The Ameliorative Effect of Ashwagandha- Withania somnifera (L.) Dunal on park25 Induced Neurodegeneration in Drosophila melanogaster Parkinson’s Disease Model

Ashwagandha - Withania somnifera (L.) Dunal is a perennial shrub belonging to the family Solanaceae. Ashwagandha has been used for over 3000 years in traditional Indian Ayurveda for treatment of various neurological, and stress disorders. The root of Ashwagandha (ASH) is regarded as a tonic, aphrodisiac, narcotic, diuretic, anthelmintic, astringent, thermogenic and stimulant. Ashwagandha with other herbal decoctions was recognized to treat Kampavatha (Parkinson’s Disease) since 18th century. With this wide array of ethnopharmacological relevance, Ashwagandha has been recognized as one of the prominent complementary and alternative medicine to treat many neurodegenerative diseases like Alzheimer’s (AD) and Parkinson’s disease (PD). There is a prominent increase in the cases of AD and PD all over the world and it demands the requirement of complementary and alternative herbal remedies with no/minimal side effects. Many genetic factors are responsible for the onset and progression of PD. Loss-of-function mutations in the parkin gene are a major cause of early onset of autosomal recessive juvenile parkinsonism (AR-JP). Drosophila park25 loss of function mutants exhibit significantly increased number of mitochondria-endoplasmic reticulum contacts and a significantly decreased number of dopaminergic neurons in the adult brain which is the main cause of PD condition. Several studies have demonstrated the ability of Ashwagandha in imparting neuroprotection, improved locomotory ability, memory and learning abilities. The challenge lies in scrutinizing the mechanism and the pathways involved in the neuroprotective properties of this well-known herb. Here in our study, we test the possible neuroprotective effect of Ashwagandha on park25 mutants of Drosophila using lifespan analysis and climbing disability as a disease marker. Parkinson’s mimicking flies were administered with aqueous extraction of Ashwagandha-root mixed with the fly food and subjected to negative geotaxis assay. We observed that there is a prominent increase in the climbing ability in park25 treated flies compared to its age-matched untreated flies. This is the first report showing that, aqueous extraction of Ashwagandha-root extract was able to ameliorate the disease phenotype in the park25 Drosophila Parkinson’s disease model.

Effects of Rehabilitation Training Combined with Acupuncture on Upper Limb Function of Stroke Patients Based on Kinect / 医用生物力学

Objective To investigate the effect of rehabilitation training combined with acupuncture ( RTA) on upper limb function of stroke patients by Kinect. Methods Stroke patients with upper limb dysfunction werrandomly divided into control group (rehabilitation training) and treatment group ( RTA), with 15 cases in each group. The modified Barthel Index ( MBI), Fugl Meyer assessment ( FMA), and Wolf motor function test (WMFT) were compared between two groups before and after treatment. The changes in motor time ( MT), motor unit number (MUN), index of curvature (IC), elbow flexion angle (EFA), shoulder flexion angle (SFA),and shoulder adduction angle ( SAA) during three actions, namely, placing forearm on the table, extending elbow and drinking water, were evaluated by Kinect and then compared between two groups before and after treatment. Results After 6 weeks of intervention, the scores of MBI, FMA, WMFT and elbow extension in treatment group were higher than those in control group (P<0. 05). The scores of MBI, FMA, WMFT and three actions after treatment were higher than those before treatment (P<0. 05). For three actions, the improvement of MT, MUN, IC, EFA, SFA, and SAA in treatment group were better than those in control group ( P< 0. 05). Compared with pre-treatment, for the action of forearm placement on the table and elbow extension, both treatment group and control group showed an increase in EFA (P<0. 05), and a decrease in MT, MUN, IC, SFA and SA (P<0. 05). For the action of drinking water, both treatment group and control group showed an increase in EFA and SAA (P< 0. 05), and a decrease in MT, MUN, IC and SAA ( P< 0. 05). Conclusions RTA can improve the upper limb function of stroke patients. Kinect can accurately reflect the changes in upper limb function of stroke patients, and it is suitable for clinical work.

Jiao's scalp acupuncture combined with virtual reality rehabilitation training for motor dysfunction in patients with Parkinson's disease: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between Jiao's scalp acupuncture combined with virtual reality (VR) rehabilitation training and VR rehabilitation training alone for motor dysfunction in patients with Parkinson's disease (PD).@*METHODS@#A total of 52 patients with PD were randomly divided into an observation group and a control group, 26 cases in each group. The patients in both groups were treated with routine basic treatment, and the patients in the control group were treated with VR rehabilitation training. The patients in the observation group were treated with Jiao's scalp acupuncture on the basis of the control group. The scalp points included the movement area, balance area and dance tremor control area. Both groups were treated once a day, 5 times a week for a total of 8 weeks. Before treatment and 4 and 8 weeks into treatment, the gait parameters (step distance, step width, step speed and step frequency), timed "up and go" test (TUGT) time and unified Parkinson's disease rating scale part Ⅲ (UPDRS-Ⅲ) score were compared between the two groups, and the clinical efficacy was evaluated.@*RESULTS@#Four weeks into treatment, except for the step width in the control group, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01, P<0.05); the step distance in the observation group was better than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05). Eight weeks into treatment, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01); the step distance and step speed in the observation group were better than those in the control group, the TUGT time in the observation group was shorter than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05, P<0.01). The total effective rate was 92.3% (24/26) in the observation group, which was higher than 69.2% (18/26) in the control group (P<0.05).@*CONCLUSION@#Jiao's scalp acupuncture combined with VR rehabilitation training could improve the gait parameters, walking ability and motor function in patients with PD. The clinical effect is better than VR rehabilitation training alone.

Effect of panlong needling at Jiaji (EX-B 2) on motor dysfunction in patients with Parkinson's disease of liver and kidney deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the curative effect of panlong needling at Jiaji (EX-B 2) combined with western medication and western medication alone on motor dysfunction in patients with Parkinson's disease (PD) of liver and kidney deficiency.@*METHODS@#A total of 98 patients with PD were randomly divided into an acupuncture and medication group (49 cases, 1 case dropped off) and a western medication group (49 cases,1 case was removed). The patients in the western medication group were given oral of levodopa and benserazide hydrochloride tablets, 125 mg each time, three times a day in the 1st week, and the dose was increased according to the needs of the patients' condition from the 2nd week until 250 mg each time, three times a day, for 16 consecutive weeks. On the basis of the same western medication treatment as the western medication group, panlong needling was applied at Jiaji (EX-B 2) from C2 to L5 in the acupuncture and medication group, once a day, 20 times as a course of treatment, for 4 consecutive courses. The scores of unified Parkinson's disease rating scale (UPDRS-Ⅲ, UPDRS-Ⅳ), TCM symptoms score, and 39-item Parkinson's disease questionnaire (PDQ-39) score were evaluated before treatment, after treatment and during follow-up of 1 month after treatment, respectively. The safety of the two groups was compared.@*RESULTS@#After treatment and during follow-up, except the PDQ-39 score of the western medication group, the scores of UPDRS-Ⅲ, UPDRS-Ⅳ, TCM syndrome and PDQ-39 were lower than those before treatment in the two groups (P<0.05), and the scores of above indexes in the acupuncture and medication group were lower than those of the western medication group (P<0.05). The total incidence of adverse reactions in the acupuncture and medication group was 10.4% (5/48), which was lower than 29.2% (14/48) in the western medication group (P<0.05).@*CONCLUSION@#Panlong needling at Jiaji (EX-B 2) combined with western medication could significantly improve the motor dysfunction and clinical symptoms, improve the quality of life and has high safety, and the efficacy is superior to western medication alone.

Brain network functional connectivity as unilateral or bilateral upper limb training for patients with upper limb motor dysfunction after stroke: study with functional near-infrared spectroscopy / 中国康复理论与实践

ObjectiveTo compare the functional connectivity of brain networks in stroke patients with upper limb motor dysfunction during unilateral or bilateral upper limb movement using functional near-infrared spectroscopy (fNIRS). MethodsFrom April to June, 2021, 40 stroke patients with upper limb motor dysfunction in Department of Rehabilitation Medicine, Huashan Hospital, finished unilateral (affected) and bilateral upper limb movement. Eight-minute fNIRS data were collected before and after movement, and the functional activities and connectivity of prefrontal cortex (PFC), upper limb and hand functional area (H), primary sensory cortex (S1) were analyzed based on oxygenated hemoglobin. ResultsFunctional activities increased in affected H after unilateral task (t = -3.135, P < 0.05), while the functional connectivity increased between affected H and affected S1, affected H and unaffected S1, and affected S1 and unaffected S1 (|t| > 3.218, P < 0.05). There was no significant difference in the functional activities and connectivity of all the areas after bilateral upper limb task (|t| < 2.385, P > 0.05). The improvement of affected H was more after unilateral task than after bilateral upper limb task (t = 2.026, P < 0.05). ConclusionUnilateral affected upper limb training is more effective on functional activities and connectivity for corresponding brain regions than bilateral task.

Scalp acupuncture combined with lower-limb intelligent feedback training for lower-limb motor dysfunction after stroke: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the efficacy of scalp acupuncture combined with lower-limb intelligent feedback training and lower-limb intelligent feedback training alone for lower-limb motor dysfunction after stroke.@*METHODS@#A total of 154 patients with lower-limb motor dysfunction after stroke were randomly divided into an observation group (76 cases, 6 cases dropped off) and a control group (78 cases, 8 cases dropped off). The patients in both groups were treated with conventional medication and exercise rehabilitation training. In addition, the patients in the observation group were treated with scalp acupuncture combined with lower-limb intelligent feedback training. The scalp acupuncture was given at upper 1/5 of the anterior oblique line of parietal temporal area and upper 1/5 of the posterior oblique line of parietal temporal area. The patients in the control group were treated with lower-limb intelligent feedback training alone. All the treatment was given once a day, 6 days a week, totaling for 8 weeks. The affected-side lower-limb Brunnstrom stage and modified Ashworth scale (MAS) grade, 6-minute walk test (6MWT), Berg balance scale (BBS) score and modified Barthel index (MBI) score were evaluated before and after treatment in the two groups. The plantar pressure was measured by gait function evaluation system.@*RESULTS@#Compared before treatment, the Brunnstrom stage in the two groups was improved after treatment (@*CONCLUSION@#The scalp acupuncture combined with lower-limb intelligent feedback training could reduce the muscle tension of lower limbs, promote the separation movement mode of lower limbs, improve the plantar pressure distribution, and improve the balance ability and walking ability in stroke patients, and the curative effect is better than lower-limb intelligent feedback training alone.

Progress of Telerehabilitation Techniques in Stroke Patients with Lower Extremity Dysfunction / 中国医疗器械杂志

Stroke has the characteristics of high prevalence, high morbidity, and high mortality, which seriously affects life quality of patients and also creates a huge social burden. Telerehabilitation technology is on the basis of traditional rehabilitation equipment and it integrates with cloud computing and big data technologies. It provides a new way for rehabilitation by providing comprehensive rehabilitation technology and service based on the cloud platform. Therefore, it provides a solution for the situation that the rehabilitation medical resources and the rehabilitation talents in China are relatively insufficient. This article mainly discusses the telerehabilitation technologies of lower extremity motor dysfunction in patients with stroke, the problems and the future development direction.

Biomarkers for assessing motor dysfunction after stroke / 中华物理医学与康复杂志

Objective@#To investigate whether diffusion tensor imaging (DTI) and motor evoked potentials (MEP) can be used as biomarkers to assess the degree of motor dysfunction of stroke survivors.@*Methods@#Sixty partially-paralyzed stroke survivors were given Fugl-Meyer assessments (FMAs) and MEP tests and assessed using DTI seeking any correlations among the results. The receiver operating characteristics curves (ROCs) were prepared to determine the tests′ efficacy in assessing severe motor dysfunction.@*Results@#① Asymmetry in the fractional anisotropy (aFA) of the peduncles cerebra as measured by DTI was negatively correlated with the FMA scores of the upper and lower limbs on the affected side. The aFA values of the posterior limb of the internal capsule (PLIC) were negatively correlated with the FMA scores of the affected upper limb, but not with the FMA scores of the affected lower limbs. The abnormalities in central motor conduction time and motor threshold, which are MEP parameters, were negatively correlated with the FMA scores of the affected limbs. ② The ROCs showed that the aFA value of the PLIC was the best indicator for assessing severe upper limb motor dysfunction, with a cut-off value of 0.167 giving the best discrimination. MEP waveform loss could also be used. It has high sensitivity but low specificity. ③ A combination of DTI and MEP can improve specificity in assessing severe motor dysfunction in the upper limbs.@*Conclusion@#DTI and MEP can both be used to evaluate motor dysfunction in stroke survivors. They have high clinical value for assessing severe motor dysfunction of the upper limbs.

Biomarkers for assessing motor dysfunction after stroke / 中华物理医学与康复杂志

Objective To investigate whether diffusion tensor imaging ( DTI) and motor evoked potentials (MEP) can be used as biomarkers to assess the degree of motor dysfunction of stroke survivors. Methods Sixty partially-paralyzed stroke survivors were given Fugl-Meyer assessments ( FMAs) and MEP tests and assessed using DTI seeking any correlations among the results. The receiver operating characteristics curves ( ROCs) were prepared to determine the tests' efficacy in assessing severe motor dysfunction. Results ① Asymmetry in the fractional ani-sotropy ( aFA) of the peduncles cerebra as measured by DTI was negatively correlated with the FMA scores of the up-per and lower limbs on the affected side. The aFA values of the posterior limb of the internal capsule ( PLIC) were negatively correlated with the FMA scores of the affected upper limb, but not with the FMA scores of the affected low-er limbs. The abnormalities in central motor conduction time and motor threshold, which are MEP parameters, were negatively correlated with the FMA scores of the affected limbs. ②The ROCs showed that the aFA value of the PLIC was the best indicator for assessing severe upper limb motor dysfunction, with a cut-off value of 0.167 giving the best discrimination. MEP waveform loss could also be used. It has high sensitivity but low specificity. ③A combination of DTI and MEP can improve specificity in assessing severe motor dysfunction in the upper limbs. Conclusion DTI and MEP can both be used to evaluate motor dysfunction in stroke survivors. They have high clinical value for assess-ing severe motor dysfunction of the upper limbs.

Effects of Xingzhi Yinao particles combined with hyperbaric oxygen therapy on cognitive and motor dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning / 中国中西医结合急救杂志

Objective To investigate the therapeutic effects of Xingzhi Yinao (XZYN) particles combined with hyperbaric oxygen therapy on cognitive impairment and motor dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods Sixty-seven patients with DEACMP were admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University from January 2011 to December 2015, and they were randomly divided into a control group (given conventional treatment such as inhalation of oxygen, cytidine diphosphate cholin and vitamin B, 19 cases), a hyperbaric oxygen (HBO) treatment group (given conventional treatment + hyperbaric oxygen therapy once a day, 24 cases) and a XZYN particles treatment (XZYN group, given conventional treatment, hyperbaric oxygen and XZYN particles, 24 cases), the therapeutic course being 2 months in the three groups. Before and after treatment for 1 and 2 months, the cognitive function and motor function of the patients were evaluated by the use of activity of daily living (ADL) scale, Montreal cognitive assessment (MoCA) scale, and mini-mental state examination (MMSE) scale; the severity of cerebral white matter injury was assessed by age related white matter changes (ARWMC) scale; and the electromyographic evoked potential was used to detect the amplitude and latency of P300 to assess the severity of cognition impairment and prognosis. Results With the prolongation of therapeutic time, after treatment, the neurological function scores of ADL, MoCA, MMSE and amplitude of P300 were increased, while ARWMC was decreased and the latency of P300 was shortened gradually in the three groups, and the changes of above indexes after treatment for 2 months in XZYN group were more significant than those in either HBO group or control group[ADL score: 70.2±8.3 vs. 60.5±8.1, 23.0±6.1, MoCA score: 26.1±3.1 vs. 22.2±2.7, 18.2±3.6, MMSE score:25.9±4.1 vs. 22.4±3.5, 18.1±4.5, ARWMC score: 7.0±2.1 vs. 8.7±2.2, 15.2±3.3, latency of P300 (ms):332.9±20.4 vs. 352.5±23.6, 381.7±30.3, amplitude of P300 (μV): 6.5±1.6 vs. 5.6±1.3, 4.1±1.5, all P < 0.05]. Conclusion The hyperbaric oxygen therapy combined with XZYN particles for treatment of patients with DEACMP can significantly improve their cognitive and motor functions and ameliorate the severity of cerebral white matter injury.

Clinical Study on Motor Dysfunction of Infantile Spastic Cerebral Palsy Treated by Zheng's "Golden Chicken Pecking Rice" Acupuncture / 中国中医药信息杂志

Objective To compare the clinical efficacy of "golden chicken pecking rice" and flat tonifying diarrhea in the treatment of pediatric spastic cerebral palsy. Methods Totally 90 cases of children with pediatric spastic cerebral palsy diagnosis standard were divided into golden chicken pecking rice group and flat tonifying diarrhea group by random number table method, with 45 cases in each group. Bobath rehabilitation training was used for both groups, 30–60 min each time. Body acupoints were Fengchi, Ganshu, Shenshu, Mingmen, Taixi, Kongzui, Quchi, Hegu, Yanglingquan, Sanyinjiao, Huantiao, Liangqiu, Juegu, and Taichong. Head acupoints were taken from the top midline, top temporal lobe, the top side of line 1, and the top side of line 2. Golden chicken pecking rice group was given "golden chicken pecking rice" needling, and head acupoints were given flat tonifying diarrhea method; flat tonifying diarrhea group was given flat tonifying diarrhea method. Acupuncture and Bobath rehabilitation training were given alternatively, three time per week, 12 times as a course, for 3 courses. GMFCS and GMFM-88 of the two groups before and after treatment were observed. Clinical efficacy was evaluated. Results The GMFCS of both groups were higher after treatment, with statistical significance (P<0.05). GMFM-88 scores in both groups increased after treatment (P<0.05). GMFM-88 score of the golden chicken pecking rice group was significantly higher than that of the flat tonifying diarrhea group, with statistical significance (P<0.05). The total effective rate was 95.6% (43/45) in golden chicken pecking rice group and 88.9% (40/45) in flat tonifying diarrhea group, with statistical significance (P<0.05). Conclusion Zheng's "golden chicken pecking rice" acupuncture on the treatment of children spastic cerebral palsy with motor dysfunction is with confirmed efficacy, which can obviously improve the motor function of children with cerebral palsy.

Drooling in cerebral palsy and its relationship with dysphagia and gross motor functioning / 中华物理医学与康复杂志

Objective To analyze the incidence and severity of drooling in children with cerebral palsy and explore its correlation with oral dyskinesia,dysphagia and gross motor function.Methods A hundred children with cerebral palsy treated in Qingdao Women's and Children's Hospital between July 2013 and 2016 and 50 healthy children examined in the health examination center were assessed using the drooling severity scale,oral motor assessment,a dysphagia disorders survey (DDS) and the gross motor function classification system (GMFCS).The relationship between drooling severity,oral dyskinesia,dysphagia and their gross motor function was analyzed.Results Of the 100 children with cerebral palsy,32％ displayed drooling (at levels Ⅱ through Ⅴ),which was significantly higher than among the healthy controls.Another sixty-eight displayed level Ⅰ drooling.The severity of drooling was significantly different among children with different cerebral palsies.The drooling of children with spastic quadriplegia,dyskinesia or mixed-type cerebral palsy was the most severe,followed by those with ataxia and spastic diplegia whose drooling was often mild.No hemiplegic child drooled at level Ⅱ.Drooling severity was negatively correlated with the oral motor score,but positively correlated with the average DDS and GMFCS scores.Conclusions About one third of cerebral palsy children suffer from drooling.Their drooling severity is closely associated with the type of the cerebral palsy,oral dyskinesia,dysphagia and GMFCS levels.

Clinical Observation of Itopride Combined with Esomeprazole Magnesium in the Treatment of Esophageal Motility Dysfunction-induced Gastroesophageal Reflux Disease / 中国药房

OBJECTIVE:To investigate the clinical efficacy of itopride combined with esomeprazole magnesium in the treat-ment of esophageal motility dysfunction-induced gastroesophageal reflux disease(GERD). METHODS:A total of 100 patients with esophageal motility dysfunction-induced GERD were selected from our hospital during Sept. 2015-Sept. 2016,and then divided into control group and observation group according to random number table,with 50 cases in each group. Control group was given Esomeprazole magnesium enteric-coated tablets 40 mg,po,qd. Observation group was additionally given Itopride hydrochloride tablets 50 mg,po,tid,on the basis of control group. Both groups received treatment for consecutive 6 weeks. Clinical efficacies of 2 groups were observed,and symptom scores,LES resting pressure,liquid and solid swallowing and peristaltic pressure of esopha-geal body were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of obser-vation group was 94.0％,which was significantly higher than 78.0％ of control group,with statistical significance(P<0.05). Be-fore treatment,there was no statistical significance in symptom scores,LES resting pressure,liquid and solid swallowing or peri-staltic pressure of esophageal body between 2 groups(P>0.05). After treatment,symptom scores of 2 groups were decreased sig-nificantly,and observation group was significantly lower than control group,with statistical significance (P<0.05). Compared with before treatment,LES resting pressure of observation group was increased significantly,and significantly higher than that of control group,with statistical significance (P<0.05). Success rate of liquid swallowing increased significantly in 2 groups,and that of observation group was significantly higher than that of control group,with statistical significance(P<0.05). Success rate of solid swallowing,liquid and solid peristaltic pressure of esophageal body(near segment,middle segment and far segment)in con-trol group were higher than before treatment,without statistical significance (P>0.05). Success rate of solid swallowing, liquid and solid peristaltic pressure of esophageal body(near segment,middle segment and far segment)in observation group were signifi-cantly higher than before treatment,and significantly higher than control group at corresponding period,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:For esophageal motility dysfunction-in-duced GERD,itopride combined with esomeprazole magnesium can significantly improve clinical symptom,effectively increase LES resting pressure,strengthen esophageal motor function,improve success rate of esophageal swallowing and enhance anti-gas-troesophageal reflux ability with good safety.

Candesartan, rather than losartan, improves motor dysfunction in thioacetamide-induced chronic liver failure in rats

Minimal hepatic encephalopathy is more common than the acute syndrome. Losartan, the first angiotensin-II receptor blocker (ARB), and candesartan, another widely-used ARB, have protected against developing fibrogenesis, but there is no clear data about their curative antifibrotic effects. The current study was designed to examine their effects in an already-established model of hepatic fibrosis and also their effects on the associated motor dysfunction. Low-grade chronic liver failure (CLF) was induced in 3-month old Sprague-Dawley male rats using thioacetamide (TAA, 50 mg·kg−1·day−1) intraperitoneally for 2 weeks. The TAA-CLF rats were randomly divided into five groups (n=8) treated orally for 14 days (mg·kg−1·day−1) as follows: TAA (distilled water), losartan (5 and 10 mg/kg), and candesartan (0.1 and 0.3 mg/kg). Rats were tested for rotarod and open-field tests. Serum and hepatic biochemical markers, and hepatic histopathological changes were evaluated by H&E and Masson's staining. The TAA-CLF rats showed significant increases of hepatic malondialdehyde, hepatic expression of tumor necrosis factor-α (TNF-α), and serum ammonia, alanine aminotransferase, γ-glutamyl transferase, TNF-α, and malondialdehyde levels as well as significant decreases of hepatic and serum glutathione levels. All treatments significantly reversed these changes. The histopathological changes were moderate in losartan-5 and candesartan-0.1 groups and mild in losartan-10 and candesartan-0.3 groups. Only candesartan significantly improved TAA-induced motor dysfunction. In conclusion, therapeutic antifibrotic effects of losartan and candesartan in thioacetamide-induced hepatic fibrosis in rats are possibly through angiotensin-II receptor blocking, antioxidant, and anti-inflammatory activities. Improved motor dysfunction by candesartan could be attributed to better brain penetration and slower "off-rate" from angiotensin-II receptors. Clinical trials are recommended.

Individualized scalp acupuncture for motor dysfunction in stroke: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the effect of individualized scalp acupuncture base on location of brain function for motor dysfunction in stroke patients.</p><p><b>METHODS</b>A total of 180 patients were randomly assigned into an individualized scalp acupuncture (ISA) group, a conventional scalp acupuncture (CSA) group and a rehabilitation group, 60 cases in each one. In the ISA group, we stimulated Sishencong (EX-HN 1), motor area and balance area, matched with pre-motor area for higher muscle tension, application area and's three-needle for involuntary motion, application area for poor motor coordination, forehead five-needle for cognitive disorder, sensory area for sensory disturbance. In the CSA group, the affected Dingnieqianxiexian (MS 6), Dingniehouxiexian (MS 7) and Zhenxiapangxian (MS 14) were selected. Rehabilitation was used during needle retained in the two groups. Simple rehabilitation was used in the rehabilitation group. All the treatment was given from Monday to Friday for 4 weeks, once a day for 20 times. Eight-week follow-up was applied. The Fugl-Meyer assessment (FMA) for motor function, modified Barthel Index (MBI) were used to evaluate clinical effect.</p><p><b>RESULTS</b>After treatment and at follow-up, FMA and MBI scores increased compared with those before treatment in the three groups（all<0.01）, with significant differences among the three groups (all<0.000 1) and better results in the ISA group compared with those in the other two groups (<0.05,<0.01) at the two time points. The FMA and MBI scores in the CSA group were higher than those in the rehabilitation group after treatment and at follow-up (all<0.05).</p><p><b>CONCLUSION</b>The individualized scalp acupuncture can improve motor dysfunction and self-care ability of daily life for stroke patients.</p>

Clinical Study on Long-time Needle Retaining at Scalp Acupoints for Motor Dysfunction in Sub-acute Stage of Cerebral Stroke / 上海针灸杂志

Objective To observe the clinical efficacy of long-time needle retaining at scalp acupoints plus body acupuncture in treating motor dysfunction in the sub-acute stage of cerebral stroke.Method A hundred patients in sub-acute stage of cerebral infarction or hemorrhage scored 4-24 by the National Institute of Health Stroke Scale (NIHSS) were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by dry rehabilitation training, while the treatment group was additionally intervened by long-time needle retaining at scalp acupoints (6-8 h) plus body acupuncture. The neural functional deficit, motor function, and activities of daily life were estimated and compared respectively by using NIHSS, Fugl-Meyer Assessment Scale (FMA), and Barthel Index (BI).Result The NIHSS score was significantly changed in the treatment group after 1 treatment course (P<0.05). After 2 treatment courses, the NIHSS scores were significantly changed in both groups compared to that before treatment (P<0.05). The FMA and BI scores were remarkably changed in both groups respectively after 1 and 2 treatment courses compared to that before treatment (P<0.05). After 2 treatment courses, there were significant differences in comparing the NIHSS score and BI score between the two groups.Conclusion Long-time needle retaining at Scalp acupoints plus body acupuncture can improve the neural function deficit, motor function, and activities of daily life in sub-acute stage of cerebral stroke.

La Rizotomía Selectiva Posterior: Una alternativa en el tratamiento de la espasticidad en la Disfunción Cerebral Motora / Selective posterior rhizotomy: An alternate treatment for spasticity in cerebral motor dysfunction

La Rizotomía Selectiva Posterior (RSP) es un procedimiento quirúrgico que se realiza en las raíces posteriores (sensitivas) de la columna lumbosacra. Su fundamento se basa en disminuir la respuesta motora exagerada que producen los estímulos sensitivos en pacientes con espasticidad, como sucede en la Disfunción Motora de origen cerebral (DCM). En este trabajo se presenta una descripción de la técnica, indicación, selección de pacientes y aspectos pre y post operatorios.

Selective Dorsal Rhizotomy (SDR) is a surgical procedure performed on the posterior roots of the lumbosacral spine. It is based on the diminishment of the exaggerated motor response produced by sensitive stimuli in patients with spasticity, such as in the child with cerebral motor dysfunction (CMD). This paper presents a description of the technique, indications, patient selection and pre and post operative aspects.

Observations on the Efficacy of Electroacupuncture at Huatuo Jiaji Points in Treating Motor Dysfunction in Stroke Patients During the Flaccid Paralysis Stage / 上海针灸杂志

[Ab]stract] Objective To investigate, according to core myodynamic theory, the clinical efficacy of electroacupuncture at Huatuo jiaji points in treating motor dysfunction in stroke patients during the flaccid paralysis stage.Methods Sixty stroke patients in the stage of flaccid paralysis were randomly allocated to treatment and control groups, 30 cases each. The control group received basic treatment and conventional acupuncture and the treatment group, electroacupuncture at Huatuo jiaji points in addition. The simplified Fugl-Meyer assessment (FMA) score and the Modified Barthel Index (MBI) score were counted before and after treatment and the clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the FMA score and the MBI score in the two groups (P<0.05). There were statistically significant post-treatment differences in the FMA score and the MBI score between the treatment and control groups (P<0.05). The total efficacy rate was 96.7% in the treatment group and 86.7% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Electroacupuncture at Huatuo jiaji points has a promoting effect on the rehabilitation of limb function in the flaccid paralysis stage of stroke.

Effects of Guhong Injection on Motor Dysfunction in Cerebral Ischemia-reperfusion Rats / 中国康复理论与实践

@# Objective To evaluate the effects of Guhong Injection on motor dysfunction in rats after cerebral ischemia- reperfusion. Methods The middle cerebral arteries were occluded for 2 hours and re-perfused in Sprague-Dawley rats. They were divided in sham group, model group, Aceglutamide group, Safflowere group and Guhong group, which were intravenously administrated with normal saline, Aceglutamide, Safflower or Guhong 24 hours after operation, and continued for 14 days. They were tested with the beam-walking test after treatment. Tyrosine hydroxylase (TH) immunohistochemical staining was used to investigate the viability of neurons in the substantia nigra. Results The model group spent more time in the beam-walking test than that in the sham group (P<0.01), and it decreased in the Safflower group and Guhong group compared with that in the model group (P<0.05). The TH-positive neurons decreased in the model rat compared with that in the sham group (P<0.001), and increased in both Safflower and Guhong groups compared with that in the model group (P<0.01). Conclusion Guhong administration could significantly improve the motor dysfunction in rats after cerebral ischemia- reperfusion, which might be related to provent the neurons from injury in the substantia nigra.

Study on the Orthogonal Optimization of Acupuncture, Tuina and Ultrasonic Treatments for Upper Limb Motor Dysfunction after Cerebral Infarction / 上海针灸杂志

Objective To develop a optimized rehabilitation protocol for acupuncture, Tuina and ultrasonic treatments of upper limb motor dysfunction after cerebral infarction.Methods An orthogonal design with three factors (acupuncture as factor A, Tuina as factor B and ultrasound as factor C) and two levels was used. Eighty cerebral infarction patients with upper limb motor dysfunction were randomly allocated to eight groups, 10 cases each. The National Institute of Health Stroke Scale (NIHSS) score and the simplified Fugl-Meyer Assessment (FMA) score for upper limb motor function were recorded after four weeks of treatment. Results There were no statistically significant pre-treatment differences in the NIHSS score and the FMA score for the upper limb between the groups (P>0.05). For an improvement in NIHSS, factors A and B were both significant (bothP0.05). Factors A, B and C were all significant for an improvement in the FMA score for the upper limb (P<0.05,P<0.01,P<0.05). A2B1C1 was the optimal protocol.Conclusions A combination of bilateral acupuncture, Tuina and ultrasound is an optimized protocol for treating upper limb motor dysfunction after cerebral infarction. It can effectively reduce upper limb motor dysfunction.