Local vibration therapy promotes the recovery of nerve function in rats with sciatic nerve injury / 中西医结合学报

OBJECTIVE@#It has been reported that local vibration therapy can benefit recovery after peripheral nerve injury, but the optimized parameters and effective mechanism were unclear. In the present study, we investigated the effect of local vibration therapy of different amplitudes on the recovery of nerve function in rats with sciatic nerve injury (SNI).@*METHODS@#Adult male Sprague-Dawley rats were subjected to SNI and then randomly divided into 5 groups: sham group, SNI group, SNI + A-1 mm group, SNI + A-2 mm group, and SNI + A-4 mm group (A refers to the amplitude; n = 10 per group). Starting on the 7th day after model initiation, local vibration therapy was given for 21 consecutive days with a frequency of 10 Hz and an amplitude of 1, 2 or 4 mm for 5 min. The sciatic function index (SFI) was assessed before surgery and on the 7th, 14th, 21st and 28th days after surgery. Tissues were harvested on the 28th day after surgery for morphological, immunofluorescence and Western blot analysis.@*RESULTS@#Compared with the SNI group, on the 28th day after surgery, the SFIs of the treatment groups were increased; the difference in the SNI + A-2 mm group was the most obvious (95% confidence interval [CI]: [5.86, 27.09], P < 0.001), and the cross-sectional areas of myocytes in all of the treatment groups were improved. The G-ratios in the SNI + A-1 mm group and SNI + A-2 mm group were reduced significantly (95% CI: [-0.12, -0.02], P = 0.007; 95% CI: [-0.15, -0.06], P < 0.001). In addition, the expressions of S100 and nerve growth factor proteins in the treatment groups were increased; the phosphorylation expressions of ERK1/2 protein in the SNI + A-2 mm group and SNI + A-4 mm group were upregulated (95% CI: [0.03, 0.96], P = 0.038; 95% CI: [0.01, 0.94], P = 0.047, respectively), and the phosphorylation expression of Akt in the SNI + A-1 mm group was upregulated (95% CI: [0.11, 2.07], P = 0.031).@*CONCLUSION@#Local vibration therapy, especially with medium amplitude, was able to promote the recovery of nerve function in rats with SNI; this result was linked to the proliferation of Schwann cells and the activation of the ERK1/2 and Akt signaling pathways.

Advance in Diffusion Tensor Imaging for Peripheral Nerve Injury (review) / 中国康复理论与实践

Diffusion tensor imaging is a magnetic resonance imaging technology, based on the diffusion motion of water molecules, to obtain anisotropy informations of different tissues, which is used for early identification, accurate localization and grading in various fields of peripheral nerve injury, such as peripheral nerve injury repair, micro-lesion recognition and neuro-tumor. However, since diffusion tensor imaging is still at the early stage of clinical research, and the measurements are influenced by various factors such as technical settings and sequence specifications, the standardization of clinical measurement protocols and the quantification of parameters remain to be further studied.

Advance in Neuromuscular Electrical Stimulation on Skeletal Muscle in Patients with Chronic Obstructive Pulmonary Disease(review) / 中国康复理论与实践

Neuromuscular electrical stimulation(NMES)is one of the electrotherapy that exerts a low-frequency current over the targeted nerves and muscles to induce skeletal muscle contractions to treat skeletal muscle dysfunction in patients.As an alternative rehabilitation modality,NMES is essential for patients with chronic obstructive pulmonary disease(COPD) who are unable to participate in conventional rehabilitation program.NMES could effectively improve the skeletal mus-cle strength,endurance,exercise capacity and quality of life of the patients with COPD.It may be related to remodeling skeletal muscle structure,reducing oxidative stress in skeletal muscle,and improving balance of skeletal muscle protein metabolism.

Clinical research on post-stroke hemiplegia treated with the optimized rehabilitation program of integrated Chinese and western medicine / 中国针灸

<p><b>OBJECTIVE</b>To explore the optimized rehabilitation program in the treatment of post-stroke hemiplegia at the recovery stage.</p><p><b>METHODS</b>Based on the randomized controlled principle, 60 patients were randomized into an rehabilita tion + massage group (group A) and an rehabilitation + acupuncture group (group B), 30 cases in each one. Bobath sport therapy and functional training were adopted in the two groups. In the group A, the massage therapy was added. The rolling method and palm-rubbing method were used on the affected side, the pressing, kneading and plucking methods were applied to Jianliao (LI 15), Jianzhen (SI 9), Quchi (LI 11), Huantiao (GB 30), Weizhong (BL 40), Chengshan (BL 57), Zusanli (ST 36) and the other acu points; and the nipping method was adopted at the twelve Jing-well points. In the group B, acupuncture was applied to Baihui (BL 20), Jianliao (LI 15), Quchi (LI 11), Shousanli (LI 10), Huantiao (GB 30), Yanglingquan (GB 34), Jiexi (ST 41) and the other acupoints. The treatment was given once a day, 5 treatments a week in the two groups. The efficacy was evaluated in 3 weeks. Fugl-Meyer scale, Barthel index (BI) score, modified Rankin scale and stroke-specific quality of life (SS-QOL) were used to assess the limb motor function, the activity of daily life (ADL), independent activity of life and the quality of life of the patients in the two groups before and after treatment. Based on the total cost and benefit, the health economics evaluation was conducted in the patients of the two groups.</p><p><b>RESULTS</b>The treatments all improved the limb motor function (group A: 26.00 (22) vs 37.00 (33); group B: 30.50 (21) vs 39.50 (36)), the independent activity of life, ADL (group A: 43.50 +/- 22.25 vs 57.50 +/- 22.25; group B: 52.83 +/- 16.59 vs 66.67 +/- 12.82) and the quality of life (group A: 122.23 +/- 30.00 vs 145.50 +/- 28.14; group B: 132.43 +/- 23.87 vs 151.47 +/- 22.37) in the patients of the two groups. The differences in all the indices were significant statistically before and after treatment in the two groups (all P<0.05). Above indices after treatment were not different obviously between the two groups (all P>0.05). In terms of health economics, the expense was decreased by RMB 688.48 while BI was increased by every 5 score in group A in comparison with the group B.</p><p><b>CONCLUSION</b>Both the rehabilitation and massage therapy and the rehabilitation and acupuncture therapy improve the limb motor function and the quality of life in the patients of post-stroke hemiplegia. The therapeutic efficacies are similar between the two therapeutic programs. The program of rehabilitation and massage is more economical in the aspects of ADL improvement, being advantageous at simple operation and low cost.</p>

Features of surface myoelectric signals taken from the triceps brachii and biceps brachii of stroke patients / 中华物理医学与康复杂志

Objective To provide scientific evidence for the effectiveness of upper limb training after stroke.Methods Surface electromyograms (sEMGs) of the triceps braehii and biceps brachii were recorded in stroke patients during maximum isometric voluntary contraction (MIVC).A total of 18 patients with hemiparesis were studied.During the elbow's MIVC,flexor and extensor peak torque were measured,and sEMGs of the biceps and tri- ceps brachii were recorded.Results During MIVC,the biceps braehius of the intact side registered a stronger EMG than that of the affected side when the elbow flexed,but the differenees in the triceps braehii readings were not significant.The triceps bracbius of the intact side gave a stronger iEMG than the affected side when the elbow extend- ed,but the iEMG form the biceps brachius of the affeeted side was higher than that of the intact side.The co-contrac- tion ratio (CCR) of the triceps brachius on the affected side was higher than that of the intact side.Though there was a tendency for the CCR of the biceps brachius on the affected side to be higher than the intact side,any difference was not statistically significant.For both flexor and extensor MIVC,the peak torque on the affected side was lower than that of the intact side.Conclusions Elbow spastieity in hemiplegic patients is mainly attributable to the flexor muscles.In the rehabilitation of the upper limb after stroke,it is important when training extensor strength to inhibit co-contraction of the antagonistic muscle.