and Technology Agency,China National Knowledge Infrastructure Database,Wanfang Database,Chinese Biomedical Literature Database and China Science and Technology Journal Database were searched.The primary outcomes included Fugl-Mayer Assessment(FMA),modified Barthel Index(m BI)and clinical efficiency,while the secondary outcomes included modified Ashworth(m AS)and Berg Balance Scale(BBS).Two authors independently selected the literature,extracted the data and assessed the risk of bias,after which Meta-analysis with subgroups and sensitivity analysis was conducted.RESULTS:A total of 16 RCTs and 3 q-RCTs involved 1556 patients satisfied the inclusion.Meta-analysis showed that compared to conventional rehabilitation,meridian massage had significantly better FMA[mean difference(MD)=1.16,95%confidence interval(CI):0.43,1.89,P=0.002],FMA-L(MD=3.21,95%CI:1.97,4.45,P=0.00001),m BI(MD=8.87,95%CI:4.24,13.49,P=0.00002),clinical efficiency[relative risk(RR)=1.37,95%CI:1.24,1.51,P<0.00001],m AS(MD=-0.69,95%CI:-1.26,-0.11,P=0.02)and BBS(MD=5.07,95%CI:2.22,7.93,P=0.0005).Subgroup analysis indicated no significant difference between meridian massage and control group when the intervention duration was>8 weeks(MD=0.89,95%CI:-0.64,2.42,P=0.25)but improving motor function in the meridian massage when the intervention duration was≤8 weeks(<4 weeks intervention duration MD=0.84,95%CI:0.59,1.10,P<0.00001;4–8 weeks MD=2.41,95%CI:0.80,4.01,P=0.003).CONCLUSIONS:Meridian massage as an alternative and complementary therapy seems to have short-term benefits in improving post-stroke motor function(particularly in the lower limbs),quality of life,clinical efficiency,and balance stability and muscle spasms.The high heterogeneity of the included studies and the low methodological quality certainly limits the confidence placed in this systematic review and Meta-analysis,warranting future well-designed studies.
基金a Grant from the Health Department of Jilin Province, No. 2009ZC002
文摘OBJECTIVE： To evaluate feasibility of biofeedback therapy in China Medical Institutions to improve dysfunction following stroke. DATA SOURCE： A computer-based online search of publications was conducted using the Vip and PubMed Databases to identify publications that addressed biofeedback. The search key words included ＂electromyogram＂, ＂biofeedback＂, and ＂stroke＂. In total, 81 articles were retrieved. DATA SELECTION： Studies closely related to biofeedback, or studies with contents recently published in the same study field or in authorized journals, were included. Duplicated articles were excluded. Following full-text retrieval of selected articles, a total of 14 articles were collected, which addressed randomized, controlled trials of biofeedback therapy for dysfunction after stroke. Methodological quality was assessed for randomized, controlled trials using criteria from Cochrane reviewers＇ handbook. Results were analyzed using Revman 4.2 software. MAIN OUTCOME MEASURES： Outcomes and evaluation indices were expressed by odds ratio （OR）, weighted mean difference （WMD）, and 95% confidence interval （95% CO. Potential publication bias was presented using the funnel plot. RESULTS： The study included 14 randomized, controlled trials of 1 147 patients. Following biofeedback therapy, meta-analysis results demonstrated that： （1） The total effective rate was significantly greater in the biofeedback therapy group compared with the control group [OR = 3.46, 95% Cl （2.09, 5.73）, P = 0.62]. （2） Electromyogram changes were better in biofeedback therapy patients compared to the control group [WMD= 22.31, 95% C/（17.19, 27.43）, P〈 0.001]. （3） Motor function was better in biofeedback therapy patients compared with the control group [WMD = 12.43, 95% CI （6.71, 18.16）, P 〈 0.001]. （4） Daily living activities were better in biofeedback therapy patients compared with the control group [WMD= 18.11, 95% C/（15.77, 20.44）, P= 0.36]. （5） Joint range of motion was better in biofeedback therapy patients compared with the control group [WMD = 6.43, 95% Cl （4.44, 8.41）, P = 0.77]. Sensitivity analysis also demonstrated similar results after eliminating articles that described unknown diagnostic criteria and statistical methods. CONCLUSION： Following stroke, biofeedback therapy for dysfunction was shown to result in significant and valid outcomes, increased motor function and electromyogram values, improved joint range of motion, and improved daily living activities.
基金the Foundation from China Rehabilitation Research Centre,No.2007-15
文摘BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.
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supported by the National Natural Science Foundation of China, No.81871768(to YH)Chinese Academy of Medical Sciences Initiative for Innovative Medicine of China, No.2016-I2 M-2-006(to HYC)High Level-Hospital Program, Health Commission of Guangdong Province, China, No.HKUSZH201902011(to YH)。
文摘Fine motor skills are thought to rely on the integrity of ascending sensory pathways in the spinal dorsal column as well as descending motor pathways that have a neocortical origin.However, the neurophysiological processes underlying communication between the somatosensory and motor pathways that regulate fine motor skills during spontaneous recovery after spinal cord contusion injury remain unclear.Here, we established a rat model of cervical hemicontusive injury using C5 laminectomy followed by contusional displacement of 1.2 mm(mild injury) or 2.0 mm(severe injury) to the C5 spinal cord.Electrophysiological recordings were performed on the brachial muscles up to 12 weeks after injury to investigate the mechanisms by which spinal cord pathways participate in motor function.After spinal cord contusion injury, the amplitudes of somatosensory and motor-evoked potentials were reduced, and the latencies were increased.The forelimb open field locomotion test, grooming test, rearing test and Montoya staircase test revealed improvement in functions.With increasing time after injury, the amplitudes of somatosensory and motor-evoked potentials in rats with mild spinal cord injury increased gradually, and the latencies gradually shortened.In comparison, the recovery times of somatosensory and motor-evoked potential amplitudes and latencies were longer, and the recovery of motor function was delayed in rats with severe spinal cord injury.Correlation analysis revealed that somatosensoryevoked potential and motor-evoked potential parameters were correlated with gross and fine motor function in rats with mild spinal cord contusion injury.In contrast, only somatosensory-evoked potential amplitude was correlated with fine motor skills in rats with severe spinal cord injury.Our results show that changes in both somatosensory and motor-evoked potentials can reflect the changes in gross and fine motor functions after mild spinal cord contusion injury, and that the change in somatosensory-evoked potential amplitude can also reflect the change in fine motor function after severe spinal cord contusion injury.This study was approved by the Animal Ethics Committee of Nanfang Hospital, Southern Medical University, China(approval No.NFYY-2017-67) on June 11, 2017.
