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Objective:To observe any effect of combining low-frequency transcranial magnetic stimulation (rTMS) with interactive virtual scenario training on the recovery of upper limb motor function after a stroke.Methods:Ninety stroke survivors were randomly divided into a pseudo-rTMS group, an rTMS group and a combination group, each of 30. In addition to basic medication, conventional rehabilitation and nursing care, the pseudo-rTMS, rTMS and combination groups received either sham rTMS treatment, 1Hz rTMS or virtual situational interaction along with 1Hz rTMS 5 days a week for 4 weeks. Before and after the 4 weeks their motor evoked potentials, cortical latency and central motor conduction time were measured, and surface electromyography was applied to the affected biceps brachii and triceps brachii. Meanwhile, the National Institutes of Health Stroke Scale, the Fugl-Meyer upper extremity assessment and the modified Barthel index were employed to assess the degree of neurological deficit, upper extremity motor function and ability in the activities of daily living (ADL).Results:After the 4-week intervention, a significant improvement was observed in all of the outcome measurements with all three groups. At that time the average scores of the rTMS group were significantly better than the pseudo-rTMS group′s averages but the average scores of the combination group were significantly better than those of either of the other two groups.Conclusion:Repeated application of low-frequency transcranial magnetic stimulation combined with virtual scenario interactive training can effectively improve the upper limb motor function and ADL performance of stroke survivors, and relieve the symptoms of neurological deficit. The combined therapy is worthy of application in clinical practice.
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OBJECTIVE: To observe the therapeutic effect of balance acupuncture combined with motor relearning training for upper limb and hand functions of stroke patients. METHODS: Sixty-two stroke patients were randomly divided into balance acupuncture group (n＝31) and routine acupuncture group (n＝31). For patients of the balance acupuncture group, Piantan, Jiantong and Wantong points on the healthy side were used. When Jiantong point taken, the acupuncture needle was removed after the patient experienced an electric shock-like spreading needling sensation. When Wantong point employed, the needle was removed after the patient experienced a local, intensified or spreading needling sensation. When Piantan point used, the needle was retained after the patient experienced an electric shock-like needling sensation, then, the motor relearning training was conducted, and the needle was removed immediately after the training. For patients of the routine acupuncture group, Jianyu(LI 15), Jianzhen (SI 9), Quchi (LI 11), etc. were needled with the needles retained for 30 min after getting needling sensations. The motor relearning training was also carried out after removal of the needle. The treatment in both groups was performed once daily, 6 days a week, and lasted for 8 weeks. The Fugl-Meyer score and motor function scale (MAS) of the upper limb, and the fine performance score and motor function score of the hand were assessed before and after the treatment. RESULTS: Following treatment, the Fugl-Meyer score and MAS of the upper limbs, and the motor function score and fine performance score of the hand were significantly increased in both groups compared with pre-treatment in each group (P<0.05 ), suggesting a functional improvement of both upper limb and hand. The therapeutic effect of the balance acupuncture was obviously superior to that of routine acupuncture in improving functions of both the upper limb and hand (P<0.05)．. CONCLUSION: Balance acupuncture combined with motor relearning training is helpful to improve the comprehensive function of the upper limb and hand in stroke patients.
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OBJECTIVE: To investigate the effect of balance acupuncture combined with motor relearning training on lower limb motor function in stroke patients with hemiplegia. METHODS: Eighty stroke patients were randomly assigned to motor relearning training group and balance acupuncture plus motor relearning group (n＝40 cases in each). The motor relearning training program consisting of upper-limb functional training, lying supine, bedside sitting, sitting-balancing, standing up and down, standing-balancing, walking, orofacial functional training, etc. was given to patients of the two groups. Balance acupuncture stimulating was applied to Piantan-， Jiantong-， Xitong-， Tuntong- and Huaitong-points for 30 min, once daily, 5 times a week for 8 weeks. The lower limb motor performance ability was assessed by using Fugl-Meyer Assessment (FMA-L) scale, the balance function assessed by using Berg balance scale (BBS), the motor ability evaluated by using Rivermead motor index (RMI), and the gait (walking speed, cadence, and step length) evaluated by using Brunnstrom hemiplegia gait evaluation scale. RESULTS: After the treatment, the scores of FMA-L, BBS, RMI and hemiplegia gait were significantly increased in the two groups compared with their own pre-treatment (P<0.05), and were significantly higher in the balance acupuncture plus motor relearning group than in the motor relearning training group (P<0.05). CONCLUSION: The balance acupuncture combined with motor relearning can improve lower limb motor function and balance function, and has a better effect than simple motor relearning training.
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Objective To investigate the effect of transcranial direct current stimulation combined with motor relearning program on the recovery of upper limb motor function after stroke.Methods From September 2015 to June 2016,40 patients with first-ever stroke received rehabilitation therapy at the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were enrolled prospectively.Their course of disease was 1 to 6 months.They were divided into either a combined treatment group or a control group according to the odd and even numbers in hospital (n =20 in each group).The patients of both groups received traditional rehabilitation training and motor relearning program for upper lindb recovery,2 times a day,once for 30 min,5 days a week for 6 weeks.The combined treatment group was also given transcranial direct current stimulation,2 times a day,once for 20 min,5 days a week,while the control group was only treated with sham stimulation treatment.The patients were assessed before treatment and at 6 weeks after treatment.Fugl-Meyer Assessment (FMA) scores and Action Research Arm Test (ARAT) were used to assess upper limb motor function.The modified Barthel index (MBI) was used to evaluate the activities of daily living.Results There was no significant difference in the observation indices before treatment between the 2 groups (P ＞ 0.05).Six weeks after treatment,the differences of the upper limb FMA score and ARAT score before treatment were superior to the control group,they were 13 ± 3,10 ± 3 and 10 ± 2,8 ± 2,respectively (t =3.503 and 3.244 respectively,all P ＜ 0.01).There was no significant difference in the MBI score between the 2 groups (P ＞ 0.05).Conclusion Transcranial direct current stimulation combined with motor relearning program may effectively improve the upper limb motor function in patients with stroke and promote the improvement of the activities of daily living.
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Dysfunction after stroke caused great burden to patients,families and society,early rehabilitation training is an effective and economic way to improve the function.Motor relearning program (MRP) is a popular rehabilitation method in recent years.In this reviw,the concept and characteristics of MRP are introduced firstly,then we summarize three elements in implementation of MRP,including time,strength and environment,and finally,the application of MRP in clinical stroke patients is emphasized.
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Objective To observe the effects of a motor relearning programme (MRP) combined with different early acupuncture interventions on muscle tension and motor function recovery after cerebral infarction.MethodsA total of 90 patients with cerebral infarction who met the inclusion criteria were divided into three groups at random:a YANGMING meridian acupuncture and MRP group ( group A),an anti-spasm acupuncture and MRP group ( group B),and an MRP group ( group C ).All of the patients in all three groups were treated with routine medication.The National Institute of Health stroke scale (NIHSS),the composite spasticity scale (CSS),Fugl-Meyer assessment (FMA),the Fugl-Meyer balance scale (FM-B) and the modified Barthel index (MBI) were used to measure performance before treatment and after 4 weeks of treatment.Another comparison was intra-group between before and after treatment. ResultsThere were significant differences in the assessment results in all of the groups after treatment compared with those before treatment.After treatment,group B was superior to group C only in terms of NIHSS scores.There was no significant NIHSS score difference between groups A and C.The FMA,CSS and MBI results revealed significant differences among all three groups,with the scores of group A consistently the highest.The average FMA score in group B was significantly higher than in group C but there was no statistically significant difference in FM-B scores among the three groups. ConclusionMRP therapy combined with early acupuncture intervention can improve motor function and muscular tension after cerebral infarction.Anti-spasm acupuncture can improve motor function and control muscular tension effectively at the same time,making it beneficial for MRP training.
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@#Objective To explore the effect of core stability training (CST) on motor of upper limbs after stroke. Methods 60 patients with stroke were divided into observation group (n=30) and control group (n=30). Both groups accepted routine medicine and motor relearning program, and the observation group accepted CST before training. They were assessed with Simple Test for Evaluating Hand Function (STEF), modified Barthel index (MBI), and the Trunk Control Test (TCT) before and 4 weeks after treatment. Results The scores of STEF,MBI, and TCT improved after treatment in both groups (P<0.01), and improved more in the observation group than in the control group (P<0.01). Conclusion CST may facilitate the motor recovery of upper limbs after stroke.
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@#ObjectiveTo explore the effect of motor on functional recovery of the lower limb in hemiplegic patients after cerebral infarction. Methods62 patients recovering from cerebral infarction were divided into the control group (30 cases) and motor imagery group (32 cases). All patients received routine treatment and a motor relearning program. Patients in the motor imagery group were given mental practice in activities of the lower limb. They were assessed with Fugl-Meyer Assessments (FMA) and Modified Barthel Index (MBI) before and after treatment. ResultsThe scores of FMA and MBI were improved in the motor imagery group compared with those in the control group (P<0.05) after treatment. ConclusionMotor imagery can facilitate the recovery of lower limb function in patients with hemiplegia.
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@#ObjectiveTo observe the effect of motor relearning programme(MRP) training on lower Limbs function of stroke patients.MethodsSixty patients were randomly and equally allocated to training group (30 patients) and control group (30 patients). The control group was prescribed Bobath therapy while the training group received the MRP training. The lower limbs function was then assessed by the Fugl-Meyer Assessment Scale.ResultsLower limbs function improved significantly in both groups while the training group was better than the control group after three months(P<0-05). ConclusionMRP training can promote the recovery of lower limbs function of patients with stroke.
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@#Objective To explore event-related potential(ERP) P300 of cerebral infarction patients during motor relearning program. Methods 99 cerebral infarction patients were divided into observation group(52 cases, receiving motor relearning program) and control group(47 cases, no treatment), and 50 healthy subjects as normal control. After 12 weeks, they were measured by: 1)Berg balance scale; 2)Sheikh body control scale; 3)Fugl-Meyer movement assessment; 4) walk ability and 5) ERP P300.Results The scores of Berg balance scale, Fugl-Meyer movement assessment, Sheikh body control scale and walk ability scale increased significantly, and the latency of ERP P300 decreased significantly(P<0.01), and the amplitude of ERP P300 increased significantly in the observation group. ERP P300 of the observation group has significantly difference(P<0.01) from the normal control group.Conclusion Motor relearning program can effectively retrieve the ERP P300 and motor ability of cerebral infarction patients.
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@#Objective To observe the effect of motor relearning program (MRP) on balance function of stroke patients.Methods Sixty stroke patients were randomly divided into the MRP group and control group with 30 cases in each group. The patients of the control group were trained with proprioceptive neuromuscular facilitation (PNF) therapy; those of the MRP group were trained with the MRP therapy. The balance function of all patients was assessed with the Fugl-Meyer Balance Function Assessment before and after training.Results After training, the scores of Fugl-Meyer Assessment of all patients increased ( P<0.05), but scores of the patients of the MRP group were significantly higher than that of the control group ( P<0.05).Conclusion The MRP training can improve the recovery of balance function of stroke patients.
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@#ObjectiveTo study the effect of early electroacupuncture(EA) associated with motor relearning program therapy during the recovery stage for the limb function in patients with cerebral infarction.Methods128 patients with cerebral infarction at the recovery stage were divided into two groups: electroacupuncture group (57 cases) and control group(71 cases).Patients in the two groups were given clinical treatment and regularly motor relearning program therapy.The patients in electroacupuncture group were given electroacupuncture additionally for 10～14 d at the acute stage. The evaluation was done pre- and post-treatment respectively with Fugl-Meyer Assessment (FMA).ResultsThe motor scores in each group improved after treatment(P<0.01). The scores in the electroacupuncture group were obviously higher than that in the control group (P<0.01). ConclusionEarly electroacupuncture associated with motor relearning program therapy during the recovery stage can significantly promote the limb function in patients with cerebral infarction.
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@#Motor learing and different motor skills were introducded. Progress of motor relearning and control, training principles at each stage of motor relearning following paralysis caused by brain injury were also discussed. The main role of therapists in rehabilitation of patients with brain injury was to use pattern of motor learning, to guide and promote the progress of motor relearning successfully.