ABSTRACT
Objective:To evaluate the efficacy and long-term effect of functional electrical stimulation (FES) on cerebral palsy. Methods:Literature retrieval was carried out in the electronic databases of PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine Disc (CBM), CNKI, Wanfang Database and VIP. The time limit was from the establishment of these databases to March 26th, 2020. According to the inclusion and exclusion criteria, randomized controlled trials about FES for children with cerebral palsy were included. At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies. The data was analyzed with Review Manager 5.3 software. Results:A total of eleven studies with 513 children were included. The Gross Motor Function Measure-88 (GMFM-88) D/E scores (MD = 8.14, 95%CI 6.26 to 10.02, P < 0.001), GMFM-88 B score (MD = 8.77, 95%CI 4.00 to 13.53, P < 0.001), modified Ashworth Scale (MAS) score (MD = -1.05, 95%CI -1.25 to -0.84, P < 0.001), Kyphosis angle (MD = -10.67, 95%CI -12.21 to -9.13, P < 0.001), Cobb's angle (MD = -2.66, 95%CI -3.38 to -1.93, P < 0.001), step length (MD = 3.35, 95%CI 1.81 to 4.90, P < 0.001), walking speed (MD = 0.09, 95%CI 0.05 to 0.14, P < 0.001) and GMFM score at six weeks follow-up (MD = 4.84, 95%CI 1.90 to 7.77, P = 0.001) were better in FES group than in the control group. There was no significant difference in MAS score between two groups after six weeks of follow-up (MD = 0.04, 95%CI -0.30 to 0.37, P = 0.84). Conclusion:FES could improve the lower-limb and trunk function of children with cerebral palsy, however, the long-term effect of relieving muscle spasm was not significant.
ABSTRACT
Cerebral palsy is a common clinical syndrome of neurological disability in childhood, which seriously affects the quality of life of children and their families, and brings a heavy economic burden to the society. Domestic and foreign scholars had a long history of the application of selective posterior rhizotomy for the treatment of spastic cerebral palsy or mixed cerebral palsy with limb paralysis. It is effective in improving the lower extremity spasm of patients with cerebral palsy, and there are few cases with recurrences. After rehabilitation therapy, the muscle strength of patients with cerebral palsy was significantly improved compared with the previous one. The range of motion was significantly improved after operation, and there is no rebounded in aspect of joint activety in the long-term follow-up. The overall gait of the patient was significant improved. The author thought that selective posterior rhizotomy is effective in improving the motor function of lower limbs in patients with cerebral palsy, and it is worth being spread. However, it has to follow the principle of selecting appropriate cases before surgery, precise operation during operation, and timely and effective rehabilitation treatment after surgery, in order to achieve a better curative effect.
Subject(s)
Humans , Cerebral Palsy , Lower Extremity , Muscle Spasticity , Quality of Life , Rhizotomy , Treatment OutcomeABSTRACT
The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries.Nine patients subjected to parotid gland and duct injuries with 1-to 3-month treatment delay were retrospectively evaluated with special reference of etiology,past medical history,and injury location.Conservative treatment,microsurgical anastomosis,and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury,time of repair and procedures.Assistant treatment as pressure dressing was adopted thereafter.All patients experienced an uneventful recovery at the time of finalizing the study.Two patients received Stensen's duct ligation,5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas,and no re-occurrence was found.Facial paralysis occurred after surgery in 4 patients,and 3 of them recovered after the nerve nutrition treatment.Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.
ABSTRACT
The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries.Nine patients subjected to parotid gland and duct injuries with 1-to 3-month treatment delay were retrospectively evaluated with special reference of etiology,past medical history,and injury location.Conservative treatment,microsurgical anastomosis,and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury,time of repair and procedures.Assistant treatment as pressure dressing was adopted thereafter.All patients experienced an uneventful recovery at the time of finalizing the study.Two patients received Stensen's duct ligation,5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas,and no re-occurrence was found.Facial paralysis occurred after surgery in 4 patients,and 3 of them recovered after the nerve nutrition treatment.Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.