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@#Objective To compare the reliability of modificatory method and traditional method in preparing ischemic stroke rat model in rehabilitation period.Methods 173 female SD rats were divided into traditional method group(n=63),modificatory method group(n=109) and control group(n=37).In the traditional method group,the thread embolus was inserted through the left external carotid artery(ECA),and then left ECA and pterygopalatine artery(PPA) were ligated.In the modificatory method group,the thread embolus was inserted through the left internal carotid artery(ICA) and only left common carotid artery(CCA) was ligated.In the control group,the thread embolus was not inserted,only CCA was ligated.Results There was no significant difference in neurofunction score between the modificatory method group and the traditional method group(P>0.05).The operating time was significantly shortened(P<0.01) and the survival time was significantly prolonged in the modificatory method group compared with that of the traditional method group(P<0.01).The two-month survival rate was 54.13% in the modificatory method group and 31.75% in the traditional method group receptively,the former was significantly longer than the latter(P<0.01).Conclusion The ischemic stroke model established by modificatory methods is not only precisely and reliable but also save operating time and improve survival rate of the animals compared with the traditional method.The main death causes of animals are large-area cerebral edema and electrolyte imbalance after operation.
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@# Balance function is one of injured functions needed rehabilitation after stroke. It is also the considerable signal of the restoration for motor function, which being thought highly in the field of rehabilitation. In some aspect, the restoration of balance function cannot be substituted by stance. The authors mainly discussed the mechanism and issues of balance training by which the balance function of stroke patients in chronic period improved, based on nerve compensative mechanism.
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@#Objective To study the effects of constraint-induced movement train (CIMT) on the neurological medullary sheath in the rats after middle cerebral artery occlusion (MCAO). Methods 55 SD rats were randomly divided into CIMT group and nature recovery (NR) group after MCAO. The CIMT group were trained with balance beam and rolling cage everyday, with restrictting the movement of the intact upper limbs. The NR group lived in the same condition. The rats in CIMT group were assessed with ethology 5 d, 10 d, 15 d, 30 d and 60 d after operation respectively. At last, 5 rats of each group were checked with MRI, then they were immolated for myelin staining. Results The balance and muscle strength of CIMT group improved better compared with the NR ones (P<0.05), as well as the diameter and the demyelination of neurofibril in the infarcted area. Conclusion CIMT can collect more functional neurofibra and decrease myelinolysis.
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Objective To economically investigate tertiary stroke rehabilitation treatment.Methods 3 tertiary rehabilitation networks were set up in Beijing.82 patients with acute cerebrovascular diseases were enrolled into the study according to standardized criteria in all centers and randomized into rehabilitation group and control group.Rehabilitation training was implemented according to standardized procedures.The patients in rehabilitation group were given rehabilitation training in acute stage for 28 days and then underwent long term rehabilitation'program for 6 months in rehabilitation centers or community rehabilitation settings.The patients in control group were only given rehabilitation training in acute stage for 28 days. Altogether 4 evaluations were conducted in one week after the onset and at the end of 1,3,6 months, respectively.Results Significant differences of motor function,ability of daily activities,quality of life evaluation and cost were found in the 1st,3rd and 6th month after the onset of diseases.The rehabilitation group surpassed the control group significantly.At the end of 6 months,the average of Barthel Index of rehabilitation group was 83.18?18.22 while that of control group was 63.69?12.73.At the end of 6 months,total cost of rehabilitation group was(56 420.0?17 831.8)Yuan and that of control group was (64 864.2?18 267.5)Yuan.The rehabilitation group had better cost/effectiveness and cost/utility.There was a significant difference of cost between two groups.The total rehabilitation cost of rehabilitation group was 4613 Yuan,accounting for 15.3%of all the cost.Conclusion The tertiary rehabilitation treatment for stroke patients has achieved better cost/effectiveness and cost/utility.In China pharmaceutical cost constitutes the major part of the stroke therapy while the rehabilitation cost only a small portion,which is significantly different from the situation in developed countries.
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@#ObjectiveWe discussed the effect of TMS on the motor conduction pathway and studied the function of TMS in the motor function of patients with stroke. Methods65 patients with acute brain infarction were divided into two groups, treatment group given TMS once a day and contral group. Motor nerve center was stimulated twice or three times each day. 14 days were one period of treatment. MEP, CMCT, force and Fugl-Meyer scores were recorded on the first and the last days. Results Before treatment, there was no difference between two groups on CMCT, force and Fugl-Meyer scores. After treatment, the patients in the treatment group got much better improvement in movement ability than the patients in the control group. But there was no difference between two groups on MEP neither before nor after treatment. Conclusions TMS can help patients with stroke to regain movement ability, and improve the recovery of force and fine movement, and also reduce the CMCT distinguishably. TMS is easy to use and no evidently uncomfortable influence on patients happens.
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Objective To observe the cerebral activation by functional MRI(F MRI) during the thumb movement in different motor fashion. Methods Four stroke patients with hemiplegia were involved in this study During the examination by F MRI, these patients were asked to move thumbs in passive, active and overcoming resistance fashion. Results (1) During the thumb at unaffected side moving in active fashion, functional activity was observed in the contralateral primary motor cortex In passive fashion, however, functional activity was observed in contralateral somatosensory cortex The overcoming resistance motor test was associated with activity in bilateral primary motor cortex and somatosensory cortex (2) The same motor tests were made in movement of the thumb at affected side , functional activity appeared not only in primary motor cortex, somatosensory cortex of affected side, but also in basal ganglia(affected area), frontal lobe, supplementary motor cortex, somatosensory cortex, and contralateral primary motor cortex. Conclusion These results have proved the neurorehabilitation theory such as neuroplasticity and so on