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ObjectiveTo observe the effect of repetitive facilitative exercise (RFE) on the hand function of stroke patients with hemiplegia during recovery period. MethodsFrom January to December, 2022, 80 stroke patients with hemiplegia following hand dysfunction during recovery period in Beijing Bo'ai Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, the control group added functional occupational therapy, and the experimental group added RFE, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF) and modified Barthel Index (MBI) before and after treatment. ResultsOne case dropped down in the experimental group. After treatment, all the scores increased in both groups (|t| > 12.698, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.302, P < 0.05). ConclusionRFE could promote the recovery of hand function and activities of daily living in patients with hemiplegia during stroke recovery period.
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ObjectiveTo explore the neuromuscular control mechanism of training strategies based on mirror neuron system (MNS): action observation (AO), action execution (AE) and action imitation (AO+AE) using functional Near Infrared Spectroscopy (fNIRS) and surface electromyography (sEMG). MethodsFrom July, 2022 to February, 2023, 64 healthy adults were asked to finish four tasks: watching landscape video (control), watching landscape video and acting right wrist and hand extension (AE), watching right wrist and hand extension video (AO), and watching right wrist and hand extension video and acting right wrist and hand extension (AO+AE). A block design was adopted, five times a task in a block, eight cycles, random orders in videos and tasks. The activation of each channel and regions of interest (ROI, namely BA40, BA44, BA45, BA46, BA6 and BA7) in left MNS regions was detected with fNIRS synchronously, as well as the average electromyography (AEMG) of extensor digitorum and extensor carpi radialis with sEMG. ResultsCompared with the control condition, MNS activated in AO, AE and AO+AE conditions, and the intensities mildly increased in turn. Compared with the control condition, 15 channels activated in AO condition, 15 channels activated in AE condition, and all 20 channels activated in AO+AE condition; and the activation intensities of most channels were AO+AE > AE > AO. Four ROI, BA40, BA46, BA6 and BA7, activated in AO condition, all the six ROI activated in AE and AO+AE conditions, and the activation intensities of most ROI were AO+AE > AE > AO. The standardized AEMG of extensor digitorum and extensor carpi radialis were higher in AO+AE condition than in AE condition (|t| > 4.24, P < 0.001). ConclusionMNS has been activated during action observation, execution and imitation, and the ranges and intensities of activation increase in turn. The target muscles activate more during imitation than during execution. Synchronous application of fNIRS and sEMG is feasible in the study of neural mechanism of rehabilitation strategies based on mirror neuron theory.
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ObjectiveTo investigate the mood states, cognitive performance and the factors related to cognitive function of patients with complete spinal cord injury. MethodsA total of 60 male patients with complete spinal cord injury (SCI) admitted to Beijing Bo'ai Hospital from November, 2020 to March, 2022 were selected as SCI group, and 30 healthy males were selected as the control group. They were assessed with Montreal Cognitive Assessment Beijing Version (MoCA), Digital Span Test (DST) of Wechsler Memory Scale, Symbol Digit Modalities Test-Oral Version (SDMT), Rey-Osterrieth Complex Figure Test-30 min recall (CFT), Stroop Color-Word Test Chinese Version (CWT), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). ResultsCompared with the control group, the SDMT and CFT scores were significantly lower (t > 3.052，P < 0.01); the reflect and square root transformation of MoCA score, the square root transformation of Stroop interference effects time consuming, HAMA score and HAMD score were higher (|t| > 2.542, |Z| > 7.676, P < 0.05) in SCI group. Multiple linear regression analysis indicated that age, education level, HAMD score and sleep disorder were significantly correlated with the scores of cognitive function in SCI group. ConclusionThere are more intensive anxiety and depression in patients with complete SCI. The patients with complete SCI present cognitive impairment, especially in information processing speed, visuospatial ability and visual memory, and executive function. Age, education level, depression and sleep disorder are the related factors of cognitive impairment in patients with complete SCI.
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ObjectiveTo explore the effects of upper limb exergames on cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment. MethodsFrom August, 2020 to November, 2021, 50 troke patients with mild cognitive impairment in Beijing Bo'ai Hospital were randomly allocated to control group (n = 25) and experimental group (n = 25). Both groups received traditional occupational therapy. Additional functional occupational therapy was provided to the control group, and upper limb exergames were provided to the experimental group, for four weeks. They were assessed with Montreal Cognitive Assessment (MoCA), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after the treatment. ResultsAfter treatment, the scores of MoCA, FMA-UE and MBI improved in both groups (|t| > 3.354, |Z| > 4.379, P < 0.01), and the scores increased in five MoCA cognitive domains in the control group (except map naming and abstract thinking) (|Z| > 2.000, P < 0.05) and in six MoCA cognitive domains in the experimental group (except map naming) (|Z| > 2.646, P < 0.01). After treatment, the scores of MoCA, MoCA five cognitive domains (except map naming and abstract thinking) and FMA-UE were better in the experiment group than in the control group(|Z| > 1.982, t = 3.565, P < 0.05). ConclusionUpper limb exergames can facilitate the recovery of cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.
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ObjectiveTo investigate the effects of cathodic transcranial direct current stimulation (ctDCS) on upper limb and finger dysfunction after right brain injury (RBI). MethodsFrom October, 2020 to May, 2022, 40 RBI patients in Beijing Bo'ai Hospital were randomly divided into control group and experimental group, with 20 patients in each group. All the patients accepted conventional drug treatment, conventional rehabilitation treatment and functional occupational therapy. The cathode electrode was placed in the M1 area of the uninjured side of brain, then the control group received sham stimulation and the experimental group received stimulation, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and -Finger, and the modified Barthel Index (MBI) before and after treatment. ResultsAfter treatment, the scores of FMA-UE, FMA-Finger and MBI improved in the two groups (t > 5.627, P < 0.001), and improved more in the experimental group than in the control group (t > 2.161, P < 0.05). ConclusionctDCS can effectively improve the motor function of upper limbs and fingers of RBI patients, and improve the ability of activities of daily living.
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@#Objective To investigate the lifestyles for young and middle-aged stroke patients (aged 18 to 59). Methods From October, 2020 to March, 2021, 268 young adult stroke inpatients in Beijing Bo'ai Hospital and 363 healthy controls for healthy examination were collected the basic information (gender, age, marital status and educational level). The lifestyles were investigated with questionnaire based on Activity-Interest-Opinion (AIO) scale and Health Education and Health Advocacy in China, including 26 items in five dimensions of smoking, drinking, sleep, diet and exercise (before the onset for patients). The lifestyles were compared between the two groups, and analyzed with Logistic regression. Results Frequent smoking (OR = 1.383, P = 0.048), frequent passive smoking (OR = 1.511, P < 0.001), less sleeping time (OR = 0.582, P = 0.018), staying up later (OR = 0.400, P < 0.001), irregular meal time (OR = 0.454, P < 0.001), less weekly breakfast (OR = 0.752, P = 0.012), more oil intake (OR = 0.623, P < 0.001), more barbecue and fried food intake (OR = 0.440, P < 0.001), frequent takeaway or catering (OR = 0.716, P < 0.001), more alcohol consumption (OR = 1.502, P < 0.001) and less aerobic exercise (OR = 1.540, P < 0.001) were the risk factors for stroke in young and middle-aged persons. Conclusion Adverse lifestyle affects the occurrence of stroke in young and middle-aged people.
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Spinal cord injury is a catastrophic injury causing lifelong severe disabilities, and poses a great burden to the individuals, families and society. In order to promote the standardization in treatment of traumatic spinal cord injury, the consensus on the evaluation, treatment and rehabilitation of traumatic spinal cord injury was suggested by experts, who came from authoritative multicenter in China. The expert consensus, which formed a standardization process from the first aid clinical treatment to rehabilitation of spinal cord injury, shall give a better practical guide for clinic and rehabilitation physicians.
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Occupational therapy provides protective and corrective non-surgical measures for carpal tunnel syndrome. The information gained from the assessment process can help the occupational therapists determine the targets and treatment options, including the nerve-gliding exercises, tendon-gliding exercises, production or select splints, modification of tasks resulting in patients with exacerbations, modification of equipment and environment, transformation of daily necessities. The education would cover the pathophysiology of carpal tunnel syndrome, treatment options (conservative management and surgery), posture and activity modification principles. This information can also be provided in the form of an education booklet which participants will be encouraged to review at home.
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Objective To observe the effect of bilateral movement training on upper extremities dysfunction in stroke patients in conva-lescent phase. Methods 52 patients with hemiplegia were randomly divided into treatment group (n=26) and control group (n=26). The treat-ment group accepted bilateral upper extremities movement training, and the control group accepted routine neurodevelopment training main-ly with affected upper extremities, for 6 weeks. They were assessed with Fugl-Meyer Assessment upper-extremity section (FMA-UE) and modified Barthel Index (MBI) before and after treatment. Results The FMA-UE and MBI scores improved in both groups after treatment (P<0.01), and improved more in the treatment group than in the control group (P<0.001). Conclusion Bilateral movement training may im-prove upper extremity function and activities of daily living more effectively for stroke patients in convalescent phase.
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Japanese pension insurance, consisting of two parts including the national pension insurance and welfare pension insurance, is a public mechanism under direct government operation and management. Just like that in other developed countries in the world, Japanese pension insurance adopted mechanisms of social insurance, price changes, lifetime pensions, taxes, etc., which plays an important role in in-come security for the retired elderly people in Japan. Due to the increasing low birthrate and aging in Japan, Japanese government is en-gaged in continual reforms to establish a national stable and sustainable development system trusted by the public.
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@#Objective To observe the thermal thresholds in normal subjects and their relation with gender and site.MethodsThe thresholds of sensation of cold,warm,cold pain and hot pain in 20 healthy subjects were measured at 10 sites of upper limbs with the TSA-Ⅱ Neurosensory Analyzer under the Limits model.ResultsThere was no remarkable differences between the thresholds of sensation of cold and warm,but obvious differences between the sensation of cold pain and hot pain in different skin sites,as well as between the males and females,left and right in some sensation and some sites.ConclusionFor the normal people,there is a certain relationship among thermal threshold and gender or site of body.