ABSTRACT
Objective :To explore rehabilitative effect of low—frequency (1Hz ,LF) repetitive transcranial magnetic stimulation (rTMS) combined functional electrical stimulation (FES) on lower limb spasm and motor function in pa—tients with subacute ischemic stroke (SAIS).Methods : A total of 92 SAIS patients with lower limb spasm and motor dysfunction hospitalized in our department were randomly divided into sham stimulation + FES group (sham stimu—lation group ,n＝45) and low—frequency rTMS + FES group (LF—rTMS group ,n＝47) ,both groups were continu—ously treated for three weeks .Lower limb motor function and spasm severity were assessed by Fugl—Meyer motor as—sessment (FMA) and modified Ashworth scale (MAS) respectively before and after treatment ,and motor evoked potential (MEP) was detected .Results : Compared with before treatment ,there was significant rise in FMA score , and significant reductions in MAS score and MEP in two groups after three—week treatment , P＝ 0.001 all ;com—pared with sham stimulation group ,there was significant rise in FMA score [16. 0 (13.0 ,23. 5 ) scores vs. 19. 0 (16.0 ,27.0) scores] ,and significant reductions in MAS score [1. 5 (1. 3 ,1.5) scores vs. 1. 0 (0. 5 ,1. 5) scores] and MEP [ (24.64 ± 0. 39) ms vs. (24.43 ± 0.31) ms] in LF—rTMS group after treatment , P＜0.05 or ＜ 0. 01 . Conclusion : Compared with sham stimulation + FES ,LF—rTMS + FES can more significantly improve lower limb spasm and motor function in patients with subacute ischemic stroke .
ABSTRACT
Objective To observe the effects on and the possible mechanism of early exercise training underlying the mobilization of circulating endothelial progenitor cells in patients with acute ischemic stroke.Methods One hundred and twenty patients with acute ischemic stroke were randomized into two groups:an early exercise group (treated with exercise training,n =60) and a control group(no exercise training,n =60).Meanwhile,each group was divided into two different age groups (50-68 years group of 32 cases,＞ 68 years group of 28 cases in exercise group;50-68 years group of 29 cases,＞ 68 years of 31 cases in control group).The amount of circulating endothelial progenitor cells in peripheral blood was accounted by flow cytometry (FCM),while the level of vascular endothelial cell growth factor (VEGF) in blood serum was examined by enzyme-linked immunoassay (ELISA).National Institutes of Health Stroke Scale (NIHSS),Fugl-Meyer Assessment (FMA) and modified Barthel index (MBI) were used to evaluate the patients at 1st day and 14th day after exercise.Results The amount of circulating progenitor cells after 14 days of exercise training in exercise group (from 27.93 ± 6.08/ml to 457.49 ± 73.02/ml)is higher than in control group(from 28.29 ± 5.93/ml to 81.87 ± 9.92/ml) (P ＜ 0.01).Compared with the control group,the level of VEGF at 14th day of exercise group is significantly higher (P ＜ 0.01).The score of NIHSS,FMA,MBI were not significantly different between exercise group and control group (P ＜ 0.01).However,the score of NIHSS was decrease in both exercise group and control group after treatment.Furthermore,the amount of circulating progenitor cells was not significantly different between the age groups either in exercise group or control group (P ＞ 0.05).Conclusion Early Exercise training may promote the mobilization of the circulating progenitor cells,which might be related to the increase of VEGF.The mobilization of the EPCs has no effect on the early neurological function after acute ischemic stroke.Age is not associated with the amount of circulating endothelial progenitor cells.