BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients ha...BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were presented and analyzed using the Wilcoxon rank sum test.RESULTS At the 8-wk postoperative mark,the observation group demonstrated significantly higher scores in AVF symptom recognition,symptom prevention,and self-management compared to the control group(P<0.05).However,the variance in symptom management scores between the observation and control groups lacked statistical signi-ficance(P>0.05).At 4 wk after the operation,the observation group displayed a superior vessel diameter and depth from the skin of the drainage vessels in comparison to the control group(P<0.05).While the observation group did manifest elevated blood flow rates in the drainage vessels relative to the control group,this distinction was not statistically significant(P>0.05).By the 8-wk postoperative interval,the observation group outperformed the control group with notable enhancements in blood flow rates,vessel diameter,and depth from the skin of drainage vessels(P<0.01).Seven days following the procedure,the observation group manifested significantly diminished limb swelling and an overall reduced complication rate in contrast to the control group(P<0.05).The evaluation of infection,thrombosis,embolism,arterial aneurysm stenosis,and incision bleeding showed no notable differences between the two groups(P>0.05).By the 4-wk postoperative juncture,complications between the observation and control groups were statistically indistinguishable(P>0.05).CONCLUSION Stage-specific limb function exercises,under the guidance of a self-management education model,amplify the capacity of AVF patients to discern and prevent symptoms.Additionally,they expedite AVF maturation and miti-gate postoperative limb edema,underscoring their efficacy as a valuable method for the care and upkeep of AVF in hemodialysis patients.展开更多
With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be e...With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.展开更多
Objective: to explore the treatment of hemiplegia patients with cerebral apoplexy, adopt different treatment programs, summarize and explore the implementation effect and excellence of early rehabilitation treatment p...Objective: to explore the treatment of hemiplegia patients with cerebral apoplexy, adopt different treatment programs, summarize and explore the implementation effect and excellence of early rehabilitation treatment program, and analyze the impact on patients' daily living ability and limb function. Methods: a total of 132 patients, all of whom were stroke patients, were enrolled in the study from January 20 to January 21. There were 66 patients in each group. Two groups of patients to implement different treatment, conventional treatment group for patients to implement conventional treatment, rehabilitation treatment group for patients to implement rehabilitation treatment, explore the implementation effect of conventional treatment group and rehabilitation treatment group. Results: Barthel scores were improved after treatment and before treatment, and were significantly higher than before treatment (P < 0.05). After 30 days of treatment and 90 days of treatment, the scores of Barthel in the rehabilitation group increased, and the difference was lower than 0.05, indicating that the improvement effect of the rehabilitation group was better. Conclusion:the effect of early rehabilitation therapy is more ideal after stroke hemiplegia treatment, which can improve the therapeutic effect and clinical symptoms.展开更多
Objective: to analyze the effect of rapid rehabilitation neurosurgical nursing in patients with craniocerebral injury. Methods: the subjects were 46 patients with craniocerebral trauma treated in our hospital from Jan...Objective: to analyze the effect of rapid rehabilitation neurosurgical nursing in patients with craniocerebral injury. Methods: the subjects were 46 patients with craniocerebral trauma treated in our hospital from January 2019 to October 2020.After average grouping according to the order of admission, the control group was given routine nursing and the experimental group was given rapid rehabilitation neurosurgical nursing. The difference of nursing results was evaluated. Results: the scores of limb function and BI in the experimental group were slightly higher than those in the control group (P < 0.05);The incidence of complications, readmission and death in the experimental group was slightly lower than that in the control group (P < 0.05). Conclusion: in the nursing intervention of patients with craniocerebral trauma, the rapid rehabilitation neurosurgical nursing mode is helpful to improve the limb function of patients, and the prognosis of patients under this nursing mode is more ideal, which should become the first choice of clinical nursing.展开更多
Objective: to observe the effect of early acupuncture and moxibustion on limb function in the rehabilitation treatment of patients with acute ischemic stroke. Methods: the patients with acute ischemic stroke treated i...Objective: to observe the effect of early acupuncture and moxibustion on limb function in the rehabilitation treatment of patients with acute ischemic stroke. Methods: the patients with acute ischemic stroke treated in our hospital from January 2021 to January 2022 were selected as the research subjects, and they were treated with early acupuncture and rehabilitation. Results: after receiving the corresponding intervention, the patients condition improved obviously, and the scores of limb function showed a good trend, and the total effective rate of treatment was high, which further promoted the improvement of their quality of life. Conclusion: for patients with acute ischemic stroke, it is significant to apply early acupuncture in their rehabilitation treatment, which is mainly reflected in accelerating the recovery of limb function, and it is worth popularizing.展开更多
Objective: to explore the influence of continuous rehabilitation nursing mode on the limb function and living ability of stroke hemiplegia patients. Methods: 80 patients with stroke hemiplegia from March 2021-January ...Objective: to explore the influence of continuous rehabilitation nursing mode on the limb function and living ability of stroke hemiplegia patients. Methods: 80 patients with stroke hemiplegia from March 2021-January 2022.The control group was given routine care, and the experimental group implemented a continuous rehabilitation nursing model. Body function, living ability, compliance with rehabilitation training, time of exercise, discharge and satisfaction rate is between the two groups. Results: the experimental group had limb function, and the living ability was higher;the rehabilitation training compliance than the control group was higher than the control group;the time of start exercise and discharge was shorter than the control group;the satisfaction rate was higher than the control group, and there was a significant difference, P < 0.05. Conclusion: continuous rehabilitation care mode for stroke hemiplegia patients can improve compliance, start early exercise and discharge time, improve limb function, living ability, and improve satisfaction rate.展开更多
Objective: to explore the application effect of early exercise on limb function recovery in the treatment of cerebral hemorrhage hemiplegia. Methods: from March 1, 2019 to February 28, 2022, 136 hemiplegic patients wi...Objective: to explore the application effect of early exercise on limb function recovery in the treatment of cerebral hemorrhage hemiplegia. Methods: from March 1, 2019 to February 28, 2022, 136 hemiplegic patients with cerebral hemorrhage admitted and treated in our hospital were selected as participants in this study. They were randomly divided into reference group (68 cases) and study group (68 cases). Patients in the reference group were given routine nursing mode, and patients in the research group were given early exercise on this basis. The clinical efficacy of two groups of patients was observed and compared. Results: before the nursing intervention, there was no significant difference in limb function, neurological function score and self-care ability between the two groups. After the intervention, all scores of the two groups were improved, and the improvement in the research group was more ideal, namely, upper limb function (51.25 ± 6.13), lower limb function (25.21 ± 2.19), self-care ability (74.23 ± 5.25) and self-care ability. Conclusion: on the basis of symptomatic treatment, early exercise for hemiplegic patients with cerebral hemorrhage can promote the recovery of limb function as soon as possible and significantly improve their self-care ability.展开更多
Objective: to use early rehabilitation treatment for the patients with acute stroke hemiplegia, to observe and analyze its impact on the upper and lower limb function recovery and daily life ability. Methods: in June ...Objective: to use early rehabilitation treatment for the patients with acute stroke hemiplegia, to observe and analyze its impact on the upper and lower limb function recovery and daily life ability. Methods: in June 2021-June 2022 for intercept research time interval, a total of 60 cases of acute stroke hemiplegia, random principle specification grouping, control group received 30 cases of routine treatment, observation group received 30 cases of early rehabilitation treatment, around the upper and lower limb function assessment score, daily life ability evaluation score, balance function, cognitive function scale evaluation score and complication rate data line to compare. Results: before the treatment work, the evaluation results, daily life ability, balance function, and cognitive function evaluation results showed no difference (P> 0.05), and the results were higher (P <0.05);for the complication rate, the observation group showed lower results (P <0.05). Conclusion: for acute stroke cases, early rehabilitation treatment, which can improve the function of upper and lower limbs, strengthen their living ability, balance function and cognitive function, and prevent complications in patients, which is worthy of clinical application.展开更多
Objective: to investigate the clinical efficacy of limb function rehabilitation in patients with cerebrovascular disease. Methods: the admission time was set from March 2020 to June 2021, and the research subjects wer...Objective: to investigate the clinical efficacy of limb function rehabilitation in patients with cerebrovascular disease. Methods: the admission time was set from March 2020 to June 2021, and the research subjects were selected as 70 patients with cerebrovascular disease admitted to our hospital, who were randomly divided into groups, 35 cases in each group, and the control group received conventional treatment and the experimental group received early rehabilitation training on the basis of routine treatment, and observed the daily living ability (ADL) score, neurological deficit (NIHSS) score, limb function score, anxiety (SAS) score, depression before treatment and 3 months after treatment (SDS) score changes, complication rates, satisfaction, and total effective rate of clinical treatment. Results: before treatment, there was no significant difference in ADL score, NIHSS score, limb function score, SAS score and SDS score between the two groups (P>0.05). The functional scores were significantly improved, and the NIHSS, SAS, and SDS scores were significantly decreased. At the same time, the incidence of complications in the experimental group was significantly lower, and the satisfaction was significantly higher. There was a significant difference between the two groups (P0.05). Conclusion: limb function rehabilitation training in patients with cerebrovascular disease has a good effect. It can not only reduce the NIHSS score, SAS score, SDS score and the incidence of complications, but also improve the ADL score, limb function score and satisfaction.展开更多
Objective: patients with cerebral hemorrhage need early nursing for their limb function recovery after operation, and the related influencing methods need to be explored. Methods: the patients with cerebral hemorrhage...Objective: patients with cerebral hemorrhage need early nursing for their limb function recovery after operation, and the related influencing methods need to be explored. Methods: the patients with cerebral hemorrhage in recent years were mainly studied and randomly divided into two groups. One group was given routine operation, and the second group was given rehabilitation treatment. At the same time, some relevant conditions of patients after rehabilitation treatment were compared, including limb function, satisfaction degree of care, possible complications, and the situation was compared. Results: the quality score of the rehabilitation group was higher than that of the control group. Relevant conclusions were drawn. Early rehabilitation therapy for patients has obvious effect on the improvement of the body, which can improve the quality of life and satisfaction of patients, reduce neurological damage, improve the quality of life and satisfaction, and reduce complications.展开更多
Neglecting the use of the affected limb in stroke patients can result in learned non-use.Modified constraint-induced movement therapy(mCIMT)is a form of rehabilitation therapy that limits the less paretic side,and thr...Neglecting the use of the affected limb in stroke patients can result in learned non-use.Modified constraint-induced movement therapy(mCIMT)is a form of rehabilitation therapy that limits the less paretic side,and through repeated and concentrated training improve the upper limb function of the paretic side.The aim of this paper is to develop a critical systematic review on the research evidence evaluating the effectiveness of applying mCIMT in the recovery of upper limb function in stroke patients.The outcome of this evaluation support that mCIMT significantly improves the upper limb function of stroke patients.Moreover,group mCIMT modality and TR(trunk restraint)+mCIMT modality provide greater benefits than mCIMT alone.展开更多
Background:Lower limb burns can significantly delay recovery of function.Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid too...Background:Lower limb burns can significantly delay recovery of function.Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid tools.The aims of this study were to examine the test-retest reliability,sensitivity,and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10(LLFI-10)questionnaire for measuring functional ability in patients with lower limb burns over time.Methods:Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the study.In addition,the minimal detectable change(MDC)was calculated for Section 1 and 3 of the LLFI-10.Section 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury duties.Results:Section 1 of the LLFI-10 demonstrated excellent test-retest reliability(intra-class correlation coefficient(ICC)0.98,95%CI 0.96–0.99)whilst Section 3 demonstrated high test-retest reliability(ICC 0.88,95%CI 0.79–0.94).MDC scores for Sections 1 and 3 were 1.27 points and 30.22%,respectively.Internal consistency was demonstrated with a significant negative association(rs=?0.83)between Sections 1 and 3 of the LLFI-10(p<0.001).Conclusions:This study demonstrates that Section 1 and 3 of the LLFI-10 are reliable for measuring functional ability in patients who have sustained lower limb burns in the previous 12 months,and furthermore,Section 1 is sensitive to changes in patient function over time.展开更多
Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. ...Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. Methods: Form January, 2019 to December, 2019, 80 cerebrovascular disease patients were recruited, and had been divided into control group (n = 40) and observation group (n = 40), randomly. The control groups received conventional rehabilitation treatment, for 40 minutes per day, while observation group received conventional rehabilitation treatment, for 20 minutes per day, and virtual reality technology treatment, 20 minutes per day, 5 days a week for 4 weeks. Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and ADL before and after treatment. Results: Before treatment, the scores of WMFT, FMA-UE and MBI were no significant difference between two groups (P > 0.05). The scores improved in both groups after treatment (P < 0.01), and were higher in the observation group than in the control group (P < 0.05). Conclusion: The somatosensory interaction technology combined with virtual reality technology could facilitate to improve the upper limbs function and ADL in cerebrovascular disease patients.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the ex...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. How...Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.展开更多
Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarctio...Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.展开更多
BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe...BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.展开更多
Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with isc...Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.展开更多
BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimu...BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.展开更多
基金Supported by The Research Project 2022 of The People's Hospital of Jianyang City,No.JY202208.
文摘BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were presented and analyzed using the Wilcoxon rank sum test.RESULTS At the 8-wk postoperative mark,the observation group demonstrated significantly higher scores in AVF symptom recognition,symptom prevention,and self-management compared to the control group(P<0.05).However,the variance in symptom management scores between the observation and control groups lacked statistical signi-ficance(P>0.05).At 4 wk after the operation,the observation group displayed a superior vessel diameter and depth from the skin of the drainage vessels in comparison to the control group(P<0.05).While the observation group did manifest elevated blood flow rates in the drainage vessels relative to the control group,this distinction was not statistically significant(P>0.05).By the 8-wk postoperative interval,the observation group outperformed the control group with notable enhancements in blood flow rates,vessel diameter,and depth from the skin of drainage vessels(P<0.01).Seven days following the procedure,the observation group manifested significantly diminished limb swelling and an overall reduced complication rate in contrast to the control group(P<0.05).The evaluation of infection,thrombosis,embolism,arterial aneurysm stenosis,and incision bleeding showed no notable differences between the two groups(P>0.05).By the 4-wk postoperative juncture,complications between the observation and control groups were statistically indistinguishable(P>0.05).CONCLUSION Stage-specific limb function exercises,under the guidance of a self-management education model,amplify the capacity of AVF patients to discern and prevent symptoms.Additionally,they expedite AVF maturation and miti-gate postoperative limb edema,underscoring their efficacy as a valuable method for the care and upkeep of AVF in hemodialysis patients.
文摘With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.
文摘Objective: to explore the treatment of hemiplegia patients with cerebral apoplexy, adopt different treatment programs, summarize and explore the implementation effect and excellence of early rehabilitation treatment program, and analyze the impact on patients' daily living ability and limb function. Methods: a total of 132 patients, all of whom were stroke patients, were enrolled in the study from January 20 to January 21. There were 66 patients in each group. Two groups of patients to implement different treatment, conventional treatment group for patients to implement conventional treatment, rehabilitation treatment group for patients to implement rehabilitation treatment, explore the implementation effect of conventional treatment group and rehabilitation treatment group. Results: Barthel scores were improved after treatment and before treatment, and were significantly higher than before treatment (P < 0.05). After 30 days of treatment and 90 days of treatment, the scores of Barthel in the rehabilitation group increased, and the difference was lower than 0.05, indicating that the improvement effect of the rehabilitation group was better. Conclusion:the effect of early rehabilitation therapy is more ideal after stroke hemiplegia treatment, which can improve the therapeutic effect and clinical symptoms.
文摘Objective: to analyze the effect of rapid rehabilitation neurosurgical nursing in patients with craniocerebral injury. Methods: the subjects were 46 patients with craniocerebral trauma treated in our hospital from January 2019 to October 2020.After average grouping according to the order of admission, the control group was given routine nursing and the experimental group was given rapid rehabilitation neurosurgical nursing. The difference of nursing results was evaluated. Results: the scores of limb function and BI in the experimental group were slightly higher than those in the control group (P < 0.05);The incidence of complications, readmission and death in the experimental group was slightly lower than that in the control group (P < 0.05). Conclusion: in the nursing intervention of patients with craniocerebral trauma, the rapid rehabilitation neurosurgical nursing mode is helpful to improve the limb function of patients, and the prognosis of patients under this nursing mode is more ideal, which should become the first choice of clinical nursing.
文摘Objective: to observe the effect of early acupuncture and moxibustion on limb function in the rehabilitation treatment of patients with acute ischemic stroke. Methods: the patients with acute ischemic stroke treated in our hospital from January 2021 to January 2022 were selected as the research subjects, and they were treated with early acupuncture and rehabilitation. Results: after receiving the corresponding intervention, the patients condition improved obviously, and the scores of limb function showed a good trend, and the total effective rate of treatment was high, which further promoted the improvement of their quality of life. Conclusion: for patients with acute ischemic stroke, it is significant to apply early acupuncture in their rehabilitation treatment, which is mainly reflected in accelerating the recovery of limb function, and it is worth popularizing.
文摘Objective: to explore the influence of continuous rehabilitation nursing mode on the limb function and living ability of stroke hemiplegia patients. Methods: 80 patients with stroke hemiplegia from March 2021-January 2022.The control group was given routine care, and the experimental group implemented a continuous rehabilitation nursing model. Body function, living ability, compliance with rehabilitation training, time of exercise, discharge and satisfaction rate is between the two groups. Results: the experimental group had limb function, and the living ability was higher;the rehabilitation training compliance than the control group was higher than the control group;the time of start exercise and discharge was shorter than the control group;the satisfaction rate was higher than the control group, and there was a significant difference, P < 0.05. Conclusion: continuous rehabilitation care mode for stroke hemiplegia patients can improve compliance, start early exercise and discharge time, improve limb function, living ability, and improve satisfaction rate.
文摘Objective: to explore the application effect of early exercise on limb function recovery in the treatment of cerebral hemorrhage hemiplegia. Methods: from March 1, 2019 to February 28, 2022, 136 hemiplegic patients with cerebral hemorrhage admitted and treated in our hospital were selected as participants in this study. They were randomly divided into reference group (68 cases) and study group (68 cases). Patients in the reference group were given routine nursing mode, and patients in the research group were given early exercise on this basis. The clinical efficacy of two groups of patients was observed and compared. Results: before the nursing intervention, there was no significant difference in limb function, neurological function score and self-care ability between the two groups. After the intervention, all scores of the two groups were improved, and the improvement in the research group was more ideal, namely, upper limb function (51.25 ± 6.13), lower limb function (25.21 ± 2.19), self-care ability (74.23 ± 5.25) and self-care ability. Conclusion: on the basis of symptomatic treatment, early exercise for hemiplegic patients with cerebral hemorrhage can promote the recovery of limb function as soon as possible and significantly improve their self-care ability.
文摘Objective: to use early rehabilitation treatment for the patients with acute stroke hemiplegia, to observe and analyze its impact on the upper and lower limb function recovery and daily life ability. Methods: in June 2021-June 2022 for intercept research time interval, a total of 60 cases of acute stroke hemiplegia, random principle specification grouping, control group received 30 cases of routine treatment, observation group received 30 cases of early rehabilitation treatment, around the upper and lower limb function assessment score, daily life ability evaluation score, balance function, cognitive function scale evaluation score and complication rate data line to compare. Results: before the treatment work, the evaluation results, daily life ability, balance function, and cognitive function evaluation results showed no difference (P> 0.05), and the results were higher (P <0.05);for the complication rate, the observation group showed lower results (P <0.05). Conclusion: for acute stroke cases, early rehabilitation treatment, which can improve the function of upper and lower limbs, strengthen their living ability, balance function and cognitive function, and prevent complications in patients, which is worthy of clinical application.
文摘Objective: to investigate the clinical efficacy of limb function rehabilitation in patients with cerebrovascular disease. Methods: the admission time was set from March 2020 to June 2021, and the research subjects were selected as 70 patients with cerebrovascular disease admitted to our hospital, who were randomly divided into groups, 35 cases in each group, and the control group received conventional treatment and the experimental group received early rehabilitation training on the basis of routine treatment, and observed the daily living ability (ADL) score, neurological deficit (NIHSS) score, limb function score, anxiety (SAS) score, depression before treatment and 3 months after treatment (SDS) score changes, complication rates, satisfaction, and total effective rate of clinical treatment. Results: before treatment, there was no significant difference in ADL score, NIHSS score, limb function score, SAS score and SDS score between the two groups (P>0.05). The functional scores were significantly improved, and the NIHSS, SAS, and SDS scores were significantly decreased. At the same time, the incidence of complications in the experimental group was significantly lower, and the satisfaction was significantly higher. There was a significant difference between the two groups (P0.05). Conclusion: limb function rehabilitation training in patients with cerebrovascular disease has a good effect. It can not only reduce the NIHSS score, SAS score, SDS score and the incidence of complications, but also improve the ADL score, limb function score and satisfaction.
文摘Objective: patients with cerebral hemorrhage need early nursing for their limb function recovery after operation, and the related influencing methods need to be explored. Methods: the patients with cerebral hemorrhage in recent years were mainly studied and randomly divided into two groups. One group was given routine operation, and the second group was given rehabilitation treatment. At the same time, some relevant conditions of patients after rehabilitation treatment were compared, including limb function, satisfaction degree of care, possible complications, and the situation was compared. Results: the quality score of the rehabilitation group was higher than that of the control group. Relevant conclusions were drawn. Early rehabilitation therapy for patients has obvious effect on the improvement of the body, which can improve the quality of life and satisfaction of patients, reduce neurological damage, improve the quality of life and satisfaction, and reduce complications.
文摘Neglecting the use of the affected limb in stroke patients can result in learned non-use.Modified constraint-induced movement therapy(mCIMT)is a form of rehabilitation therapy that limits the less paretic side,and through repeated and concentrated training improve the upper limb function of the paretic side.The aim of this paper is to develop a critical systematic review on the research evidence evaluating the effectiveness of applying mCIMT in the recovery of upper limb function in stroke patients.The outcome of this evaluation support that mCIMT significantly improves the upper limb function of stroke patients.Moreover,group mCIMT modality and TR(trunk restraint)+mCIMT modality provide greater benefits than mCIMT alone.
基金We wish to thank Larissa Boon for her assistance in patient recruitment.We also appreciate Phil Gabel's work in developing the LLFI-10 and approving its use within this study
文摘Background:Lower limb burns can significantly delay recovery of function.Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid tools.The aims of this study were to examine the test-retest reliability,sensitivity,and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10(LLFI-10)questionnaire for measuring functional ability in patients with lower limb burns over time.Methods:Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the study.In addition,the minimal detectable change(MDC)was calculated for Section 1 and 3 of the LLFI-10.Section 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury duties.Results:Section 1 of the LLFI-10 demonstrated excellent test-retest reliability(intra-class correlation coefficient(ICC)0.98,95%CI 0.96–0.99)whilst Section 3 demonstrated high test-retest reliability(ICC 0.88,95%CI 0.79–0.94).MDC scores for Sections 1 and 3 were 1.27 points and 30.22%,respectively.Internal consistency was demonstrated with a significant negative association(rs=?0.83)between Sections 1 and 3 of the LLFI-10(p<0.001).Conclusions:This study demonstrates that Section 1 and 3 of the LLFI-10 are reliable for measuring functional ability in patients who have sustained lower limb burns in the previous 12 months,and furthermore,Section 1 is sensitive to changes in patient function over time.
文摘Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. Methods: Form January, 2019 to December, 2019, 80 cerebrovascular disease patients were recruited, and had been divided into control group (n = 40) and observation group (n = 40), randomly. The control groups received conventional rehabilitation treatment, for 40 minutes per day, while observation group received conventional rehabilitation treatment, for 20 minutes per day, and virtual reality technology treatment, 20 minutes per day, 5 days a week for 4 weeks. Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and ADL before and after treatment. Results: Before treatment, the scores of WMFT, FMA-UE and MBI were no significant difference between two groups (P > 0.05). The scores improved in both groups after treatment (P < 0.01), and were higher in the observation group than in the control group (P < 0.05). Conclusion: The somatosensory interaction technology combined with virtual reality technology could facilitate to improve the upper limbs function and ADL in cerebrovascular disease patients.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
文摘Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.
基金supported by the Guangdong Province Medical Science Research Fund, No. B200258
文摘Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.
基金a grant from the Tackle Key Problem and Planning Projectin Science and Technology of Hebei Province,No.052761224
文摘BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.
基金Shandong Province Traditional Chinese Medicine Technology Development Program。
文摘Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.
基金a grant from Military Tenth Five-Year Key Research Project Foundation, No. mymjzyy 010
文摘BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.
