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@#Objective To diagnose crossed cerebellar diaschisis (CCD) after supratentorial cerebral infarction with intravoxel incoherent motion (IVIM) magnetic resonance imaging. Methods From May, 2016 to May, 2017, 120 patients with unilateral supratentorial cerebral infarction were divided as CCD positive and CCD negative, and investigated with IVIM. Results The cerebral infarction volume (CIV) was more in CCD positive patients than in CCD negative patients in acute and chronic phase (t>13.943, P<0.05). The apparent diffusion coefficients (ADC) was significantly different between affected and unaffected lateral cerebellar in CCD positive patients (t=11.413, P<0.05), and it was significantly different between CCD positive and negative patients in unaffected lateral cerebellar (t=10.026, P<0.05). Conclusion CIV and ADC can be the indexes of IVIM to evaluate the cerebral perfusion in patients with cerebral infarction.
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Objective:To observe effects of lower-limb rehabilitation robots on the lower limb spasticity,motor function and ADL of hemiplegic patients after stroke.Method:40 cases of hemiplegic patients were randomly allocated to experiment and control groups (n=20 in each).The experiment group received training assisted by a leg rehabilitation robot LR2 for 30 min once daily for 6 weeks in addition to conventional treatments.The control group was given conventional treatments once daily for 6 weeks.Their lower limbs spasticity,motor function and ADL were assessed with the modified Ashworth rating scale(MAS),Simplified Fugl-Meyer Movement Scale (FMA) and Modified Barthel Index assessment method (MBI) before and after training.Result:After treatment,the lower limb spasticity was significantly lowered (P＜0.05),lower limb motor function and ADL were significantly improved (P＜0.05),and the experimental group was significantly better than the control group (P＜0.05).Conclusion:Leg rehabilitation robot LR2 can lower the spasticity of lower limb muscle and improve lower limb motor function and the ability of daily living in stroke patients,and the short term effect is better than conventional rehabilitation.
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Rehabilitation medicine education for bachelor degree is essential for development of rehabilitation professionals. This arti-cle discussed the contents, teaching, models of the education for the rehabilitation medicine bachelor degree, and some advice for the im-provement.
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Objective To explore the effect of motor imagery on motor recovery in hemiplegic patients after stroke. Methods From May, 2015 to October, 2016, 40 hemiplegic patients after stroke were randomly divided into control group (accepted routine rehabilitation, n=20) and motor imagery group (accepted motor imagery and routine rehabilitation, n=20). They were assessed with Fugl-Meyer Assess-ment (FMA), modified Barthel Index (MBI) before and six weeks after treatment. Fractional anisotropy (FA) of the focus was measured with diffusion tensor imaging (DTI). Results The scores of FMA and MBI improved in both groups after treatment (t>5.088, P2.124, P3.892, P0.05). FA increased in more patients of the motor imagery group (5/5) than in the control group (2/4). Conclusion Motor imag-ery can promote the recovery of motor function and activities of daily living in stroke patients, and may help the recovery of fibers in white matter.
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Objective To study the reliability of an implicit memory test-Fragmented Character Identification Assessment. Methods Some Chinese pictographic characters and non-pictographic characters were fragmented to form two sets of identification task. From Sep-tember, 2013 to March, 2016, a total of 78 health young and middle aged people were assessed with the task, and 20 of them were assessed again with another parallel version 14 days later. The internal consistency, test-retest reliability and duplicate split-half reliability were ana-lyzed. Results There was no significant difference in priming of implicit memory between pictograph and non-pictograph (t=1.006, P>0.05). Cronbach's α was 0.763 and 0.729 for the pictograph and non-pictograph fragmented character identification assessment, respectively;while the inter-class coefficients (ICC) of test-retest were 0.785 and 0.771, ICC of split-half reliability were 0.792 and 0.789. Conclusion The reliability is satisfactory in Chinese Fragmented Character Identification Assessment.
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Objective To explore the effect of leg rehabilitation robot training on motor and activities of daily living in hemiplegic pa-tients after stroke. Methods From June, 2015 to July, 2016, 40 hemiplegic patients were randomly divided into control group (n=20) and ex-perimental group (n=20). Both groups received routine rehabilitation, and the experimental group received leg rehabilitation robot training in addition for six weeks. The Fugl-Meyer Assessment-Lower Limb (FMA-L), the Fugl-Meyer Assessment-Balance (FMA-B), Holden walk-ing function classification and modified Barthel Index (MBI) were used to access the motor function, balance function, walking ability and activities of daily living (ADL), respectively. Results After treatment, the scores of FMA-L, FMA-B, Holden walking function classification and MBI improved (χ2>8.980, t>3.902, P2.075, P<0.05). Conclusion Leg rehabilitation robot could facilitate to improve lower extremity motor function, balance function, walking ability and ADL in hemiplegic patients after stroke.
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Objective To investigate the self-regulation of the autonomic nervous system following the cognitive stress tests after heart rate variability (HRV) biofeedback therapy in patients with post-stroke depression (PSD). Methods From May, 2013 to December, 2015, 48 patients with PSD were randomly divided into feedback group (n=25) and control group (n=23). The feedback group received HRV biofeed-back therapy, while the control group only received relaxation therapy without feedback signal. HRV parameters were tracked during the cognitive stress test in quiet baseline state, cognitive stress state, and resting state before and after treatment. Results Under the stress condi-tion, the low frequency of both groups increased during the first cognitive test, and the rate was higher in the control group than in the feed-back group (P=0.02). The heart rates during the second cognitive test decreased in the feedback group, while increased in the control group (P=0.05). After rest, the heart rate of the feedback group decreased below the baseline (P=0.02). Conclusion During the cognitive stress test, HRV biofeedback therapy can achieve a dynamic balance between sympathetic and parasympathetic nerves by reducing sympathetic sensibility, which improved patients' adaptive capacity to cope with their internal physiological environment and external environmental pressures.
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@#Objective To investigate the change of serum vascular endothelial growth factor (VEGF) in cerebral infarction before and af-ter rehabilitation. Methods Forty-eight patients with first cerebral infarction were enrolled from June, 2014 to August, 2016 in Beijing Bo'ai Hospital. Level of serum VEGF was measured by enzyme-linked immunosorbent assay (ELISA) before and six weeks after rehabilitation. The level of serum VEGF of 33 normal subjects was compared with the patients'. Results The level of serum VEGF was higher in the pa-tients group than in the control group before and six weeks after rehabilitation (t>2.540, P<0.05). The level of VEGF was higher in the large area infarction group (>4 cm) than in the small area infarction group (≤4 cm) (t=4.436, P<0.05), and was higher in the short course (less than one month) infarction group than in the long course (more than one month) group (t=2.316, P<0.05). Conclusion VEGF can be main-tained in high level after rehabilitation.
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@#Objective To develop a comprehensive rehabilitation information system based on browser/server (B/S) structure, to implement entry, retrieval, statistics, analysis, browsing and exhibition of electronic data in rehabilitation medicine. Methods Based on the systematic analysis of the rehabilitation work flow and the data need to be disposed, a distributed database system was established, and some modules of applications were developed, such as treatment planning, efficacy evaluation, outcome prediction and performance appraisal. Results The simplified version of Hydrotherapy Comprehensive Rehabilitation Information System was initially developed based on Ruby on Ralis framework and PostgreSQL database, and tested in the local area network of China Rehabilitation Research Center. Conclusion The comprehensive rehabilitation information system based on B/S structure is feasible, and shows the potentialities to improve the team work in rehabilitation based on internet.
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Objective To develop a comprehensive rehabilitation information system based on browser/server (B/S) structure, to imple-ment entry, retrieval, statistics, analysis, browsing and exhibition of electronic data in rehabilitation medicine. Methods Based on the system-atic analysis of the rehabilitation work flow and the data need to be disposed, a distributed database system was established, and some mod-ules of applications were developed, such as treatment planning, efficacy evaluation, outcome prediction and performance appraisal. Results The simplified version of Hydrotherapy Comprehensive Rehabilitation Information System was initially developed based on Ruby on Ralis framework and PostgreSQL database, and tested in the local area network of China Rehabilitation Research Center. Conclusion The compre-hensive rehabilitation information system based on B/S structure is feasible, and shows the potentialities to improve the team work in reha-bilitation based on internet.
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@# Objective To explore the 3D gait analysis of stroke hemiplegic patients. Methods 28 stroke hemiplegic patients were examined with the 3D gait analysis system before and after 6-week rehabilitation. Results After rehabilitation, support phase time of the affected lower limb increased and swing phase time decreased (P<0.05). Step length, stride length and walking speed increased (P<0.05). There was significantly difference in range of motion (ROM) of hip deduction/abduction, flexion/extension, and knee flexion/extension, and ankle internal/external rotation, varus/eversion, dorsiflexion/plantar flexion before and after rehabilitation (P<0.05). Conclusion 3D gait analysis system can evaluate the patient's gait objectively and quantitatively, and provide the basis for rehabilitation assessment.
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Objective To explore the 3D gait analysis of stroke hemiplegic patients. Methods 28 stroke hemiplegic patients were exam-ined with the 3D gait analysis system before and after 6-week rehabilitation. Results After rehabilitation, support phase time of the affected lower limb increased and swing phase time decreased (P<0.05). Step length, stride length and walking speed increased (P<0.05). There was significantly difference in range of motion (ROM) of hip deduction/abduction, flexion/extension, and knee flexion/extension, and ankle inter-nal/external rotation, varus/eversion, dorsiflexion/plantar flexion before and after rehabilitation (P<0.05). Conclusion 3D gait analysis sys-tem can evaluate the patient's gait objectively and quantitatively, and provide the basis for rehabilitation assessment.
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@#Objective To investigate the long-term outcome of old stroke patients after rehabilitation. Methods 25 old hospitalized patients with first attack of stroke in recovery were followed up with Mini-mental Status Examination (MMSE), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Brunnstrom stages of hemiplegia, modified Ashworth scale (MAS), range of motion (ROM) in hemiplegic ankle, manual muscle test (MMT) of quadriceps femoris, Berg balance scale (BBS), modified Barthel index (BI) and the Zarit burden interview (ZBI) for caregiver before rehabilitation, discharge, 6 and 12 months after discharge. Results The Brunnstrom stages of lower limbs, MAS of upper limbs improved (P<0.05) after 3-month rehabilitation in hospital, as well as the scores of BBS, BI and ZBI. As 6 and 12 months in home, the limb function remained stable, while the scores of BBS, MMSE, BI, SAS, and ZBI improved, but SDS fluctuated (P<0.05). Conclusion It is important to offer the long-term rehabilitation or consultation service when advocating old stroke patients early return to family or community, including psychological support and intervention.
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@#Objective To investigate the implicit memory in brain injured patients. Methods 24 brain injury patients and 24 normal controls were estimated by Montreal Cognitive Assessment (MoCA) Beijing version, a fragmented picture naming task and a fragmented Chinese character identification task. Results The scores of 2 tasks were both lower in the patient group than in the control group (P<0.01). The implicit memory negatively correlated with the score of perceptual closure in both groups (P<0.05). Conclusion Implicit memory is possible to be concerned with occipital, frontal and temporal lobe.
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@#Electromyography-triggered stimulation is being used as a method of combined therapy to improve upper extremity function for hemiplegia patients. It can induce voluntary motion and reduce muscular tone of affected extremity, enlarge range of motion, relieve shoulder pain, and reduce shoulder joint subluxation.
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@#ObjectiveTo investigate the effect of electromyography-triggered neuromuscular stimulation on rehabilitation of hemiplegia patient.Methods20 stroke patients following hemiplegia were treated with electromyography-triggered neuromuscular stimulation on base of routine physical therapy, occupational therapy. Myoelectricity value, active range of motion (AROM) of wrist dorsiflexion, and Fugl-Meyer Assessment(FMA) of upper extremity were assessed before and after the treatment.ResultsThe value of myoelectricity, AROM of wrist dorsiflexion, and FMA of upper extremity have significant statistical improvement (P<0.05) after the treatment.ConclusionElectromyography-triggered neuromuscular stimulation has positive effect on recovery of hemiplegic upper extremity.
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@# Objective To discuss therapeutic effect of mechanical horseback riding on the activities of daily living in the elderly stroke patient.Methods 47 stroke patients were randomly divided into two groups: Treatment group was treated with mechanical horseback riding exercise and routine traditional treatment, while control group was treated the traditional treatment only. 8 weeks after treatment, the degree of activity of daily living and motor function were assessed with the modified Barthel Index and the Fugl-Meyer Motor Scale respectively before and after the treatment.Results Comparing with control group, the score of FMA and modified Barthel index in horseback riding group were higher significantly(P<0.05).Conclusion Mechanical horseback riding could enhance the activity of daily living of elder stroke patients.
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@# This paper reviewed the development of the horseback riding exercise machine in Japan based on the theory of therapeutic riding, imitating the saddle movement by using data collected three dimensional from living horse, involving virtual reality technique, 6-axes parallel mechanism and motion capturing technique. It is effective to improve muscular strength and insulin resistance in elderly people. Mechanical horseback riding is hopeful to be used in clinical approach to improve the quality of life in elderly people in the future.
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@#Objective To observe the effect of mechanical horseback riding on balance ability in stroke patient. Methods 40 stroke patients were divided into 2 groups. Treatment group was treated with mechanical horseback riding exercise and routine rehabilitation therapy, while control group was treated with the routine therapy only. They were assessed with the flat pressure test system and the Berg balance scale before and 10 weeks after the treatment. Results Comparing with control group, the whole path length and the unit path length when opening eyes decreased in treatment group （P<0.05）. Conclusion Mechanical horseback riding could improve the balance ability in stroke patients.
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@#Recent years a large number of researches and studies of modern rehabilitation medicine have made great progress in various fields,such as basic theory,evaluation,treatment,institution,and network.The objective of this paper is to outline these advances,which could be benefit for medical affairs in rehabilitation of cerebrovascular diseases.