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The demand for rehabilitation therapists is rising in response to social development, disease spectrum changes and population aging. Under the guidance of the integration of rehabilitation and clinical medicine, Beijing Rehabilitation Hospital has carried out a comprehensive scientific design and practice in the sub-professional training mode for new rehabilitation therapists according to the discipline development and clinical needs, strengthened their training of sub-professional skills, and provided an effective way to standardize the profession admission and specialty advancement.
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@#Virtual reality is an integrated technology which simulates the real world via the computer, with characteristics of immersion, interaction and imagination. It is widely used in neurological rehabilitation. Freezing of gait (FOG) is a destructive symptom which appears in late stage of Parkinson's disease, which can be divided into subtypes of moving forward with very small steps, leg trembling in place and total akinesia, and often results in fall and injury of the patients. Virtual reality can simulate the environment of FOG to provide a new idea for the assessment. Virtual reality combined with treadmill training can provide challenging functional training in a complex environment to improve the gait. How it works is remained unclear.
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@#Dysphagia commonly occurs in Parkinson's disease (PD) at any stage, which may result in serious complications. The mechanism is uncertain. Swallowing Disturbance Questionnaire (SDQ) and Munich Dysphagia Test-Parkinson's Disease (MDT-PD) are often used for screening dysphagia in PD patients. But Non-motor Symptoms Questionnaire (NMSQ) and Unified Parkinson's Disease Rating Scale (UPDRS) underestimate the severity of dysphagia in PD patients. Videofluoroscopic Swallowing Examination (VFSE) and Videoendoscoptic Swallowing Study (VESS) are the gold standards for the dysphagia. There is no systemic management yet. Interventions includes medication, deep brain stimulation, etc. Early diagnosis and management facilitate to decrease the complications.
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@#The core symptoms of Parkinson's disease include motor symptoms and non-motor symptoms. For the motor symptoms, the rehabilitation includes the basic training of joints, gait training, the training of core muscle group and posture balance, the training of oral, facial, neck muscle and pharyngeal reflex, the training of lip movement, vocalization, sound volume, rhythm and speed, and the training of deep breathing exercises and abdominal pressure. For the non-motor symptoms, the rehabilitation includes the training of memory, attention, problem solving ability, activities of daily living and others, psychotherapy, family support, social participation, and other comprehensive treatments combined with medicine.
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Neural prosthesis control system is based on brain-computer interface and functional electrical stimulation technology, by an-alyzing the electroencephalograph control commands directly into the muscle system or an external device, which compensated efferent pathway from the brain-spinal cord, and recovered motor function of patients with cervical spinal cord injury. This paper described the basic structure, working principle and key technology of neural prosthetic system, summarized the application, problems and prospects of neural prosthetic technology in the rehabilitation of cervical spinal cord injury.
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Objective To observe the real-time effect of retaining needle at Lingtai (GV 10) and Shendao (GV 11) on ST-T segment on cardiogram in patients with angina pectoris of coronary heart disease (CHD).Method Thirty patients with angina pectoris of CHD who received acupuncture at Lingtai (GV 10) and Shendao (GV 11) were divided into group A with needles retained after insertion of the needles and group B without needles retained. The two groups were observed by using 12-lead electrocardiogram (ECG) before and after treatment, to compare the ST segment and T wave atⅡ,Ⅲ, avF lead and V4, V5, V6lead before and after treatment.Result After treatment, ST segment atⅡ,Ⅲ, avF lead and V4, V5, V6lead was changed significantly in group A (P<0.05). T wave was significantly changed atⅡ,Ⅲ, avF lead after treatment in group A (P<0.05). T wave at V4, V5, V6 lead was significantly changed after treatment in both groups (P<0.01,P<0.05).Conclusion Acupuncture at Lingtai (GV 10) and Shendao (GV 11) can improve myocardial ischemia in angina pectoris of CHD; compared to acupuncture without needles retained, retaining needles after acupuncture can produce a more significant effect in improving the inferior and anterior myocardial walls and a better real-time effect on ST-T on ECG of angina pectoris of CHD.
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Objective To observe the effects of electroacupuncture on genu recurvatum after stroke. Methods 80 stroke patients with genu recurvatum were randomly assigned to treatment group (n=40) and control group (n=40). The control group accepted routine rehabilita-tion, and the treatment group accepted electroacupuncture at Yanglingquan (GB34), Futu (ST32), Weizhong (BL40), Chengshan (BL57) and Zusanli (ST36) in addition, for 30 days. The incidence of effectiveness was compared between groups. All the patients were assessed with range of motion (ROM) of knee and Fugl-Meyer Assessment of lower limbs (FMA) before and after treatment. Results The incidence of ef-fectiveness was 72.5%in the treatment group, which was more than 55%in the control group (P<0.05). The ROM and score of FMA im-proved more in the treatment group than in the control group (P<0.05). Conclusion The electroacupuncture can promote the recovery of genu recurvatum after stroke.
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@#Neurological rehabilitation involves the most functional impairments. The students of rehabilitation medicine are required to master diagnosis and treatments of diseases, and assessments and rehabilitation of disabilities in neurological field during practice. This article introduced the experience of teaching for the students practised neurological rehabilitation.
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Neurological rehabilitation involves the most functional impairments. The students of rehabilitation medicine are required to master diagnosis and treatments of diseases, and assessments and rehabilitation of disabilities in neurological field during practice. This arti-cle introduced the experience of teaching for the students practised neurological rehabilitation.
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@# A 33-year-old male patient with tick-borne encephalitis (TBE) was reviewed, who presented with severe neurological deficits following TBEV infection, and improved in his motor and quality of life after an individualized rehabilitation.
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@# Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (rTMS) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency rTMS for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P<0.05). The USN degree of patients in the treatment group decreased significantly after the treatment (P<0.05), while patients in the controlled group had no difference (P>0.05). Conclusion USN induced by stroke could be improved obviously through low frequency rTMS.
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@#Objective To study physiological foundation of acupunctureDeqi.Methods 28 healthy volunteers who never experienced acupuncture were recruited. The right Zusanli (ST36) and a site 1.5 cm beside Zusanli (ST36) (nominated as A) were acupunctured at different time. Shallow and deep acupuncturing was inserted at Zusanli (ST36). Only deep acupuncturing was inserted at A. Hemodynamic parameters of the anterior tibial artery including the peak value in the systolic phase (Vmax), the average blood flow velocity (Vm), and the inner diameter of vessels (Dist) were observed with colored Doppler ultrasound before, at the end of acupuncture, and 3 min afterDeqi response. Results There was significant difference in those parameters between before acupuncture and 3 min after deqi response when deep acupuncturing at Zusanli (ST36) (P＜0.05), but was not significant difference when shallow acupuncturing (P＞0.05). There was significant difference in ΔVmax and ΔVm between acupuncture at Zusanli (ST36) and A points (P＜0.05). Conclusion Arterial haemodynamics variation seems to be associated with acupunctureDeqi.
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@# Objective To study the relationship between needle retaining anddeqi. Methods Manual acupuncture was performed at the left ST36 of 26 naive healthy adult volunteers. Half of them retained the needles for 6 min and others were put the needle out immediately afterdeqi. Hemodynamic parameters of the anterior tibial artery were observed with color Doppler ultrasonography before and at 0, 1, 2, 3, 4, 5 min after acupuncture. Results There was significant difference in Vmax、Vm、Pi and Dist in anterior tibial artery before and 3 min after acupuncture, but wasn't between needle remaining and not. Conclusion Needle retaining cannot change the regional haemodynamics during acupuncture, which suggest it cannot strengthendeqi.
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@#Stroke is common clinically and spasticity is one of the main symptoms.There is some advance in recognition of the spasticity after stroke in the basic and clinic,but it remains obscure.
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@#Objective To observe the effects of electroacupuncture at Zusanli (ST36) on lower limbs motor function in patients with stroke. Methods 63 patients were evenly randomized into electroacupuncture group and control group. All the patients received routine rehabilitation training and at the same time,patients in electroacupuncture group, received electroacupuncture at zusanli (ST36). They were assessed with Fugl-Meyer Assessment (lower limb, hip, knee and ankle), gait analysis (gait frequency, gait speed and step length of both sides) and lower limb Composite Spasm Scale (CSS) before and after treatment. Results The scores of Fugl-Meyer Measure, gait analysis, and CSS improved in both groups, and more significantly in electroacupuncture group. Conclusion Electroacupuncture at zusanli (ST36) can significantly improved lower limb motor function without worsening the spasm.