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ObjectiveTo explore the effects of upper limb exergames on cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment. MethodsFrom August, 2020 to November, 2021, 50 troke patients with mild cognitive impairment in Beijing Bo'ai Hospital were randomly allocated to control group (n = 25) and experimental group (n = 25). Both groups received traditional occupational therapy. Additional functional occupational therapy was provided to the control group, and upper limb exergames were provided to the experimental group, for four weeks. They were assessed with Montreal Cognitive Assessment (MoCA), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after the treatment. ResultsAfter treatment, the scores of MoCA, FMA-UE and MBI improved in both groups (|t| > 3.354, |Z| > 4.379, P < 0.01), and the scores increased in five MoCA cognitive domains in the control group (except map naming and abstract thinking) (|Z| > 2.000, P < 0.05) and in six MoCA cognitive domains in the experimental group (except map naming) (|Z| > 2.646, P < 0.01). After treatment, the scores of MoCA, MoCA five cognitive domains (except map naming and abstract thinking) and FMA-UE were better in the experiment group than in the control group(|Z| > 1.982, t = 3.565, P < 0.05). ConclusionUpper limb exergames can facilitate the recovery of cognitive function, upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.
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OBJECTIVES@#To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain, shoulder range of motion (ROM) and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain (PSHSP).@*METHODS@#Eighty-two patients with PSHSP were randomly divided into an observation group (41 cases, 1 case was eliminated, 4 cases dropped out) and a control group (41 cases, 2 cases were eliminated and 2 cases dropped out). The routine treatment, nursing care and rehabilitation training were performed in the control group. On the basis of the intervention as the control group, in the observation group, the turmeric blistering moxibustion plaster was applied to bilateral ashi points, Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14), Shousanli (LI 10) and Hegu (LI 4), once a day, remained for 6 hours each time. This moxibustion therapy was operated 5 times weekly, one course of treatment consisted of 2 weeks and 2 courses were required. Separately, before treatment and after 2 and 4 weeks of treatment, the score of visual analogue scale (VAS), shoulder ROM and the score of upper limbs in Fugl-Meyer assessment (U-FMA) were observed in the two groups.@*RESULTS@#VAS scores were lower (P<0.05), ROM in shoulder flexion, abduction, internal rotation and external rotation was larger (P<0.05), and U-FMA scores were higher (P<0.05) after 2 and 4 weeks of treatment when compared with those before treatment in the two groups. After 4 weeks of treatment, VAS score decreased (P<0.05), and ROM in shoulder flexion, abduction, internal rotation, external rotation and U-FMA score increased (P<0.05) in comparison with those after 2 weeks of treatment in either group. In the observation group, VAS scores were dropped (P<0.05) after 2 and 4 weeks of treatment respectively, and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment (P<0.05) when compared with those in the control group. After 4 weeks of treatment, ROM in shoulder flexion, abduction, internal rotation and external rotation in the observation group was larger (P<0.05) and U-FMA score was higher (P<0.05) than those in the control group.@*CONCLUSIONS@#Acupoint application with turmeric blistering moxibustion plaster may effectively reduce the degree of shoulder pain and improve the shoulder range of motion and the upper limb motor function in the patients with post-stroke hemiplegic shoulder pain.
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Humans , Shoulder , Moxibustion , Shoulder Pain/therapy , Acupuncture Points , Curcuma , Hemiplegia/therapy , Treatment OutcomeABSTRACT
Objective:To observe the effect of mirror visual feedback training on upper limb function and muscle tension in children with spastic hemiplegia resulting from cerebral palsy (SHCP).Methods:Seventy-six children aged 2-5 with SHCP were randomly divided into a control group of 33 and a treatment group 34. All were given routine occupational therapy, physical therapy, massage and physical agents. Each therapy session lasted 30 minutes daily, 5 times a week over 3 weeks as a course of treatment. There was a one week interval after each of 6 courses, so the total treatment lasted 6 months. The treatment group was additionally trained with mirror visual feedback with the same schedule. Before, as well as after 3 and 6 months of treatment, each patient′s upper limb motor function, fine motor function and muscle tone were evaluated using the Fugl-Meyer motor function assessment scale (FMA), the Peabody fine motor development scales (PDMS-FM), the modified Ashworth scale (MAS) and integrated electromyograms (iEMGs).Results:There were no significant differences between the two groups before treatment. After both 3 and 6 months significant improvement was observed in both groups′ average FMA score, PDMS-FM total score, grip, and visual motor integration. At both points the treatment group′s averages were significantly better than those of the control group. The average MAS and iEMG results, however, were not significantly different at either time point.Conclusions:For children with spastic hemiplegia caused by cerebral palsy, mirror visual feedback training can effectively improve upper limb functioning, but it cannot reduce their muscle tone.
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Objective:To explore the effect of combining functional electric stimulation (FES) with upper limb cycle training in rehabilitating upper limb motor function and ability in the activities of daily living after a stroke.Methods:Sixty hemiplegic stroke survivors were randomly divided into an experimental group and a control group. In addition to conventional rehabilitation therapy, the experimental group underwent 20 minutes of MOTOmed upper limb cycle training every day while receiving FES. The control group received only the 20 minutes of cycle training. Before and after 4 weeks, Brunnstrom staging was used to quantify hand and upper extremity functioning. The Fulg-Meyer assessment upper extremity scale (FMA-UE) and the modified Barthel index (MBI) were also used before the training and after 1, 2, 3 and 4 weeks of the treatments.Results:After 4 weeks of treatment, significant differences were observed in the average BS scores of both groups compared with before the intervention. The average hand and upper limb stages of the experimental group were significantly better than the control group′s averages. Significant improvement was also observed in the average FMA-UE and MBI scores of both groups after only one week, with significantly greater improvement in the experimental group.Conclusions:Supplementing upper limb cycle training with FES can significantly improve the upper limb motor function and ability in the activities of daily living of stroke survivors. It is more effective than the MOTOmed exercise alone.
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Objective:To observe any effect of combining motor imagery therapy (MIT) with repeated transcranial magnetic stimulation (rTMS) for improving upper limb motor functioning after a stroke.Methods:Ninety stroke survivors were randomly divided into a control group, an MIT group and a combination group, each of 30. All received conventional rehabilitation therapy, while the MIT group additionally received MIT and the combination group received the MIT along with 1Hz rTMS applied over the M1 region of the contralateral cortex. Before and after 4 weeks of treatment, everyone′s upper limb functioning was quantified using the Fugl-Meyer assessment scale (FMA) and the Hong Kong version of the hemiplegia upper limb function test (FTHUE-HK). Motor evoked potentials (MEPs), cortical latency (CL) and central motor conduction time (CMCT) were also recorded.Results:After the treatment the average FMA and FTHUE-HK scores of all three groups had improved significantly. The average CL and CMCT were significantly shortened. Compared with the control group, the average upper limb FMA score and FTHUE-HK scores of the treatment group were significantly higher. The combination group showed a significant improvement in its average MEP cortical latency and CMCT values.Conclusions:MIT therapy alone can improve the upper limb motor functioning of stroke survivors, but it is more effective in combination with rTMS.
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Objective:To investigate the effects of Buqi Huayu Tongluo recipe combined with quantitative rehabilitation training on upper extremity motor function and hemorheology in patients with post-stroke shoulder-hand syndrome. Methods:A total of 100 patients with post-stroke shoulder-hand syndrome who received treatment in Shengzhou Hospital of Traditional Chinese Medicine from January 2017 to December 2019 were included in this study. They were randomly divided into control ( n = 56) and study ( n = 44) groups. The control group was given routine drugs and quantitative rehabilitation training, and the study group was given Buqi Huatan Tongluo recipe combined with quantitative rehabilitation training based on the intervention applied to the control group. Before and after treatment, upper limb motor function and hemorpheology indexes were compared between the two groups. Results:Time to improvement in shoulder pain, wrist redness, swelling and thermal pain, limited wrist mobility and limited finger flexion in the study group was (3.44 ± 1.14) weeks, (2.96 ± 1.01) weeks, (3.38 ± 1.08) weeks, (3.76 ± 1.24) weeks, respectively, which were significantly shorter than (4.38 ± 1.19) weeks, (4.87 ± 1.26) weeks, (4.81 ± 1.04) weeks, (3.56 ± 1.05) weeks in the control group ( t = 3.99, 2.88, 6.71, 4.40, all P < 0.05). After treatment, Fugl-Meyer Assessment score in the study group was significantly higher than that in the control group [(50.47 ± 11.38) points vs. (42.21 ± 12.54) points, t = 2.94, P < 0.05). After treatment, plasma viscosity, hematocrit and platelet aggregation rate in the study group were (1.43 ± 0.15) mPa/s, (40.27 ± 3.12)%, (55.82 ± 3.30)%, which were significantly lower than (1.70 ± 0.14) mPa/s, (44.27 ± 3.49)%, (63.67 ± 4.29)% in the control group ( t = 7.80, 5.04 ,8.88, all P < 0.05). Conclusion:Buqi Huayu Tongluo recipe combined with quantitative rehabilitation training is highly effective on post-stroke shoulder-hand syndrome. The combined therapy can promote the improvement in clinical symptoms, accelerate the recovery of upper limb motor function, and improve hemorheology.
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Objective:To observe any improvement in hemiplegic upper limb functioning when transcranial direct current stimulation (tDCS) is combined with robot-assisted upper limb treatment, and analyze the potential mechanism of neural plasticity through diffusion tensor imaging (DTI).Methods:Twenty stroke survivors with hemiplegia were randomly divided into a treatment group and a control group, each of 10, according to a random number table. Both groups were treated with conventional medication and rehabilitation training using an upper limb robot, while the treatment group also received tDCS daily, with the current increasing from 0 to 1mA over 10 seconds, and then decreasing to 0 over twenty minutes. The experiment lasted for 15 days. The upper extremity portion of the Fugl-Meyer rating scale (UE-FMA) and the Wolf Motor Function Rating Scale (WMFT) were used to evaluate motor functioning before and after the treatment. DTI was also conducted for both groups.Results:After the treatment, the average UE-FMA and WMFT scores of the two groups were significantly higher than before the treatment, with the average UE-FMA score of the treatment group (35.32±13.25), significantly higher than that of the control group (21.80±13.93). After the treatment there were significant differences between the groups in their average FA, rFA and FAasy of the posterior limb of the internal capsule, as well as in FA and the CST length of the central anterior gyrus.Conclusion:tDCS combined with robot-assisted upper limb rehabilitation training can significantly improve the motor functioning of hemiplegic upper limbs, possibly due to neuroplasticity mechanisms that promote CST integrity and symmetry changes. tDCS can be an important adjunct therapy in clinical neurorehabilitation.
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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 repetitive transcranial magnetic stimulation (rTMS) combined with the mirror therapy (MT) on the recovery of upper limb function recovery 3 to 6 months after a stroke.Methods Forty-five male patients were randomly assigned to an MT (A) group,an rTMS+MT (B) group or an MT +rTMS group (C),each of 15.All received conventional medical treatment and stroke rehabilitation.In addition,group A received 60 min of MT daily,5 days a week for 4 weeks.Group B received 10 min of rTMS over the M1 area of the affected hemisphere followed by 50 min of MT treatment,and group C received 50 min of MT treatment followed by 10 min of rTMS.rTMS was delivered at a frequency of 10 Hz and an intensity of 90％ resting motor threshold.The latency of motor evoked potential (MEP) for the affected abductor pollicis brevis muscle and its central motor conduction time (CMCT) were observed before and after the treatment.The upper extremity portion of the Fugl-Meyer assessment (FMA) was performed along with a functional test for the hemiplegic upper extremity (FTHUE).The motricity index (MI) was also quantified.Results Average MEP latency and CMCT had decreased significantly in all three groups after the treatments.The average MEP latency of group B was significantly shorter than that of group A,and CMCT was also significantly shorter than for groups A and C.Moreover,after the intervention,all of the groups had significantly improved their average FMA,MI and FTHUE scores,with the average FMA score of group B significantly better than those of groups A and C.The average FTHUE score of group B was also significantly better than that of group A.Conclusions MT either alone or in combination with rTMS can improve cerebral motor cortex excitability and motor recovery after a stroke.Ten minute rTMS sessions followed by 50 min of MT have the best effect.
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Introduction: There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities. Methods: Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test. Results: Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention. Conclusion: There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.
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The upper limb dysfunction resulted from stroke has a high incidence and is hard to recover,seriously affecting the daily life and life quality of patients.The nerve tissue damage caused by stroke usually leads to the injuries of movement,sensory,cognitive and etc.The effective rehabilitation therapy can promote the rebuilding of the surviving cranial nerves to enhance the function and ability.As a modem intelligent nerve rehabilitation technology,brain-machine interface (BCI) directly builds the exchange channel between the brain and the surrounding environment.BCI extracts the brain's neural activity information,and transfers into the command to drive external equipment.BCI does not rely on the peripheral nerve system and muscle tissue.BCI technology is well suited for neurological rehabilitation training,because the repeated training associated with external equipments and BCI feedback can induce a normal exercise mode,indirectly induced the generation of normal brain signal,and promote brain remodeling,so that improve the patient's athletic ability and exercise control level.In this paper,the research progress of BCI technology for the rehabilitation of the upper limb motor function after stroke was reviewed,including the application,the efficacy and the existing limitations.
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@#Objective To observe the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function after stroke. Methods 40 patients with ischemic internal carotid artery (ICA) stroke were randomly divided into treatment group (n=20) and control group (n=20). Both groups received conventional rehabilitation and medication. The treatment group received rTMS while the control group received pseudo stimulation, 1 Hz at 100% resting motor threshold (RMT) over contralesional motor cortex (unaffected side). The treatment group was tested with motor evoked potentials (MEPs), and both groups were assessed with Fugl-Meyer Assessment (FMA) and grip strength after treatment. Results The amplitude of MEPs of the unaffected cortex increased in the treatment group after treatment (P< 0.001). The treatment group improved in grip strength and the scores of FMA in the affected side compared with the control group after treatment (P<0.001). No serious side-effect was found. Conclusion rTMS was safe and feasible for patients with ischemic ICA stroke to improve the upper limb motor function.
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Objective To observe the effect of nerve mobilization on shoulder pain in hemiplegic patients after stroke. Methods 50 pa-tients with hemiplegic shoulder pain after stroke were randomly divided into control group (n=25) and observation group (n=25). Both groups were given conventional rehabilitation training, and the observation group received nerve mobilization additionally. Number Ana-logue Scale (NAS), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were used to evaluate the shoulder pain, the the up-per limb motor function and activities of daily living (ADL) before and 4 weeks after treatment. Results The score of NAS decreased in both groups after treatment (P<0.001), and was lower in the observation group than in the control group (P<0.01). The score of FMA and MBI increased in both groups after treatment (P<0.001), and was higher in the observation group than in the control group (P<0.05). Con-clusion Nerve mobilization could further relieve the shoulder pain and improve the motor function of upper limb and ADL in patients with hemiplegia after stroke.
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@#Objective To observe the effect of 1 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function after stroke. Methods 40 patients with ischemic internal carotid artery (ICA) stroke were randomly divided into treatment group (n=20) and control group (n=20). Both groups received conventional rehabilitation and medication. The treatment group received rTMS while the control group received pseudo stimulation, 1 Hz at 100% resting motor threshold (RMT) over contralesional motor cortex (unaffected side). The treatment group was tested with motor evoked potentials (MEPs), and both groups were assessed with Fugl-Meyer Assessment (FMA) and grip strength after treatment. Results The amplitude of MEPs of the unaffected cortex increased in the treatment group after treatment (P< 0.001). The treatment group improved in grip strength and the scores of FMA in the affected side compared with the control group after treatment (P<0.001). No serious side-effect was found. Conclusion rTMS was safe and feasible for patients with ischemic ICA stroke to improve the upper limb motor function.