ABSTRACT
Objective To observe the effects of early rehabilitation on the motor function of post-stroke hemiplegic patients treated with intravenous thrombolysis.Methods Thirty-six post-stroke hemiplegic patients after intravenous thrombolysis with rtPA were recruited in this study.They were randomly divided into the early rehabilitation group (with the course less than three days) and the control group (with the course between three and seven days),18 cases in each group.Both group received a two-week rehabilitation programme.They were assessed using the Fugl-Meyer assessment (FMA) of up extremity,FMA of lower extremity and ADL score (modified Barthel index,MBI) before and after treatment,as well as at the 3rd month after treatment (during the following-up).Results After treatment and at the following-up,FMA scores of up extremity,FMA scores of lower extremity and MBI scores had improved significantly compared with before treatment in both groups.Furthermore,after treatment,in the early rehabilitation group the average FMA score of lower extremity and MBI score reached (23.33 ± 4.37) and (56.11 ± 22.27) respectively,significantly higher than those of the control group [(17.06 ± 4.70) and (40.00 ± 15.81) respectively].Conclusion Early rehabilitation contributes to short-term recovery of lower extremity motor function and ability in the activities of daily living in post-stroke hemiplegic patients after intravenous thrombolysis.
ABSTRACT
@#Objective To observe the brain glucose metabolism after limb ischemic preconditioning (LIPC) for ischemic moyamoya disease with positron emission tomography (PET) and statistical parametric mapping (SPM). Methods 62 patients with ischemic moyamoya disease were enrolled and randomized into LIPC group (n=31) and control group (n=31). The glucose metabolism of patients was analyzed with PET before and after treatment in both groups, using the methods of radioactivity ratio and SPM. Results The glucose metabolism ratio improved more in the LIPC group than in the control group (P<0.01), and aggravated less than in the control group (P<0.001). As setting the glucose metabolism increased after treatment, there were 7 areas activated in LIPC group, including frontal, temporal and parietal lobes, and the KE=1121; while there were 5 areas activated in the control group, including frontal and parietal lobes, and the KE=292. As setting the glucose metabolism decreased after treatment, there was only frontal area activated in LIPC group, while there were 8 areas activated in the control group, including frontal, parietal, occipital lobes, and the KE=629. Conclusion LIPC may improve the brain glucose metabolism in patients with moyamoya disease, which can be observed with PET and SPM.
ABSTRACT
Objective To observe the brain glucose metabolism after limb ischemic preconditioning (LIPC) for ischemic moyamoya dis-ease with positron emission tomography (PET) and statistical parametric mapping (SPM). Methods 62 patients with ischemic moyamoya disease were enrolled and randomized into LIPC group (n=31) and control group (n=31). The glucose metabolism of patients was analyzed with PET before and after treatment in both groups, using the methods of radioactivity ratio and SPM. Results The glucose metabolism ratio improved more in the LIPC group than in the control group (P<0.01), and aggravated less than in the control group (P<0.001). As setting the glucose metabolism increased after treatment, there were 7 areas activated in LIPC group, including frontal, temporal and parietal lobes, and the KE=1121;while there were 5 areas activated in the control group, including frontal and parietal lobes, and the KE=292. As setting the glu-cose metabolism decreased after treatment, there was only frontal area activated in LIPC group, while there were 8 areas activated in the con-trol group, including frontal, parietal, occipital lobes, and the KE=629. Conclusion LIPC may improve the brain glucose metabolism in pa-tients with moyamoya disease, which can be observed with PET and SPM.
ABSTRACT
Objective To investigate the clinical effect of early rehabilitation treatment on patients with severe traumatic brain injury (sTBI).Methods Forty sTBI patients were divided into treatment group (n =20) and control group (n =20) according to the random number table.Conventional treatment was performed on all patients including dehydration to decrease intracranial pressure,hemorrhage control,neurotrophic treatment,antiinflammation therapy,and gastric acid control.In addition to these interventions,patients in treatment group received hyperbaric oxygen treatment,median nerve stimulation,fastigial nucleus stimulation,and bedside motor therapy in the early period.Intracranial pressure and partial pressure of brain tissue oxygen (PbtO2) were continuously monitored during the process of treatment.GCS was measured before and 15 days after treatment and single-photon emission computed tomography (SPE-CT) was used to evaluate cerebral perfusion.Results There was no statistical difference between the two groups with respect to GCS in advance of treatment (P ＞ 0.05),but GCS differed between treatment group and control group after treatment [(10.18 ± 3.75) points vs (8.33 ±2.36) points,P ＜0.05],with substantial improvement in treatment group.Significantly improved cerebral perfusion was seen in treatment group.On day 5 after treatment,intracranial pressure in treatment group lowered significantly compared with that in control group (P ＜ 0.05).On day 6 after treatment,PbtO2 was significantly higher in treatment group than in control group (P ＜ 0.05).Conclusion Early rehabilitation treatment leads to improved outcome and acts a positive effect on nerve function recovery.
ABSTRACT
Objective To investigate the clinical effects of early hyperbaric oxygen (HBO) treatment combined with mild hypothermia treatment on patients with severe traumatic brain injury (TBI).Methods A total of 45 participants with severe TBI were randomly divided into combination group (15 cases),mild hypothermia group (15 cases) and control group (15 cases).In control group the patients were managed with treatments for reducing the intracranial pressure (ICP) and controlling the hemorrhage and gastric acid,and with administration of neurotrophic treatment and nutritional support.In addition to above mentioned interventions,the patients in mild hypothermia group received mild hypothermia treatment; while those in the combination group received mild hypothermia plus HBO treatment.The scores of Glasgow coma scale (GCS) were measured before and after treatment.The ICP and pressure of oxygen in brain tissue (PbtO2) were recorded during the process of treatment.Results After treatment,the scores of GCS in 3 groups all increased significantly,but the improvement of the GCS scores in combination group was the highest(P ＜0.05).The ICP in combination group were significantly lower than that in mild hypothermia group and control group since the 5th day (P ＜ 0.05).The PbtO2 in combination group were significantly higher than that in mild hypothermia group and control group since the 7th day(P ＜0.01).Conclusions Early HBO treatment combined with mild hypothermia treatment could improve the therapeutic efficiency in patients with severe TBI.
ABSTRACT
Objective To study the reliability and validity of the Chinese version of an instrument for assessing quality of life after traumatic brain injury (QOLIBRI).Methods A total of 49 patients with traumatic brain injury were studied.The test-retest reliability of the instrument was examined by computing intraclass correlation coefficients and its internal consistency was examined using Cronbach's α statistic.Its criterion-related validity was examined using reference instruments such as the HADS,SF-36 and Glasgow outcome scale-extended (GOSE).The Kaiser-Meyer-Olkin measure and Barlett's test of sphericity as well as factor analysis were used for construct validity testing.Results The test-retest reliability of the QOLIBRI subscales was stable,with Pearson's correlation coefficients ranging from 0.906 to 0.987.Good internal consistency was demonstrated by the Cronbach's αs ranging from 0.498 to 0.921.The Kaiser-Meyer-Olkin measure of QOLIBRI was 0.813.Factor analysis yielded four factors,and their cumulative contribution was 68.4％.The QOLIBRI scores were highly negatively correlated with HADS scores,moderately correlated with GOSE scores and positively correlated to SF-36 scores.Conclusions The Chinese QOLIBRI instrument has good reliability and validity.