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ObjectiveTo observe the effect of motor imagery therapy on hand function and motor imagery ability of stroke patients. MethodsFrom March, 2018 to March, 2020, 41 stroke patients in Beijing Bo'ai Hospital were selected and randomly divided into control group (n = 20) and observation group (n = 21). Both groups received conventional rehabilitation training, and the observation group received motor imagery therapy in addition, for four weeks. Before and after training, the scores of Fugl-Meyer Assessment-Hand (FMA-H) and Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), and the accuracy of mental rotation task were compared between two groups. ResultsOne patient in the observation group dropped down. Before training, there was no significant difference in the scores of FMA-H and KVIQ, and the accuracy of mental rotation task between two groups (P > 0.05). After training, all the indexes improved in both groups (t > 6.611, P < 0.001), and the scores of FMA-H (t = 3.742, P < 0.001) and KVIQ (t = 4.122, P < 0.001), and the accuracy of mental rotation task (t = 2.075, P < 0.05) were higher in the observation group than in the control group. ConclusionMotor imagery therapy could facilliate the recovery of hand dysfunction and improve the motor imagery ability of stroke patients.
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Objective:To design a new type of assistive chopsticks for the hand disorders, such as hand weakness and poor fine movement, etc. Methods:The assistive chopsticks were palm-control operative, integrated structure designed, and bending stamping processing technology was adopted. The key parts such as the bends and joint, holding parts were improved. The prototype was tested with finite element analysis and mechanical testing, and used on trial by a three years old boy. Results:The gripping force needed was related to the bending radius, material, section size and holding position. It required less dexterity and force for particular fingers, and was not easy to drop down. They could bounce off automatically and were suitable for left hand. Conclusion:The new type of assistive chopsticks may help the patients with hand dysfunction to have meals with chopsticks, to improve the quality of life. However, it is also suitable for Westerners with less experience.
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OBJECTIVE@#To observe the difference in clinical efficacy between chicken-claw needling at Shangbaxie (Extra) and Hegu (LI 4) combined with acupuncture at Houxi (SI 3) and the conventional acupuncture at the 3 points for the treatment of hand dysfunction after stroke.@*METHODS@#Forty-two patients were divided into an observation group and a control group according to the random number table, 21 cases in each one. The chicken-claw needling was used at Shangbaxie (Extra) and Hegu (LI 4) on the affected side combined with acupuncture at Houxi (SI 3) in the observation group. The conventional acupuncture was performed at the same point as the observation group in the control group, once a day, 6 days for a course, 1 day of interval after a course, and the therapeutic effect was observed after 5 courses. The simplifying Fugl-Meyer Motor Function Rating Scale (FMA), the modified Barthel index and the Brunnstrom grading criteria were used to evaluate the hand function of the two groups before and after treatment.@*RESULTS@#The FMA score, Barthel index and Brunnstrom grade were improved after treatment in the two groups (all <0.05), and the FMA score, Barthel index and Brunnstrom grade in the observation group were better than those in the control group (all <0.05).@*CONCLUSION@#Chicken-claw needling at Shangbaxie (Extra) and Hegu (LI 4) combined with acupuncture at Houxi (SI 3) can effectively treat hand dysfunction after stroke, and the curative effect is better than the conventional acupuncture at the 3 points.
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Humans , Acupuncture Therapy , Hand , Needles , Stroke , Treatment OutcomeABSTRACT
@# Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on upper limbs function in chronic stroke patients. Methods From March, 2016 to May, 2018, 53 patients were randomly divided into control group (n = 27) and research group (n = 26). All the patients received conventional rehabilitation, and the research group received additional intervention of TEAS, for six weeks. They were assessed with Manual Muscle Test (MMT) on upper limbs, modified Ashworth Scale (MAS), Fugl-Meyer Assessment-upper extremities (FMA-UE), Hand Motor Status Scale and modified Barthel Index (MBI) before, at the end of 6-week treatment and twelve weeks after treatment. Results There was no significant difference in all the scores between two groups at the end of 6-week treatment (t < 1.511, P > 0.05). The scores of MMT of wrist dorsal extension, FMA-UE and MBI were better in the research group than in the control group twelve weeks after end of treatment (t > 2.312, P < 0.05). Conclusion TEAS may promote the recovery of hands and upper limbs function in chronic stroke patients.
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OBJECTIVE: Motor impairments related to hand function are common symptoms in patients with movement disorders, such as Parkinson’s disease (PD) and focal hand dystonia (FHD). However, hand dysfunction has not been quantitatively assessed as a clinical tool for screening patient groups from healthy controls (HCs). The aim of our study was 1) to quantitatively assess hand dysfunction in patients with PD and FHD and its usefulness as a screening tool 2) to grade disease severity in PD and FHD based on hand dysfunction. METHODS: The current case-control study included HCs (n = 50) and patients with known history of PD (n = 25) or FHD (n = 16). Hand function was assessed by a precision grip task while participants lifted objects of 1.3 N and 1.7 N under dry skin conditions, followed by very wet skin conditions (VWSCs). Receiver operating characteristic and summative scoring analyses were performed. RESULTS: In PD, the combination of loading phase duration and lifting phase duration at quantitative cutoffs of 0.36 and 0.74 seconds identified 21/25 patients as diseased and 49/50 subjects as HCs with 1.7 N under VWSCs. In PD, 5/21 was graded as “mild” and 16/21 as “moderate cases.” In FHD, slip force at a cutoff of 1.2 N identified 13/16 patients as diseased and 41/50 subjects as HC with 1.7 N under VWSCs, but disease severity could not be graded. CONCLUSION: Our results demonstrate the use of precision grip task as an important clinical tool in assessment of hand dysfunction in movement disorder patients. Use of quantitative cutoffs may improve diagnostic accuracy and serve as a valuable adjunct to existing clinical assessment methods.
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Humans , Case-Control Studies , Dystonia , Hand Strength , Hand , Lifting , Mass Screening , Movement Disorders , Parkinson Disease , ROC Curve , SkinABSTRACT
Objective To observe the effects of transcutaneous electrical acupoint stimulation (TEAS) on hand dysfunction after stroke. Methods From March, 2013 to June, 2015, 56 cases of stroke with hand dysfunction were divided into group A (n=28) and group B (n=28). Both groups received basic rehabilitation, while group B received TEAS in addition, for six weeks. They were evaluated with Brunnstrom Grades, Manunl Muscle Test (MMT), Fugl- Meyer Assessment (FMA) of fingers, Motor Status Scale (MSS), modified Ashworth Scale (MAS), National Institutes of Health Stroke Scale (NIHSS), Motor Hand Functional Status Score and Barthel Index (BI). Results The scores of FMA of fingers, MMT of wrist flexion, MSS, MAS and BI were more in group B than in group A (t>2.2527, P0.05). Conclusion TEAS can promote the recovery of hand function and the activi-ties of daily living in patients after stroke.
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Objective To observe the effect of virtual reality robotic hand on hand motor function and activities of daily living of pa-tients after stroke. Methods From June, 2015 to June, 2016, 32 patients with hand motor dysfunction were assigned into experimental group (n=16) and control group (n=16). The experimental group received training with virtual reality robotic hand and hand based rehabilitation, while the control group received hand based rehabilitation only, for four weeks. They were evaluated with Fugl-Meyer Assessment (FMA) of fingers and wrists and modified Barthel index (MBI) before and after treatment. Results The total score and the scores of items of FMA and MBI improved after treatment in the experimental group (Z>3.45 or t>3.45, P2.07 or t>4.18, P2.14 or t>3.20, P<0.05). Conclusion Virtual reality robotic hand training can promote the recovery of hand function and activities of daily living in patients af-ter stroke.
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Objective To apply a hand function laserimager to evaluate the effect of acupuncture on hand dysfunction after stroke. Meth-ods From January to June, 2016, 18 stroke patients with upper limb dysfunction were divided into control group (n=9) and acupuncture group (n=9). The control group received routine medication and rehabilitation, while the acupuncture group received acupuncture in addi-tion. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) of upper limb motor function and modified Bathel Index (MBI) before and after three-week treatment, while the region of interest (ROI) of their hands was tested with the hand func-tion laserimager. Results The scores of MAS and FMA improved after treatment in both groups (t>4.44, P3.17, P7.78, P0.05) between groups. Conclusion The hand function laserimager, which responds to the blood perfusion of the hand, can be used as a tool to evaluate the hand function.
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@#Objective To observe the effect of the expanding training orthosis on webbed-finger adhesion post burn. Methods From May, 2014 to April, 2016, 37 hands of 33 patients with webbed-finger adhesion post burn were divided into two groups. 21 hands from 18 patients were as experimental group, 16 hands from 15 patients were as control group. The control group accepted routine care, while the experimental group accepted the expanding training orthosis in addition. Their angles between the fingers were measured six months after treatment. Results The angles between the fingers increased in the experimental group after treatment (t>3.060, P<0.01), and were more than those of the control group (t>2.273, P<0.05). Conclusion Application of expanding training orthosis can improve the compliance of the patients with webbed-finger adhesion post burn, and promote hand function recovery.
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Objective] To study the effect of 50 hz frequency of electricity stimulating finger extensor tendon for hand dysfunction caused by incident storke. [Methods] 67 cases diagnosed as hand dysfunction of incident storke patients randomly divided into treatment group and control group(33 cases in treatment group, 34 cases in control group). The control group was given Bobath method for hand function recovery training. The treatment group was given 50 hz frequency of electricity stimulating finger extensor tendon on the basis of Bobath rehabilitation treatment, 5 times every week, for 4 weeks. Evaluate patients' symptoms improvement, before and after, with Fugl-Meyer grade(hand part) and modified Barthel index evaluation, and then make statistical analysis of the results. [Result] After the treatment,the grades, Fugl-Meyer grade(hand part) and modified Barthel index, of two groups both increased significantly, with statistical significance(P<0.01); Both of the grades of treatment group were significantly higher than that of control group, with statistical significance(P<0.01). [Conclusion] 50 hz electrical stimulating finger extensor tendon can significantly improve hand dysfunction caused by incident storke, improve their abilities of daily life.
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@#Patients often suffered limb dysfunction after stroke. Upper limb and hand function recovered more slowly than lower limb, and became one of the research focuses in rehabilitation medicine. Timely and effective assessments were important to guide the rehabilitation treatment, evaluate the treatment efficacy and predict functional recovery of upper extremity and hand function. The assessment methods of upper limb and hand motor function included subjective evaluations and objective evaluations. The former included different kinds of scales, which involved assessment focusing on muscle, motor pattern, change of upper limb and hand function. While the latter contained biomechanics, neuroelectrophysiology, functional magnetic resonance imaging, upper limb robotic evaluation system and so on. Scales were proved to have good reliability and validity. But they could not show patients' function accurately because of the subjectivity, and the data could not be kept. Evaluation system with computer was applied in clinical practice more and more widely. In this review, we summarized the assessments on upper limb and hand motor function in patients after stroke.