OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randoml...OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randomly divided into an experimental group(acupuncture combined with upper limb rehabilitation robot assisted training)and a control group(upper limb rehabilitation robot assisted training).Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery.Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.RESULTS:The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group(P<0.05).Additionally,the experimental group had significantly lower concentrations of deoxygenated hemoglobin(P<0.05).After treatment,both groups showed improvements in various measures,but the experimental group had significantly greater improvements(P<0.05).CONCLUSION:Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients.This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction poststroke.展开更多
Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its effi...Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group showed a better change in the MBI at both week 4 and week 12(P=0.004 and P=0.010,respectively).Although the intervention group had a higher BRS for the hand at week 12(P=0.041),no intergroup differences were observed at week 4(all P>0.05).The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12(all P>0.05).Conclusion Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function,muscle strength,and activities of daily living in patients with PSSP-UL.展开更多
Objective:To explore the rehabilitation effect of upper limb rehabilitation robots combined with isokinetic muscle strength training on hemiplegic patients in the recovery phase of stroke,and to provide a more effecti...Objective:To explore the rehabilitation effect of upper limb rehabilitation robots combined with isokinetic muscle strength training on hemiplegic patients in the recovery phase of stroke,and to provide a more effective intervention plan for clinical rehabilitation treatment.Methods:One hundred and sixty type 2 stroke patients with hemiplegia in recovery phase treated at Jintan First People’s Hospital from May 2020 to May 2025 were selected as the research subjects.They were divided into a control group(n=80)and an observation group(n=80)using a random number table method.The control group received isokinetic muscle strength training,while the observation group received additional upper limb rehabilitation robot-assisted intervention based on the control group’s treatment.The general information(age,gender,course of disease),Brunnstrum staging,Barthel index,FMA score,and facial expression pain score were compared between the two groups.Results:After treatment,the indicators of both groups improved compared to before treatment.The observation group showed significant advantages in improving various indicators.In terms of Brunnstrum staging,the number of patients in stage IV and above was significantly higher than that in the control group;in terms of the Barthel index,the increase was more significant than that of the control group(P=0.000<0.001).In terms of the FMA score,the increase was more pronounced(P=0.000<0.001);and in terms of facial expression pain assessment,the decrease was more evident(P=0.000<0.01).Conclusion:The combination of upper limb rehabilitation robots and isokinetic muscle strength training can significantly improve the recovery of limb function and activities of daily living in hemiplegic patients during the recovery phase of stroke,and reduce pain.Compared with simple isokinetic muscle strength training,the rehabilitation effect is better,and it is worthy of clinical application.展开更多
[Objectives]To quantify the efficacy of Extracorporeal Shock Wave Therapy(ESWT)for upper limb spasticity in stroke patients using Modified Ashworth Scale(MAS)across three timeframes:immediate,short-term(24 h-4 wks),an...[Objectives]To quantify the efficacy of Extracorporeal Shock Wave Therapy(ESWT)for upper limb spasticity in stroke patients using Modified Ashworth Scale(MAS)across three timeframes:immediate,short-term(24 h-4 wks),and long-term(>4 wks).[Methods]Six databases(PubMed,EMBASE,CENTRAL,CINAHL,Scopus,Web of Science)until May 2025,were systematically searched,identifying 11 RCTs(n=505)meeting inclusion criteria(adults≥18 yrs old with stroke-related spasticity[MAS≥1]).Risk of bias was rigorously assessed using Cochrane criteria,revealing uniformly low risk across all domains.Random-effects meta-analyses(REML model)calculated Hedges'g with 95%CI for MAS outcomes,with subgroup analyses for joint-specific effects.[Results]ESWT demonstrated non-significant immediate MAS reduction(g=-0.69,p=0.07;=93.95%),but statistically significant short-term(g=-0.58,p=0.02;I^(2)=89.64%)and long-term effects(g=-0.52,p=0.02;I^(2)=78.72%).Effects were driven by composite MAS scores(short-term g=-0.63;long-term g=-0.56,both p<0.05)rather than isolated joints(elbow/finger/wrist all non-significant).Substantial heterogeneity persisted across analyses,particularly in joint-specific subgroups(I^(2)>90%).[Conclusions]ESWT provides statistically significant,clinically relevant reductions in global upper limb spasticity with durable efficacy beyond four weeks,supporting its use as a non-invasive adjunct therapy despite substantial heterogeneity warranting protocol standardization.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
Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-str...Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.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
The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patient...The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains un- clear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The FugI-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sen- sorimotor cortex.展开更多
Dyskinesia of the upper limbs caused by stroke,sports injury,or trafc accidents limits the ability to perform the activities of daily living.Besides the necessary medical treatment,correct and scientifc rehabilitation...Dyskinesia of the upper limbs caused by stroke,sports injury,or trafc accidents limits the ability to perform the activities of daily living.Besides the necessary medical treatment,correct and scientifc rehabilitation training for the injured joint is an important auxiliary means during the treatment of the efected upper limb.Conventional upperlimb rehabilitation robots have some disadvantages,such as a complex structure,poor compliance,high cost,and poor portability.In this study,a novel soft wearable upper limb rehabilitation robot(SWULRR)with reinforced soft pneumatic actuators(RSPAs)that can withstand high pressure and featuring excellent loading characteristics was developed.Driven by RSPAs,this portable SWULRR can perform rehabilitation training of the wrist and elbow joints.In this study,the kinematics of an SWULRR were analyzed,and the force and motion characteristics of RSPA were studied experimentally.The results provide a reference for the development and application of wearable upper limb rehabilitation robots.An experimental study on the rotation angle of the wrist and the pressure of the RSPA was conducted to test the efect of the rehabilitation training and verify the rationality of the theoretical model.The process of wrist rehabilitation training was tested and evaluated,indicating that SWULRR with RSPAs will enhance the fexibility,comfort,and safety of rehabilitation training.This work is expected to promote the development of wearable upper-limb rehabilitation robots based on modular reinforced soft pneumatic actuators.展开更多
BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cance...BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery,and is considered non-invasive,painless and without side effects.AIM To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention.METHODS The study included 100 patients with upper extremity lymphedema after breast cancer surgery.The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy.The study population was further divided into the experimental group and control group with 50 cases in each group.The control group was given conventional CDT(four-step method),which included skin care,freehand lymphatic drainage,foam granule pressurized bandage,and functional exercise.In the experimental group,a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT.Patients in both groups were given one course of treatment daily(20 times),and the changes in body moisture and subjective symptoms were measured before and after treatment,preoperatively and 20 times after treatment.RESULTS No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment,suggesting comparability of the baseline data.After treatment,the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group,and the extracellular moisture ratio was significantly lower than that in the control group.A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group.After 20 treatments,according to subjective evaluations,the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group.CONCLUSION The six-step CDT method can effectively reduce lymphedema,promote lymphatic circulation,and alleviate the subjective symptoms of patients,and thereby improve the quality of life and treatment compliance among patients.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
An assessment of the human motion repeatability for three selected Activities of Daily Living(ADL)is performed in this paper.These exercises were prescribed by an occupational therapist for the upper limb rehabilitati...An assessment of the human motion repeatability for three selected Activities of Daily Living(ADL)is performed in this paper.These exercises were prescribed by an occupational therapist for the upper limb rehabilitation.The movement patterns of five participants,recorded using a Qualisys motion capture system,are compared based on the Analysis of Variance(ANOVA)method.This survey is motivated by the need to find the appropriate task workspace of a 6-degrees of freedom cable-driven parallel robot for upper limb rehabilitation,which is able to reproduce the three selected exercises.This comparison is performed to justify,whether or not,there is enough similarity between the participants’gestures,and so a single reference trajectory can be adopted as the robot-prescribed workspace.Using the results of the comparative study,an optimization process of the sought robot design is carried out,where the structure size and the cable tensions simultaneously minimized.展开更多
BACKGROUND Upper limb venous thrombosis(ULVT)is rarer than lower-extremity deep venous thrombosis,and is related to Paget-Schroetter syndrome,central venous catheterization,and malignancy.There are few reports of pulm...BACKGROUND Upper limb venous thrombosis(ULVT)is rarer than lower-extremity deep venous thrombosis,and is related to Paget-Schroetter syndrome,central venous catheterization,and malignancy.There are few reports of pulmonary embolism(PE)from upper-extremity vein thrombosis due to surgery.Herein,we report two cases of PE that originated from upper limb venous thrombosis on the surgical side in two patients undergoing modified radical mastectomy for breast cancer.These cases challenge the traditional theory that PE originate only from the lower extremities.CASE SUMMARY We describe two female patients,aged 68 and 65 years,respectively,who had undergone modified radical mastectomy for breast cancer.They did not have a central venous catheter and did not undergo preoperative neoadjuvant chemotherapy.They were transferred to the intensive care unit due to symptomatic PE on the first day after surgery.Colour Doppler ultrasound identified fresh thrombosis in their upper limb veins,which was the presumed source of the PE.They all received anticoagulation therapy,and one of them experienced bleeding that required discontinuation of the drug.Ultimately,they were discharged in stable condition.CONCLUSION ULVT as a source of PE after breast cancer surgery cannot be ignored.展开更多
Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open...Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.展开更多
This paper addresses the design of a novel bionic robotic device for upper limb rehabilitation tasks at home.The main goal of the design process has been to obtain a rehabilitation device,which can be easily portable ...This paper addresses the design of a novel bionic robotic device for upper limb rehabilitation tasks at home.The main goal of the design process has been to obtain a rehabilitation device,which can be easily portable and can be managed remotely by a professional therapist.This allows to treat people also in regions that are not easily reachable with a significant cost reduction.Other potential benefits can be envisaged,for instance,in the possibility to keep social distancing while allowing rehabilitation treatments even during a pandemic spread.Specific attention has been devoted to design the main mechatronic components by developing specific kinematics and dynamics models.The design process includes the implementation of a specific control hardware and software.Preliminary experimental tests are reported to show the effectiveness and feasibility of the proposed design solution.展开更多
<strong>Objective:</strong> To evaluate the effect of physical methods on the prevention of venous thrombosis in patients with peripherally inserted central catheter (PICC). <strong>Methods:</stro...<strong>Objective:</strong> To evaluate the effect of physical methods on the prevention of venous thrombosis in patients with peripherally inserted central catheter (PICC). <strong>Methods:</strong> Randomized controlled trials meeting the inclusion and exclusion criteria were retrieved from the following databases: Cochrane library, Pubmed, EMbase, Web of science, Ovid, CBM, CNKI, Wanfang, VIP, then Review Manage (RevMan) 5.3 software was used for data analysis. <strong>Results:</strong> A total of 24 RCTs including 3496 patients were analyzed in the study. The results of meta-analysis showed that various forms of upper limb movements could effectively decrease the incidence of venous thrombosis in the patients with PICC [<em>RR</em> = 0.23, 95% <em>CI</em> (0.16, 0.33), <em>P</em> < 0.01], upper limb movements could effectively improve the mean blood flow velocity of basilic vein [<em>MD</em> = 1.65, 95% <em>CI</em> (1.19, 2.11), <em>P</em> < 0.01]. <strong>Conclusion:</strong> Upper limb movements can effectively decrease the incidence of phlebothrombosis and improve the mean flow velocity of basilic vein in the patients undergoing PICC. Other forms of physical prevention methods need to be further studied due to insufficient sample size.展开更多
BACKGROUND This study aims to describe the application of a modified St.Thomas'solution in patients with severe limb injuries.CASE SUMMARY Four patients who sustained a high-energy trauma and underwent complete up...BACKGROUND This study aims to describe the application of a modified St.Thomas'solution in patients with severe limb injuries.CASE SUMMARY Four patients who sustained a high-energy trauma and underwent complete upper limb amputation were pretreated with a modified St.Thomas'solution before upper limb replantation.After the perfusion solution stopped flowing from the blood vessel,the amputated upper limb amputation was replanted.The patients were instructed to perform functional rehabilitation training after the operation.All 4 patients were followed up for 5 years.All the severed upper limbs survived.Routine re-examination after the operation showed that the function of the affected limb was restored.All the patients were satisfied with the sensory and functional recovery of the affected limb.CONCLUSION The modified St.Thomas'solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.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
<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="f...<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Active rehabilitation of the paralyzed limb is necessary for functional recovery from upper limb paralysis after stroke. In particular, the </span><span style="font-family:Verdana;">amount of training is very important, and robot rehabilitation is useful. Howev</span><span style="font-family:Verdana;">er, most conventional robots are expensive, large, and stationary. We have d</span><span style="font-family:Verdana;">eveloped Rehabili-Mouse, a new tabletop rehabilitation robot that is compact and portable. The purpose of this study was to conduct paralyzed upper limb training for a patient after stroke using Rehabili-Mouse and to examine its effect.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The patient was a 44-year-old man who had left-sided paresis after a right cerebral infarction, 3 months after onset. The training was carried out between February 2021 and March 2021 at Oyu Rehabilitation Hot</span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">spring Hospital. The training was 20 minutes of Rehabili-Mouse in addition to 40 minutes of usual occupational therapy and performed five times a week </span><span style="font-family:Verdana;">for four weeks. Upper limb functions were evaluated before and after the t</span><span style="font-family:Verdana;">raining, and two questionnaires of patient satisfaction with the device and the training were administered after the completion of the training. Upper limb function improved. The patient’s satisfaction with the device was poor, but his satisfaction with the training was good.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Discussion</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Training for the paralyzed upper limb after stroke using Rehabili-Mouse improved upper limb function and satisfied the trained patient. We plan to increase the number of cases and conduct further studies.</span></span></span></span></span>展开更多
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Project(2024ZL769):Effect of Xingshen Kaiqiao Acupuncture Method combined with Upper Limb Robot-assisted Training on Upper Limb Function and Neuroplasticity Mechanism of Hemiplegia after Stroke based on Functional Near-Infrared Spectroscopy Technology。
文摘OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randomly divided into an experimental group(acupuncture combined with upper limb rehabilitation robot assisted training)and a control group(upper limb rehabilitation robot assisted training).Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery.Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.RESULTS:The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group(P<0.05).Additionally,the experimental group had significantly lower concentrations of deoxygenated hemoglobin(P<0.05).After treatment,both groups showed improvements in various measures,but the experimental group had significantly greater improvements(P<0.05).CONCLUSION:Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients.This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction poststroke.
基金funded by Science Foundation for Youth supported by Shanghai Municipal Health Commission(No.20204Y0313)Sailing Program with the support of Science and Technology Commission of Shanghai Municipality(No.21YF1443800).
文摘Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group showed a better change in the MBI at both week 4 and week 12(P=0.004 and P=0.010,respectively).Although the intervention group had a higher BRS for the hand at week 12(P=0.041),no intergroup differences were observed at week 4(all P>0.05).The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12(all P>0.05).Conclusion Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function,muscle strength,and activities of daily living in patients with PSSP-UL.
基金Changzhou Applied Basic Research Program(Project No.:CJ20241042)。
文摘Objective:To explore the rehabilitation effect of upper limb rehabilitation robots combined with isokinetic muscle strength training on hemiplegic patients in the recovery phase of stroke,and to provide a more effective intervention plan for clinical rehabilitation treatment.Methods:One hundred and sixty type 2 stroke patients with hemiplegia in recovery phase treated at Jintan First People’s Hospital from May 2020 to May 2025 were selected as the research subjects.They were divided into a control group(n=80)and an observation group(n=80)using a random number table method.The control group received isokinetic muscle strength training,while the observation group received additional upper limb rehabilitation robot-assisted intervention based on the control group’s treatment.The general information(age,gender,course of disease),Brunnstrum staging,Barthel index,FMA score,and facial expression pain score were compared between the two groups.Results:After treatment,the indicators of both groups improved compared to before treatment.The observation group showed significant advantages in improving various indicators.In terms of Brunnstrum staging,the number of patients in stage IV and above was significantly higher than that in the control group;in terms of the Barthel index,the increase was more significant than that of the control group(P=0.000<0.001).In terms of the FMA score,the increase was more pronounced(P=0.000<0.001);and in terms of facial expression pain assessment,the decrease was more evident(P=0.000<0.01).Conclusion:The combination of upper limb rehabilitation robots and isokinetic muscle strength training can significantly improve the recovery of limb function and activities of daily living in hemiplegic patients during the recovery phase of stroke,and reduce pain.Compared with simple isokinetic muscle strength training,the rehabilitation effect is better,and it is worthy of clinical application.
文摘[Objectives]To quantify the efficacy of Extracorporeal Shock Wave Therapy(ESWT)for upper limb spasticity in stroke patients using Modified Ashworth Scale(MAS)across three timeframes:immediate,short-term(24 h-4 wks),and long-term(>4 wks).[Methods]Six databases(PubMed,EMBASE,CENTRAL,CINAHL,Scopus,Web of Science)until May 2025,were systematically searched,identifying 11 RCTs(n=505)meeting inclusion criteria(adults≥18 yrs old with stroke-related spasticity[MAS≥1]).Risk of bias was rigorously assessed using Cochrane criteria,revealing uniformly low risk across all domains.Random-effects meta-analyses(REML model)calculated Hedges'g with 95%CI for MAS outcomes,with subgroup analyses for joint-specific effects.[Results]ESWT demonstrated non-significant immediate MAS reduction(g=-0.69,p=0.07;=93.95%),but statistically significant short-term(g=-0.58,p=0.02;I^(2)=89.64%)and long-term effects(g=-0.52,p=0.02;I^(2)=78.72%).Effects were driven by composite MAS scores(short-term g=-0.63;long-term g=-0.56,both p<0.05)rather than isolated joints(elbow/finger/wrist all non-significant).Substantial heterogeneity persisted across analyses,particularly in joint-specific subgroups(I^(2)>90%).[Conclusions]ESWT provides statistically significant,clinically relevant reductions in global upper limb spasticity with durable efficacy beyond four weeks,supporting its use as a non-invasive adjunct therapy despite substantial heterogeneity warranting protocol standardization.
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 Hebei Administration of Traditional Chinese Medicine(2009180)
文摘Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.
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 National Natural Science Foundationof China,No.30973165
文摘The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains un- clear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The FugI-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sen- sorimotor cortex.
基金Supported by National Natural Science Foundation of China(Grant Nos.51975505 and U2037202)Science and Technology Project of Hebei Education Department(Grant No.SLRC2019039)+1 种基金Postgraduate Innovation Ability Cultivation Funded Project of Hebei Province(Grant No.CXZZBS2021135)Open Project of Hebei Industrial Manipulator Control and reliability Technology Innovation Center,Hebei University of Water Resources and Electric Engineering(Grant No.JXKF2102).
文摘Dyskinesia of the upper limbs caused by stroke,sports injury,or trafc accidents limits the ability to perform the activities of daily living.Besides the necessary medical treatment,correct and scientifc rehabilitation training for the injured joint is an important auxiliary means during the treatment of the efected upper limb.Conventional upperlimb rehabilitation robots have some disadvantages,such as a complex structure,poor compliance,high cost,and poor portability.In this study,a novel soft wearable upper limb rehabilitation robot(SWULRR)with reinforced soft pneumatic actuators(RSPAs)that can withstand high pressure and featuring excellent loading characteristics was developed.Driven by RSPAs,this portable SWULRR can perform rehabilitation training of the wrist and elbow joints.In this study,the kinematics of an SWULRR were analyzed,and the force and motion characteristics of RSPA were studied experimentally.The results provide a reference for the development and application of wearable upper limb rehabilitation robots.An experimental study on the rotation angle of the wrist and the pressure of the RSPA was conducted to test the efect of the rehabilitation training and verify the rationality of the theoretical model.The process of wrist rehabilitation training was tested and evaluated,indicating that SWULRR with RSPAs will enhance the fexibility,comfort,and safety of rehabilitation training.This work is expected to promote the development of wearable upper-limb rehabilitation robots based on modular reinforced soft pneumatic actuators.
文摘BACKGROUND Complex decongestive therapy(CDT)is currently recommended as the standard treatment for lymphedema.CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery,and is considered non-invasive,painless and without side effects.AIM To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention.METHODS The study included 100 patients with upper extremity lymphedema after breast cancer surgery.The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy.The study population was further divided into the experimental group and control group with 50 cases in each group.The control group was given conventional CDT(four-step method),which included skin care,freehand lymphatic drainage,foam granule pressurized bandage,and functional exercise.In the experimental group,a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT.Patients in both groups were given one course of treatment daily(20 times),and the changes in body moisture and subjective symptoms were measured before and after treatment,preoperatively and 20 times after treatment.RESULTS No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment,suggesting comparability of the baseline data.After treatment,the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group,and the extracellular moisture ratio was significantly lower than that in the control group.A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group.After 20 treatments,according to subjective evaluations,the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group.CONCLUSION The six-step CDT method can effectively reduce lymphedema,promote lymphatic circulation,and alleviate the subjective symptoms of patients,and thereby improve the quality of life and treatment compliance among patients.
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"PHC Utiquc"program of the French Ministry of Foreign Affairs and Ministry of Higher Education,Research and Innovation and the Tunisian Ministry of Higher Education and Scientific Research.P.n°19G1121the support of the Erasmus+KA 107 program.
文摘An assessment of the human motion repeatability for three selected Activities of Daily Living(ADL)is performed in this paper.These exercises were prescribed by an occupational therapist for the upper limb rehabilitation.The movement patterns of five participants,recorded using a Qualisys motion capture system,are compared based on the Analysis of Variance(ANOVA)method.This survey is motivated by the need to find the appropriate task workspace of a 6-degrees of freedom cable-driven parallel robot for upper limb rehabilitation,which is able to reproduce the three selected exercises.This comparison is performed to justify,whether or not,there is enough similarity between the participants’gestures,and so a single reference trajectory can be adopted as the robot-prescribed workspace.Using the results of the comparative study,an optimization process of the sought robot design is carried out,where the structure size and the cable tensions simultaneously minimized.
文摘BACKGROUND Upper limb venous thrombosis(ULVT)is rarer than lower-extremity deep venous thrombosis,and is related to Paget-Schroetter syndrome,central venous catheterization,and malignancy.There are few reports of pulmonary embolism(PE)from upper-extremity vein thrombosis due to surgery.Herein,we report two cases of PE that originated from upper limb venous thrombosis on the surgical side in two patients undergoing modified radical mastectomy for breast cancer.These cases challenge the traditional theory that PE originate only from the lower extremities.CASE SUMMARY We describe two female patients,aged 68 and 65 years,respectively,who had undergone modified radical mastectomy for breast cancer.They did not have a central venous catheter and did not undergo preoperative neoadjuvant chemotherapy.They were transferred to the intensive care unit due to symptomatic PE on the first day after surgery.Colour Doppler ultrasound identified fresh thrombosis in their upper limb veins,which was the presumed source of the PE.They all received anticoagulation therapy,and one of them experienced bleeding that required discontinuation of the drug.Ultimately,they were discharged in stable condition.CONCLUSION ULVT as a source of PE after breast cancer surgery cannot be ignored.
基金Supported by Militar Nueva Granada University of Colombia (Grant No.IMP-ING-3127)。
文摘Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.
文摘This paper addresses the design of a novel bionic robotic device for upper limb rehabilitation tasks at home.The main goal of the design process has been to obtain a rehabilitation device,which can be easily portable and can be managed remotely by a professional therapist.This allows to treat people also in regions that are not easily reachable with a significant cost reduction.Other potential benefits can be envisaged,for instance,in the possibility to keep social distancing while allowing rehabilitation treatments even during a pandemic spread.Specific attention has been devoted to design the main mechatronic components by developing specific kinematics and dynamics models.The design process includes the implementation of a specific control hardware and software.Preliminary experimental tests are reported to show the effectiveness and feasibility of the proposed design solution.
文摘<strong>Objective:</strong> To evaluate the effect of physical methods on the prevention of venous thrombosis in patients with peripherally inserted central catheter (PICC). <strong>Methods:</strong> Randomized controlled trials meeting the inclusion and exclusion criteria were retrieved from the following databases: Cochrane library, Pubmed, EMbase, Web of science, Ovid, CBM, CNKI, Wanfang, VIP, then Review Manage (RevMan) 5.3 software was used for data analysis. <strong>Results:</strong> A total of 24 RCTs including 3496 patients were analyzed in the study. The results of meta-analysis showed that various forms of upper limb movements could effectively decrease the incidence of venous thrombosis in the patients with PICC [<em>RR</em> = 0.23, 95% <em>CI</em> (0.16, 0.33), <em>P</em> < 0.01], upper limb movements could effectively improve the mean blood flow velocity of basilic vein [<em>MD</em> = 1.65, 95% <em>CI</em> (1.19, 2.11), <em>P</em> < 0.01]. <strong>Conclusion:</strong> Upper limb movements can effectively decrease the incidence of phlebothrombosis and improve the mean flow velocity of basilic vein in the patients undergoing PICC. Other forms of physical prevention methods need to be further studied due to insufficient sample size.
基金Supported by the National Natural Science Foundation of China,No.81600694the Science and Technology Project of Nanjing,No.201503008.
文摘BACKGROUND This study aims to describe the application of a modified St.Thomas'solution in patients with severe limb injuries.CASE SUMMARY Four patients who sustained a high-energy trauma and underwent complete upper limb amputation were pretreated with a modified St.Thomas'solution before upper limb replantation.After the perfusion solution stopped flowing from the blood vessel,the amputated upper limb amputation was replanted.The patients were instructed to perform functional rehabilitation training after the operation.All 4 patients were followed up for 5 years.All the severed upper limbs survived.Routine re-examination after the operation showed that the function of the affected limb was restored.All the patients were satisfied with the sensory and functional recovery of the affected limb.CONCLUSION The modified St.Thomas'solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.
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.
文摘<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Active rehabilitation of the paralyzed limb is necessary for functional recovery from upper limb paralysis after stroke. In particular, the </span><span style="font-family:Verdana;">amount of training is very important, and robot rehabilitation is useful. Howev</span><span style="font-family:Verdana;">er, most conventional robots are expensive, large, and stationary. We have d</span><span style="font-family:Verdana;">eveloped Rehabili-Mouse, a new tabletop rehabilitation robot that is compact and portable. The purpose of this study was to conduct paralyzed upper limb training for a patient after stroke using Rehabili-Mouse and to examine its effect.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The patient was a 44-year-old man who had left-sided paresis after a right cerebral infarction, 3 months after onset. The training was carried out between February 2021 and March 2021 at Oyu Rehabilitation Hot</span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">spring Hospital. The training was 20 minutes of Rehabili-Mouse in addition to 40 minutes of usual occupational therapy and performed five times a week </span><span style="font-family:Verdana;">for four weeks. Upper limb functions were evaluated before and after the t</span><span style="font-family:Verdana;">raining, and two questionnaires of patient satisfaction with the device and the training were administered after the completion of the training. Upper limb function improved. The patient’s satisfaction with the device was poor, but his satisfaction with the training was good.</span></span></span></span></span></span><span><span><span><span><span style="font-family:;" "=""> </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Discussion</span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Training for the paralyzed upper limb after stroke using Rehabili-Mouse improved upper limb function and satisfied the trained patient. We plan to increase the number of cases and conduct further studies.</span></span></span></span></span>
