<p align="left"> <span style="font-family:Verdana;">To investigate the relationship between muscle strength and sEMG of biceps brachii during elbow flexion by measuring the maximum musc...<p align="left"> <span style="font-family:Verdana;">To investigate the relationship between muscle strength and sEMG of biceps brachii during elbow flexion by measuring the maximum muscle strength and sEMG value of normal children and adults, and to analyze their sources, so as to lay a theoretical foundation for the method of motor program reconstruction to restore the function after brain injury, 30 healthy children aged 9 - 10 years and 30 adults aged 20 - 30 years were randomly selected. The muscle strength and sEMG of biceps brachii during elbow flexion were detected and recorded, and the data were statistically analyzed. The muscle strength of children was significantly lower than that of adults (P < 0.001), and the sEMG value of biceps brachii was significantly lower than that of adults (P < 0.001), but the sEMG value per kilogram force of children was significantly higher than that of adults (P < 0.01). The results show that there was a very significant difference in pull (efficiency) between adults and children when there was no significant difference in SEMG signal intensity. This is because although children’s central nervous system has matured, the muscle tissue has not been well trained, resulting in insufficient muscle strength. The muscle strength of adults is significantly higher than that of children, because they have been exercising for a long time after the development of the central nervous system. It is proved that sEMG signal is not produced by muscle contraction itself, but comes from the motor program signal of central nervous system which drives muscle contraction, and it is produced before muscle contraction.</span> </p>展开更多
The motor relearning program can significantly improve various functional disturbance induced by ischemic cerebrovascular diseases. However, its mechanism of action remains poorly understood. In injured brain tissues,...The motor relearning program can significantly improve various functional disturbance induced by ischemic cerebrovascular diseases. However, its mechanism of action remains poorly understood. In injured brain tissues, glial fibrillary acidic protein and neurofilament protein changes can reflect the condition of injured neurons and astrocytes, while vascular endothelial growth factor and basic fibroblast growth factor changes can indicate angiogenesis. In the present study, we induced ischemic brain injury in the rhesus macaque by electrocoagulation of the M1 segment of the right middle cerebral artery. The motor relearning program was conducted for 60 days from the third day after model establishment. Immunohistochemistry and single-photon emission CT showed that the numbers of glial fibrillary acidic protein-, neurofilament protein-, vascular endothelial growth factor- and basic fibroblast growth factor-positive cells were significantly increased in the infarcted side compared with the contralateral hemisphere following the motor relearning program. Moreover, cerebral blood flow in the infarcted side was significantly improved. The clinical rating scale for stroke was used to assess neurological function changes in the rhesus macaque following the motor relearning program. Results showed that motor function was improved, and problems with consciousness, self-care ability and balance function were significantly ameliorated. These findings indicate that the motor relearning program significantly promoted neuronal regeneration, repair and angiogenesis in the surroundings of the infarcted hemisphere, and improve neurological function in the rhesus macaque following brain ischemia.展开更多
BACKGROUND: Previous studies believed that the effect of rehabilitation training within 6 months after stroke (early rehabilitation training) is usually unsatisfactory. The rehabilitation training when acute stroke...BACKGROUND: Previous studies believed that the effect of rehabilitation training within 6 months after stroke (early rehabilitation training) is usually unsatisfactory. The rehabilitation training when acute stroke is stabilized may be better for the recovery of limb function. OBJECTIVE: To observe the effects of the rehabilitation training of motor relearning program plus Bobath technique on the motor function of limbs, nerve function and activities of daily life (ADL) in patients with acute stroke hemiplegia. DESIGN: A randomized controlled observation SETTING: Department of Neurology, Yaan People's Hospital PARTICIPANTS: A total of 150 patients with acute post-stroke hemiplegia were selected from the Department of Neurology, Yaan People's Hospital from March 2000 to October 2002. The patients were all accorded with the diagnostic standards about stroke set by the Fifth National Academic Meeting for Cerebrovascular Disease (1996), confirmed by CT and MRI, and they were all informed with the interventions and the items of evaluation. The enrolled patients were randomly divided into training group (n=78) and control group (n=72) at admission. METHODS : ① Interventions: All the patients were given routine treatments for stroke, including managin blood pressure, maintaining the balance of hydrolyte and electrolure, reducing intracranial pressure by dehydration, and venous injection of citicoline, besides those in the training group received rehabilitation training by motor relearning program and Bobath technique. The rehabilitation training began after the vital signs became stable within 24 hours to 3 days after attack for the patients with cerebral infarction and 48 hours to 5 days after at- tack for those with cerebral hemorrhage respectively, three times a day in the morning, at noon and in the evening respectively, 30 minutes for each time, they were trained for 1 month. Lying position: The patients should keep the anti-spasm posture in the supine position, contralateral and ipsilateral lying positions, and the postures should be changed regularly; The patients should exercise each joint passively; turn the body over and move actively; They should also performed the bringing training, and the weight loading training for the affected upper limb. Sitting position: The patients should finish the conversion from a lying position to a sitting one independently. Standing position: The patients should finish the conversion from a sitting position to a standing one independently; They also took weight loading training for the affected lower limb. The walking training should be performed when the affected lower limb could support 2/3 of body mass. Walking training: In a standing position supported by the affected lower limb, the unaffected one stepped in small range forward and backward; Each process of balancing and controlling standing position was trained by supporting the body mass by the affected lower limb; In swinging position, the independent movement of the ipsilateral knee joint was trained in alternation of flexion and extension. ② Evaluation of limb function, ADL and nerve function: The motor function of the affected limb was evaluated with the Fugl-Meyer assessment (FMA), the total score of the motor function of upper and lower limbs was 100 points, the higher the score, the better the limb function. ADL were assessed with the modified Barthel index (MBI), the total score was 100 points, the higher the score, the better the independence and the smaller the dependence. The severities of neurological deficit were assessed with neurological deficit score (NDS), the total score ranged 0-45 points, the higher the score, the severer the neurological deficit. ③ Statistical analysis: The ttest was applied to compare the differences of the measurement data. MAIN OUTCOME MEASURES: The changes of nerve function, motor function and ADL in patients with post-stroke hemiplegia after motor relearning program training were observed. RESULTS: All the 150 patients with post-stroke hemiplegia were involved in the analysis of results. ① The scores of NDS, FMA and MBI before intervention in the training group were (25±9), (23±23), (20±16) points, which were close to those in the control group [(24±8), (24±21), (24±20) points, P 〉 0.05]. ② The NDS score after intervention in the training group was obviously lower than that in the control group [(10±7), (18±9) points, t=4.07, P 〈 0.01], but the FMA and MBI scores were markedly higher than those in the control group [(72±28), (80±24) points; (43±28), (40±24) points, t=3.99, 6.50, P 〈 0.01]. CONCLUSION : The comprehensive rehabilitation of motor relearning program plus Bobath technique at early period can remarkably improve the motor function of the affected limbs, nerve function and ADL in patients with post-stroke hemiplegia.展开更多
BACKGROUND: In the natural evolution of cerebrovascular disease, unconscious use of affected extremity during drug treatment and daily life can improve the function of affected upper extremity partially, but it is ver...BACKGROUND: In the natural evolution of cerebrovascular disease, unconscious use of affected extremity during drug treatment and daily life can improve the function of affected upper extremity partially, but it is very slow and also accompanied by the formation of abnormal mode. Therefore, functional training should be emphasized in recovering the motor function of extremity. OBJECTIVE: To observe the effects of combination of motor relearning program and Bobath method on motor function of upper extremity of patients with stroke. DESIGN: Comparison of therapeutic effects taking stroke patients as observation subjects. SETTING: Department of Neurology, General Hospital of Beijing Jingmei Group. PARTICIPANTS: Totally 120 stroke patients, including 60 males and 60 females, averaged (59±3) years, who hospitalized in the Department of Neurology, General Hospital of Beijing Jingmei Group between January 2005 and June 2006 were recruited. The involved patients met the following criteria: Stroke attack within 2 weeks; diagnosis criteria of cerebral hemorrhage or infarction made in the 4th National Cerebrovascular Disease Conference; confirmed by skull CT or MRI; Informed consents of therapeutic regimen were obtained. The patients were assigned into 2 groups according to their wills: rehabilitation group and control group, with 30 males and 30 females in each group. Patients in rehabilitation group averaged (59±2)years old, and those in the control group averaged (58±2)years old. METHODS: ① Patients in two groups received routine treatment in the Department of Neurology. When the vital signs of patients in the rehabilitation group were stable, individualized treatment was conducted by combined application of motor relearning program and Bobath method. Meanwhile, training of activity of daily living was performed according to the disease condition changes of patients at different phases, including the nursing and instruction of body posture, the maintenance of good extremity position, bed exercise, bedside sit up and sitting position balance, sit up exercise, dynamic and static balance exercise, walking exercise, active training and passive training. The strength, time and speed of training were increased gradually according to their physical abilities. Patients were trained 45 to 60 minutes once, 5 times a week, within 2 weeks. ② Evaluation criteria of therapeutic effect: The motor function of upper extremity was evaluated by Fugl-Meyer method on the day of beginning and end of treatment. Higher points indicated better function of upper extremity. ③ t test and paired t test were used for comparing the difference of intergroup and intragroup measurement data, respectively. MAIN OUTCOME MEASURES: Changes in Fugl-Meyer scoring of two groups before and after treatment. RESULTS: Totally 120 stroke patients participated in the final analysis. Before treatment, Fugl-Meyer scoring was close between rehabilitation group and control group [(14.47±2.38),(14.16±2.39) points, P > 0.05]; Fugl-Meyer scoring of rehabilitation group after treatment was significantly higher than that before treatment and that of control group[(37.93±2.67),(18.36±2.43) points, t =11.053, 5.408, P < 0.01]; There were no significant differences in Fugl-Meyer scoring between before treatment in the control group and control group (P > 0.05). CONCLUSION: Combined application of motor relearning program and Bobath method can significantly improve the motor function of upper extremity of patients with stroke.展开更多
The purpose of this paper is to develop an implementable strategy of brake energy recovery for a parallel hydraulic hybrid bus. Based on brake process analysis, a dynamic programming algorithm of brake energy recovery...The purpose of this paper is to develop an implementable strategy of brake energy recovery for a parallel hydraulic hybrid bus. Based on brake process analysis, a dynamic programming algorithm of brake energy recovery is established. And then an implementable strategy of brake energy recovery is proposed by the constraint variable trajectories analysis of the dynamic programming algorithm in the typical urban bus cycle. The simulation results indicate the brake energy recovery efficiency of the accumulator can reach 60% in the dynamic programming algorithm. And the hydraulic hybrid system can output braking torque as much as possible.Moreover, the accumulator has almost equal efficiency of brake energy recovery between the implementable strategy and the dynamic programming algorithm. Therefore, the implementable strategy is very effective in improving the efficiency of brake energy recovery.The road tests show the fuel economy of the hydraulic hybrid bus improves by 22.6% compared with the conventional bus.展开更多
文摘<p align="left"> <span style="font-family:Verdana;">To investigate the relationship between muscle strength and sEMG of biceps brachii during elbow flexion by measuring the maximum muscle strength and sEMG value of normal children and adults, and to analyze their sources, so as to lay a theoretical foundation for the method of motor program reconstruction to restore the function after brain injury, 30 healthy children aged 9 - 10 years and 30 adults aged 20 - 30 years were randomly selected. The muscle strength and sEMG of biceps brachii during elbow flexion were detected and recorded, and the data were statistically analyzed. The muscle strength of children was significantly lower than that of adults (P < 0.001), and the sEMG value of biceps brachii was significantly lower than that of adults (P < 0.001), but the sEMG value per kilogram force of children was significantly higher than that of adults (P < 0.01). The results show that there was a very significant difference in pull (efficiency) between adults and children when there was no significant difference in SEMG signal intensity. This is because although children’s central nervous system has matured, the muscle tissue has not been well trained, resulting in insufficient muscle strength. The muscle strength of adults is significantly higher than that of children, because they have been exercising for a long time after the development of the central nervous system. It is proved that sEMG signal is not produced by muscle contraction itself, but comes from the motor program signal of central nervous system which drives muscle contraction, and it is produced before muscle contraction.</span> </p>
基金supported by the Combined pecific Foundation of Department of Science and Technology of Yunnan Province and Kunming Medical University,No.2008CD037
文摘The motor relearning program can significantly improve various functional disturbance induced by ischemic cerebrovascular diseases. However, its mechanism of action remains poorly understood. In injured brain tissues, glial fibrillary acidic protein and neurofilament protein changes can reflect the condition of injured neurons and astrocytes, while vascular endothelial growth factor and basic fibroblast growth factor changes can indicate angiogenesis. In the present study, we induced ischemic brain injury in the rhesus macaque by electrocoagulation of the M1 segment of the right middle cerebral artery. The motor relearning program was conducted for 60 days from the third day after model establishment. Immunohistochemistry and single-photon emission CT showed that the numbers of glial fibrillary acidic protein-, neurofilament protein-, vascular endothelial growth factor- and basic fibroblast growth factor-positive cells were significantly increased in the infarcted side compared with the contralateral hemisphere following the motor relearning program. Moreover, cerebral blood flow in the infarcted side was significantly improved. The clinical rating scale for stroke was used to assess neurological function changes in the rhesus macaque following the motor relearning program. Results showed that motor function was improved, and problems with consciousness, self-care ability and balance function were significantly ameliorated. These findings indicate that the motor relearning program significantly promoted neuronal regeneration, repair and angiogenesis in the surroundings of the infarcted hemisphere, and improve neurological function in the rhesus macaque following brain ischemia.
文摘BACKGROUND: Previous studies believed that the effect of rehabilitation training within 6 months after stroke (early rehabilitation training) is usually unsatisfactory. The rehabilitation training when acute stroke is stabilized may be better for the recovery of limb function. OBJECTIVE: To observe the effects of the rehabilitation training of motor relearning program plus Bobath technique on the motor function of limbs, nerve function and activities of daily life (ADL) in patients with acute stroke hemiplegia. DESIGN: A randomized controlled observation SETTING: Department of Neurology, Yaan People's Hospital PARTICIPANTS: A total of 150 patients with acute post-stroke hemiplegia were selected from the Department of Neurology, Yaan People's Hospital from March 2000 to October 2002. The patients were all accorded with the diagnostic standards about stroke set by the Fifth National Academic Meeting for Cerebrovascular Disease (1996), confirmed by CT and MRI, and they were all informed with the interventions and the items of evaluation. The enrolled patients were randomly divided into training group (n=78) and control group (n=72) at admission. METHODS : ① Interventions: All the patients were given routine treatments for stroke, including managin blood pressure, maintaining the balance of hydrolyte and electrolure, reducing intracranial pressure by dehydration, and venous injection of citicoline, besides those in the training group received rehabilitation training by motor relearning program and Bobath technique. The rehabilitation training began after the vital signs became stable within 24 hours to 3 days after attack for the patients with cerebral infarction and 48 hours to 5 days after at- tack for those with cerebral hemorrhage respectively, three times a day in the morning, at noon and in the evening respectively, 30 minutes for each time, they were trained for 1 month. Lying position: The patients should keep the anti-spasm posture in the supine position, contralateral and ipsilateral lying positions, and the postures should be changed regularly; The patients should exercise each joint passively; turn the body over and move actively; They should also performed the bringing training, and the weight loading training for the affected upper limb. Sitting position: The patients should finish the conversion from a lying position to a sitting one independently. Standing position: The patients should finish the conversion from a sitting position to a standing one independently; They also took weight loading training for the affected lower limb. The walking training should be performed when the affected lower limb could support 2/3 of body mass. Walking training: In a standing position supported by the affected lower limb, the unaffected one stepped in small range forward and backward; Each process of balancing and controlling standing position was trained by supporting the body mass by the affected lower limb; In swinging position, the independent movement of the ipsilateral knee joint was trained in alternation of flexion and extension. ② Evaluation of limb function, ADL and nerve function: The motor function of the affected limb was evaluated with the Fugl-Meyer assessment (FMA), the total score of the motor function of upper and lower limbs was 100 points, the higher the score, the better the limb function. ADL were assessed with the modified Barthel index (MBI), the total score was 100 points, the higher the score, the better the independence and the smaller the dependence. The severities of neurological deficit were assessed with neurological deficit score (NDS), the total score ranged 0-45 points, the higher the score, the severer the neurological deficit. ③ Statistical analysis: The ttest was applied to compare the differences of the measurement data. MAIN OUTCOME MEASURES: The changes of nerve function, motor function and ADL in patients with post-stroke hemiplegia after motor relearning program training were observed. RESULTS: All the 150 patients with post-stroke hemiplegia were involved in the analysis of results. ① The scores of NDS, FMA and MBI before intervention in the training group were (25±9), (23±23), (20±16) points, which were close to those in the control group [(24±8), (24±21), (24±20) points, P 〉 0.05]. ② The NDS score after intervention in the training group was obviously lower than that in the control group [(10±7), (18±9) points, t=4.07, P 〈 0.01], but the FMA and MBI scores were markedly higher than those in the control group [(72±28), (80±24) points; (43±28), (40±24) points, t=3.99, 6.50, P 〈 0.01]. CONCLUSION : The comprehensive rehabilitation of motor relearning program plus Bobath technique at early period can remarkably improve the motor function of the affected limbs, nerve function and ADL in patients with post-stroke hemiplegia.
文摘BACKGROUND: In the natural evolution of cerebrovascular disease, unconscious use of affected extremity during drug treatment and daily life can improve the function of affected upper extremity partially, but it is very slow and also accompanied by the formation of abnormal mode. Therefore, functional training should be emphasized in recovering the motor function of extremity. OBJECTIVE: To observe the effects of combination of motor relearning program and Bobath method on motor function of upper extremity of patients with stroke. DESIGN: Comparison of therapeutic effects taking stroke patients as observation subjects. SETTING: Department of Neurology, General Hospital of Beijing Jingmei Group. PARTICIPANTS: Totally 120 stroke patients, including 60 males and 60 females, averaged (59±3) years, who hospitalized in the Department of Neurology, General Hospital of Beijing Jingmei Group between January 2005 and June 2006 were recruited. The involved patients met the following criteria: Stroke attack within 2 weeks; diagnosis criteria of cerebral hemorrhage or infarction made in the 4th National Cerebrovascular Disease Conference; confirmed by skull CT or MRI; Informed consents of therapeutic regimen were obtained. The patients were assigned into 2 groups according to their wills: rehabilitation group and control group, with 30 males and 30 females in each group. Patients in rehabilitation group averaged (59±2)years old, and those in the control group averaged (58±2)years old. METHODS: ① Patients in two groups received routine treatment in the Department of Neurology. When the vital signs of patients in the rehabilitation group were stable, individualized treatment was conducted by combined application of motor relearning program and Bobath method. Meanwhile, training of activity of daily living was performed according to the disease condition changes of patients at different phases, including the nursing and instruction of body posture, the maintenance of good extremity position, bed exercise, bedside sit up and sitting position balance, sit up exercise, dynamic and static balance exercise, walking exercise, active training and passive training. The strength, time and speed of training were increased gradually according to their physical abilities. Patients were trained 45 to 60 minutes once, 5 times a week, within 2 weeks. ② Evaluation criteria of therapeutic effect: The motor function of upper extremity was evaluated by Fugl-Meyer method on the day of beginning and end of treatment. Higher points indicated better function of upper extremity. ③ t test and paired t test were used for comparing the difference of intergroup and intragroup measurement data, respectively. MAIN OUTCOME MEASURES: Changes in Fugl-Meyer scoring of two groups before and after treatment. RESULTS: Totally 120 stroke patients participated in the final analysis. Before treatment, Fugl-Meyer scoring was close between rehabilitation group and control group [(14.47±2.38),(14.16±2.39) points, P > 0.05]; Fugl-Meyer scoring of rehabilitation group after treatment was significantly higher than that before treatment and that of control group[(37.93±2.67),(18.36±2.43) points, t =11.053, 5.408, P < 0.01]; There were no significant differences in Fugl-Meyer scoring between before treatment in the control group and control group (P > 0.05). CONCLUSION: Combined application of motor relearning program and Bobath method can significantly improve the motor function of upper extremity of patients with stroke.
基金supported by Shanghai Science and Technology Committee(No.0904H155100)
文摘The purpose of this paper is to develop an implementable strategy of brake energy recovery for a parallel hydraulic hybrid bus. Based on brake process analysis, a dynamic programming algorithm of brake energy recovery is established. And then an implementable strategy of brake energy recovery is proposed by the constraint variable trajectories analysis of the dynamic programming algorithm in the typical urban bus cycle. The simulation results indicate the brake energy recovery efficiency of the accumulator can reach 60% in the dynamic programming algorithm. And the hydraulic hybrid system can output braking torque as much as possible.Moreover, the accumulator has almost equal efficiency of brake energy recovery between the implementable strategy and the dynamic programming algorithm. Therefore, the implementable strategy is very effective in improving the efficiency of brake energy recovery.The road tests show the fuel economy of the hydraulic hybrid bus improves by 22.6% compared with the conventional bus.