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Objective:To observe the effect of gaze stabilization exercises on the balance of stroke patients.Methods:Forty stroke patients were randomly divided into an experimental group ( n=20) and a control group ( n=20). Both groups were given conventional rehabilitation therapy, while the experimental group was additionally provided with gaze stabilization exercises, once a day, five days a week, for a total of four weeks. Each session lasted 30 minutes. Before and after the four weeks, both groups were evaluated in terms of their envelope ellipse area and the plantar pressure distribution on the affected side in static standing and using the anterior-posterior center of pressure displacement velocity (AP-COPV). They were also assessed using the Berg Balance Scale (BBS), the timed up-and-go test (TUGT), and the Activities-specific Balance Confidence Scale (ABC). Results:After the gaze stabilization exercises, the average envelope ellipse area, the plantar pressure distribution of the affected side with the eyes open and closed, AP-COPV, BBS score, TUGT time and ABC score of the experimental group were significantly superior to the control group′s averages and to the results four weeks previously.Conclusions:Gaze stabilization exercises can improve balance, weight shifting and one-leg standing after a stroke. That should enhance balance confidence and reduce the risk of falling.
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ObjectiveTo identify the appropriate definition, scope of application, the mechanism and the efficacy of the chin-down maneuver in aspiration reduction or prevention. MethodsLiteratures about chin-down published before July, 2021 were reviewed. ResultsA total of 13 articles were included. Chin-down refered to the action of bending the neck and leaning the chin as far as possible toward the chest. Chin-down maneuver could change the position and pressure of the pharyngeal structure to guide the food safely into the esophagus, to prevent or reduce aspiration. Chin-down maneuver was effctive on dysphagia caused by insufficient laryngeal elevation, delayed pharyngeal reflex, epiglottal defect, lychee cartilage defect, and glottis closure defect. However, this action worked in patients with premature overflow of food clumps, weak pharyngeal contraction muscle strength, and poor oral preservation. ConclusionChin-down maneuver is beneficial to aspiration dysphagia after dysphagia.
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@#Objective To systematically summarize the animal models of acquired heterotopic ossification (AHO), and provide reliable modeling methods for the study of disease prevention and treatment programs.Methods Literatures about the animal models of AHO were researched from PubMed, Web of Science, CNKI and Wanfang Database till November, 2021. The important contents of the literatures were extracted, and the animal models of various types of AHO were evaluated and analyzed by literature induction.Results A total of 20 literatures related to animal experiments were included, which could be divided into two types: post-traumatic and neurogenic heterotopic ossification animal models, which were used to simulate the occurrence and development of AHO. Currently, seven different animal models were commonly used to study post-traumatic heterotopic ossification, such as muscle injury, achilles tenotomy, muscle injury combined with joint immobilization, hip injury, heterotopic implantation, blast injury and burn. The studies of neurogenic heterotopic ossification animal models mainly included spinal cord injury and traumatic brain injury. At present, the methods of achilles tenotomy and osteogenic factor implantation were commonly used in the laboratory, and with the advantages of reliability, feasibility and high success rate; however, they could not accurately explain the pathogenesis of heterotopic ossification under complicated clinical conditions. Therefore, the improvement of modeling methods based on explosion injury, burn, nerve injury and other conditions became the basis for clinical research of molecular biological mechanism, prevention and treatment of heterotopic ossification.Conclusion Current modeling methods have their own advantages and disadvantages, but none of them can completely replicate all the characteristics of human heterotopic ossification. Therefore, there is no unified standard in the selection of animal model in clinic. According to different etiology of the disease, the selection of appropriate animal models is crucial to study effective intervention for different types of AHO in the early stage.
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Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with the mirror therapy (MT) on the recovery of upper limb function recovery 3 to 6 months after a stroke.Methods Forty-five male patients were randomly assigned to an MT (A) group,an rTMS+MT (B) group or an MT +rTMS group (C),each of 15.All received conventional medical treatment and stroke rehabilitation.In addition,group A received 60 min of MT daily,5 days a week for 4 weeks.Group B received 10 min of rTMS over the M1 area of the affected hemisphere followed by 50 min of MT treatment,and group C received 50 min of MT treatment followed by 10 min of rTMS.rTMS was delivered at a frequency of 10 Hz and an intensity of 90％ resting motor threshold.The latency of motor evoked potential (MEP) for the affected abductor pollicis brevis muscle and its central motor conduction time (CMCT) were observed before and after the treatment.The upper extremity portion of the Fugl-Meyer assessment (FMA) was performed along with a functional test for the hemiplegic upper extremity (FTHUE).The motricity index (MI) was also quantified.Results Average MEP latency and CMCT had decreased significantly in all three groups after the treatments.The average MEP latency of group B was significantly shorter than that of group A,and CMCT was also significantly shorter than for groups A and C.Moreover,after the intervention,all of the groups had significantly improved their average FMA,MI and FTHUE scores,with the average FMA score of group B significantly better than those of groups A and C.The average FTHUE score of group B was also significantly better than that of group A.Conclusions MT either alone or in combination with rTMS can improve cerebral motor cortex excitability and motor recovery after a stroke.Ten minute rTMS sessions followed by 50 min of MT have the best effect.
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Objective To explore the effect of stance width on balance in static standing.Methods Thirty healthy young subjects were evaluated using the PRO-KIN balance training apparatus.They stood with their eyes open and closed in three stances:feet together,feet 50 cm apart,and feet a comfortable distance apart (measured as 18.63±3.67 cm between the heels and 29.60±4.93 cm between the toes).The excursions of the center of pressure (COP),the standard deviation of their longitudinal sway (SDLS),the standard deviation of their horizontal sway (SDHS),the mean longitudinal and horizontal sway velocities (MVLS and MVHS),sway length (SL) and sway area (SA) were recorded.Results With the eyes either open or closed,significant differences in all of the COP data were observed when standing in the different stances.The average SDHS,MVHS,SL and SA were all significantly better when standing comfortably than when standing with the feet 50cm apart whether the eyes were open or closed.Conclusion There is a proper distance between the feet where healthy youngsters best maintain static standing balance.
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Objective:To explore the influence of constrained arms swing on temporal and spatial gait parameters in healthy young adults.Method:Thirty-six healthy young persons (18 male,18 female;age:22.72±3.54 years;height:167.35±9.15 cm;weight:63.62±16.29 kg) were recruited for this study.All subjects received gait analysis by the Gait Watch analyses system.All subjects walked combined with 10 walking conditions (the arms swinging naturally,the arms constrained in front of the abdomen,the arms constrained in back of the abdomen,the left arm constrained in body side,the left arm constrained in front of the abdomen,the left arm constrained in back of the abdomen,the right arm constrained in body side,the right arm constrained in front of the abdomen and the right arm constrained in back of the abdomen).Walking conditions were randomly set during the experiment.The differences of the temporal and spatial gait parameters were analyzed and compared.Result:There was not significant difference of the temporal and spatial gait parameters (gait cycle,stride frequency,stride length,step velocity,step length,left step,right step,double support phase) between arm constrained and the arms swinging naturally.The left support phase and left swing phase showed significantly difference with the left arm constrained in body side,the left arm constrained in front of the abdomen and the left arm constrained in back of the abdomen compared with arms swinging naturally.The right support phase and right swing phase showed significantly difference with the left arm constrained in back of the abdomen,the right arm constrained in body side,the right arm constrained in front of the abdomen and the right arm constrained in back of the abdomen compared with arms swinging naturally.Conclusion:The left support phase was shorten and left swing phase was prolonged with the left arm constrained,while the right support phase was prolonged and right swing phase was shorten with the right arm constrained.
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Objective To explore the effectiveness of the timed up and go test (TUGT) and the maximum walking speed test (MWST) in evaluating stroke patients' motor function.Methods Twenty-two stroke patients were assessed using the TUGT and MWST,and the temporal-spatial parameters of their gait were also assessed.The correlations among the TUGT times,walking speed and the gait parameters were quantified using Pearson correlation coefficients.Results The TUGT time was (18.57±7.41) s,significantly correlated with step length and velocity (P＜0.05).Walking speed showed a significant positive correlation with step length,velocity and step length (P＜ 0.05).The TUGT times were negatively correlated with walking speed (r=-0.712,P=0.000).Conclusion The MWST and TUGT both can assess stroke patients' motor function effectively.
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Objective To observe the effects of ICB orthopedic sole combined with rehabilitation training on balance and walking function in stroke survivors.Methods Thirty hemiplegic stroke patients were recruited and divided into a study group (n =15) and a control group (n =15) by using a random number table.Both groups took exercises based on the principles of a motor relearning program and conducted core stability control training,and the study group additionally undertook hemiplegic lower extremity weight-bearing exercises and walking with ICB orthopedic sole used in daily living.The program was administered 20 min twice per day for 4 weeks.All patients were evaluated with Rest Calcaneus Standing Position (RCSP),Malleolar Position (MP),Forefoot Position (FP),Berg Balance Scale (BBS),l0 m Maximum Walking Speed (MWS) and walking section of Motor Assessment Scale (MAS)before and after the program.Results After 4 weeks of intervention,all the measurements except the FP in both groups improved significantly,and significant differences were observed between the two groups.After 4 weeks of training,the average RCSP (1.78 ± 0.32) ° and MP (13.33 ± 2.51)° were improved significantly compared to those of the control group [(2.58 ± 0.59) ° and (12.45 ± 3.31) °,respectively].Moreover,the average BBS,MAS and MWS improved significantly compared to the control group.Conclusions ICB orthopedic sole combined with rehabilitation training can improve the weight-bearing,balance and ambulation abilities of stroke survivors.
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Objective To compare the effects of repetitive transcranial magnetic stimulation (rTMS) at various low frequencies on upper limb function after cerebral infarction.Methods Fifty patients were randomly assigned to a control group (10 cases),a sham rTMS group (10 cases) or an rTMS group which had three sub-groups treated at 0.25 Hz,0.5 Hz and 0.75 Hz with 10 cases in each.All of the patients were treated with conventional medical treatment and rehabilitation training.The sham and true rTMS groups received rTMS applied over the M1 area of the unaffected hemisphere,5 days per week for 4 weeks.Motor evoked potential (MEP) cortical latency,and central motor conduction time (CMCT) were measured and the Fugl-Meyer assessment (FMA),motricity index (MI) and a Hong Kong functional test for the hemiplegic upper extremity (FTHUE-HK) were evaluated beforehand and at Post 1 after 2 weeks of treatment and Post 2 after 4 weeks of treatment.Results The average CMCT and FMA scores of the control and sham rTMS groups both had improved significantly at Post 2.There was no significant difference in any of the indices between those 2 groups at any time point.At Post 1,the average MEP cortical latencies of the 0.25 Hz and 0.5 Hz subgroups had improved to be significantly better than those of the control and sham rTMS groups.The average CMCTs of the 0.25 Hz and 0.5 Hz rTMS subgroups were significantly shorter after treatment,and significantly better than those of the control and sham rTMS groups.At Post 2,the average MEP cortical latency of all groups except the control group showed significant improvement compared with pre-treatment.The 2 indices of the 0.25 Hz and 0.5 Hz subgroups were again significantly shorter than those of the control and sham rTMS groups,and the average CMCTs were significantly better than that of 0.75 Hz subgroup.At Post 1 the average FMA and MI scores of the rTMS subgroups had all improved significantly.In the 0.25 Hz and 0.5 Hz subgroups the average MI scores were significantly higher than those of the control and sham rTMS groups.The FTHUE-HK scores of those 2 subgroups had also improved significantly.At Post 2,the average FMA and MI scores of all groups and the FTHUE-HK scores of rTMS group had improved significantly.In the 0.25 Hz and 0.5 Hz subgroups,all of the indices were significantly better than in the control and sham rTMS groups.The average FTHUE-HK score of the 0.25 Hz subgroup was significantly superior to that of the 0.75 Hz subgroup.In the 0.75 Hz subgroup the average MI score was significantly higher than in the control and sham rTMS groups.Conclusions rTMS at either 0.25 Hz or 0.5 Hz applied to the unaffected hemisphere provides effective treatment for enhancing the excitability of the motor cortex and the motor function of a paretic upper limb after stroke.Compared with others,the total number of stimulus pulse in 0.25 Hz subgroup was the least,and priority consideration should be given to the frequency of 0.25 Hz when using rTMS in clinical treatment of cerebral infarction.
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Objective To study the reliability and validity of using sacral markers in evaluating the balance function in standing and walking of stroke patients with hemiplegia.Methods Twenty-one hemiplegic stroke patients were recruited and their baseline mean sway amplitude (MSA) and mean sway velocity (MSV) were measured using sacral markers and center of gravity analysis assuming a segmented body,thegold standard for such analysis.The data were analyzed using Bland-Altman plots to obtain the 95％ limits of agreement (LOA).Results ①Test-retest reliability:The 95％ LOA of the MSA in standing was (-4.42,5.14) on the X axis,(-6.04,4.52)on the Y axis,and (-1.75,1.31) on the Z axis.The MSV in standing was (-0.08,0.09) on the X axis,(-0.10,0.08) on the Y axis and (-0.03,0.02) on the Z axis.The 95％ LOA of the MSA in walking was (-185.74,105.53) on the X axis,(-22.57,2.76) on the Y axis and (4.43,2.76) on the Z axis.The MSV in walking was (-3.10,1.76) on the X axis,(-0.38,0.54) on the Y axis and (-0.07,0.02) on the Z axis.②Validity:The 95％ LOA of the MSA in standing was (-3.62,2.55) on the X axis,(-3.95,3.94) on the Y axis and (-7.35,19.43) on the Z axis.For the MSV in standing it was (-0.06,0.04) on the X axis,(-0.07,0.07) on the Y axis and (-0.12,0.32) on the Z axis.The 95％ LOA of the MSA in walking was (-4.40,4.74) on the X axis,(-17.35,4.14) on the Y axis and (-17.35,4.14) on theZ axis.For the MSV in walking itwas (-0.07,0.08) on the X axis,(-0.29,0.07) on the Y axis and (-0.12,0.18) on the Z axis.The 95％ LOAs of the variables representing their reliability and validity are small enough to be acceptable in clinical application.Conclusions The sacral marker method can be used in assessing the balance of stroke patients.
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Objective To investigate the clinical value of a three-dimensional motion analysis system by using the body segmental method for testing the balance of hemiplegic stroke patients.Methods Twenty stroke patients with hemiplegia were measured using the lower extremity Fugl-Meyer motor assessment (FMA-L),the Brunel balance assessment (BBA),the Berg balance sale (BBS) and a 5 m timed up-and-go test (5m-TUGT).The three-dimensional motion analysis system using the body segmental method was applied in three positions-sitting,standing and walking.Spearman's rank correlation coefficient was used to determine the extent of correlation between the values measured by the three-dimensional motion analysis system and the FMA-L,BBA,BBS and 5m-TUGT results.Results Some motion analysis variables (MSAx,MSVx,MSAy,MSVy and SPxy,SP3-D) are recorded in sitting and standing,while the center of gravity (COG) swing in the horizontal plane and some other variables (MSAx,MSVx and SPxy and SP3-D) are measured while walking.Anterior-posterior COG swing had a high negative correlation with the FMA-L,BBA and BBS scores and a high positive correlations with 5m-TUGT times.But except in sitting,MSAz and MSVz were both uncorrelated with FMA-L,BBA or BBS scores or with 5m-TUGT times.COG swing in the horizontal plane in sitting and standing apparently correlates with lower extremity motor function,balance,and walking ability.However,only the X axis swing parameters of the COG while walking correlated with lower extremity motor function,balance or walking ability.Conclusions A three-dimensional motion analysis system using the body segmental method can be used clinically to monitor patients' balance in real time and dynamically in different positions and activities,and it can be used to predict motor function and balance control in hemiplegic stroke patients.
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Objective To explore the effects of extrinsic and intrinsic recognition loading on gait in patients with Parkinson disease.Methods Eight patients with Parkinson disease and six control subjects were instrutted to walk with extrinsic and intrinsic recognition loading respectively.The gait parameters in two conditions were measured with three-dimension motion analysis equipment.FAB scale and Stroop Test were used as the evaluation of executive function.Results The velocity(cm/s),the cadence(step/min),single support and swing phase(%)in the audition stimulates condition in the patients group((113.4±14.32)step/min,(78.90±16.35)cm/s,(40.50±2.58)%,(40.50±2.58)%)were significantly better than those in the calculation condition(respectively(91.27±15.54)step/min,(63.79±21.49)cm/s,(37.95±2.61)%,(37.95±2.61)%).In the calculation condition,the coefficients of variability in stride length,swing and sinfle support phase were significantly higher in the patient group(respectively(6.69±3.99),(8.56±5.69),(8.56±5.69))than in thecontrol group(respectively(3.23±1.34),(5.02±2.54),(5.02±2.54));in the audition condition,except that,the coefficients of variability in step length and velocity also were significantly higher in the patient group(respeetively(11.92±5.86),(6.89±4.98))than the control group(respectively(7.35±3.32),(2.5±1.53)).In the patients group,the score of FAB(15.63±1.51)was lower and error rates of Stroop test(0.087±0.056)was higher than those in the control group(respectively(17.67±0.52),(0.027±0.03))significantly.The error rate of stroop-3 was significantly negative correlated with the gait variables of patient group in the calculation condition.Conclusion The extrinsic audition stimulates has lower effect on the gait of patients of Parkinson's disease than the intrinsic recognition loading.
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Objective To explore the effects of rhythmic auditory stimulation on the gait of patients with Parkinson's disease(PD). Methods Eight patients with PD and six healthy control subjects were studied.All subjects walked as usaal for 2 min and then Walked for 2 rain with rhythmic auditory attentional stimulation with a frequency 10% faster than their basic pace.The gait parameters in the two walking conditions were measured with three-dimension motion analysis equipment.In addition,executive function was evaluated using a frontal assessment battery (FAB)scale and the Stroop-3 test. Results In both walking conditions,average stride length and velocity were significantly lower in the PD patients than among the controls.The metronome at the higher frequency increased the cadence and stride velocity significantly in the controls.but in the PD patients it was associated with increased ca dence but decreased stride length.With auditory stimulation,the variability of velocity decreased significantly in the controls,but the variability in stride length increased significantly in the PD patients.Even with the auditory stimulation,the variability in step length,stride length and velocity were still significantly higher in the PD patients than among the controls.Executive dysfunction was clearly evident in the PD patients.Stroop-3 error rates were significantly negatively correlated with step length in the condition involving auditory stimulation.Conclusion Auditory attentional stimulation at a higher frequency becomes a new cognitive load for PD patients,and it cannot improve their gait.This may be related to executive dysfunction.
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Objectives To gain a deeper understanding of the role of the basal ganglia in implicit learning by examining Weather Prediction Category Learning Task among patients with basal ganglia stroke.Methods Seventeen patients with basal ganglia stroke including eight cases of left basal ganglia lesions and nine cases of right basal ganglia lesions.Ten cases without brain damage were used as contr0l.All of the subjects were tested by use of Weather Prediction Category Learning Task(WPCLT) and Wisconsin Card Sorting Test (WCST)in 3 consecutive days.Results The patients with right basal ganglia lesions were consistently impaired compared with the controls((52.72±5.57)%vs(61.85±8.49)%,F=3.55,P=0.048);(55.83±4.52)%vs(71.85±10.89)%,F=7.74,P=0.003);(62.33±7.70)%vs(80.15±6.67)%,F=10.96,P=0.001)),and the patients with right basal ganglia lesions were impaired in the last day(F=10.96,P=0.009).But in patients of left and right basal ganglia lesions,the learning potential of WPCLT decreased significantly compared with the control(P<0.01).In the control group,the WPCLT total number of correct and WCST Number of Categories Completed were hishly related in the second day.The WPCLT total number of correct correlated significantly with Percent Errors and Number of Categories Completed of WCST in the third day.Conclusion The basal ganglia lesions may decrease implicit learning,and the bottom-up(implicit-to-explicit)learning pattern is impaired in patients with basal ganglia lesions.
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Objective To explore the characteristics of semantic priming effects in Chinese words with different association strength in patients with aphasia by auditory stimulation.Method Stimulus-response word pairs with different association strength including strong,moderate,weak,and no association categories were chosen from word association thesaurus as experiment materials.Both patients with aphasia(n=11)and normal subjects (n=16)were requested to finish an auditory lexical decision task for target words.Semantic priming effects were investigated by means of measuring reaction time(RT)and error rate of each word-pair.Results In patients with aphasia and normal subjects,the mean RTs were significantly shorter in strong,moderate and weak association strength words than in no association strength words(patients with aphasia(1270.20±47.70)ms,(1340.50±266.25)ms,(1429.70±317.07)ms vs(1549.00±325.87)ms,P＜0.05 and normal subjects(1140.2±274.48)ms,(1196.50±284.06)ms,(1262.10±274.31)ms vs(1391.20±315.68)ms,P＜0.05).In strong,moderate,and no association strength words,the mean RTs were no significant differences between two groups.In the weak association strength words,mean RTs were significantly longer in patients with aphasia than in normal subjects((1429.70±317.07)ms vs(1262.10±274.31)ms,P＜0.05).In two groups,mean error rates were significantly less in strong,moderate and weak association strength words than in no association strength words(patients with aphasia:7.73±6.07,4.55±7.23,6.82±8.15 vs 14.09±12.41,P＜0.05 and normal subjects:3.44±4.37,2.81±3.64,5.31±5.91 vs 10.94±11.14,P＜0.05).However,in strong association strength words,mean error rates were significantly higher in patients with aphasia than in normal subjects(7.73±6.07 vs 3.44±4.37,P＜0.05).In moderate,weak and no association strength words,there were no significant differences between two groups.Conclusion The patients with aphasia follow gradient of the association strength words like normal subjects and have semantic priming effects in the strong,moderate association strength words.
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Objective To explore the effect of bio-resonance on walking efficiency in healthy youths. Methods Ten young male participants were involved in this study (age 16 ± 2 years, height 1.73 ±:0. 1 m and weight 56. 1 ± 7 kg). The time-space data were collected using a motion analysis system, and oxygen cost was meas-ured with a Cosmed K4b2 portable gas analysis system. Walking at a self-selected, comfortable walking frequency was recorded through three dimensional gait analysis. Each participant walked at 100% , 80% and 120% of their comfortable walking frequency. Results The average 100% , 80% and 120% comfortable walking frequencies were 107.60 ± 1.78, 85.80 ± 7.45 and 128.60 ±10.46 steps/min, respectively. Oxygen consumption at the three frequencies was significantly different (P≤0.01), and the oxygen costs were 0. 140 ± 0.011, 0. 193 ± 0. 049 and 0. 192 ± 0. 035 ml/m/kg, respectively. Above or below the self-selected pace, oxygen cost increased significantly (P ≤0.05). Conclusion There is an inherited bio-resonance in human walking, and walking with this natural rhythm is reflected in the lowest oxygen cost. Any change from the natural walking rhythm may result in increased en-ergy expenditure and decreased efficiency.