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Introducción. La parálisis cerebral (PC) es una de las principales causas de discapacidad en la población infantil, afectando diversas áreas del desarrollo como la función motora gruesa; equilibrio y marcha. Hay evidencia de los beneficios de la terapia acuática y de cómo puede complementar la rehabilitación. Objetivo. Describir la efectividad de las intervenciones acuáticas en personas con PC, determinar mejoras en la función motora gruesa uso de métodos, protocolos y dosificación. Métodos. Se analizaron 9 estudios aleatorizados controlados desde el 2012 a la fecha, seleccionados por un experto y cuyos sujetos tenían PC espástica, Gross Motor Function Classification System (GMFCS) I a IV, entre los 2 y 20 años. Post intervención acuática se reportan mejoras significativas en el promedio de los ítems medidos por Gross motor function measure (GMFM). De los métodos que contribuyeron a mejoras se encuentra Halliwick y ejercicios acuáticos sin un programa específico. Resultados. Se obtuvieron mejoras de 35 a 100 minutos, y de 12 a 30 sesiones en total. No se logra concluir el tipo de terapia más efectiva, ya que las medidas de resultado y las características de los sujetos eran diversas. Conclusión. Una dosificación mínima de 2 veces por semana, 35 minutos de intervención en un total de 16 sesiones (9,3 horas en total) pareciera mejorar la función motora gruesa, cuyos resultados son transferibles a las actividades en tierra inmediatamente, sin embargo, no se obtiene información si se mantienen a mediano o largo plazo.
Background. Cerebral palsy (CP) is one of the main causes of disability in the child population, affecting various areas of development such as gross motor function; balance and gait. There is evidence of the benefits of aquatic therapy and how it can complement rehabilitation. Objective. to describe the effectiveness of aquatic interventions in people with CP, to determine improvements in gross motor function using methods, protocols, and dosage. Methods. Nine randomized controlled studies were analyzed from 2012 to date, selected by an expert and whose subjects had spastic CP, Gross Motor Function Classification System (GMFCS) I to IV, between 2 and 20 years of age. Results. After the aquatic intervention, significant improvements were reported in the average of the Gross motor function measure (GMFM) items measured. Of the methods that contributed to improvements, there is Halliwick and aquatic exercises without a specific program. Results. Improvements were obtained from 35 to 100 minutes, and from 12 to 30 sessions in total. It is not possible to conclude the most effective type of therapy, since the outcome measures and the characteristics of the subjects were diverse. Conclusion. A minimum dosage of 2 times per week, 35 minutes of intervention in a total of 16 sessions (9.3 hours in total) seems to improve gross motor function, the results of which are immediately transferable to activities on land, however, it is not obtains information if they are maintained in the medium or long term.
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Background: Cerebral palsy (CP) is the most common motor disability in childhood. Quality of life (QOL) has emerged as an important concept in childhood, especially for children with disabilities. CP has an impact on a child’s capacity to do activities of daily living thus affecting QOL of patients and their families. Aims and Objectives: The objective of present study was to assess the QOL in children with CP. Materials and Methods: In this study, 29 children with CP in the age group of 4–12 years were evaluated for QOL was assessed using CPQOL-Child Primary Caregiver Questionnaire (4–12 years). The questionnaire was completed by one of the parents or their caregiver. Scores for each domain of QOL were converted to a scale ranging from 0 to 100 and analyzed. Results: The scores as reported by the parents were low for each of the domains with maximum effect seen in functioning domain and least in pain domain. Girls had better QOL than boys. The QOL scores were negatively related to the severity of CP which was assessed by gross motor function classification system suggesting that severity of disability had negative impact on QOL. Conclusion: QOL of children with CP was found to be poor and was influenced by age, sex and motor functioning
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Objective:To investigate the clinical application value of modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule after surgical treatment of osteoporotic fracture. Methods:Eighty patients undergoing surgical treatment of osteoporotic fractures in Jiamusi Orthopedic Hospital from January 2019 to January 2021 were included in this study. They were randomly divided into a control group ( n = 40, receiving routine western medicine treatment) and a study group ( n = 40, receiving adjuvant treatment with modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule based on routine western medicine treatment). All patients were treated for 6 consecutive months. The Fugl-Meyer Assessment scale score of motor function, traditional Chinese medicine symptom score, modified Barthel Index (MBI) score, bone mineral density T value at different treatment time points, clinical efficacy, and incidence of adverse reactions were compared between the two groups before and after treatment. Results:At 1, 2, 3 and 6 months of treatment, the T value of bone mineral density in the study group was significantly higher than that in the control group (all P < 0.001). At the end of treatment, the modified Barthel Index and the Fugl-Meyer Assessment scale score in the study group were (78.05 ± 4.26) points and (88.53 ± 2.35) points, which were significantly greater than (70.02 ± 6.58) points and (82.75 ± 2.44) points in the control group ( t = 6.49, 13.92, both P < 0.05). At the end of treatment, the symptom score in the study group was significantly lower than that in the control group ( P < 0.001). Total response rate in the study group was significantly higher than that in the control group [97.5% (39/40) vs. 80.0% (32/40), χ2 = 6.14, P < 0.05]. There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule can effectively improve motor ability and increase bone mineral density T value in patients after surgical treatment for osteoporotic fracture.
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【Objective】 To investigate the efficacy of autologous ozoneized blood transfusion(AOBT) in improving consciousness and motor function in convalescent stroke patients. 【Methods】 A total of 44 patients who were diagnosed as convalescent cerebral apoplexy and received treatment in Rehabilitation Department of our hospital from August 2016 to September 2021 were randomly divided into the experimental group and control group by blind method. The experimental group (n=22) received general rehabilitation training (such as exercises, occupational therapy, acupuncture and transcranial magnetic stimulation) plus AOBT (200 mL venous phlebotomy at the median elbow), once every 2 to 3 days and 12 occasions as a course of treatment; the control group solely recieved general rehabilitation training. The consciousness (GCS score) and ability of daily living (Barthel index score) score of the two groups before and after treatment were statistically compared, and Ueda motor function grade, Brunnstrom stage and muscle tone grade were observed and evaluated. 【Results】 After the treatment, the experimental group and the control were compared as follows: 1) the GCS score and Barthel score was 14.82±0.39 vs 12.41±2.52, 61.14±12.24 vs 52.05±11.72(P<0.05); 2) The recovery rate of motor function was 95.45% (21/22) vs 63.64% (14/22) (P<0.05); 3) The total recovery rate of muscle tone was 90.91% (20/22) vs 63.64% (14/22) (P<0.05). 【Conclusion】 AOBT, with somewhat high safety and effectiveness, can improve the state of consciousness, motor function and muscle tone in convalescent patients with stroke.
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ObjectiveTo explore the effect of anodal transcranial direct current stimulation (atDCS) on premotor cortex (PMC) on upper limb motor function in patients with severe stroke. MethodsFrom June, 2021 to December, 2022, 60 patients with severe stroke in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 20), primary motor cortex (M1) group (n = 20) and PMC group (n = 20). All the groups accepted routine rehabilitation treatment, while the control group accepted atDCS pseudo stimulation to the focus side PMC, M1 group accepted atDCS to the focus side M1, and PMC group accepted atDCS to the focus side PMC, for six weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Wolf Motor Function Test (WMFT), the surface electromyography root mean square (RMS) ratio of affected/unaffected side of triceps and extensor carpus were used to evaluate the efficacy before and after treatment. ResultsAfter treatment, the scores of FMA-UE and WMFT, and RMS ratio of triceps and extensor carpus significantly increased in all the groups (|t| > 2.458, P < 0.05), and were better in PMC group than in the other two groups (F > 4.084, P < 0.05). ConclusionatDCS on PMC could improve the overall function of upper limb in patients with severe stroke.
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ObjectiveTo observe the effect of music therapy on cognitive function, motor function, and activities of daily living (ADL) of patients with post-stroke cognitive impairment. MethodsFrom December, 2020 to July, 2022, 48 patients with post-stroke cognitive impairment in Beijing Bo'ai Hospital were enrolled and randomly divided into control group (n = 24) and experimental group (n = 24). Both groups received conventional medication, nursing, and conventional rehabilitation, while the experimental group received music therapy additionally, for eight weeks. Before and after intervention, the cognitive function was assessed by Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and motor function and ADL were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI), respectively. ResultsSix cases in the control group dropped down. The increase in the scores of LOTCA and FMA was more in the experimental group than in the control group (t > 2.665, P < 0.05), however, no significant difference was found in the increase of MBI score between two groups. ConclusionMusic therapy could improve the cognitive function and motor function of patients with post-stroke cognitive impairment.
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ObjectiveTo observe the effect of video-based mirror therapy on lower limb motor function, walking ability, and balance of stroke patients at recovery stage. MethodsFrom January to October, 2022, 43 stroke patients in Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and mirror therapy group (n = 21). Both groups received routine rehabilitation, and the mirror therapy group received video-based mirror therapy additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC) and Berg Balance Scale (BBS) before and after treatment. ResultsAfter treatment, the scores of FMA-LE, FAC and BBS improved significantly in both groups (|t| > 6.205, P < 0.001), and the scores of FMA-LE and BBS were better in the mirror therapy group than in the control group (|t| > 2.164, P < 0.05). ConclusionCombining with video-based mirror therapy could facilitate to improve the lower limb motor function and balance ability of stroke patients at recovery stage.
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ObjectiveTo investigate the effect of transcutaneous auricular vagus nerve stimulation (taVNS) combined with robot-assisted therapy on upper limb function of subacute stroke patients. MethodsFrom March, 2022 to March, 2023, 60 subacute stroke patients from Dushu Lake Hospital and the First People's Hospital of Kunshan were randomly divided into control group (n = 20), robot group (n = 20) and combined group (n = 20). All the groups received conventional treatments including medication, physical therapy and occupational therapy; the robot group received sham taVNS combined with hand robot-assisted therapy; while the combined group received taVNS combined with hand robot-assisted therapy, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and hand part, the root mean square (RMS) electromyography of the extensor carpi radialis and extensor digitorum muscles during contraction, and the latency and amplitude of transcranial magnetic stimulation motor-evoked potential (TMS-MEP) before and after treatment. ResultsAfter treatment, the scores of FMA-UE and hand part, RMS of the extensor carpi radialis and extensor digitorum muscles, and latency and amplitude of TMS-MEP improved in all the groups (t > 2.099, P < 0.05); and they were the best in all indicators in the combined group (F > 9.106, P < 0.001). ConclusiontaVNS combined with robot-assisted therapy can promote central nervous system remodeling and further improve upper limb function in stroke patients.
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ObjectiveTo explore the effect of repetitive peripheral magnetic stimulation on upper limb motor function rehabilitation of stroke patients after contralateral seventh cervical nerve transfer (CC7). MethodsFrom May, 2020, to May, 2022, 34 stroke patients with hemiplegia underwent CC7 in Jing'an District Centre Hospital of Shanghai were randomly divided into control group (n = 17) and observation group (n = 17). Both groups received conventional rehabilitation. The observation group accepted repetitive peripheral magnetic stimulation, and the control group received sham stimulation, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Hua-Shan Grading of Upper Extremity (H-S grading) before and after treatment. ResultsTwo cases dropped down in each group. There was difference in gender between two groups (χ2 = 6.136, P < 0.05). After treatment, the scores of FMA-UE and H-S grading significantly improved in both groups (t > 4.000, P < 0.01), and the improvement was better in the observation group than in the control group (t > 2.362, P < 0.05). ConclusionRepetitive peripheral magnetic stimulation could improve the motor function of upper limb and hand of stroke patients with hemiplegia after CC7.
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ObjectiveTo observe the characteristics of gait symmetry and its influencing factors in patients with incomplete spinal cord injury (ISCI). MethodsFrom May, 2018 to November, 2021, 34 patients with ISCI in Beijing Bo'ai Hospital were divided into symmetrical injury of lower limb (SI) group and asymmetrical injury of lower limb (ASI) group according to the lower extremities motor score (LEMS). Three dimensional motion acquisition system and plantar pressure acquisition system were used for gait test. The symmetry indexes of step length, stance time and swing time were caculated. ResultsThe symmetry indexes of step length, stance time and swing time were significant lower in SI group than in ASI group (|t| > 2.619, P < 0.01). Stance time and swing time significantly correlated to the difference of bilateral LEMS in ASI group (r > 0.468, P < 0.01). Discriminant analysis showed that gait parameter equations were different for patients with different symmetry of lower limb injuries. ConclusionThe symmetry of lower limb motor function impacts gait symmetry for patients with ISCI, especially the difference value of bilateral total LEMS. Gait parameters can be used to determine the symmetry of lower limb injury in patients with ISCI.
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ObjectiveTo evaluate the main structural and content features of four instruments for motor function and motor ability assessment and their psychometric properties for children and adolescents with disabilities, based on International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). MethodsPubMed, Medline and Web of Science databases were searched for literature on motor function and motor ability assessment for children and adolescents with disabilities published from establishment to May, 2023. The main structural and content characteristics of the tools were analyzed using ICF-CY, and the quality of measurement tools was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). ResultsNine papers were eventually included, and four assessment tools were identified, including Gross Motor Function Measure-88 (GMFM-88), Peabody Developmental Motor Scales second edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2), and Movement Assessment Battery for Children second edition (MABC-2). The GMFM-88 consisted of 88 items in five dimensions: zone A (lying and rolling), zone B (sitting), zone C (crawling and kneeling), zone D (standing), and zone E (walking and running and jumping); it involved joint movement function (b710), random movement control function (b760), etc., in body function; and the change of basic body posture to maintain a body posture (d410) and maintain a body posture (d415) in activity and participation, with good to excellent levels of internal consistency reliability, test-retest reliability, content validity, and structural validity. The PDMS-2 consisted of six subtests, including reflexes, posture, movement, physical manipulation, grasping and visuomotor integration, with a total of 249 items; it involved memory function (b144) and joint mobility function (b710) in body function; as well as looking (d110) and imitation (d130) in activity and participation; with good psychometric properties in terms of internal consistency reliability, test-retest reliability, content validity, structural validity, and hypothesis testing and cross-cultural feasibility. There are two versions of BOT-2: long form and short form. The long form consisted of eight subtests with 53 items, involving joint mobility function (b710) and joint stability function (b715) in body function; as well as imitation (d130) and learned calculation (d150) in activity and participation; it achieved excellent levels of psychometric properties in terms of internal consistency reliability, content validity, and structural validity, and good level in reliability and test-retest reliability. MABC-2 consisted of two parts: an activity ability test and a checklist with 30 items; it involved joint mobility function (b710), joint stability function (b715), etc., in body function; as well as fine-hand use (d440), hand and arm use (d445) in activity and participation; with good psychometric properties such as reliability, content validity, and structural validity. ConclusionThis systematic review analyzed the main structural and content characteristics of four types of measurement tools for assessing motor function and motor ability in children and adolescents with disabilities based on the ICF-CY, and evaluated the quality of psychometric properties (internal consistency reliability, test-retest reliability, content validity, structural validity, and cross-cultural consistency, etc.) of the four types of measurement tools using the COSMIN criteria. For the structure and content, PDMS-2 appears the broadest content, and measures fine hand movements, dynamic and static balance, along with the BOT-2 and MABC-2. GMFM-88 focuses more on gross motor functions such as postural control. Four instruments show high internal consistency reliability, test-retest reliability, content validity and structural validity, while the BOT-2 and PDMS-2 show better reliability. To ensure the reliability and validity of the measures, rehabilitation workers and educators need to receive standardized training and qualification before using the standardized instruments for motor function and motor ability for children with disabilities. With norm-referenced measures, the results need to be converted to standard scores.
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ObjectiveTo observe the effect of bilateral sequential repetitive transcranial magnetic stimulation on the motor function of upper limbs in stroke patients. MethodsFrom December, 2020 to December, 2022, 62 stroke inpatients in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were included. They were randomly divided into control group (n = 31) and observation group (n = 31). Both groups accepted conventional medicine and rehabilitation, as well as electroacupuncture antagonistic muscle therapy. Before electroacupuncture, the observation group acceped low-frequency repetitive transcranial magnetic stimulation at primary motor cortex (M1) on the healthy side, followed by intermittent theta burst stimulation at M1 on the affected side, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Barthel Index (MBI) and modified Ashworth Scale (MAS), and motor evoked potential (MEP) latency was compared before and after treatment. ResultsOne patient dropped down in the observation group, and no adverse event happened. After treatment, the scores of FMA-UE and MBI significantly increased (|t| > 9.953, P < 0.001), and the score of MAS and the latency of MEP significantly decreased (|t| > 5.043, P < 0.001) in both groups; while all of them were better in the observation group than in the control group (|t| > 2.237, P < 0.05). ConclusionBilateral sequential repetitive transcranial magnetic stimulation can effectively promote the recovery of upper limb motor function in stroke patients.
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ObjectiveTo explore the effect of transcranial direct current stimulation (tDCS) combined with acupuncture on central and upper limb function in stroke patients at flaccid stage based on central-peripheral-central theory. MethodsFrom September, 2018 to December, 2021, 120 patients with upper limb dysfunction after stroke in Guangdong Work Injury Rehabilitation Hospital were selected and randomly divided into control group 1 (n = 40), control group 2 (n = 40) and experimental group (n = 40). All the groups received conventional rehabilitation treatment. In addition, the control group 1 received acupuncture treatment, the control group 2 received anodal tDCS, and the experimental group received combined treatment of both, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment. Electroencephalograph (EEG) was used to detect brain symmetry index (BSI), and electromyography (EMG) was used to detect root mean square values (RMS) of triceps brachii, biceps brachii, extensor wrist and flexor wrist of the affected upper limbs. ResultsTwo cases in the control group 1, one in the control group 2 and one in the experimental group dropped off, respectively. After treatment, the scores of FMA-UE and MBI significantly increased in all the groups (t > 11.757, P < 0.001), and they were higer in the experimental group than in the control groups (P < 0.001); the BSI decreased in the control group 2 and the experimental group (t > 2.324, P < 0.05), and it was less in the experimental group than in the control group 2 (P < 0.05); the RMS of biceps increased in all the groups (t > 2.953, P < 0.01), and was higer in the experimental group than in the control groups (P < 0.05); the RMS of flexor wrist and triceps increased in the control group 1 and the experimental group (t > 2.230, P < 0.05), and were higher in the experimental group than in the control group 1 (P < 0.05); the RMS of wrist extensor muscle increased only in the experimental group (t = 3.350, P < 0.01). ConclusiontDCS combined with acupuncture based on central-peripheral-central theory could effectively improve the upper limb function of stroke patients at flaccid stage, with advantages in improving hemispheric asymmetry and enhancing the activation level of affected muscles.
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ObjectiveTo explore the correlation of index of standing balance tester to score of Berg Balance Scale (BBS) and Fugl-Meyer Assment-Lower Extremites (FMA-LE) in stroke patients with hemiplegia, and analyze the predictive effect to BBS. MethodsFrom March to October, 2022, 66 stroke hemiplegic patients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected. The elliptical area and length of motion were measured with a balance tester when they were standing with eyes open or closed, respectively. They were also evaluated with BBS and FMA-LE. The correlation between the test results and the scores of BBS and FMA-LE was analyzed with Pearson's correlation analysis, and the predictive effect of the test results to the score of BBS was also analyzed with receiver operating characteristic (ROC) curve. ResultsHypertension, diabetes, coronary heart disease, smoking and alcohol drinking were not significant for the scores of BBS and FMA-LE (|t| < 1.124, P > 0.05). In the balance test, the eye opening movement ellipse area, eye opening movement length, eye closing movement ellipse area and eye closing movement length were negatively correlated with the scores of BBS and FMA-LE (|r| > 0.250, P < 0.05). The area under the ROC curve of eye opening movement ellipse area to the score of BBS was 0.685 (P = 0.019), and the area under the ROC curve of the eye opening movement length to the score of BBS was 0.764 (P < 0.001). ConclusionThe open eye movement ellipse area, open eye movement length, closed eye movement ellipse area and closed eye movement length are significantly negatively correlated with the scores of BBS and FMA-UE. The indexes of the balance test with eyes open may predict the score of BBS.
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ObjectiveTo observe the effect of hyperbaric oxygen therapy (HBOT) combined with repetitive peripheral magnetic stimulation (rPMS) on ankle motor function and balance of stroke patients. MethodsFrom April, 2022 to March, 2023, 96 patients in the First Affiliated Hospital of Bengbu Medical College were randomly divided into control group (n = 32), rPMS group (n = 32) and combined group (n = 32). The control group received conventional rehabilitation; rPMS group received rPMS on the basis of the control group; and the combined group received HBOT on the basis of rPMS group, for two weeks. Before and after treatment, the plantar weight-bearing ratio of the affected side, Berg Balance Scale (BBS), active range of motion (AROM) of ankle dorsiflexion of the affected side, and integrated electromyographic (iEMG) values during maximum isometric contraction of the tibialis anterior and gastrocnemius muscles were measured. ResultsTwo cases dropped out in each group, and 90 cases were finally included, and no adverse events occurred during treatment. Before treatment, there was no significant difference in plantar weight-bearing ratio of the affected side, BBS score, AROM of ankle dorsiflexion of the affected side, and iEMG of tibialis anterior and gastrocnemius among three groups (F < 2.070, P > 0.05). After treatment, all the indicators significantly improved in all the groups (|t| > 27.004, P < 0.001), and they were better in the combined group than in rPMS group and the control group (P < 0.001); except the proportion of plantar weight-bearing on the affected side, the other indicators were better in rPMS group than in the control group (P < 0.001). ConclusionrPMS can promote the recovery of ankle motor function and balance of stroke patients, and the effect combining with HBOT is better.
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ObjectiveTo explore the neuromuscular control mechanism of training strategies based on mirror neuron system (MNS): action observation (AO), action execution (AE) and action imitation (AO+AE) using functional Near Infrared Spectroscopy (fNIRS) and surface electromyography (sEMG). MethodsFrom July, 2022 to February, 2023, 64 healthy adults were asked to finish four tasks: watching landscape video (control), watching landscape video and acting right wrist and hand extension (AE), watching right wrist and hand extension video (AO), and watching right wrist and hand extension video and acting right wrist and hand extension (AO+AE). A block design was adopted, five times a task in a block, eight cycles, random orders in videos and tasks. The activation of each channel and regions of interest (ROI, namely BA40, BA44, BA45, BA46, BA6 and BA7) in left MNS regions was detected with fNIRS synchronously, as well as the average electromyography (AEMG) of extensor digitorum and extensor carpi radialis with sEMG. ResultsCompared with the control condition, MNS activated in AO, AE and AO+AE conditions, and the intensities mildly increased in turn. Compared with the control condition, 15 channels activated in AO condition, 15 channels activated in AE condition, and all 20 channels activated in AO+AE condition; and the activation intensities of most channels were AO+AE > AE > AO. Four ROI, BA40, BA46, BA6 and BA7, activated in AO condition, all the six ROI activated in AE and AO+AE conditions, and the activation intensities of most ROI were AO+AE > AE > AO. The standardized AEMG of extensor digitorum and extensor carpi radialis were higher in AO+AE condition than in AE condition (|t| > 4.24, P < 0.001). ConclusionMNS has been activated during action observation, execution and imitation, and the ranges and intensities of activation increase in turn. The target muscles activate more during imitation than during execution. Synchronous application of fNIRS and sEMG is feasible in the study of neural mechanism of rehabilitation strategies based on mirror neuron theory.
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ObjectiveTo observe the effect of transcranial direct current stimulation (tDCS) combined with task-oriented rehabilitation training single pellet reaching and grasping (SPG) on the motor function of forelimb in rats with unilateral contusion of C5 spinal cord. MethodsA total of 60 adult male Sprague-Dawley rats were randomly divided into sham operation group (sham group), spinal cord injury (SCI) group, tDCS group, SPG group, false group and tDCS+SPG group, with ten rats in each group. Only C5 lamina was removed in the sham group, and the C5 spinal cord contusion model was established by IH spinal cord impactor in the other five groups. The rats received tDCS in tDCS group, SPG in SPG group, tDCS without current in false group, tDCS combined with SPG in tDCS+SPG group, and no treatment in the SCI and the sham groups. The rats were evaluated with Rearing and Grooming tests, and motor-evoked potential (MEP). ResultsFour weeks after operation, compared with SCI group, the scores of Rearing and Grooming increased in tDCS group and tDCS+SPG group (P < 0.05), and they were more in the tDCS+SPG group than in tDCS group and SPG group (P < 0.05); the score of Grooming increased in SPG group (P < 0.05); while the amplitude of MEP increased in tDCS group, SPG group and tDCS+SPG group (P < 0.05), and the latency shortened in tDCS group and tDCS+SPG group (P < 0.05); and the amplitude increased more in tDCS+SPG group than in tDCS group and SPG group (P < 0.01). ConclusiontDCS could promote the recovery of motor function in rats with SCI, and the combination therapy of tDCS and task-oriented rehabilitation training is more effective.
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ObjectiveTo investigate the effect of hyperbaric oxygen combined with dynamic scalp acupuncture on motor function for stroke patients with hemiplegia, and compare the effect of dynamic scalp acupuncture inside or outside hyperbaric oxygen chamber. MethodsFrom January, 2021 to June, 2022, 72 stroke inpatients with hemiplegia in Fuyang People's Hospital were randomly divided into control group (n = 24), combination group 1 (n = 24) and combination group 2 (n = 24). All the patients received routine treatment, while the control group received dynamic scalp acupuncture, the combination group 1 received hyperbaric oxygen and dynamic scalp acupuncture outside the hyperbaric oxygen chamber, and the combination group 2 received hyperbaric oxygen and dynamic scalp acupuncture inside the hyperbaric oxygen chamber, for four weeks. They were assessed with National Institutes of Health Stroke Scale (NIHSS), modified Barthel Index (MBI), Berg Balance Scale (BBS), and Fugl-Meyer Assessment (FMA) before and after treatment. The rest pulse oximetry saturation (SpO2)，the lowest SpO2 (SpO2L) and the variation of SpO2 (ΔSpO2) were measured in the first and last treatment. ResultsThe scores of NHISS, MBI, BBS and FMA increased in all the groups after treatment (|t| > 7.681, P < 0.001), and they were more in both the combination group 1 and the combination group 2 than in the control group (P < 0.05). During the first and last treatment, the rest SpO2 and SpO2L increased in the combination group 2 compared with the control group and the combination group 1 (P < 0.05), while ΔSpO2 decreased (P < 0.05); and SpO2L increased in the combination group 1 compared with the control group during the last treatment. ConclusionThe combination of hyperbaric oxygen and dynamic scalp acupuncture can significantly improve motor function and oxygen-carrying capacity in stroke patients with hemiplegia.
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ObjectiveTo investigate the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) combined with mirror therapy on upper limb motor function and cortical neurophysiological indicators in stroke patients with hemiplegia. MethodsSixty stroke patients who were admitted to Jinshan Hospital of Fudan University, from October, 2022 to March, 2023 were randomly assigned to control group (n = 15), rTMS group (n = 15), mirror therapy group (n = 15) and combined group (n = 15). All groups received routine medicine and rehabilitation. In addition, the control group received sham rTMS and sham mirror therapy, rTMS group received 1 Hz rTMS and sham mirror therapy, the mirror therapy group received sham rTMS and mirror therapy, and the combined group received 1Hz rTMS combined with mirror therapy, for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) were used to evaluate the motor function of the affected upper limb. The motor-evoked potential (MEP) amplitude and central motor conduction time (CMCT) of the affected cortex were measured using a transcranial magnetic stimulation device. ResultsAfter treatment, the scores of FMA-UE and ARAT, and the amplitude of MEP significantly improved in all groups (|t| > 3.854, P < 0.001), while the CMCT significantly shortened (t > 5.967, P < 0.001). Compared to the control group, rTMS group, the mirror therapy group and the combined group showed more significant improvement in the scores of FMA-UE and ARAT, and the amplitude of MEP, and shorter CMCT (P < 0.05). When compared to rTMS group and the mirror therapy group, the combined group showed more significant improvement the scores of FMA-UE and ARAT, and the amplitude of MEP, and shorter CMCT (P < 0.05). There was significant positive correlation of the scores of FMA-UE and ARAT with the amplitude of MEP, and negative correlation with the CMCT in all groups (R2 > 0.804, P < 0.001). ConclusionThe combination of 1 Hz rTMS and mirror therapy contributes to the post-stroke brain functional remodeling and facilitates upper limb motor recovery in stroke patients with hemiplegia.
ABSTRACT
Objective:To explore any effect of supplementing low-frequency repeated transcranial magnetic stimulation (rTMS) with intermittent resistance training on muscle tone and the recovery of motor function among persons with Parkinson′s disease (PD).Methods:A total of 104 PD patients were randomly divided into an observation group and a control group, each of 52. Both groups were treated with conventional drugs and low-frequency rTMS, while the observation group was additionally provided with intermittent resistance training for 8 weeks. Before and after the intervention, the motor functioning of both groups was evaluated using unified Parkinson′s disease rating scale-III (UPDRS-III) and the Berg Balance Scale (BBS). Limb muscle tension was quantified using the modified Ashworth scale (MAS). The subjects′ psychological states were quantified using the exercise self-efficacy scale (ESE), and the modified Barthel index (MBI) was applied to evaluate their ability in the activities of daily living. A 3D motion processing system collected and analyzed data describing each subject′s gait kinematics.Results:After the intervention, significantly greater average improvement was observed in all of the outcome measures among the observation group compared with the control group.Conclusion:Combining intermittent resistance training with low-frequency rTMS can significantly reduce muscle tone and improve the motor functioning of PD patients. The combination is more effective than low-frequency rTMS alone.