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ObjectiveTo observe the effect of transcranial direct current stimulation (tDCS) combined with task-oriented rehabilitation training single pellet reaching and grasping (SPG) on the motor function of forelimb in rats with unilateral contusion of C5 spinal cord. MethodsA total of 60 adult male Sprague-Dawley rats were randomly divided into sham operation group (sham group), spinal cord injury (SCI) group, tDCS group, SPG group, false group and tDCS+SPG group, with ten rats in each group. Only C5 lamina was removed in the sham group, and the C5 spinal cord contusion model was established by IH spinal cord impactor in the other five groups. The rats received tDCS in tDCS group, SPG in SPG group, tDCS without current in false group, tDCS combined with SPG in tDCS+SPG group, and no treatment in the SCI and the sham groups. The rats were evaluated with Rearing and Grooming tests, and motor-evoked potential (MEP). ResultsFour weeks after operation, compared with SCI group, the scores of Rearing and Grooming increased in tDCS group and tDCS+SPG group (P < 0.05), and they were more in the tDCS+SPG group than in tDCS group and SPG group (P < 0.05); the score of Grooming increased in SPG group (P < 0.05); while the amplitude of MEP increased in tDCS group, SPG group and tDCS+SPG group (P < 0.05), and the latency shortened in tDCS group and tDCS+SPG group (P < 0.05); and the amplitude increased more in tDCS+SPG group than in tDCS group and SPG group (P < 0.01). ConclusiontDCS could promote the recovery of motor function in rats with SCI, and the combination therapy of tDCS and task-oriented rehabilitation training is more effective.
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ObjectiveTo explore the effect of motor imagery (MI) on knee function after unicompartmental knee arthroplasty (UKA). MethodsFrom January to September, 2022, 32 patients underwent UKA for the first time in Xuanwu Hospital were randomly divided into control group (n = 16) and experimental group (n = 16). All the patients accepted routine rehabilitation, and the experimental group accepted MI in addition, until four weeks after discharge. They were assessed with Oxford Knee Score (OKS), Visual Analogue Scale for pain (VAS), range of motion (ROM) of knee, and Timed Up and Go Test (TUGT) before and after treatment. ResultsAll the indexes improved after treatment (|t| > 2.517, P < 0.05), except ROM in the control group; and they improved more in the experimental group than in the control group (F > 7.999, P < 0.01), except the VAS score. ConclusionMI can further improve the knee function after UKA, but do less for pain.
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@#Objective To study the effects of integrated orthopedic rehabilitation pathway on motor function in six months after total knee arthroplasty (TKA), including pain, stiffness, range of motion and muscle strength, etc. Methods From March, 2016 to March, 2019, 180 patients who underwent TKA and treated with integrated orthopedic rehabilitation pathway were enrolled. Age, gender, operation time, time of follow-up, the scores of Hospital for Special Surgery-Knee Scale (HSS-KS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) at preoperative/postoperative/one-month after operation/three-month after operation/six-month after operation time points were collected. The sub items, such as muscle strength, range of motion, flexion deformity, pain, stiffness, functional difficulty were primarily focused on. Results A total of 42 patients were followed up for three months and 22 patients were followed up for six months. There was no significant difference in the scores of HSS-KS and WOMAC before and after operation (P > 0.05). Within three months after operation, the HSS-KS scores gradually increased (P < 0.05) and the WOMAC scores gradually decreased (P < 0.05). The active knee flexion range of motion and knee extensor muscle strength scores of HSS-KS significantly decreased after operation (P < 0.05), and gradually recovered one month and three months after operation (P < 0.05). The flexion deformity scores of HSS-KS increased after operation (P < 0.05), decreased one month after operation (P < 0.05), and got a trend of incensement again three months after operation. The pain score of WOMAC decreased continuously within three months after operation (P < 0.05); the stiffness score of WOMAC did not change after operation (P > 0.05), decreased significantly one month after operation (P < 0.05), and did not change three months after operation (P > 0.05). The degree of functional difficulty of WOMAC decreased after operation (P < 0.05), and improved continuously within six months after operation (P < 0.05). Conclusion The overall function after TKA shows a trend of improvement within three months, and there is no obvious improvement from three to six months after operation. The flexion deformity score showed a downward trend in one month after operation, and it could be improved again after strengthening rehabilitation, which needs more attention in the postoperative rehabilitation.
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Objective To study spatial attention processing characteristics in patients with unilateral spatial neglect (USN)by comparing the patients with right USN and behavioral findings of event-related potential (ERP)in normal subjects and the amplitude and latency of P1,N1 and P300. Methods Ten consecutive patients with USN (USN group)after right-hemisphere stroke admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University from April 2012 to April 2013 were enrolled retrospectively. Age-and sex-matched 10 normal subjects with the USN group were selected. ERP was used to document the electroencephalogram changes of two groups of subjects when performing visual Oddball pattern tasks. The response time and accuracy of target stimuli in both groups appearing on the left (left target)and right (right target)were analyzed and compared. The amplitude and latency of all ERP components (P1,N1,P300)on the left and right target stimuli were analyzed by repeated measurement of multivariate analysis of variance. The pathogenesis of USN after stroke was investigated. Results In the USN group,the accuracy of target stimuli on left side and right side was lower than that in the normal group (left target:17. 7 ± 7. 5% vs. 98. 5 ± 7. 5%,P＜0. 01;right target:88. 5 ± 2. 0% vs. 99. 0 ± 2. 0 %,P＝0. 002). There was no significant difference in P1 amplitude between the two groups (F ＝1. 104,P ＝0. 307). When the target stimulus appeared on the left side,the N1 amplitude on the right hemisphere of the USN group was lower than that of the normal group (-0. 3 ± 1. 1 μV vs. -5. 8 ± 1. 1 μV;P＝0. 001), when the target stimulus appeared on the right side,the N1 amplitude of USN group was lower than that of the normal group (-1. 8 ± 1. 0 μV vs. -6. 0 ± 1. 0 μV;F＝9. 799,P＝0. 006). The P300 amplitude of left target of the USN group was lower than that of the normal group (1. 0 ± 1. 1 μV vs. 7. 2 ± 1. 1 μV;P＝0. 001). Compared with the normal group,the latency of each wave of P1 (right hemisphere)(136. 7 ± 3. 8 ms vs. 122. 1 ± 3. 8 ms;P ＝0. 013),N1 (179. 7 ± 2. 0 ms vs. 172. 8 ± 2. 0 ms;F ＝5. 775,P ＝0. 027),and P300 (490 ± 12 ms vs. 402 ± 12 ms;F＝27. 310,P＜0. 01]in the USN group was prolonged. Conclusion During the spatial attention processing in patients with USN,regardless of the stimuli from the left and right,its information processing had been damaged to a certain degree.
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Objective To explore the effect of goal-oriented repetitive training on motor function of upper limb in patients with stroke. Methods From March, 2014 to February, 2016, a total of 60 stroke patients were randomly divided into experiment group (n=30) and con-trol group (n=30). Both groups received routine rehabilitation, while the experiment group received goal-oriented repetitive training in addi-tion, 30 minutes once a day, 5 days a week for 4 weeks. They were assessed with simple Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and modified Barthel index (MBI) before and after training. Results There was no difference in the scores of FMA-UE and MBI between two groups before training (Z0.05). The scores of FMA-UE and MBI significantly improved in both groups after treat-ment (Z>5.645, P2.275, P5.770, P<0.001). Conclusion Goal-oriented repetitive training could promote the recovery of upper limb motor function in patients with stroke.
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@#Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on motor recovery in patients with incomplete spinal cord injury （SCI）. Methods 22 patients with T5～T12 incomplete spinal cord injury (ASIA C) were randomly divided into rTMS group and control group. 12 ptients in rTMS group were treated with 10Hz rTMS （10×5 s with 2 min interval) on motor cortex and rehabilitation. 10 patients in control group treated with rehabilitation only. They were assessed with ASIA motor score, ASIA pin prick score, ASIA light touch score, range of motion (ROM) of legs in antigravitation position, walking index for spinal cord injury Ⅱ (WISCIⅡ) and functional independence measure (FIM) score before and 4 weeks after treatment. Results There was no difference between two groups with the clinical assessment before treatment （P>0.05）. The ASIA motor score, ROM of legs and FIM score improved in both groups after treatment （P<0.05）. The score of WISCIⅡ also improved in rTMS group （P<0.05）, and ASIA motor score improved more in rTMS group than that of control group （P<0.05）. Conclusion rTMS can facilitate the recovery of the motor and walking function in patient with incomplete spinal cord injury.