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ObjectiveTo investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) combined with rehabilitation robot on upper limb and hand dysfunction in patients with subacute stroke. MethodsFrom December, 2019 to December, 2021, 50 inpatients with subacute stroke in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 25) and experimental group (n = 25). Both groups received routine rehabilitation therapy, while the control group added sham HD-tDCS combined with rehabilitation robot, and the experimental group added HD-tDCS combined with rehabilitation robot, for four weeks. The upper limb and hand function was assessed with Action Research Arm Test (ARAT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Motor Assessment Scale (MAS) before and after treatment. ResultsAfter treatment, the scores of ARAT, FMA-UE and MAS increased in the two groups (∣Z∣ > 3.320, t > 6.379, P < 0.01), while the scores of FMA-UE and MAS were higher in the experimental group than in the control group (Z = -2.379, t = 3.181, P < 0.05), as well as the scores of grasping and gross motor of ARAT (∣Z∣ > 2.033, P < 0.05). ConclusionThe combination of HD-tDCS and rehabilitation robot can be more effective on upper limb and hand function in patients with subacute stroke than rehabilitation robot alone.
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Brain functional network changes over time along with the process of brain development, disease, and aging. However, most of the available measurements for evaluation of the difference (or similarity) between the individual brain functional networks are for charactering static networks, which do not work with the dynamic characteristics of the brain networks that typically involve a long-span and large-scale evolution over the time. The current study proposes an index for measuring the similarity of dynamic brain networks, named as dynamic network similarity (DNS). It measures the similarity by combining the "evolutional" and "structural" properties of the dynamic network. Four sets of simulated dynamic networks with different evolutional and structural properties (varying amplitude of changes, trend of changes, distribution of connectivity strength, range of connectivity strength) were generated to validate the performance of DNS. In addition, real world imaging datasets, acquired from 13 stroke patients who were treated by transcranial direct current stimulation (tDCS), were used to further validate the proposed method and compared with the traditional similarity measurements that were developed for static network similarity. The results showed that DNS was significantly correlated with the varying amplitude of changes, trend of changes, distribution of connectivity strength and range of connectivity strength of the dynamic networks. DNS was able to appropriately measure the significant similarity of the dynamics of network changes over the time for the patients before and after the tDCS treatments. However, the traditional methods failed, which showed significantly differences between the data before and after the tDCS treatments. The experiment results demonstrate that DNS may robustly measure the similarity of evolutional and structural properties of dynamic networks. The new method appears to be superior to the traditional methods in that the new one is capable of assessing the temporal similarity of dynamic functional imaging data.
Subject(s)
Humans , Aging/physiology , Brain/physiology , Brain Mapping , Magnetic Resonance Imaging/methods , Nerve Net/physiology , Transcranial Direct Current Stimulation/methodsABSTRACT
Objective:To explore the research and teaching ability of rehabilitation in medical institutions at different levels in Zhejiang province, for better guiding and promoting of rehabilitation medicine.Methods:90 public hospitals in Zhejiang province were surveyed by Zhejiang Rehabilitation Center from May to August during 2019, to collect information of the research papers, research project applications, patents and monographs of each rehabilitation medicine department in the past five years, as well as the teaching and training activities in 2018.Results:Among the 90 hospitals surveyed, 86 hospitals had rehabilitation medicine departments. In the past five years, 86 hospitals published 636 papers in core journals, 120 SCI/EI papers, and applied for 19 national projects, 40 provincial projects, and 204 bureau level projects, and applied for 25 invention patents and 40 utility model patents, and edited 19 monographs. The average research capacity of rehabilitation including research paper, research project application, patent invention and monograph preparation in tertiary hospitals was significantly better than that of secondary general hospitals in recent 5 years. No SCI/EI papers have been published in the secondary hospital in the past 5 years, and no national project has been awarded. The proportion of SCI/EI papers published by tertiary hospitals was 92.5% (111/120). More teaching work was conducted by tertiary hospitals.Conclusions:The research and teaching ability of rehabilitation in public hospitals of Zhejiang province has reached a certain scale, but there is still a long way to go with other subjects. It is suggested that we should take the opportunity of development of great health and great rehabilitation, different levels of rehabilitation institutions should take their advantages to carry out scientific research and teaching training at different levels. Combined with the three-level rehabilitation network, a number of rehabilitation development measures such as linkage between the upper and the lower levels, mutual assistance in scientific research and integration in teaching should be implemented.
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Objective To elucidate the mechanism underlying eletroacupuncture's (EA's) amply-documented analgesic effect.To observe its effect on the pain threshold and on the expression of P2X4 receptor and microglia activation in the spinal cords of rats with neuropathic pain.To demonstrate whether or not interfering with A1 receptors and P2X4 receptors at the same time could enhance the analgesic effect.Methods A total of 40 SpragueDawley rats weighing 150 to 180 g were randomly divided into a sham group,a CCI group,an EA group,a 2-chloroN(6)-cyclopentyladenosine (CCPA) group and a CCPA+EA group,each of 8.Chronic constriction injury (CCI)was induced successfully in the rats of all groups except the sham group.Five days later,EA and 20 μL injections of 0.1 mm/L CCPA were applied to the rat analogues of the Zusanli (ST36) and Yanglingquan (GB34) acupoints once a day for 15 days for the rats in the appropriate groups.The mechanical withdrawal threshold (MWT) and the thermal withdrawal latency (TWL) were measured before the CCI operation and 20 days afterward.L4-L6 spinal cord tissue was then resected and the fluorescence intensity of P2X4 and OX42 receptors was detected using double label immunohistochemical staining.The correlation between the mean fluorescence intensity and the pain threshold gap was analyzed.Results The average MWT and TWL of the CCI group were significantly lower than in the other four groups.The expression of P2X4 receptor and OX42 in the spinal cord increased significantly in the CCI group compared to the other four groups.There was significant correlation between the mean fluorescence intensity of P2X4 and OX42 receptors and the gap in pain threshold,with correlation coefficients of 0.907 and 0.717 respectively.Conclusion P2X4 receptor and microglia activation might be involved in the development of neuropathic pain.CCPA and EA can inhibit the activation of microglia and reduce the activity of P2X4 receptors.The interaction between A1 receptors and P2X4 receptors can strengthen the analgesic effect of EA.
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@#Objective To observe the effects of Pilates on balance, walking and lower limbs motor function in older patients after stroke. Methods From November, 2016 to December, 2017, 60 older patients after stroke were divided into control group (n=30) and Pilates group (n=30). The control group received routine medicine and rehabilitation, the Pilates group accepted Pilates training in addition, for ten weeks. They were evaluated with Berg Balance Scale (BBS), 10-metre Maximum Walking Speed (MWS), Timed 'Up and Go' Test (TUGT) and Fugl-Meyer Assessment-Lower Extremity (FMA-LE) before, and five weeks and ten weeks after training.Results The BBS score, MWS, TUGT and FMA-LE score all improved ten weeks after training in both groups (t>2.122, P<0.05), and improved more in the Pilates group than in the control group (t>2.264, P<0.05).Conclusion Pilates can improve the balance, walking and lower limbs motor function in older patients after stroke.
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Functional magnetic resonance imaging (fMRI) is a technology combined with function, anatomy and images to evaluate the brain function in real-time, dynamic, non-invasive ways. fMRI has been applied in the rehabilitation after stroke for the assessment and prog-nosis of motor, speech, cognition and sense function, etc.
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Objective To investigate the therapeutic effects of acupuncture on pelvic floor muscles and urinary function in patients with spinal cord injury. Methods From March, 2012 to March, 2015, 23 patients with spinal cord injury were divided into control group (n=8), early intervention group (n=8) and later intervention group (n=7). The control group received routine rehabilitation, the intervention groups received acupuncture at Baliao (BL-31, BL-32, BL-33 BL-34), Yanglingquan (GB-34), Sanyinjiao (SP-6) and Taichong (LR-3) acupoints in addition. The early intervention group was acupunctured one week before removal of catheter, and the later intervention group adopted inter-mittent catheterization after removal of catheter, and then received acupuncture. The pelvic floor muscles strength, the urine function and quality of life were recorded before and six weeks after intervention. Results There was no significant difference in all the indices before in-tervention (P>0.05). After intervention, the pelvic floor muscles strength improved in the intervention groups compared with the control group (P0.05). The quality of life improved in all the groups after inter-vention (F>0.864, P<0.05), however, no significant difference was found among three groups (F=1.558, P<0.05). Conclusion Acupuncture, especially early acupuncture, could improve the pelvic floor muscle strength and bladder function in spinal cord injury patients.
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@#Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD decreased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P<0.05), and there was no significant difference between the two groups 4 and 8 weeks after treatment (P>0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.
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Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD de-creased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.
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@#Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD decreased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P<0.05), and there was no significant difference between the two groups 4 and 8 weeks after treatment (P>0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.