ABSTRACT
ObjectiveTo investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) combined with rehabilitation robot on upper limb and hand dysfunction in patients with subacute stroke. MethodsFrom December, 2019 to December, 2021, 50 inpatients with subacute stroke in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 25) and experimental group (n = 25). Both groups received routine rehabilitation therapy, while the control group added sham HD-tDCS combined with rehabilitation robot, and the experimental group added HD-tDCS combined with rehabilitation robot, for four weeks. The upper limb and hand function was assessed with Action Research Arm Test (ARAT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Motor Assessment Scale (MAS) before and after treatment. ResultsAfter treatment, the scores of ARAT, FMA-UE and MAS increased in the two groups (∣Z∣ > 3.320, t > 6.379, P < 0.01), while the scores of FMA-UE and MAS were higher in the experimental group than in the control group (Z = -2.379, t = 3.181, P < 0.05), as well as the scores of grasping and gross motor of ARAT (∣Z∣ > 2.033, P < 0.05). ConclusionThe combination of HD-tDCS and rehabilitation robot can be more effective on upper limb and hand function in patients with subacute stroke than rehabilitation robot alone.
ABSTRACT
Objective To study the effects of binary cardiac rehabilitation (CR) composed of hospital-based and home-based CR in patients after acute myocardial infarction (AMI) evaluated by six-minute walking distance (6MWD). Methods A total of 38 post-MI patients were divided into two groups, namely conventional CR group (n=20) and binary CR group (n=18). In the first seven days, CR training was carried out in all 38 patients in our hospital, and then 20 patients were kept at CR training in the hospital (hospital-based CR group), whereas the remaining 18 patients (binary CR group) got tele-monitored walking training at home for eight weeks (binary model). Before discharge from hospital based CR or after 8 weeks CR at home, all patients received Cardiopulmonary Exercise Testing and Six-minute Walk Test, and the data of patients' body mass index (BMI),thyroid function, serum lipid metabolism and echocardiography were collected before and after CR. Results After CR, BMI and low density lipoprotein (LDL) decrease in both groups compared with those before CR[hospital-based group: BMI, (25.99±3.36)kg/m2 vs. (23.04±3.72) kg/m2,P＜0.05; LDL, (3.40±1.38) mg/dl vs. (2.04±0.73)mg/ dl,P＜0.01; binary group: BMI, (24.84±2.70) kg/m2 vs. (22.88±2.56) kg/m2,P＜0.05; LDL, (3.40±1.01) mg/dl vs. (92.11±0.37) mg/dl,P＜0.01]. After 8 weeks CR at home or hospital based CR until discharge, the anaerobic threshold (AT), maximum rate of oxygen consumption (VO2max),metabolic equivalent (MET) and 6MWD improved significantly in both groups compared with those at 7 days after CR in hospital [Hospital-based group: AT, (12.37±1.53) mL/(kg. min) vs. (14.77±1.57) mL/(kg. min); VO2max (17.87± 1.66 mL/(kg. min) vs. (20.73±2.14) mL/(kg. min); MET (5.02±0.36) vs. (6.09±0.53); 6MWD (500±53.36) m vs. (582.5±57.6) m,P＜0.01; Binary group: AT, (12.56±1.11) mL/(kg·min) vs. (14.30±1.23) mL/(kg. min); V02max, (17.28±1.38) mL/(kg. min) vs. (20.02±1.37) mL/(kg. min); MET, (5.07±0.47)vs (5.94±0.46); 6MWD,(511.4±50.96) m vs. (590.3±56.1)m,P＜0.01]. There was no significant difference in CR effects observed between two groups (P＞0.05). Conclusions In post-MI patients,a binary model of CR training improved physical capacity and was a similarly effective form of CR as a entirely hospital-based approach. A home-based tele-monitored program facilitated patients' adherence to CR. The 6 minute walk experiment is economical and good evaluation on the CR effect of binary cardiac rehabilitation.