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Objective:To investigate the effect of treadmill training on spasticity and the expression of potassium chloride co-transporter 2 (KCC2) after blocking BDNF-TrkB signaling pathway in rats with incomplete spinal cord injury (SCI).Methods:Forty female Sprague-Dawley rats were randomly divided into a sham-operation group (Sham group), an SCI+ phosphate-buffered saline group (SCI/PBS group), an SCI-treadmill training+ PBS group (SCI-TT/PBS group), an SCI/TrkB-IgG group and an SCI-TT/TrkB-IgG group. All of the rats underwent 1 week of intrathecal catheterization, and then T 10 incomplete SCI was induced. In the Sham group the spinal cord was only exposed. Seven days later, BDNF-TrkB signaling was blocked in the SCI/TrkB-IgG and SCI-TT/TrkB-IgG groups using the TrkB-IgG. The remaining three groups were controls treated with PBS. The SCI-TT/PBS and SCI-TT/TrkB-IgG groups began exercising 7 days after the SCI and continued for 4 weeks. The spasticity in their hind limbs was assessed using the Asworth assessment and H reflex (H-max/M-max ratio). The expression of KCC2 in the distal spinal cord was detected using western blotting and immunohistochemistry. Results:After the SCI the average Ashworth spasticity grades of the four SCI groups increased significantly compared with the Sham group. The average Ashworth spasticity grade of the SCI-TT/PBS group was significantly lower than those of the SCI/PBS and SCI/TrkB-IgG groups in the 3rd through the 5th week, and the SCI-TT/PBS group′s average grade was significantly less than that of the SCI-TT/TrkB-IgG group after 4 weeks. Within 5 weeks the average H-max/M-max ratio of the Sham group remained unchanged, significantly lower than the other 4 groups′ averages. There was no significant difference in the H-max/M-max ratio among the 4 groups of injured rats within 2 weeks after the SCI, but after 3-5 weeks the average H-max/M-max ratio of the SCI-TT/PBS group was significantly lower than those of the SCI/PBS, SCI/TrkB-IgG and SCI-TT/TrkB-IgG groups. At the 4th and 5th week the average H-max/M-max ratio in the SCI-TT/TrkB-IgG group was significantly lower than that in the SCITrkB-IgG group. And after 5 weeks the average expression of KCC2 in the anterior horn of the injured spinal cord was significantly lower in the 4 SCI groups than in the Sham group. Exercise significantly increased the expression of KCC2 in the SCI-TT/PBS group, and its immune intensity and relative optical density were significantly higher than those in the SCI/PBS, SCI/TrkB-IgG and SCI-TT/TrkB-IgG groups. However, there was no significant difference between the SCI/TrkB-IgG group and the SCI-TT/TrkB-IgG group.Conclusions:Treadmill training can improve spasticity after incomplete SCI and the expression of KCC2 in the distal spinal cord, at least in rats.
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@#ObjectiveTo explore the effects of type and hemisphere of acute stroke on balance function and activity of daily living (ADL). Methods50 stroke patients were studied retrospectively. ResultsThe scores of balance subscale of Fugle-Meyer Assessment (FMB) (t=5.888, P=0.000) and Modified Barthel Index (MBI) (t=3.504, P=0.001) were lower in the hemorrhagic stroke patients than in the ischemic ones. Factor analysis showed that there was interaction between types and hemispheres of stroke for the scores of FMB (P=0.525), the score of FMB in the difference types (hemorrhagic or ischemic) was significantly different (P<0.05), but was not between left and right hemisphere focus (P<0.05). There were interaction between types and hemispheres of stroke for the scores of MBI (P=0.534), the score of MBI in the difference types (hemorrhagic or ischemic) of stroke patients was significantly different (P<0.05), but was not between left and right hemisphere focus (P>0.05). ConclusionPatients with hemorrhagic stroke result in more poor balance function and ADL than those with ischemic stroke.
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@#Objective To explore the factors correlated with low extremity muscle strength in inpatients with acute stroke. MethodsThe low extremity muscle strength determined with manual muscle test (MMT) in 100 inpatients were multiple linear regression analyzed with other 11 factors. ResultsThe low extremity muscle strength were positively correlative with low extremity paralysis (RR=0.613,P=0.000) and rehabilitation (RR=1.178,P=0.000). ConclusionRehabilitation might be a main factor for recover of low extremity muscle strength in patient with stroke.
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@# Objective To observe the effects of electric stimulation on mastoidea in the patients with ischemic stroke by transcranial Doppler sonography (TCD) and brainstem auditory evoked potentials (BAEP).Methods 40 patients with ischemic stroke were equally divided into two groups, i.e., observation group (20 cases) and control group(20 cases). The two groups received routine treatment, while the observation group added electrical stimulation on mastoidea. The blood flow vecolity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vetebral artery (VA) and basilar artery (BA), and the peak latency(PL) of wavesⅠ, Ⅲ and Ⅴ, and inter-peak latency(IPL) of Ⅰ-Ⅲ and III-V were examined by TCD and BAEP before and 2 weeks after treatment.Results The blood flow velocity in the observation group accelerated after treatment compared to pre-treatment(P<0.05). Compared with the control group, the blood flow velocity in the observation group accelerated more markedly(P<0.001). The nerve conduction in both groups improved after treatment. After treatment, PL of waves I, Ⅲ and V, and IPL of I-Ⅲ, III-V and III-V/I-Ⅲ in the observation group improved more significantly than the control group(P<0.05). Conclusion Electric stimulation on mastoidea can enhance the blood flow velocity of brain and the function of brainstem nerve conduction in patients with ischemic stroke.
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@#This article reviewed the literatures on brain plastic reorganization theory, time of treatment, Methods and techniques of rehabilitation treatment, which inclued Bobath, Brunnstrom, Rood, PNF, MRP, biofeedback electrical stimulation therapy, constraint induced movement therapy, nerve muscle electrical stimulation therapy, acupuncture, body weight support treadmill training, motor imagery therapy, robot assisted therapy, and comprehensive rehabilitation therapy. It can provide theory basis and technique for early rehabilitation treatment after stroke.
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@#ObjectiveTo investigate the effect of early rehabilitation combined with electrotherapeutics on motor function of patients with acute stroke.Methods90 patients with acute stroke were randomly divided into the treatment group and control group with 45 cases in each group. All patients of two groups were treated by routine medication, the cases of the treatment group were added with physical therapy and electrotherapeutics. The motor function of all patients was assessed before and one month after treatment.ResultsAfter treatment, the scores of Fugl-Meyer Assessment, Modified Barthel Index and NFI of all patients in the two groups improved obviously, but the effect of the treatment group was superior to that of the control group ( P<0.05).ConclusionEarly rehabilitation combined with electrotherapeutics can improve the motor function of patients with acute stroke.
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@#颈椎牵引是治疗颈椎病的重要方法。近年来 ,由于运动学和力学的发展 ,人们对其作用机理有了更深入细致的认识。本文描述了脊柱颈段不稳的力学运动学特性、颈椎发病的力学因素及与颈椎牵引三要素(角度、时间、重量 )有关的力学试验 ,以便为临床诊断和治疗颈椎病提供便利。