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Objective:To explore vibration, position and motion proprioception of the ankle joints after a stroke.Methods:Twenty-eight stroke survivors with impaired ankle proprioception were divided into a right-side stroke group ( n=18) and a left-side stroke group ( n=8). Twenty-two healthy volunteers constituted a control group. Vibration perception thresholds, passive and active joint angle resetting, and motion minimum thresholds were quantified among the stroke survivors on both the healthy and the affected side. With the controls the dominant and non-dominant sides were used. The differences in proprioception between the healthy volunteers and the stroke patients, between the affected side and the healthy side of the stroke patients, and between left- and right-side stroke patients were analyzed and compared. Results:Among the stroke survivors the vibration perception threshold on the affected side averaged (28.91±22.53)μm. The absolute difference in the perception of passive positioning was (5.49±5.39)° for 15° of plantar flexion and (4.48±3.89)° for 5° of dorsal extension. In active positioning plantar flexion was (5.23±4.34)° and for 30° of plantar flexion it was (3.26±1.73)°. The 5° dorsal extension error was (4.97±3.48)°. The motion perception thresholds between 20° of plantar flexion, 10° of plantar flexion and the neutral position were significantly higher, on average, than among the control group. The stroke group also had significantly higher motion perception thresholds than the control group.Conclusion:The vibration, position, and motion sense of the ankle joint on a stroke survivor′s affected side tend to be impaired, with the impairment of vibration and motion sensing tend to be more substantial. After stroke, there is also mild impairment of vibration, position and motion sensing in the healthy ankle joint. The impairment of proprioception caused by right cerebral hemisphere injury may be more serious than that caused by injury on the left.
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Objective:To test the utility of monofilament cutaneous threshold testing among patients with impaired touch sensation caused by central nervous system injury.Methods:Thirty stroke survivors and 30 patients with spinal cord injury were recruited. Monofilament threshold testing and cotton wool tests were performed on the bilateral forehead, face, palms and dorsum of feet among the stroke survivors. Among those with a spinal cord injury both tests were performed on each side of the L 4, L 5 and S 1 vertebrae. One week later, all were retested. Intra-class correlation coefficients (ICCs) were used to quantify the test-retest reliability of the tests. Kappa values were calculated to determine the degree of agreement between them. Stepwise multiple linear regressions were evaluated to examine the relationship between touch perception thresholds and age, height, gender, type of injury and injured site. Results:①The ICC for the monofilament test was between 0.74 and 0.95, higher than that of the cotton wool test (ICC: 0.60 to 0.83). ②The kappa value between the monofilament and cotton wool tests was 0.550, indicating good agreement. ③The types of injury and injured sites were independent correlates of the touch perception thresholds, but there was no significant correlation between the touch perception thresholds and age, height, gender or group.Conclusions:The monofilament cutaneous threshold test has good test-retest reliability, better than the cotton wool test. Therefore, it may be useful as a tool for assessing impaired touch sensation caused by central nervous system injury.
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ObjectiveTo explore the features and assessment for far space neglect in left spatial neglect patients after right brain stroke. MethodsFrom January to October, 2021, 30 left unilateral spatial neglect (USN) patients after right stroke (patients, n = 30) from Beijing Bo'ai Hospital and healthy volunteers matching with gender, age and level of education (controls, n = 30) were evaluated with line cancelation (LC), star cancelation (SC) and line bisection (LB) tests, nearly and far away. The 25 controls were evaluated with LB on the second day. ResultsNo line or star was omissed in the controls. Both the deviation and percentage were more in the patients than in the controls (|t| > 4.319, P < 0.001). Both the deviation and percentage were less different for all the test (|Z| < 1.638, t = -1.282, P > 0.05) between nearly and far away, except the deviation of LB (t = -4.994, P < 0.001). The ICC of test-retest was above 0.462 (P < 0.01). ConclusionRight brain stroke patients with USN may present far spatial neglect, which can be assessed with LB.
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Objective:To explore the factors influencing executive functioning after a brain injury and analyze the relationship between executive functioning and other cognitive functions.Methods:Forty-six brain injury survivors were given the Executive Function Performance Task (EFPT) assessment and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). The scores and time of the EFPT tasks, and the orientation, perception, visual motor organization, thinking, and attention and concentration results in the LOTCA were observed. Regression analysis compared the males and females, those younger and older than 40, those with more or less than 12 years of education, trauma and stroke survivors, as well as those with left, right and bilateral lesion to isolate the factors most influencing executive functioning.Results:The average EFPT score on the cooking task, the medication score and the total score of the young group were all significantly higher than those of the older group. Their telephone time, medication time and bill payment time were all significantly shorter. Those with more than 12 years of education had average scores on the cooking, bill payment and EFPT significantly higher than those with less than 12 years of education. The average bill paying and total EFPT scores of the brain trauma group were significantly higher than the stroke group′s averages. No significant differences were observed between the different genders or those with different injury sites. Age was the strongest predictor of total EFPT scores. Except for the medication scores, the average scores of the other three tasks and the total score of EFPT were moderately correlated with the visual motor organization, thinking, attention and concentration, and total LOTCA scores, with correlation coefficients ranging from 0.31 to 0.64.Conclusions:Older persons and those will less education tend to have worse executive functioning. Traumatic damage to executive functioning is more serious than that caused by stroke. Executive functioning is closely related to visual-motor organization, and to the ability to think, attend and concentrate.
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Objective:To explore the value of the Chinese version of the test of everyday attention (TEA) for diagnosing attention deficit after brain injury, and to determine the best cut-off value for each subtest.Methods:A total of 117 healthy adults and 33 brain-injured patients were evaluated using the TEA (Chinese version). The original scores of each sub-test were obtained and statistically compared between the control group and the brain injury group. Receiver operating characteristics (ROC) curves were used to determine the optimal cutoff values in each subtest for diagnosing attention deficits.Results:Significant differences were found between the two groups. Except for the elevator counting test, the area under the ROC curves of all the other subtests (Map Search, Elevator Counting with Distraction, Visual Elevator, Elevator Counting with Reversal, Telephone Search, Telephone Search while Counting and lottery) were between 0.795 and 0.955. The average sensitivities were in the range 74.1-97.0% and the specificities were 58.8% to 94.1%. Maximum Youden indices were used to determine optimal diagnostic cut-off values for each subtest.Conclusions:The TEA (Chinese version) has good clinical applicability. It can be used to diagnose and differentiate different types of attention deficits.
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Objective:To test the reliability and validity of the Chinese version of the executive function performance test (EFPT) when it is used with persons with a brain injury.Methods:Forty-six brain injury patients comprised the patient group, and forty-nine healthy counterparts formed the normal group. All completed the EFPT, the Flanker task, a color shape task, the speech and visual space 2-back and the Wisconsin Card Sorting Test (WCST). Thirty normal subjects were asked to complete the EFPT again 4 weeks after the first test. Spearman correlation analysis was used for reliability and validity analysis.Results:The EFPT scale showed good internal consistency, as Cronbach′s α coefficient was 0.73 to 0.83. Test-retest reliability was good, as the internal correlation coefficients ranged from 0.50 to 0.85. The results of the EFPT correlated moderately well ( r=0.29-0.57) with the total number of responses, the number of completed collocations, persistent responses and non-persistent errors, as well as with the percentage of the generalized level of the WCST. Moreover, all of the EFPT results correlated moderately well with those of the IADL except for the task of taking medication. Compared with the control group, the brain-injured group got significantly higher sub-test and total scores on the EFPT. Conclusions:The Chinese version of the EFPT has demonstrated adequate reliability and validity with brain-injured Chinese persons. It is a good tool for evaluating the executive functioning of such persons and can reflect any executive dysfunction in their daily living activities.
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Objective To study the reliability of an implicit memory test-Fragmented Character Identification Assessment. Methods Some Chinese pictographic characters and non-pictographic characters were fragmented to form two sets of identification task. From Sep-tember, 2013 to March, 2016, a total of 78 health young and middle aged people were assessed with the task, and 20 of them were assessed again with another parallel version 14 days later. The internal consistency, test-retest reliability and duplicate split-half reliability were ana-lyzed. Results There was no significant difference in priming of implicit memory between pictograph and non-pictograph (t=1.006, P>0.05). Cronbach's α was 0.763 and 0.729 for the pictograph and non-pictograph fragmented character identification assessment, respectively;while the inter-class coefficients (ICC) of test-retest were 0.785 and 0.771, ICC of split-half reliability were 0.792 and 0.789. Conclusion The reliability is satisfactory in Chinese Fragmented Character Identification Assessment.
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Objective To investigate the effect of telerehabilitation on memory disorders. Methods From August, 2010 to April, 2015, 81 patients with memory disorders were randomized into control group (n=26), computer-assisted training group (n=33) and telerehabilita-tion training group (n=22). All the patients accepted medicine to facilitate the recovery of memory. Besides, the computer-assisted training group and the telerehabilitation training group accepted memory-based training programs with cognitive rehabilitation system locally or on network respectively, for six weeks. They were evaluated with Wechsler Memory Scale, Rivermead Behavioural Memory Test-2nd Edition and Rey Auditory Verbal Learning Test before and after training. Results Both computer-assisted and telerehabilitation training groups im-proved in all the assessment after training (t>4.059, P0.05). There was no sig-nificant improvement in the control group after training (t0.05). Conclusion Memory rehabilitation training can significantly im-prove memory abilities, similar with locally or telerehabilitation system.
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Objective To investigate the effects of Working Memory Training System on working memory impairment after brain injury. Methods From November, 2013 to March, 2015, 20 patients of brain injury with impairment of working memory were divided into training group (n=10) and control group (n=10). The training group was trained with the Working Memory Training System for four weeks, while the control group did not accept any cognitive rehabilitation. They were tested with digital forwards/backwards, space forwards/backwards, n-back test and Everyday Memory Questionnaire before and after training. Results All of the tests improved more in the training group than in the control group (Z>2.014, P<0.05), except that of digital forwards, as well as the score of Everyday Memory Questionnaire (Z=1.970, P=0.049). Conclusion Application of Working Memory Training System can improve the ability of memory in patients with brain injury, both the working memory and everyday memory.
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Objective To explore the characteristics of brain activation when solving simple multiplication and complex multiplication tasks. Methods From June, 2010 to June, 2012, Thirteen normal subjects completed four functional magnetic resonance imaging (fMRI) ex-periments, including control tasks, visuospatial memory tasks, simple (single-digit) multiplication tasks and complex (multi-digit) multiplica-tion tasks. Results Compared with the control tasks, visuospatial memory tasks activated the bilateral occipital lobe, the right precuneus and superior parietal lobe;simple multiplication tasks activated the bilateral middle occipital gyri, the left superior parietal lobe, the left cingu-late gyrus, the left middle frontal gyrus and inferior frontal gyrus;complex multiplication tasks activated the right superior parietal lobe, the right inferior frontal gyrus, and the bilateral middle frontal gyri. Conclusion A right parieto-frontal network is involved in the multi-digit multiplication, which supports the containing of the spatial layout information.
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Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Respons-es Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with trau-matic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Catego-ries Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention.
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Objective To analyze the reliability and validity of the Chinese version of the Rivermead Behavioural Memory Test-Third Edition (RBMT-III). Methods The items of RBMT-III were translated in Chinese and adjusted. A total of 131 healthy subjects were tested with Chinese version of RBMT-III, 30 of them were tested again with other materials two weeks later. Results The Cronbach'sαcoefficient was 0.799. The correlation coefficient of parallel-forms in subtest scale and meory index were all more than 0.65. There were six main fac-tors extracted, which explained 64.47%of the accumulated variance, those were novel task learning, spatial memory, verbal memory, visual memory, prospective memory and orientation/date. Conclusion RBMT-III is a reliable and validated instrument for assessment of memory.
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@# Objective To investigate the characteristic of picture forgetting in closed traumatic brain injury (CTBI) patients during recovery. Methods From October, 2012 to August, 2013, 60 colour slides of target or interference picture were presented to 38 CTBI patients during recovery and 31 matched healthy controls. Their discriminability index (d′) was observed 10 minutes, 30 minutes and 24 hours later. Results Forteen patients failed to attain d′ of 2.0 10 minutes later, and were excluded from further study. The d′ of the other 24 patients was less than that of the controls 10 minutes, 30 minutes and 24 hours later (t>2.044, P<0.05). The d′ in the patients was more of 10 minutes and 30 minutes than that of 24 hours (P<0.05). Conclusion Some patients with CTBI during recovery exhibit impairment in acquisition of pictorial information, and accelerated forgetting is found in the others without impairment.
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Objective To establish the reference values of static balance function with Active Balancer EAB-100 in healthy Chinese adults, and to screen the valuable indices for clinical work. Methods There were 227 healthy adults measured with Active Balancer EAB-100 when standing still with eyes opened and closed. All the data recorded were analyzed with SPSS 19.0, and the weight of every pa-rameter was obtained with principal component analysis. Results The reference values of parameters for static balance function were estab-lished in healthy Chinese adults. The loadings of whole path length, rectangle area, circumference area, effective value area, deflection cen-ter displacement X, deflection center displacement Y, rectangle area of Romberg rate and circumference area of Romberg rate were more than average. Conclusion It is need to focus on whole path length, circumference area, deflection center displacement X, deflection center displacement Y, and effective value area and circumference area of Romberg rate much more in clinical practice for the static balance assess-ment.
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Objective To investigate the correlation between Semmes-Weinstein monofilament test and light touch exam of international standard for spinal cord injury (SCI). Methods 84 inpatients with SCI were assessed with Semmes-Weinstein monofilament test and light touch exam of international standard to determine the SCI level. The results were recorded as right-side and left-side of the body respective-ly. Results The normal tactual level of monofilament test and the normal light touch level of International Standard of Spinal Cord Injury (ISSCI) was consistent in 36%result to the unilateral level of SCI. For the 45 cases with ASIA A injury, 71%of the key points below the SCI level lost the tactual sensation in monofilament test, and 84%lost in light touch exam of ISSCI. Conclusion The result of monofilament test is poorly consistent with light touch exam of SCI, which may result from tactile sensitization after SCI. It is recommended to combine these exam in practices.
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@#Objective To investigate the correlation between Semmes-Weinstein monofilament test and light touch exam of international standard for spinal cord injury (SCI). Methods 84 inpatients with SCI were assessed with Semmes-Weinstein monofilament test and light touch exam of international standard to determine the SCI level. The results were recorded as right-side and left-side of the body respectively. Results The normal tactual level of monofilament test and the normal light touch level of International Standard of Spinal Cord Injury (ISSCI) was consistent in 36% result to the unilateral level of SCI. For the 45 cases with ASIA A injury, 71% of the key points below the SCI level lost the tactual sensation in monofilament test, and 84% lost in light touch exam of ISSCI. Conclusion The result of monofilament test is poorly consistent with light touch exam of SCI, which may result from tactile sensitization after SCI. It is recommended to combine these exam in practices.
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@#Objective To establish the reference values of static balance function with Active Balancer EAB-100 in healthy Chinese adults, and to screen the valuable indices for clinical work. Methods There were 227 healthy adults measured with Active Balancer EAB-100 when standing still with eyes opened and closed. All the data recorded were analyzed with SPSS 19.0, and the weight of every parameter was obtained with principal component analysis. Results The reference values of parameters for static balance function were established in healthy Chinese adults. The loadings of whole path length, rectangle area, circumference area, effective value area, deflection center displacement X, deflection center displacement Y, rectangle area of Romberg rate and circumference area of Romberg rate were more than average. Conclusion It is need to focus on whole path length, circumference area, deflection center displacement X, deflection center displacement Y, and effective value area and circumference area of Romberg rate much more in clinical practice for the static balance assessment.
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@#Objective To explore the effects of computerized working memory training on working memory and brain functional activition for stroke paitents. Methods 3 stroke patients voluntarily joined in the study, 10 healthy adults were recruited as control group. The patients received computerized working memory training for 4 weeks. Cognitive psychological tests (the n-back task, Stroop task and Raven`s Advanced Progressive Matrices task) and neuroimaging test (task- state functional magnetic resonance imaging) were administered before and after treatment. Results Working memory training significantly improved the working memory, fluid intelligence and attention for each trained patient (P<0.001), and could renovate the abnormal functional activity model and reorganize the functional brain network. Conclusion Computerized working memory could be used as an effective cognitive rehabilitation intervention for stroke patients.
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Objective To explore the effects of computerized working memory training on working memory and brain functional activi-tion for stroke paitents. Methods 3 stroke patients voluntarily joined in the study, 10 healthy adults were recruited as control group. The pa-tients received computerized working memory training for 4 weeks. Cognitive psychological tests (the n-back task, Stroop task and Raven`s Advanced Progressive Matrices task) and neuroimaging test (task-state functional magnetic resonance imaging) were administered before and after treatment. Results Working memory training significantly improved the working memory, fluid intelligence and attention for each trained patient (P<0.001), and could renovate the abnormal functional activity model and reorganize the functional brain network. Conclu-sion Computerized working memory could be used as an effective cognitive rehabilitation intervention for stroke patients.
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Objective To explore the correlation of cognitive impairment and areas of middle cerebral artery (MCA) territory infarction. Methods The Montreal Cognitive Assessment (MoCA) was used to evaluate neuropsychological statuses in the patients who developed first-time acute cerebral infarction for 2 weeks. MoCA scores and sub-scores were recorded. 132 patients were selected with MCA occlu-sion, scores of MoCA were more than 15, and cognitive impairment in at least one domain, and then subgrouped by infarction site. The cor-relation between the results of neuropsychological cognitive assessment and the sites of infarction was analyzed. Results MCA occlusion was correlated with the impairments of visual spatial/executive, attention, language and memory (B=-1.875~-1.094, P<0.05). Infarction in frontal lobe was correlated with the impairments of visual spatial/executive, attention, abstract and memory (B=-1.760~-1.329, P<0.05), temporal lobe with visual spatial/executive and memory impairment (B=-1.849~-1.735, P<0.05), parietal lobe with visual spatial/execu-tive, attention and memory impairment (B=-1.695~-1.482, P<0.05), basal ganglia with visual spatial/executive, attention, language and memory impairment (B=-1.932~-1.041, P<0.01). Conclusion The characteristics of impairment in cognitive function is different with in-farction sites in MCA territory.