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Objective:To analyze the clinical characteristics of elderly acute pulmonary thromboembolism(APE)patients complicated with preexisting atrial fibrillation(AF)and the impact of preexisting AF on in-hospital adverse outcomes in elderly patients with APE.Methods:A retrospective analysis was performed on elderly APE patients with preexisting AF hospitalized in Beijing Anzhen Hospital, Capital Medical University between January 1, 2008 and December 31, 2021.We compared the comorbidities, symptoms, signs, laboratory test results and echocardiographic features, simplified pulmonary embolism severity index(sPESI)scores and adverse in-hospital outcomes between the preexisting AF group and the non-AF group.Logistic regression was used to analyze the risk factors of in-hospital adverse outcomes in elderly patients with APE.Results:A total of 240 patients diagnosed with APE were enrolled.There were 120 patients in the AF group and 120 patients in the non-AF group.For patients in the AF group and the non-AF group, the proportions with chronic heart failure were 38.3%(46/120)and 15.8%(19/120), the proportions with lower extremity deep vein thrombosis(DVT)were 36.7%(44/120)and 65.8%(79/120), the left ventricular ejection fractions(LVEF)were(59±10)% and(62±7)%, and hospital stays were(15±7)and(11±4)days, respectively, and the differences were statistically significant( χ2=15.381, 20.429, t=2.527, -4.710, all P<0.05). The incidences of in-hospital adverse outcomes in the AF group and the non-AF group were 4.2%(5/120)and 3.3%(4/120), respectively, with no significant difference( χ2=0.000, P=1.000). The overall incidence of in-hospital adverse outcomes was 3.8%(9/240). Multivariate Logistic regression analysis showed that elevated lactic acid was an independent risk factor for in-hospital adverse outcomes( OR=2.753, 95% CI: 1.367-5.542, P=0.005). However, AF( OR=2.880, 95% CI: 0.587-14.141, P=0.192)and sPESI score( OR=2.056, 95% CI: 0.904-4.673, P=0.086)were not associated with in-hospital adverse outcomes. Conclusions:Elderly APE patients with preexisting AF have a relatively low incidence of DVT, but a higher proportion have concurrent chronic heart failure and need a longer hospital stay.Elevated lactic acid is an independent risk factor for in-hospital adverse outcomes of elderly APE patients with preexisting AF.However, preexisting AF has no predictive value for in-hospital adverse outcomes in elderly patients with APE.
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Objective:To investigate the correlations between subacromial impingement syndrome (SIS) and acromial morphology and subacromial intervals after surgery of proximal humerus fracture.Methods:A retrospective study was conducted of the 62 patients with proximal humerus fracture who had been treated by internal fixation with a locking titanium plate from December 2014 to December 2019 at Department of Orthopedics, People's Hospital of Gaoming District. They were 40 men and 22 women, with an average age of 53.5 years (from 35 to 71 years). By the Neer classification, there were 38 three-part and 24 four-part fractures. The incidence of SIS was determined by Nikolaus's diagnostic criteria. The patients were divided into a SIS group and a non-SIS group. The acromial morphology was observed and the subacromial intervals [acromio-greater tuberosity of humerus interval (AGI) and acromio-plate interval (API)] were measured on postoperative X-ray films. The correlations were analyzed between them and SIS.Results:All patients completed treatments and follow-ups from 3 to 15 months (average, 10 months). There was no incision infection or internal fixation failure. There were 18 cases in the SIS group and 44 ones in the non-SIS group. In the SIS group, 3 cases had type Ⅰ acromion while 15 ones type Ⅱ or type Ⅲ acromion; in the non-SIS group, 20 cases had type Ⅰ acromion while 24 ones type Ⅱ or type Ⅲ acromion. The proportion of patients with type Ⅱ or type Ⅲ acromion in the SIS group was significantly higher than that in the non-SIS group ( P<0.05). AGI and API in the SIS group were (11.6±2.1) mm and (14.2±2.4) mm, significantly shorter than those in the non-SIS group [(15.7±2.8) mm and (18.5±3.2) mm] ( P<0.05). Conclusions:SIS is a common complication after surgery of proximal humerus fracture. Abnormal acromial morphology (type Ⅱ or type Ⅲ acromion), poor fracture reduction (reduced AGI), and high placement of a titanium plate (reduced API) may be all important factors leading to SIS.
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Objective:To discuss the effect of modified Yangxintang on chronic pulmonary heart disease (CPHD) with syndrome of deficiency of heart and lung Qi and progress of disease. Method:One hundred and twenty-eight patients were randomly divided into control group 64 cases and observation group 64 cases by random number table. Patients in control group got comprehensive rehabilitation measures of western medicine. Those who had respiratory distress got Salmeterol ticasone powder inhaler, 1-2 times/day, 1 inhale/time.And those who had cough and phlegm got Ambroxol hydrochloride tablets for 1-2 week, 1-2 tablet/time, 3 times/day. In addition to the therapy of control group, patients in observation group was also added with modified Yangxintang, 1 dose/day, 5 days/week. Record the and times of acute aggravate and cold, pulmonary artery systolic pressure (PASP), mean pulmonary artery pressure (MPAP), left ventricular ejection fraction (LVEF), stroke volume (SV) and cardiac output (CO) were recorded during 48 weeks. Before and after treatment, scores of modified British medical research council respiratory questionnaire (mMRC questionnaire), Minnesota Heart Failure Quality of life scale (MLHFQ), syndrome of deficiency of heart and lung Qi and 6-minute walking test (6 MWT) were scored. And levels of N-terminal B-type natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), endothelin (ET-1), CD3+, CD4+, CD8+ and CD4+/CD8+ were detected. Result:The clinical efficacy in observation group was better than that in control group (Z=2.108, P<0.05). During 48 weeks of observation period, times of acute aggravate and cold in observation group were less than those in control group (P<0.01). Levels of PASP, MPAP and NT-proBNP were lower than those in control group (P<0.01). And levels of LVEF, SV, CO, 6 MWT and NO were higher than those in control group (P<0.01), levels of CD3+, CD4+ and CD4+/CD8+ were higher than those in control group (P<0.05). And levels of mMRC, MLHFQ, score of syndrome of deficiency of heart and lung Qi, TNF-α , IL-6, ET-1, CD8+ and were all lower than those in control group (P<0.01, P<0.05). Conclusion:In addition to anti-inflammatory, anti-asthmatic and anti-tussive therapies, modified Yangxintang can improve the immune function, relieve the symptoms of heart and lung, improve the function of heart and lung and the quality of life, inhibit the inflammatory reaction, improve the function of vascular endothelium, reduce the pulmonary hypertension, control the progress of disease.
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This paper reviewed the relevant literatures on physical therapy for post-stroke limb spasticity from Chinese Hospital Knowledge Database (CHKD) and PubMed since 2011, and summarized the pathology, examination, physiotherapy strategies and various physiotherapy methods. The physical therapy mainly included physical factor therapy, kinesiotherapy and manipulation therapy. It is necessary to optimize the selection of physical therapy strategies in clinical practice to improve efficiency of rehabilitation.
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This paper reviewed the relevant literatures on physical therapy for post-stroke limb spasticity from Chinese Hospital Knowledge Database (CHKD) and PubMed since 2011, and summarized the pathology, examination, physiotherapy strategies and various physiotherapy methods. The physical therapy mainly included physical factor therapy, kinesiotherapy and manipulation therapy. It is necessary to optimize the selection of physical therapy strategies in clinical practice to improve efficiency of rehabilitation.
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OBJECTIVE： To optimize the water extraction technology of Qiwei chanshen formula. METHODS： The content of polysaccharides from Gekko japonicus and Panax quinquefolium was determined by UV spectrophotometry， the contents of camptothecin from Camptotheca acuminata and ginsenoside Rb1 from P. quinquefolium were determined by HPLC. The extraction rate of above three components， dry extractum yield and HPLC fingerprint similarity were used as evaluation indicators； information entropy theory was used to determine the weight of each indicator so as to calculate comprehensive score. L9（34） orthogonal test was used to screen the optimal extraction technology of Qiwei chanshen formula with decoction time， water volume and decoction times as factors. Validation test was also performed. RESULTS： The optimal extraction technology included 10-fold water， decocting for 3 times， 1.0 h each time. The results of validation test showed that the average extraction rate of polysaccharide， camptothecin and ginsenoside Rb1 were 74.306％， 13.860％ and 52.958％， respectively. The average dry extractum yield was 16.150％， the average value of fingerprint similarity was 0.991 （all RSDs＜3.0％， n＝3）. CONCLUSIONS： The optimized extraction technology is reproducible， stable and feasible， providing reference for the subsequent development and industrial production of the formula.
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BACKGROUND: Multilevel thoracolumbar fractures are mainly treated with percutaneous pedicle screw and open pedicle screw system, but the treatment effect of different systems and the accuracy rate of screw placement are controversial, resulting in the lack of uniform standards for choosing the treatment method. OBJECTIVE: To evaluate the effect of percutaneous pedicle screw and open pedicle screw system in the treatment of multilevel thoracolumbar fractures and to evaluate the accuracy of the screw placement. METHODS: Totally 90 patients with multilevel thoracolumbar fractures were divided into open pedicle screw group (n=43 cases) and percutaneous pedicle screw group (n=47) according to different surgical methods. Open pedicle screw group was treated with open pedicle screw treatment, and percutaneous pedicle screw group was treated with percutaneous pedicle screw. Comprehensive effects were analyzed by comparing perioperative indicators (operation time, postoperative drainage volume, and incision length) imaging index (anterior vertebral height percentage, posterior vertebral height percentage, sagittal Cobb angle), postoperative complications, and pedicle screw accuracy. RESULTS AND CONCLUSION: (1) The amount of bleeding, postoperative drainage volume, and incision length were less (shorter) in the percutaneous pedicle screw group compared with the open pedicle screw group (P < 0.05). However, operation time and the number of undergoing fluoroscopy were longer (more) in the percutaneous pedicle screw group than in the open pedicle screw group (P < 0.05). (2) Anterior vertebral height percentage and posterior vertebral height percentage were higher in the percutaneous pedicle screw group than in the open pedicle screw group (P < 0.05). Sagittal Cobb angle was smaller in the percutaneous pedicle screw group than in the open pedicle screw group (P < 0.05). (3) At 2 months after surgery, the complication rate was significantly lower in the percutaneous pedicle screw group (4%) than in the open pedicle screw group (14%) (P < 0.05). (4) The accuracy rate of pedicle screw was significantly higher in the percutaneous pedicle screw group (92.1%; 279 screws) than in the open pedicle screw group (77.0%; 257 screws) (P < 0.05). (5) Results indicated that percutaneous pedicle screw fixation is characterized by less trauma and rapid recovery in the treatment of multilevel thoracolumbar fractures. It is helpful for the reduction of the injured vertebra, the maintenance of vertebral height; the safety and the accuracy of screw placement are high.
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Objective To investigate the intervening effect of transcutaneous electrical nerve stimulation plus auricular plaster therapy on depression and self-esteem in elderly patients with coronary heart disease. Methods One hundred and twenty-eighty patients with coronary heart disease were randomized to groups A, B, C and D, 32 cases each. Group A received conventional medication and health education. In addition to those given to group A, group B received auricular plaster therapy; group D, transcutaneous electrical nerve stimulation; group C, transcutaneous electrical nerve stimulation plus auricular plaster therapy. The Hamilton Depression Scale (HAMD) score and the Rosenberg self-esteem scale (RSES) score were recorded in every group before and after treatment. Results There were statistically significant pre-/post-treatment differences in the HAMD score and RSES score in all the four groups (P<0.05, P<0.01). After the intervention, the HAMD score and RSES score in group D were significantly different from those in group A (P<0.05). Conclusion Transcutaneous electrical nerve stimulation plus auricular plaster therapy and conventional medication helps to relieve depression and raise self-esteem in elderly patients with coronary heart disease.
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<p><b>OBJECTIVE</b>The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015.</p><p><b>DATA SOURCES</b>Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based.</p><p><b>STUDY SELECTION</b>The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full.</p><p><b>RESULTS</b>Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine.</p><p><b>CONCLUSIONS</b>At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.</p>
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Objective To compare the curative effect of percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) in lumbar disc herniation.Methods A literature search was performed in PubMed, Web of Science, Embase, Wanfang, CNKI. Two authors reviewed all articles individually. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool, and the quality of retrospective studies was evaluated by the modified Newcastle-Ottawa scale. The data was extracted by the Review Manager 5.30.Results A total of 19 articles were brought into this Meta-analysis. The outcomes were divided into primary outcomes and secondary outcomes. Excerpt for the short-term VAS score was lower in PELD group (P = 0.010), other index, including long-term VAS score (P = 0.120), ODI score (P = 0.260), complication (P = 0.100) and recurrence (P = 0.100), didn't had significant difference in two groups. The blood loss (P = 0.000), hospital stay (P = 0.000) and the length of incision (P = 0.000) were all superiority in PELD group. Whereas the operative time was shorter in MED group (P = 0.001).Conclusion PELD was a more minimally invasive and secure technique in lumbar disc herniation.
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<p><b>BACKGROUND</b>Exposure of adult mice to more than 95% O2 produces a lethal injury by 72 hours. Nuclear factor kappa B (NF-κB) is a transcriptional factor that plays a key role in the modulation of cytokine networks during hyperoxia-induced acute lung injury (ALI). Osteopontin (OPN) is a phosphorylated glycoprotein produced principally by macrophages. Studies have reported that exogenous OPN can maintain the integrity of the cerebral microvascular basement membrane and reduce brain damage through inhibiting NF-κB activities in the brain after subarachnoid hemorrhage. However, it is not clear whether OPN can reduce lung injury during ALI by inhibiting transcriptional signal pathways of NF-κB and consequent inhibition of inflammatory cytokines. Thus we examined the effects and mechanisms of recombinant OPN (r-OPN) on ALI.</p><p><b>METHODS</b>Ninety-six mice were randomly divided into phosphate buffered saline (PBS) and r-OPN groups. Mice were put in an oxygen chamber (>95% O2) and assessed for lung injury at 24, 48, and 72 hours. Expressions of NF-κB, matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9), and tissue inhibitors of MMP-2 and MMP-9 (TIMP-1, TIMP-2) mRNA in lungs were examined with RT-PCR. Expression and distribution of NF-κB protein in lungs were measured with immunohistochemistry.</p><p><b>RESULTS</b>Exposure to hyperoxia for 72 hours induced more severe lung injury in the PBS group compared with the r-OPN group. Expression of NF-κB mRNA in the PBS group exposed to hyperoxia for 48 and 72 hours was significantly higher than the r-OPN group (P < 0.05). With 72-hour exposure, expression of TIMP-1 mRNA in the r-OPN group was significantly higher than that of the PBS group (P < 0.05). Expression of TIMP-2 mRNA in the r-OPN group at 48 and 72 hours was significantly higher than those in the PBS group (P < 0.05). After 72-hour exposure, expression of NF-κB protein in airway epithelium in the PBS group was significantly higher than that in the r-OPN group (P < 0.05).</p><p><b>CONCLUSION</b>r-OPN can inhibit the release and activation of MMPs through inhibition of the expression of NF-κB and promotion of the expression of TIMPs, and alleviate hyperoxia-induced ALI.</p>
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Animals , Mice , Acute Lung Injury , Genetics , Metabolism , Hyperoxia , Metabolism , Matrix Metalloproteinase 2 , Genetics , Metabolism , Matrix Metalloproteinase 9 , Genetics , Metabolism , NF-kappa B , Genetics , Metabolism , Osteopontin , Genetics , Metabolism , Tissue Inhibitor of Metalloproteinase-1 , Genetics , Metabolism , Tissue Inhibitor of Metalloproteinase-2 , Genetics , MetabolismABSTRACT
A population-based case-control study was conducted to evaluate the relative factors in the environments, agricultural works, outdoor activities, and the effectiveness of Lyme borreliosis (LB)- associated personal protective measures in Beijing. Thirty-four cases and 272 controls were personally interviewed by well-trained interviewers. Venous blood samples were taken from each subject. Sowing or harvesting in summer (OR=2.571, 95% CI: 1.109-5.962), living in house with weeding in the yard (OR=2.247, 95% CI: 1.062-4.755), and residence at the plain area (OR=2.630, 95% CI: 1.050-6.588) were the independent relative factors for seropositive LB. Wearing long pants and clothes with cuffs was the only protective behavior against tick bite (OR=0.186, 95% CI: 0.041-0.846). The findings showed that local farmers were easily infected with LB and almost no protective measure was taken against LB infection. Infection with LB was easier in residents of plain regions. Pets raising and outdoor activities were not the risk factors for infection with LB. Further studies are needed to fully understand the risk of infection with LB in China.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Agriculture , Case-Control Studies , China , Epidemiology , Cities , Environment , Human Activities , Lyme Disease , Epidemiology , Microbiology , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment battery in Chinese patients with post-stroke aphasia.</p><p><b>METHODS</b>Cognitive functions of 59 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of LOTCA battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale, respectively. The Results of LOTCA were analyzed and compared across different groups, in the light of gender, age, educational background, the length of illness, and the degree of aphasia.</p><p><b>RESULTS</b>Neither the score of subtests of the LOTCA nor the overall scores of LOTCA of aphasia patients with different gender and educational background differed (all P>0.05). In different age groups, apart from thinking operation (F=3.373, P=0.016), visuomotor organization (F=3.124, P=0.022), attention (F=3.729, P=0.009) and the total score (F=2.683, P=0.041), there was no difference in terms of the other subtest scores of LOTCA (all P>0.05). In the groups of different length of time with illness, apart from orientation (F=2.982, P=0.039) and attention (F=3.485, P=0.022), the score of other subtests and the total score of LOTCA were not different (all P>0.05). In the groups of different degree of aphasia, apart from attention (F=2.061, P=0.074), both the score of other subtests and the total score of LOTCA differed (all P<0.05).</p><p><b>CONCLUSION</b>LOTCA might be suitable to assessing the cognitive ability of post-stroke Chinese patients with aphasia.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Aphasia , Psychology , Therapeutics , Asian People , China , Cognition , Occupational Therapy , Retrospective Studies , Stroke , Psychology , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>There has been a long debate among scholars surrounding the relationship between language and cognition. The worldwide study of aphasia is actively exploring the function of language from cognitive point of view. This study aimed to investigate the relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia.</p><p><b>METHODS</b>Cognitive functions of 63 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale, respectively. The correlation between the results observed on the LOTCA battery and those on the WAB was analyzed. Aphasia quotient, performance quotient, cortical quotient, and linguistic function of the patients were compared. Then, each language function was analyzed by way of dependent adopt multiple regression analysis.</p><p><b>RESULTS</b>The total score of 63 patients as shown on the LOTCA battery was significantly correlated with the aphasia quotient, performance quotient, and cortical quotient observed on the WAB Scale (P < 0.05, P < 0.01). However, the correlation between visuomotor organization under LOTCA and repeat under WAB was not significant (P > 0.05). The attention of LOTCA and WAB's spontaneous speech, repeat, naming, and aphasia quotient was not relevant either (P > 0.05). In addition, correlations between the results observed on the LOTCA battery and the WAB were significant (P < 0.05, P < 0.01). Among the significant variables finally entered into the standardized canonical discriminant functions, main factors affected the aphasia. Multiple regression analysis showed that orientation, spatial perception, and visual perception had a notable influence on aphasia quotient and naming. Orientation and thinking operation was found to have a notable influence on spontaneous speech. Spatial perception and visual perception was found to have a notable influence on auditory comprehension. Thinking operation and orientation was found to have an obvious influence on reading. Thinking operation, spatial perception, and attention was found to have a notable effect on writing (P < 0.01).</p><p><b>CONCLUSION</b>There exists a close relationship between linguistic functions and cognitive orientation, spatial perception, visual perception, and thinking operation in a clinical study of Chinese patients with post-stroke aphasia.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Aphasia , Asian People , Cognition , Physiology , Language , Space Perception , PhysiologyABSTRACT
Objective To investigate the status of Ehrlichia (E.)chaffeensis and A naplasma (A.) phagocytophilum infection among farming populations and domestic animals in the rural area of Beijing,China.Methods Blood samples from 562 farmers and 163 blood samples including 90 goats,71 ox and 2 dogs,were collected.Specificity of IgG antibodies against E.chaffeensis and A.phagocytophilum were tested by micro-indirect immunofluorescent assay (mIFA).16S rRNA genes of A.phagocytophilum were amplified from the domestic animal blood samples and products were sequenced and analyzed by nested PCR.Results The positive rates of E.chaffeensis and A.phagocytophilum antibody were 16.5％ and 14.0％ respectively for farmers.The total positive rates of A.phagocytophilum were 2.3％ and 0 for both goats and oxen respectively.No antibody was found for the 2 tested dogs.The PCR positive rates were 48.9％ and 23.9％ for goats and oxen respectively.Three dominant varieties of A.phagocytophilum were demonstrated in goats and oxen.Conclusion The prevalence rates of E.chaffeensis and A.phagocytophilum were identified in the rural areas of Beijing.
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ObjectiveTo study the types of anatomical variations of hepatic arteries. Methods Hepatic arteries of 64-slice spiral CT scanning data were three-dimensional constructed by using self-designed software. The types of anatomical variations were analyzed and classified with Michels' classification criteria. Results The model presented with realistic profile of hepatic arteries which allowed vivid three-dimensional observation. Of these patients, 40 had normal hepatic arteries (60.61%), 26 had variations (39.39%), and 5 had infrequent aberrant hepatic arteries that was not included in Michels' classification (7.58%). Conclusion Three-dimensional model of hepatic arteries can volumetricly display the anatomical variations of hepatic arteries.
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@#Objective To verify the convergent validity,discriminant validity and concurrent validity of the Action Research Arm Test(ARAT)in patients with chronic stroke.Methods 30 cases with chronic stroke were assessed with ARAT,upper limb section at Fugl-Meyer Assessment and Motor Activity Log(MAL)on the same day.The validity was investigated using Spearman ρ and t test.Results The scores of the ARAT closely correlated with upper limb section at Fugl-Meyer Assessment(ρ=0.906,P<0.001).The upper limb section at Fugl-Meyer scores≥33 group achieved a significantly higher scores of the ARAT than the scores<33 group(t =6.614,P<0.001).The scores of the ARAT closely correlated with the amount of use(AOU)and quality of movement(QOM)of MAL(ρ=0.894 and 0.761,respectively,P<0.001).Conclusion The ARAT has been shown good convergent validity,discriminant validity and concurrent validity in people with stroke.
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@#Objective To verify the inter-rater reliability,intra-rater reliability and internal reliability of the action research arm test(ARAT)in patients with chronic stroke.Methods 30 people with chronic stroke were tested with the ARAT by two experienced raters.The inter-rater reliability,intra-rater reliability and internal reliability were examined.Results The ARAT showed high inter-rater reliability and intra-rater reliability(ICC=0.992 and 0.987,respectively)and internal consistency(Cronbach's alpha coefficient=0.936).Conclusion The ARAT shows good inter-rater reliability,intra-rater reliability and internal reliability in assessing patients after stroke.
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@#ObjectiveTo determine the efficacy of constraint-induced movement therapy(CIMT) on different severity of the motor deficit of upper extremity after stroke.Methods27 stroke patients who had upper-limb hemiparesis and learned nonuse were allocated either to the moderate group(n=12) or the severe group(n=15) according to severity of initial motor deficit of upper extremity by Upper Extremity Function Test(UEFT).The two group patients were given CIMT,involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training(by repetitive practice,shaping) of the more affected extremity for 6 hours on the 10 weekdays during that period.Outcome were measured with UEFT.ResultsThere was no significant difference in treatment gain on the UEFT between the moderate patients and the severe patients(P>0.05).However,the Effect Size for the severe patients(ES=2.2) was larger than for the moderate patients(ES=1.8) at the quality of movement(UEFT).ConclusionCIMT is an effective rehabilitation technique for different severity of the motor deficit of upper extremity after stroke,especially in severe stroke patients.
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@#ObjectiveTo explore the efficacy of constraint-induced movement therapy (CIMT) on motor function of upper extremity of chronic stroke patients.MethodsFifteen chronic stroke patients with hemiparesis (course of diseases more than 13.5 months) were treated by CIMT, involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training (by shaping) of the more affected extremity for 6 hours on the 10 workdays during that period. The therapeutic effect was evaluated with upper extremity function test (UEFT) and simple test for evaluating hand function (STEF).ResultsPatients showed a significant and very large degree of improvement after treatment on UEFT and STEF (ES, 0.8 and 0.5, respectively).ConclusionCIMT may be an efficacious method for improvement of the affected arm function of chronic stroke patients.