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Objective@#To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with donepezil on the cognition of persons with post-stroke cognitive impairment (PSCI) and their ability to perform activities of daily living (ADL).@*Methods@#A total of 106 PSCI patients were randomly divided into an observation group and a control group using a random number table. Those in the observation group received 10Hz rTMS (5 seconds on and 25 seconds off for 20 minutes daily) and donepezil daily, 5 days per week for 4 weeks, while those in the control group were provided with donepezil but only sham rTMS on the same schedule. Before and after 4 weeks of treatment, the Montreal cognitive assessment scale (MoCA), the Rivermead behavior memory test (RBMT) and the modified Barthel index (MBI) were used to evaluate the subjects′ cognitive functioning, memory capacity and ADL ability. The latency and amplitude of auditory event-related potential P300 were also assessed using a myoelectric evoked potential apparatus.@*Results@#After the treatment, improvement was observed in all the measurements of both groups. After the treatment, the average MoCA, RBMT and MBI scores, as well as the latency and amplitude of P300 in the observation group were all significantly better than among the control group.@*Conclusions@#rTMS can supplement donepezil′s ability to improve the cognition and ADL ability of persons with PSCI. Such therapy is worthy of clinical promotion and application.
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Objective:To investigate the knowledge, attitudes and practices of medical staff rehabilitating COVID-19 survivors to provide references for related training.Methods:A questionnaire survey was administered in early March 2020 to 296 medical staff assessing their knowledge, attitudes, and practices in COVID-19 rehabilitation.Results:More than half of those surveyed received full marks on knowledge and attitudes, but only about 43% received full marks for their practices. Significant differences were found in the knowledge, attitude and practices scores among medical staff of different ages, with different numbers of years of training and working experience, with different professional titles, and in different departments.Conclusion:The COVID-19 rehabilitation knowledge and practices of a minority of the medical staff tested needed improving, and targeted training should be conducted.
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Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with donepezil on the cognition of persons with post-stroke cognitive impairment (PSCI) and their ability to perform activities of daily living (ADL).Methods:A total of 106 PSCI patients were randomly divided into an observation group and a control group using a random number table. Those in the observation group received 10Hz rTMS (5 seconds on and 25 seconds off for 20 minutes daily) and donepezil daily, 5 days per week for 4 weeks, while those in the control group were provided with donepezil but only sham rTMS on the same schedule. Before and after 4 weeks of treatment, the Montreal cognitive assessment scale (MoCA), the Rivermead behavior memory test (RBMT) and the modified Barthel index (MBI) were used to evaluate the subjects′ cognitive functioning, memory capacity and ADL ability. The latency and amplitude of auditory event-related potential P300 were also assessed using a myoelectric evoked potential apparatus.Results:After the treatment, improvement was observed in all the measurements of both groups. After the treatment, the average MoCA, RBMT and MBI scores, as well as the latency and amplitude of P300 in the observation group were all significantly better than among the control group.Conclusions:rTMS can supplement donepezil′s ability to improve the cognition and ADL ability of persons with PSCI. Such therapy is worthy of clinical promotion and application.
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Objective To study the therapeutic effects of extracorporeal shock wave therapy (ESWT) on temporomandibular joint disorders (TMDs).Methods Sixty patients with a temporomandibular joint disorder were randomly divided into an ESWT group and a control group,each of 30.Both groups were given routine rehabilitation training,but the treatment group additionally received ESWT for 2 weeks.Fricton's index was used to evaluate temporomandibular joint function.The subjects used a visual analogue scale (VAS) to evaluate their pain levels.The SF-36 scale was applied to assess their life quality.Results After two weeks of treatment,the average assessment score and VAS score had decreased significantly in both groups.After treatment the average scores for mandibular movement,muscle palpation,joint noise and joint palpation,and the palpation,dysfunction and craniomandibular indexes were all significantly lower in the ESWT group than in the control group.Significant differences were also found in the average VAS scores and on the social functioning domain of the SF-36 between the ESWT group and the control group.Conclusion ESWT combined with rehabilitation training can significantly relieve the symptoms and pain of TMDs.
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<p><b>OBJECTIVE</b>To observe the effect on post-stroke dysphagia treated with acupuncture of meridian differentiation.</p><p><b>METHODS</b>One hundred and thirty patients of post-stroke dysphagia were randomized into an observation group (67 cases) and a control group (63 cases). Conventional medication and rehabilitation training were applied in the two groups. In the observation group, acupuncture based on meridian differentiation was adopted. The main acupoints were Neiguan (PC 6), Shuigou (GV 26), Sanyinjiao (SP 6), Fengchi (GB 20), Lianquan (CV 23), Jialianquan (Extra), Jinjin (EX-HN 12), Yuye (EX-HN 13), etc. The supplementary points were selected according to different patterns/syndromes. In the control group, the points were selected 5 cm lateral to the acupoints used in the observation groups and stimulated with shallow puncture. The needles were retained for 30 min, once daily, 5 treatments a week and continuously for 6 weeks in the two groups. Separately, before treatment, in 6 weeks after treatment and in follow-up after 3 months, the standardized swallowing assessment (SSA), the video fluoroscopic swallowing study (VFSS), the modified Barthel index (MBI) and the swallowing related quality of life (SWAL-QOL) were observed in the two groups and the efficacy was assessed.</p><p><b>RESULTS</b>In 6 weeks of treatment, the scores of SSA, VFSS, MBI and SWAL-QOL were improved apparently as compared with those before treatment (<0.01,<0.05) in the patients of the two groups. The results in the observation group were better apparently than those in the control group (<0.01,<0.05). In follow-up after 3 months, the scores of SSA, MBI and SWAL-QOL were improved apparently as compared with those before treatment in thepatients of the two groups (all<0.01), in which, MBI score was improved apparently as compared with that in 6 weeks of treatment in the patients of the two groups (both<0.05). Those scores in the observation group were improved apparently as compared with those in the control group (<0.01,<0.05). In 6 weeks of treatment and in 3 months of follow-up, the effective rates in the observation group were 91.8% (56/61) and 93.4% (57/61), better than 80.0% (44/55) and 85.5% (47/55) in the control group separately, indicating the significant difference (both<0.05).</p><p><b>CONCLUSIONS</b>The acupuncture of meridian differentiation improves significantly swallowing function and survival quality in patients of stroke.</p>
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ObjectiveTo observe the effect of acupuncture plus rehabilitation training on the function recovery of patients with post-stroke depression.MethodNinety-eight patients with post-stroke depression were randomized into two groups to receive conventional management and anti-depressants. The control group was intervened by sham-acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training, while the observation group was by acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training. Prior to the intervention and after 8-week treatments, the depression state, motor function and activities of daily life (ADL) were evaluated by using Hamilton Depression Scale (HAMD), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI). The indexes and quality of life were also determined during the 3-month follow-up study.ResultBefore intervention, there were no significant differences in comparing HAMD, FMA and MBI scores (P>0.05). After 8-week treatment, the HAMD, FMA and MBI scores were significantlyimprovedin both groups (P<0.01,P<0.05). After treatment, the HAMD, FMA, and MBI scores in the observation group were significantlydifferent fromthat in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the observation group versus 79.2% in the control group, and the difference was statistically significant (P<0.05). The 3-month follow-up study showed significant differences in comparing the indexes between the two groups (P<0.05, P<0.01).ConclusionAcupuncture plus rehabilitation training benefits the improvement of depression state, motor function, cognitive function and quality of life in patients withpost-stroke depression, and is worth promotion.
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Objective To investigate the effects of neuromuscular electrical stimulation (NMES) combined with swallowing training for relieving dysphagia in stroke patients.Methods A total of 150 chronic stroke patients at least 3 months post-stroke who were afflicted with dysphagia were randomly and evenly divided into a conventional swallowing training group,an NMES group,and an NMES combined with conventional swallowing training group.Prior to and after treatment,surface electromyography (sEMG) signals from the swallowing muscles were detected,swallowing function was evaluated using the standardized swallowing assessment (SSA),their swallowing was studied videofluoroscopically (VFSS),and a swallowing-related quality of life questionnaire (SWAL-QOL) was administered.Results There were significant differences in the maximum amplitude of sEMG signals,and the scores on the SSA,VFSS and SWAL-QOL in both groups between prior to and after treatment.After 4 weeks of treatment,the maximum amplitude of the sEMG signals and all three assessment scores were significantly higher where NMES had been combined with conventional swallowing training group compared with the other two groups.Indeed,there was no significant difference between the group which had received conventional swallowing training and the NMES groups.The analysis of coefficients revealed correlation between sEMG maximum amplitude and the SSA,VFSS and SWALQOL results.Conclusions NMES combined with conventional swallowing training is helpful for improving swallowing function in chronic stroke patients with dysphagia.
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To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia, a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups: conventional swallowing therapy group, VitalStim therapy group, and VitalStim therapy plus conventional swallowing therapy group. Prior to and after the treatment, signals of surface electromyography (sEMG) of swallowing muscles were detected, swallowing function was evaluated by using the Standardized Swallowing Assessment (SSA) and Videofluoroscopic Swallowing Study (VFSS) tests, and swallowing-related quality of life (SWAL-QOL) was evaluated using the SWAL-QOL questionnaire. There were significant differences in sEMG value, SSA, VFSS, and SWAL-QOL scores in each group between prior to and after treatment. After 4-week treatment, sEMG value, SSA, VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group, but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group. It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.
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Objective To study the validity and reliability of Tengdao's swallowing standard for stroke pa-tients with dysphagia.Methods A total of 128 patients with postroke dysphagia took the swallowing test and then were divided into three sub-groups.Their scores on Tengdao's evaluation and their fluoroscopy results were analyzed using Spearman's correlation coefficient.Intra-class coefficients (ICCs)were used to examine the intra-rater and in-ter-rater reliability of Tengdao's evaluation.Results TenIgdao's evaluation possessed good validity and reliability.There was a high correlation between the scores in Tengdao's evaluation and fluoroscopy results. Conclusions Tengdao's evaluation is valid,reliable,simple and safe.It can be used in the clinic to evaluate the stroke patients with dysphagia.