ABSTRACT
Objective To investigate the effect of graded motor imagery ( GMI) therapy combined with rou-tine occupational therapy on the recovery of upper extremity function after stroke. Methods Thirty stroke survivors who met inclusion criteria were randomly assigned to a control group ( n=15) or a GMI group ( n=15) . The control group received routine medication, conventional physical therapy and routine occupational therapy ( one hour a day) , while the GMI group received 30 minutes of routine occupational therapy and 30 minutes of graded motor imagery therapy every day in addition to conventional medication and physical therapy. Before and after four weeks of treat-ment, the patients in both groups were evaluated using the Fugl-Meyer Assessment for the Upper Extremities ( FMA-UE) , the Box and Block Test ( BBT) and Brunnstrom arm and hand staging. Surface electromyography of the biceps brachii and triceps brachii was performed as the affected elbow flexed and stretched in maximum isometric contrac-tions, and the co-contraction ratios ( CRs) were calculated. Results After the treatment, the average FMA-UE score, Brunnstrom arm and hand stage, BBT and CR scores in both groups had improved significantly. The average improvement in the GMI group was significantly greater than in the control group. Conclusions Graded motor im-agery therapy can significantly promote motor recovery of the upper extremities of hemiplegic patients after a stroke.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture (EA) on the activation of microglia cells in the Lto Lspinal cord in rats with neuropathic pain, so as to investigate whether EA could inhibit the activation of spinal microglial cells and regulate the expression of brain-derived neurotrophic factor (BDNF) to achieve the analgesic effect.</p><p><b>METHODS</b>Forty male Sprague Dawley rats were randomly divided into a normal group, a sham-model group, a model group and an EA group, 10 rats in each one. The rats in the normal group received no treatment; the rats in sham-model group were treated with operation to exposure sciatic nerve for 2 to 3 min (no knot); the rats in the remaining groups were treated with model establishment of chronic constrictive injury (CCI). 7 days after model establishment, the rats in the EA group were treated with EA at "Zusanli" (ST 36) and "Yanglingquan" (GB 34), 30 min per time, once a day for consecutive 7 days. Only immobilization was used in the remaining groups the mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) of affected side feet were respectively measured before model establishment and 3 days, 5 days, 7 days, 10 days, 12 days and 14 days after model establishment; 14 days after model establishment, rats were sacrificed; the immunohistochemical method was used to measure the expression of Iba1 and BDNF in the sample of Lto Lspinal cord; real-time fluorescent quantitative PCR was used to measure the expression BDNF mRNA.</p><p><b>RESULTS</b>Compared with the sham-model group, the pain threshold was decreased significantly in the model group (<0.05), leading to hyperpathia. After EA treatment, compared with the model group, the pain threshold was increased significantly in the EA group (<0.05). 14 days after operation, the microglia cells in the Lto Lspinal cord, expression of BDNF and level of mRNA in the model group were significantly higher than those in the normal group and sham-model group (all<0.01); those in the EA group were significantly lower than those in the model group (all<0.01).</p><p><b>CONCLUSIONS</b>The analgesic effect on neuropathic pain is likely to be achieved by EA through inhibiting the activation of spinal microglia cells and down-regulating the expression of BDNF.</p>
ABSTRACT
Objective To observe the efficacy of underwater partial body-weight-supported treadmill training in repairing spinal cord injury (SCI) and its relationship with spinal nerve plasticity. Methods A total of 40 Sprague-Dawley rats were randomly divided into five groups: a sham model group, a model control group, an underwater training group, a partial body-weight-supported treadmill training (PBWSTT) group and an underwater PBWSTT group. A rat model of SCI was induced by contusion of the T10 segment with a Multicenter Animal Spinal Cord Injury Study (MASCIS) impactor. One week post-operation, different rehabilitation strategies, such as free exercise in water, BWSTT and underwater PBWSTT, were administered to the rats in the underwater training groups for 8 weeks.Those in the sham model group and model control group were given no training. The Basso, Beattie and Bresnahan (BBB) locomotor rating scale and a climbing test were used to evaluate the recovery of hindlimb locomotor function.The expression of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in the spinal cords was detected with immunohistochemical methods. Results Nine weeks post-operation, hindlimb locomotor function had improved significantly more in the underwater PBWSTT group than in underwater training group or the BWSTT group.The expression of BDNF in the 3 training groups was significantly higher than in the model control group, though there was no significant difference among the 3 training groups. The expression of NT-3 in the underwater PBWSTT group increased more significantly than in the BWSTT group, however there was no significant difference between the underwater PBWSTT group and the underwater training group. Conclusion Underwater PBWSTT can promote the recovery of hindlimb locomotor function in rats after SCI, probably through increasing the expression of BDNF and NT-3 and thus promoting neural plasticity in the spinal cord.