Clinical observation of cognitive impairment after traumatic brain injury treated with acupuncture and cognitive training / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy on cognitive impairment after traumatic brain injury (TBD treated with acupuncture and cognitive training.</p><p><b>METHODS</b>Sixty patients were randomized into an observation group and a control group, 30 cases in each one, and 5 cases of them were dropped out due to the earlier discharge. Finally, there were 28 cases in the observation group and 27 cases in the control group. In the control group, the cognitive training and conventional treatment were applied. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Baihui (GV 20), Fengchi (GB 20), Geshu (BL 17) and Fenglong (ST 40), once a day, for 4 weeks totally. The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were adopted to evaluate the cognitive function in the patients of post-TBI cognitive impairment.</p><p><b>RESULTS</b>(1) After treatment, the total score in MMSE and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<0. 05). Except for the score of immediate recall, the score in MMSE and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05). (2)After treatment, the total score in MoCA and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<. 05). Except for the score of nomenclature item, the total score in MoCA and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05).</p><p><b>CONCLUSION</b>Both the simple cognitive training and the combined therapy of acupuncture and cognitive training improve MMSE and MoCA scores and relieve the cognitive impairment induced by TBI. But the combined therapy achieves the much better efficacy.</p>

A Clinical Study on Acupuncture and Moxibution Combined with Cognitive Training in Treating Cognitive Impairment after Traumatic Brain Injury / 中国中医药信息杂志

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.

Botulinum toxin in the treatment of sialorrhea attributable to brain damage : A preliminary study / 中华物理医学与康复杂志

Objective To evaluate the effect of ultrasound-guided botulinum toxin A injection into the salivary glands in treating patients with sialorrhea attributable to brain damage.Methods Nine subjects with sialorrhea attributable to traumatic brain injury (n =5),cerebral infarction (n =3) and hypoxic ischemic encephalopathy (n =1) were recruited into the study.With the guidance of ultrasound,15 units (U) of botulinum toxin type A was injected into the highest and lowest points of the two parotid glands,and 20 U was injected into two points of both submandibular glands.The saliva flow rate and the severity and frequency of sialorrhea were recorded before the treatment and 1 week,4 weeks and 12 weeks later using the Drooling Scoring System (DSS).Results The saliva flow rate before treatment (0.49 ± 0.12 g/min) decreased significantly to 0.24 ± 0.08 g/min after 1 week,but then increased again to 0.28 ±0.12 g/min after 4 weeks and 0.34 ±0.11 g/min after 12 weeks.The average DSS severity score showed the same pattern:4.35 ± 0.48 initially 1.92 ± 0.37 after 1 week,1.92 ± 0.37 after 2 weeks and 2.32 ± 0.64 after 12 weeks.The DSS frequency score,however,remained significantly lower:3.56 ± 0.49 initially,2.01 ± 0.42 after 1 and 4 weeks and 2.28 ± 0.63 after 12 weeks.Conclusion Botulinum toxin type A can effectively improve the salivary secretion and sialorrhea attributable to brain damage.

Low-frequency electrical stimulation can improve ability in the activities of daily living soon after stroke / 中华物理医学与康复杂志

Objective To assess the efficacy of low-frequency electrical stimulation (LES) in improving ability in the activities of daily living (ADL) of subjects after a recent stroke. Methods In a randomized controlled trial, 37 subjects with a first stroke were randomly divided into an electrical stimulation (ES) group and a control group. In the ES group (n = 19 ) electrodes were applied on the motor points of the tibialis anterior, the peroneal longus and the peroneus brevis muscles. Stimulation current was applied at an intensity set to cause full ankle extension. The stimulus pulse was a symmetric biphasic wave with frequency of 30 Hz, a pulse width of 200 μs, a duty cycle of 5 s on and 5 s off ramped up and down for 1 s each and amplitude up to 90 mA. The current amplitude was adjusted according to each subject's comfort. Stimulation lasted for 30 min/d, 5 d/week for 3 weeks. All subjects in the 2 groups also received a standard rehabilitation program. Evaluations included the Fugl-Meyer motor assessment (FMA) for the lower extremity and the modified Barthel index (MBI) for ADL ability. Measurements were recorded before treatment and after 2 and 3 weeks of treatment. Results Before treatment there was no significant difference between the two groups in terms of age, time post-stroke, stroke severity or the baseline measurements. After 2 and 3 weeks of treatment, the FMA scores in the ES group were significantly higher than those of the control group. The MBI scores in the ES group were also significantly higher than in the control group. The average MBI transferring, walking and stair climbing scores in the ES group were all significantly higher than those in the control group after either 2 or 3 weeks. Conclusion Three weeks of LES can improve ADL ability soon after stroke.