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<p><b>BACKGROUND</b>Restoration of both normal movement of the pelvis and centre of mass is a primary goal of walking rehabilitation in post-stroke patients because these movements are essential components of effective gait. The aim of this study is to quantitatively analyze the effect of ankle-foot orthosis on walking ability, and to investigate the correlation between improvements in trunk motion and walking capacity.</p><p><b>METHODS</b>Walking speed, centre of mass displacement, and pelvic movements were examined in 20 post-stroke hemiparetic patients with and without ankle-foot orthosis using three-dimensional motion analysis.</p><p><b>RESULTS</b>Using ankle-foot orthosis improved walking speed, pelvic rotation and tilt, and lateral and vertical displacements of the centre of mass (P < 0.01). Moreover, the gait asymmetry index was significantly decreased (P < 0.01), and the Functional Ambulation Categories score improved significantly when patients used an ankle-foot orthosis (P < 0.05). There was significant correlation between improvements in the walking capacity and the displacement of the centre of mass in both vertical and lateral directions (P < 0.01).</p><p><b>CONCLUSIONS</b>Using ankle-foot orthosis improves the walking capacity by improving the stability and concordant of the trunk in hemiplegic patients. The improvement in the walking capacity from using an ankle-foot orthosis may be attributed to its prevention of foot drop and compensation for the instability of the ankle joint.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ankle , Physiology , Ankle Joint , Physiology , Foot Orthoses , Gait , Physiology , Stroke , Walking , PhysiologyABSTRACT
Neuronal damage is associated with the excessive stimulation of N-Methyl-D- Aspartate (NMDA) receptors by glutamate during cerebral ischemia.Because of non-selective NMDA receptor antagonist can influence all NMDA receptors and produce adverse effects,and its clinical application has been restricted significantly,an increasing attention has been paid to the selective NMDA receptor in recent years.NR2B subunit antagonists are mainly divided into piperidine derivatives,amide derivatives,amidine derivatives,and aminoquinoline derivatives,etc. The representative drugs include ifenprodil and eliprodil.These drugs can selectively act on NMDA receptor NR2B subunit,and they are expected to become safe and effective neuropro- tective agents in clinical practice.
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Cerebral infarction is not only a focal damage,but also causes secondary damage in areas remote from the ischemic territory,which will retard the recovery of neurological function.Ephrin receptor B2 (EphB2) plays an important role in the development and repair mechanism of central nervous system.Blocking the effect of EphB2 in brain by using a specific inhibitor may enhance proliferation and migration of endogeneous neuronal stem cells after experimental cerebral infarc- tion,improve neurological function and influence angiogenesis and neuroplasticity in remote sites.It is expected to become a new approach for decreasing damages in areas remote from the cerebral infarction and promoting the recovery of neurological function.
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Cerebral ischemia activates endogenous angiogenic factors,and increase microvessel density and form new capillaries in ischemic brain tissues.Exogenous angiogenic factors can more effectively promote angiogenesis and the establishment of collateral circulation in ischemic regions and peripherial tissues,improving local blood supply and reducing infarct size.The further study of the mechanisms and methods in promoting regional angiogenesis after cerebral ischemia will contribute to improve neurologic deficit.
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<p><b>BACKGROUND</b>There are no reports on exnografting cultured human fetal neocortical cells in this infracted cavities of adult rat brains. This study was undertaken to observe whether cultured human cortical neurons and astrocytes can survive and grow in the infarcted cavities of adult rat brains and whether they interconnect with host brains.</p><p><b>METHODS</b>The right middle cerebral artery was ligated distal to the striatal branches in 16 adult stroke-prone renovascular hypertensive rats. One week later, cultured cells from human embryonic cerebral cortexes were stereotaxically transferred to the infarcted cavity of 11 rats. The other 5 rats receiving sham transplants served as controls. For immunosuppression, all transplanted rats received intraperitoneal injection of cyclosporine A daily starting on the day of grafting. Immunohistochemistry for glial fibrillary acidic protein (GFAP), synaptophysin, neurofilament, and microtubule associated protein-2 (MAP-2) was performed on brain sections perfused in situ 8 weeks after transplantation.</p><p><b>RESULTS</b>Grafts in the infarcted cavities of 6 of 10 surviving rats consisted of bands of neurons with an immature appearance, bundles of fibers, and GFAP-immunopositive astrocytes, which were unevenly distributed. The grafts were rich in synaptophysin, neurofilament, and MAP2-positive neurons with long processes. The graft/host border was diffuse with dendrites apparently bridging over to the host brain, into which neurofilament immunopositive fibers protruded.</p><p><b>CONCLUSION</b>Cultured human fetal brain cells can survive and grow in the infarcted cavities of immunodepressed rats and integrate with the host brain.</p>
Subject(s)
Animals , Humans , Rats , Astrocytes , Transplantation , Brain , Pathology , Cell Proliferation , Cell Survival , Cells, Cultured , Cerebral Infarction , Metabolism , Pathology , Therapeutics , Fetal Tissue Transplantation , Glial Fibrillary Acidic Protein , Microtubule-Associated Proteins , Neocortex , Cell Biology , Neurons , Transplantation , SynaptophysinABSTRACT
0.02 kgf was considered as signifieant.All patients were studied within the first week of presentation with stroke, and underwent every day follow-up within the first month.Results Nine htmdred and fourteen patients were recruited into the study during 1-year period. WECSFP without lesion in brain stem was present in 4.4% of patients within the first week of stroke presentation.The patients with WECSFP had less JFS than the patients without WECSFP(P
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Objective To investigate the Wallerian degeneration of neural fiber tract in medulla and bilateral middle cerebellar peduncle following pontine infarction and to explore its impacts on neurological recovery.Methods Fourteen patients with a recent unilateral pontine infarct underwent the diffusion tensor imaging(DTI)and evaluations with the NIH stroke scale(NIHSS),the Fugl-Meyer motor scale(FM), ataxia rating scale(ARS)and the Barthel index(BI)at the first week(W1),the fourth(W4)and twelfth week(W12)respectively.Mean diffusivity(MD)and fractional anisotropy(FA)were measured at pons, medulla and middle cerebellar peduncle.Fourteenth age and gender matched volunteers underwent a DTI were studied as controls.Results Compared with the matched regions in controls,the FA values of infarct side medulla and bilateral middle cerebellar peduncle in patients significantly decreased at W1,W4 and W12(on the infarct side of medulla:W1:0.43?0.01;W4:0.37?0.02;W12:0.30?0.02;on the infarct side of middle cerebellar peduncle:W1:0.50?0.01;W4:0.43?0.02;W12:0.35?0.04;on the opposite side of middle cerebellar peduncle infarction:W1:0.54?0.02;W4:0.52?0.03;W12:0.47?0.04,t values are 1.92 to 28.56,P0.05 respectively).The absolute value of percent reduction of FA in infarct side medulla and bilateral middle cerebellar peduncle was correlated negatively to the absolute value of percent change of NIHSS and BI score(P