Impacts on fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture combined with motor imagery / 中国针灸

<p><b>OBJECTIVE</b>To explore the impacts on the fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture and motor imagery.</p><p><b>METHODS</b>Sixty-two cases of flaccid paralysis of upper extremity in stroke were randomized into an observation group (30 cases) and a control group (32 cases). In the control group, the conventional western medication and the passive movement of the extremity were applied. Additionally, the penetrating needling technique was used at the head points [penetrating needling from Baihui (GV 20) to Taiyang (EX-HN 5)] and the local affected extremity [penetrating needling from Jianyu (LI 15) to Binao (LI1 14), from Quchi (LI 11) to Shaohai (HT 3), from Waiguan (TE 5) to Neiguan (PC 6), etc]. The needles were retained for 30 min. In the observation group, on the basic treatment as the control group, during the needle retaining, the motor imagery therapy was supplemented. The treatment was given once a day, 5 treatments a week, for 4 weeks totally in the either group. The scores in the action research arm test (ARAT) and the modified Fugl-Meyer assessment (FMA) were recorded at the moment of enrollment, in 2 and 4 weeks of treatment, in the 6th and 8th weeks, as well as after 90 days separately.</p><p><b>RESULTS</b>(1) ARAT score: since the 2nd week, ARAT scores in the observation group were all improved significantly as compared with those in the control group at the each time points (all P<0. 05). In the observation group, the scores were improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, the score in the 2nd week was not different significantly as compared with that before treatment (P>0. 05), but the scores at the rest time points were improved significantly in the pair comparison (all P<0. 05); (2) FMA score: in the 2nd week and on the 90th day, FMA score in the observation group was higher significantly than those in the control group (both P < 0. 05). In the observation group, the scores were all improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, except that in comparison between the 90th day and the 8th week (P>0. 05), the results were all P<0. 05 at the rest time points.</p><p><b>CONCLUSION</b>The early intervention of the combined therapy of acupuncture and motor imagery effectively promotes the recovery of the coordination function and the fine movement of upper extremity, especially the improvements of the fine movement in stroke at flaccid paralysis stage. The efficacy is better than the single acupuncture treatment.</p>

Dyskinetic Cerebral Palsy Associated with Bilirubin-encephalopathy: A Series Report / 中国康复理论与实践

@#Objective To investigate the clinical features and magnetic resonance imaging (MRI) finding of cerebral palsy in children with bilirubin-encephalopathy. Methods 35 cerebral palsied children with a history of bilirubin-encephalopathy were retrospectively studied. Results 27 cases appeared some early symptoms of the nervous system, including excessive crying without any reason, hypsokinesis, body torquing, opisthotonos, which usually were aggravated by respiratory infection, fever, diarrhea, etc. The marked neuromotor characteristics included the instability and asymmetry of muscle tension and posture, the remaining of some primitive reflexs. According to the Gross Motor Function Classification, there was 1 case with I grade, 3 with II, 4 with III, 5 with IV, and 22 with V (of which 15 cases were younger than 18 months）. 29 cases accepted MRI, and 25 cases appeared abnormal, of which 22 showed typically high T2 signal in the bilateral globus pallidus. Conclusion The clinical and brain MRI findings of dyskinetic cerebral palsy associated with bilirubin-encephalopathy are characteristic and can be recognized easily.