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Objective:To apply multimodal ultrasound imaging in spasticity assessment for stroke patients with hemiplegia. Methods:From March to September, 2019, 44 inpatients with lower limb spastic hemiplegia after stroke (patients) and 46 healthy volunteers (controls) were scanned with two-dimensional ultrasound imaging, shear wave elastography and super microvascular imaging at the same area of gastrocnemius muscle of both sides of patients and right side of controls, in resting and maximum isometric contraction. The parameters of shear wave velocity (SWV), blood flow signal, pinnation angle (PA), fascicle length (FL) and muscle thickness (MT) were recorded. Results:SWV increased in the affected side of the patients compared with those of the unaffected side and controls in resting (t > 6.346, P < 0.01), while FL shortened (|t| > 6.235, P < 0.01), MT and PA changed compared with those of the unaffected side (|t| > 2.198, P < 0.05), and blood flow signal decreased compared with those of the controls (t = 2.604, P < 0.05). In maximum isometric contraction, the decrease of FL was less compared with those of the unaffected side and controls (Z > 6.703, P < 0.001). Conclusion:Ultrasound imaging can quantitatively evaluate spasticity of gastrocnemius muscle for patients with stroke in terms of morphological structure, blood flow, and muscle stiffness.
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Objective:To apply the ultrasonic shear wave elastography to evaluate triceps surae and Achilles tendon for patients with lower extremity dyskinesia after stroke. Methods:Thirty-two inpatients during 2018 and 2019 with unilateral lower extremity dyskinesia after stroke were studied with 2-D ultrasound and shear wave elastography on the bilateral triceps surae and Achilles tendons before and after rehabilitation. Shear wave velocity (SWV) of the triceps surae and the Achilles tendons, the length and thickness of Achilles tendon (soleus tendon) were measured. Results:Before rehabilitation, the SWV of the Achilles tendons and the triceps surae increased more in the affected side than in the unaffected side (t > 2.426, P < 0.05), as well as the length of the Achilles tendons (t = 11.801, P < 0.001). After rehabilitation, the SWV of the triceps surae decreased (t > 2.447, P < 0.05), as well as the length of the Achilles tendons (t = 8.577, P < 0.001). Conclusion:Ultrasound shear wave elastography can be used to evaluate the elastic characteristics of the Achilles tendon and the triceps surae, to guide the rehabilitation for stroke patients.
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To explore the effects of Shaoyao Gancao decoction on contents of amino acids and expressions of receptors in the brains of spastic paralysis rats, the spastic paralysis rat models of stroke convalescence were made by line tethering method. Baclofen was used as the control group, and the experiment group received Shaoyao Gancao decoction at 3∶1 proportions. After 3 weeks, the neurobehavioral scores, muscular tension and pain threshold were measured and compared. High performance liquid chromatography (HPLC) was used to detect the contents of GABA, Gly, Glu, Asp in cerebral cortex. The protein expressions of GABA receptors Aα1, B； NMDA receptor NR1, NR2A and NR2B in cerebral cortex were determined by immunohistochemistry assay. The results showed that the Shaoyao Gancao decoction at 3∶1 proportion could improve the spastic paralysis state after stroke, significantly improve neurological symptoms (P<0.01), decrease muscular tension (P<0.01) and improve pain threshold (P<0.05) as compared with model group. Simultaneously, the contents of inhibitory amino acids GABA and Gly were increased significantly (P<0.01), while with a decrease tendency in excitatory amino acids Glu and Asp (with no statistical significance). In addition, it could significantly increase the protein expressions of neurotransmitter GABA receptors Aα1, and B (P<0.05); reduce the expressions of neurotransmitter NMDA receptors NR1, NR2A and NR2B (P<0.05). These results suggested that the Shaoyao Gancao decoction at 3：1 proportion could effectively relieve spasm and pain. The mechanism might be associated with increasing the contents of inhibitory amino acids and increasing the expressions of their receptors in spastic paralysis rats after stroke, which would consequently enhance the signal transduction of inhibitory amino acids. Meanwhile, there was a decrease tendency in excitatory amino acids, although no significant effect was observed, and it could suppress the expressions of excitatory amino acids receptors, thus weaken the excitatory signal transduction. Thereby the neurotoxicity was relieved eventually. These findings indicated that Shaoyao Gancao decoction could regulate the balance of neurotransmitter system to relieve the spasticity, and eventually achieve tendon tonifying and spasm relieving effect.
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OBJECTIVE@#To To investigate the effect of acupuncture on the tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), nitric oxide synthase (NOS) content and muscular tension of spasticity cerebral palsy rat model.@*METHODS@#The rats with spastic cerebral palsy were randomly divided into the control group, model group and acupuncture group. After successful modeling, the muscular tension and the content of TNF-α, IL-6, CRP, NOS were measured.@*RESULTS@#The serum TNF-α, IL-6, CRP, NOS content were significantly decreased in the acupuncture group (P<0.05). The low and high shear viscosity of whole blood of the acupuncture group were significantly lower than the control group and the model group (P<0.05). The erythrocyte electrophoresis indexes in the acupuncture group were significantly lower than that in the model group and the control group (P<0.05). Acupuncture significantly reduced the muscular tension of spastic cerebral palsy rat and increased the active extent in the paralytic extremity (P<0.05), but it could not be restored to normal level. Compared with the control group, the difference had significant (P<0.05).@*CONCLUSIONS@#Acupuncture treatment can inhibit the release of inflammatory cells after brain injury, then reduce immune injury, relieve muscle spasms and reduce muscular tension.
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Animals , Male , Rats , Acupuncture Therapy , Cerebral Palsy , Blood , Therapeutics , Cytokines , Blood , Disease Models, Animal , Hemorheology , Physiology , Muscle Tonus , Physiology , Rats, WistarABSTRACT
Objective:To explore the effect of rehabilitation nursing on muscle spasm of patients in persistent vegetative state (PVS). Methods:To adopt the rehabilitation nursing methods on 98 PVS patients, including the arrangement of comfortable body position, passive motion, massage, etc.and then to evaluate the patients’ spasm situation with the universally emendatory MAS (motor assessment scale) methods. Results:Under the rehabilitation nursing and correlative curing, the patients’ limbs muscular tension had been improved evidently(x2=17.04, x2=14.04, P<0.01). Conclusion:Good limb position and physical movement rehabilitation nursing training do not need special equipments or techniques. If only the nursing personnel could master the training methods and skills, they could help the PVS patients to control and to decrease the muscle spasm and then to help them ease the pain.
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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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@#ObjectiveTo observe the effect of Compound Anisodine Injection in the acupoint of the patients with cerebral infarction (CI) at recovery stage. Methods54 patients with CI at recovery stage were injected Compound Anisodine Injection into the acupoint Taiyang. They were assessed with the Ashworth Scales 0.5, 1, 2, 4, 8 h after injection. ResultsThe scores of Ashworth scale in affected sides reduced first and then reconverted after injection, but no changes in the health side. ConclusionThe Compound Anisodine Injection injecting into the acupoint Taiyang can reduce the muscular tension of paralytic limbs of patients with CI stroke at recovery stage.
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@#Objective To study the effects of electro-acupuncturing points of Yangming meridians on hemiplegia.Methods45 early hemiplegic patients were divided into Groups A,B and C(18 cases in each group).Physical therapy was performed in each group,those in Group B were electro-acupunctured at points of Yangming meridians,while those in Group C at the points according to balancing muscular tension.They were assessed with Fugl-Meyer Assessment and Ashworth Spasm Rating before and 2,4 weeks after treatment.Results2 weeks after treatment,motor function and muscular tension were significantly improved in all the groups,while the efficacy in Groups B and C was superior to Group A(P<0.05).4 weeks after treatment,the Ashworth score of lower extremity in Group B was superior to Groups C and A(P<0.05).ConclusionElectro-acupuncturing at points of Yangming meridians can improve the motor function especially muscular tension in hemiplegic patients,which may be helpful for flaccid paralysis,but adverse for spastic paralysis.
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@#ObjectiveTo observe the effect of Acupotomy on spastic cerebral palsy. Methods105 cases of spastic cerebral palsy were random divided into group A (35 cases with acupotomy), group B (34 cases with physical therapy) and group C (36 cases with acupotomy and physical therapy). Modified Ashworth Scale (MAS) was used to assess spasticity before and a month after therapy. ResultsEffective rate of group A was 65.71%, group B was 29.41%, group C was 77.78%, which of group B was significantly lower than those of group A of C. ConclusionAcupotomy can reduce muscular tension of spastic cerebral palsy, which seems more effective than physical therapy.