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Objective To investigate the effects of virtual reality prism adaptation on visuospatial neglect in stroke patients.Methods Thirty stroke patients with visuospatial neglect were studied.The subjects were divided into atreatment group and a control group.The subjects in the treatment group were treated with virtual reality prism adaptation and routine rehabilitation interventions for 2 weeks,while those in the control group were treated with routine rehabilitation interventions only.All the patients performed a battery of spatial attention tests including line bisection,letter cancellation,clock drawing and the Attention Network Test at the beginning and after 2 weeks of treatment.Results The virtual reality prism adaptation training had significant positive effects on all the measures of visuospatial neglect.Pair-wise comparisons confirmed significant differences between the treatment and control groups after 2 weeks of treatment with regard to all of the measures.Conclusions Virtual reality prism adaptation treatzment combined with routine rehabilitation can be more effective than conventional measures alone in improving the visuospatial performance of stroke survivors.
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BACKGROUND:Total hip arthroplasty is known to be a successful surgical procedure to al eviate hip pain and to regain gait ability, but there are many debates on whether patients’ gait could reach a normal level several years later. OBJECTIVE:To investigate spatiotemporal parameter characters of lower extremities in patients during walking in sequela period fol owing unilateral total hip arthroplasty, and to probe into patients’ walking abilities. METHODS:In accordance with the method of Case Database Data Analysis detected by Motion Reconstruction Laboratory, 14 patients at 5-10 years after total hip arthroplasty served as the experimental group, and 14 matched healthy persons served as the control group. Gait parameters of lower extremities during walking were col ected by Vicon Nexus. Spatiotemporal parameter characters of lower extremities during gait cycle were analyzed by using Polygon. RESULTS AND CONCLUSION:Compared with the control group, walking speed, cadence, stride length and step length decreased, but double support and opposite foot off increased on both affected and unaffected sides in the experimental group (P0.05). The results suggested that gaits of patients showed good gait symmetry at 5-10 years after surgery. However, they do not reach the level that observed in healthy subjects, and walking ability was poorer than normal persons. Systematic rehabilitation training is needed to improve walking ability.
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BACKGROUND:Most stroke patients affected walking dysfunction. Virtual reality-enhanced body weight-supported treadmil training has been proposed as a strategy for gait training of cerebral infarction subjects. OBJECTIVE:To evaluate the effectiveness of virtual reality-enhanced body weight-supported treadmil training on lower limb motor function in subacute cerebral infarction patients. METHODS:Twenty cerebral infarction patients (within 3 months of onset) were randomly divided into experiment group (virtual reality-enhanced body weight-supported treadmil training) and control group (conventional physiotherapy). Three-dimensional gait analysis in lower limb motor function was carried out before and after 3-week gait training. Intergroup and intragroup comparisons in the fol owing parameters were done before and after training:walking speed, cadence, step time, single limb support time (%), double limb support time (%), nonparetic swing (%), step length, pace, range of motion in the lower limb, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment. RESULTS AND CONCLUSION:No significant differences in patient’s gender, age, course of disease, affected. side, walking speed, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment were detected between the two groups before training (P>0.05). Fugl-Meyer Assessment and functional ambulation category were improved in patients of the two groups after training (P<0.05). The improvement in walking speed, cadence, step time in affected side, step time in healthy side, single limb support time in affected side (%), nonparetic swing (%), pace, step lengths in affected and healthy sides were better in the experimental group than those in the control group.
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Objective To seek more direct evidence of the role of the posterior parietal cortex (PPC) in controlling visuospatial attention.Methods Forty healthy subjects took the Attention Network Test following continuous theta burst stimulation (cTBS) applied over the left or right PPC or sham stimulation.The Attention Network Test measures the alerting,orienting and executive control components of visual attention separately.Results Subjects responded to spatial cues significantly slower after cTBS.Alerting and orienting showed deficits after cTBS over the right PPC.cTBS over the left PPC resulted in significant improvements in alerting,but not in the orienting.Furthermore,there were significant differences in the alerting and orienting indices between cTBS over the left and right PPC,but not in the executive control index.Conclusions The results suggest that the right PPC is associated with spatial orienting and the alerting function.The findings supported the theory of inter-hemispheric competition for visuospatial attention.Visuospatial attention bias might be selectively modulated through cTBS.
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Objective To explore the outcome of body-weight-supported treadmill training on the kinetic data of lower limb in early stage of stroke.Methods Twenty-seven hemiplegic stroke patients at early stage were recruited and randomized to an experimental group(n =15) and a control group (n =12).Both groups were administered with routine neurological interventions.In addition,the control group was treated with conventional physiotherapy and over-ground walking training,while the experimental group was treated with body-weight-supported treadmill training.The speed of the treadmill walking was started at 0.22 m/s and increased to 0.60 ～ 0.80 m/s gradually.The percentage of the body-weight being supported was not more than 30％,the training time was 5 min per session at the beginning and was increased gradually to 20 ～ 40 min.Kinetic parameters were measured by using two force plates (AMT) and six cameras capture svstem (Vicon Nexus),and motor function was evaluated using Fugl-Meyer Assessment (FMA) at baseline and after three-week's therapy.Peak moment of lower limb joints,ground reaction force and motor function were analyzed.Results FMA scores were significantly improved (P ＜ 0.05) in both groups after treatment,but there was no significant differences (P ＜ 0.05) between the two group.Ground reaction force was significantly increased (P ＜ 0.05) after treatment in the experiment group,but not in control group (P ＞ 0.05).It showed that the hip extension moment at the affected side was significantly lower (P ＜ 0.05) in experiment group than in the control group,the ankle joint flexion and extension moment peak were improved to a significantly larger extend in the experimental group (P ＜ 0.05) than in the control group.In addition,the peak flexion and extension moment of the hip-knee joint and peak flexion and extension moment of the knee-ankle joint were also significantly different from those of the control group (P ＜ 0.05).Conclusion Body-weight-supported treadmill training can facilitate motor recovery of paretic extremity by increasing ground reaction force and load support of the affected lower limb,and help normalize the abnormal gait pattern of lower extremity of stroke patients.
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Objective To investigate the effect of cognition training on the recovery of balance after stroke. Methods forty-five hemiplegic strokd patents with cognition deficit were revruited and sddigned into an experimental group and a control group according to the results of an assessment with Loewenstein's Occupational Therapy Cognition Assessment battery (LOTCA). The patients in the two groups folloled routine systmatic rehabilitation programs. The patients in the (LOTCA). The patients in the two groups followed routine systmatic rehabilitation programs.The patiena in the experimental group received pertinent cognition training 5 days/week for 6 weeks. LOTCA,Brunel's Balance Assessment (BBA), the Berg Balance Scale (BBS) and Brunnatrom functional categories were enployed to evaluate the patients before and after treatment with regard to their cognition, balance control and motor function in their lower limbs. Results After treatment, there were statistically significant differences between preand post-treatment BBA and BBS scores in all groups. Average BBA, BBS and LOTCA scores in the experimental group were significantly higher than in the control group. The improvements in BBS, BBA and LOTCA scores in the experimental grou were significantly greater than in control group. Conclusion Cognition treatment can contribute significantly to improving balance and postural control among stroke survivors.