ABSTRACT
@#Sensory Modality Assessment and Rehabilitation Technique (SMART) is one of the tools for assessing patients with disorders of consciousness (DOC) after brain injury, to detect signs and meaningful responses to the conscious presence of DOC patients, and to optimize the patient's potential communication and motor function through the development of a treatment plan, that can be used in the assessment, treatment, and long-term prognosis of patients with DOC. SMART can effectively reduce the misdiagnosis of DOC due to the environment, long observation and evaluation, the incorporation of family and care teams in the evaluation, and the normalization of the evaluation content. Besides an assessment tool, SMART provides treatment options. At present, the SMART treatment stage has been formalized, which can create personalized treatment plan for patients. The intervention after DOC evaluation can be divided into exploration, strengthening and education. SMART is advantaged in evaluation, treatment and prognosis, that can benefit the standardization of diagnosis and intervention of DOC in China.
ABSTRACT
@#The recovery of disorders of consciousness after brain injury is very difficult, music therapy is one of the important ways to promote the awakening. The effects of music therapy are various among individuals, the vegetative state and the minimally conscious state, and the pieces of music. The default mode network is one of the most important networks to maintain awareness, which many other networks participate in. The brain regions affected by music involve in many networks, including hearing, cognition, emotion, and so on.
ABSTRACT
Objective To analyze the results of theoretical test and clinical skills examination of standardized resident training gradua-tion exam in Beijing in recent years, to improve the examination standards and assessment models. Methods The results of theoretical test and clinical skills examination from 2011 to 2016 were collected. The difficulty, degree of differentiation, and factors related with the result of clinical skills examination were analyzed. Results The test paper is difficult with good degree of differentiation from 2014 to 2016. Edu-cation degree and year were not related with the clinical skills (P>0.05), while the hospital level was (P<0.05). Conclusion The standardized training and assessment of residents in rehabilitation medicine need continuously attention. Combined with the results of the assessment and the problems exposed in the assessment, a feasible scheme should be put forward, in order to improve the quality of resident training.
ABSTRACT
Objective To explore the clinical characteristics and rehabilitation of apraxia with unilateral neglect after corpus callosum in-farction. Methods A case of apraxia with unilateral neglect after corpus callosum infarction was discussed. Results After rehabilitation, the apraxia and unilateral neglect were improved. Conclusion For similar cases, rehabilitation can significantly improve the symptoms and ac-tivities of daily living.
ABSTRACT
Objective To evaluate the method of controlled cortical impact(CCI) on long term cognitive disorder after traumatic brain injury(TBI) and to investigate the possible pathological mechanism.Methods Sixty male SD rats were randomly assigned into 3 groups:sham surgery group(n =10),control group (n =10) and CCI group(n =40).CCI application was used to make the bilateral frontal lobe controlled cortical impact model (depth:1.5 mm,velocity =3.5 m/s,dwell time =400 ms).Morris water maze test and Nissl's staining was used to assess the cognitive function and pathological changes after 8 weeks of CCI.The expressions of brain derived neurotrophic factor (BDNF) and tyrosine protein kinase B (TrkB) mRNA in frontal lobe and hippocampus tissue was detected by reverse transcription polymerase chain reaction(RT-PCR).Results The mortality in CCI group was only 12.5％.Morris water maze test results showed the escape latency in CCI group was longer than that in sham surgery and control groups(F =51.784,P ＜ 0.05).Percent of time spend in goal quarter during probe trial in CCI group was significantly less than that in sham surgery and control groups(F =13.468,P ＜ 0.05).Nissl's staining showed frontal lobe had obviously defects; Nissl's bodies of frontal cortex and CA1 region in hippocampus reduced.The expressions of BDNF and TrkB mRNA in frontal lobe and hippocampus were significantly less than those in sham surgery and control groups(P ＜ 0.05).Conclusions The CCI model can be applied for study on long term cognitive disorder after TBI with good stability and repeatability.Using the experimental parameters of CCI can damage the long term cognitive function after TBI in rats,and lead the pathology changes of brain tissue clearly.This may have some relationship with the expressions of BDNF and TrkB mRNA.
ABSTRACT
@#Objective To investigate the application of Montreal Cognitive Assessment (MoCA) and Mini- Mental State Examination (MMSE) in cognitive function evaluation for stroke patients during convalescence. Methods 127 stroke patients were selected and both Mo-CA and MMSE were conducted to assess their cognitive function. Results The detection rate was higher with MoCA (86.61%) than with MMSE (57.48%) (P<0.05). Conclusion Compared to MMSE, MoCA covers a broader scope of cognitive function, and is more sensitive.
ABSTRACT
@#Objective To investigate the characteristics of Montreal Cognitive Assessment (MoCA) and analyze the influence of age, coma or not, injury side, and injury area on the scores of MoCA. Methods 135 stroke patients were evaluated with MoCA. Results The scores were poor in delayed recalling, abstraction, verbal fluency, view space and executive function, and were less poor in naming, attention and orientation. There was significantly difference in the total score, attention, verbal fluency, delayed recalling and orientation of MoCA between older and younger patients (P<0.05). There was significantly difference in the total score, view space and executive function, attention, orientation between patients with coma and without coma (P<0.05). There was significantly difference in the total score, attention, verbal fluency, abstraction, delayed recalling and orientation between thoses with left side injury and right side injury (P<0.05). Compared with basal ganglia injury, front lobes injury tended to impact the total scores, attention, abstraction and delayed recalling (P<0.05); frontal, temporal and parietal lobes tended to impact the total score, naming, abstraction and delayed recalling (P<0.05). Conclusion The total scores of MoCA do reflect the cognitive impairment in patients with stroke, while the age, coma or not, injury side and injury area of the brain may impact the cognitive impairment in patients.
ABSTRACT
@# Objective To investigate the influence of age, injury side and injury area on Mini- Mental State Examination (MMSE)scores. Methods General data of 67 patients with severe traumatic brain injury were recorded, and they were assessed with MMSE. Results The scores were low in recalling, orientation, calculation, writing and drawing, while they were high in naming, memorizing, reiteration and comprehension. The total MMSE scores and the scores of space orientation and reading were lower in 45~65 years old patients than in 18~44 years old patients (P<0.05). There was significantly difference in time orientation, space orientation, recalling and calculation between basal ganglia injury and front lobes injury (P<0.05), as well as in total MMSE scores, time orientation, space orientation, calculation and drawing between basal ganglia injury and front, temporal and parietal lobes injury (P<0.05). Conclusion MMSE scores do reflect cognitive impairment in patients with traumatic brain injury, the specific age and injury area of the brain can influence the cognitive impairment in patients.
ABSTRACT
Objective To investigate any correlation between diffusion tensor imaging (DTI) results and Montreal cognitive assessment (MoCA) scores after severe traumatic brain injury (TBI).Methods Eight male pa-tients with chronic severe TBI were given the MoCA (including memory,attention,speech and executive function).DTI was used to quantify the fractional anisotropy (FA) of white matter fiber tracts in the radial and longitudinal fasciculus,under longitudinal fasciculus,internal capsule,corpus callosum genu and body,and the cingulate cortex.Pearson correlation coefficients were calculated to quantify the correlation between the FA values and MoCA scores.Results There was a positive correlation between FA in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus and MoCA total scores.Conclusion The MoCA scores of patients with chronic severe TBI are related to white matter damage in the corpus callosum body,corpus callosum genu and the superior longitudinal fasciculus.
ABSTRACT
Objective To investigate the application of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in cognitive function evaluation for stroke patients during convalescence. Methods 127 stroke patients were selected and both Mo-CA and MMSE were conducted to assess their cognitive function. Results The detection rate was higher with MoCA (86.61%) than with MMSE (57.48%) (P<0.05). Conclusion Compared to MMSE, MoCA covers a broader scope of cognitive function, and is more sensitive.
ABSTRACT
Objective To investigate the influence of age on clinical features and prognosis of severe traumatic brain injury.Methods A total of 135 patients with severe traumatic brain injury were divided into four groups according to age:the juvenile group (＜18 years,15 cases),the young adult group (18 44 years,77 cases),the middle aged group (45 59 years,37 cases) and the elderly group (＞60 years,6 cases).Neurological functions were assessed by the Disability Rating Scale (DRS),the Mini-Mental Status Examination (MMSE),the Fugl-Meyer motor scale (FM) and the Modified Barthel Index (MBI).All the patients were followed up with DRS evaluation 1 4 years after discharge from the hospital.Results MMSE scores decreased with age,with statistically significant differences between the elderly group and the juvenile group,the young adult group and the middle aged group,respectively [(11.0±5.2) vs (21.5±8.1),(21.4±8.0) and (19.1±8.1),respectively; t=2.663、2.825、2.561,P=0.015,0.006,0.022,respectively].Similarly,when compared with the other groups,the elderly group also showed statistically significant differences in follow-up DRS scores [(12.8±6.1) vs.(4.3±3.6),(6.7±5.0) and (7.8±6.9),respectively; t=-2.382、-2.587、-2.385,P =0.040,0.013 and 0.038,respectively]; and the DRS score differentials [(2.3±4.6) vs.(6.2±4.3),(6.7±3.1) and (4.6±3.1); t=2.366、2.242、2.626,P =0.004,0.013 and 0.009,respectively].Conclusions Age may be one of the factors that affect cognitive functions and prognosis associated with traumatic brain injury,and the prognosis for elderly patients is generally unfavorable.
ABSTRACT
@#ObjectiveTo study the effect of a course of regular rehabilitation treatment on patients with different traumatic brain injury(TBI) course, explore the costs of one rehabilitation course in patients with different TBI course, and study the timing and focus of rehabilitation on patiens with different stages.Methods250 TBI patients were distributed to five groups by different TBI courses: <3 months, 3～6 months, 6 months～1 year, 1～2 years and >2 years. The clinical data and initial function evaluation were done at the admission. All of them received at least one regular rehabilitation treatment, then another function evaluation was done. Effects and costs of one rehabilitation course in patients with different TBI course were investigated.ResultsThe longer the duration of illness, the higher the cost-effectiveness ratio. The cost-effectiveness ratio of the second treatment course was higher than the first one. The patients within 12 months should receive a comprehensive rehabilitation treatment, and should be prevented and treated hydrocephalus and other complications; for patients within 1～2 years, there would be no significant improvement in balance and lower limb function, should enhance the training of activity of daily living (ADL) and upper extremity function; for the patients more than two years just improved ADL using of residual function.ConclusionTBI patients should accept rehabilitation as soon as possible, and should be conducted corresponding trainings according to different disease course.
ABSTRACT
@#The change of pitutary hormones can occur in any time after traumatic brain injury, the main cause is primary or secondary impairment of hypothalamus as well as pituitary after brain injury. It is important to further research when to test hormone and to carry on the hormone replacement therapy.
ABSTRACT
@#After several years of practice, in China the rehabilitation residency training has made some achievements, but the training quality assurance system is still need to be improved. On the quality assurance system for training residents in reference to the basic framework, combined with practical experience, training bases and sections for the perspective of improving the training quality were discussed.
ABSTRACT
@#Objective To explore the clinical characters of drug-associated spinal subarachnoiditis. Methods 6 patients with spinal subarachnoiditis were analyzed retrospectively. Results All the patients appeared acute onset, numbness and weakness of lower limbs, incontinence, dramatic increase of protein with normal or mild increase of WBC in cerebral fluid regulation. Conclusion Spinal subarachnoiditis, if occurs, is resistant to variety of medication, and lead to the poor outcome. Prevention is most important.
ABSTRACT
@#Objective To explore the features and rehabilitation for organophosphate-induced delayed polyneuropathy. Methods 2 patients with serious organophosphorus-induced delayed neuropathy due to drinking tamaron and dichlorvos were reported. Results and Conclusion The patient partially recovered after physiotherapy. Long leg orthosis is beneficial to the functional recovery of lower limb.
ABSTRACT
@#The rehabilitation and nursing for the complication and secondary disturbance are the important partition of treatment for patients with traumatic brain injury(TBI).Understanding the category,mechanism,prevention and treatment of complications can efficaciously decrease the incidence rate of them,relieve the distress of patients,increase the ablity of ADL and the quality of life,improve the effect of rehabilitation,and reduce the economic burden of family and society.It also can promote patients back to family and society as earlier as possible.
ABSTRACT
@#The rehabilitation and nursing for the complication and secondary disturbance are the important partition of treatment for patients with traumatic brain injury(TBI).Understanding the category,mechanism,prevention and treatment of complications can efficaciously decrease the incidence rate of them,relieve the distress of patients,increase the ablity of ADL and the quality of life,improve the effect of rehabilitation,and reduce the economic burden of family and society.It also can promote patients back to family and society as earlier as possible.
ABSTRACT
@#Objective To investigate the incidence of unilateral spatial neglect(USN)after brain injury in different area with varied test,and to survey their sensitivity.Methods 196 patients after brain injury were assessed with varied test to identify USN.Results The total incidence of USN was 41.33%,which was the highest in the patients with parietal lobe lesion and less in the boundary of tempo-parietal-occipital lobe,the temporal lobe and basal ganglion injury in turn.The sensitivity of the Albert test was the highest,which was less of Shenckenberg test,letter-figure-cancellation test,copying drawing test,clock-drawing test and character test in turn.However,the sensitivity of Albert test was the highest in the patients with frontal lobe lesion,and that of Shenckenberg test was the highest when the temporal,parietal lobe or the boundary of tempo-parietal-occipital lobe injured.Conclusion The incidence of USN was high after brain injury.It is important to choose the test tool according to the area of the focus.
ABSTRACT
@#In developed countries,traumatic brain injury(TBI)has been the first cause of disability and mortality in adolescents,and in China,the incidence of TBI and the amount of disable or died patients after TBI increased with years.During the past decades,much more emphasis were paid on fundamental and clinical researches on TBI in China,and much developments have been made.But there are a lot of problems and shortness in these researches and clinical treatments of TBI,especially the conditions of research get behind of advanced world levels.In this review,the recent developments of studies on TBI were summarized,mainly the researches of complications,rehabilitation and outcome after TBI,also including the researches of fundamental pathological mechanism,animal pattern,neural protect and reparative regeneration technique of TBI,as well as the difference of trend and level between researches in China and foreign countries.