Quality of Life-Related Factors in Patients with Long-Term Disease after Laryngectomy for Head and Neck Cancer / The Japanese Journal of Rehabilitation Medicine

Objective：To research studies on patients with head and neck cancer who underwent laryngectomy (patients with laryngectomy) in terms of function, activity, participation, and environment, and examine quality of life (QOL) -related factors.Methods：The participants were patients who underwent laryngectomy and belonged to the Japanese Laryngectomy Clubs. We investigated basic attributes, QOL, sarcopenia, neck and upper limb function, and upper limb-related activities of daily living (ULADL). Statistical analysis was performed using multiple logistic regression analysis after correlation analysis to investigate QOL-related factors.Results：The number of valid responders was 272 patients, median age was 74.0 years, median postoperative follow-up was 8.7 years, and 94 were still employed after surgery. Multiple logistic regression analysis results revealed that factors related to QOL included ULADL, sarcopenia, and neck and upper limb function.Conclusions：The QOL-related factors of laryngectomy were neck and upper limb function, ULADL, and sarcopenia. Rehabilitation for these factors is considered important in improving QOL.

Effect of multimodal mirror therapy on upper limb and hand function for stroke patients / 中国康复理论与实践

ObjectiveTo investigate the effect of multimodal mirror therapy on upper limb and hand function in stroke patients. MethodsFrom April, 2021 to August, 2022, 60 stroke patients from the Department of Rehabilitation Medicine of Zhejiang Provincial People's Hospital were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the patients accepted routine rehabilitation, while group B accepted mirror therapy, and group C accepted multimodal mirror therapy, in addition, for six weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Upper Extremity Function Test (UEFT) and modified Barthel Index (MBI), while the maximum grip strength and pinch strength of the affected hand were measured. ResultsThe FMA-UE score, UEFT score, maximum hand grip strength and pinch strength, and MBI scores improved in all groups after treatment (|t| > 7.878, P < 0.001), and it was the most in group C (F > 12.563, P < 0.001). ConclusionMultimodal mirror therapy may further improve the upper limb motor function and hand function of stroke patients, as well as the strength of the affected hand and the activities of daily living.

The effect of respiratory muscle training combined with occupational therapy on the upper limb function of stroke survivors / 中华物理医学与康复杂志

Objective:To observe the effect of combining respiratory muscle training with occupational therapy in rehabilitating the upper limb function of stroke survivors.Methods:Fifty stroke survivors with upper limb dysfunction were randomly divided into an observation group and a control group, each of 25. Both groups were given routine rehabilitation treatment including proper positioning of the affected limb, physical therapy and motor function training. The observation group also received progressive resistance training of the inspiratory muscles and respiration control training combined with occupational therapy twice daily for 4 weeks. The trunk control test (TCT), Berg balance scale (BBS), Fugl-Meyer Upper Extremity Assessment (FMA-UE), Action Research Arm Test (ARAT), Modified Ashworth Scale (MAS) for the Hemiplegic Upper Limb and the Modified Barthel Index (MBI) were used to assess the core stability, balance, upper limb functioning, upper limb muscle tension and ability in the activities of daily living of all of the subjects.Results:Before the treatment there were no significant differences in any of the indexes between the two groups. Afterward the average TCT, BBS, FMA-UE, ARAT, MAS and MBI scores of both groups had improved significantly, but the improvements were all significantly greater in the observation group.Conclusions:Combining respiratory muscle training with occupational therapy can further improve the function of the upper limbs and daily living ability beyond what is observed with traditional rehabilitation therapy after a stroke.

Effects of sentinel lymph node biopsy utilization on operative time, intraoperative blood loss and extubation time / 中国基层医药

Objective:To investigate the effects of sentinel lymph node biopsy utilization on operative time, intraoperative blood loss and extubation time.Methods:Sixty-two patients with breast cancer who received treatment in the First Hospital of China Medical University from January to December 2019 were included in this study. They were randomly assigned to receive either conventional breast cancer surgery (control group, n = 31) or sentinel lymph node biopsy combined with breast cancer surgery (study group, n = 31). Extubation time, operative time, intraoperative blood loss, drainage volume, breast cosmetic effect, upper limb function and complications were compared between the two groups. Results:Extubation time and operative time in the study group were (16.3 ± 1.1) hours and (61.6 ± 11.3) minutes, respectively, and they were (28.2 ± 6.4) hours and (124.2 ± 28.5) minutes, respectively in the control group. There were significant differences in extubation time and operative time between the two groups ( t = 14.922 and 16.479, both P < 0.05). Intraoperative blood loss and postoperative drainage volume in the study group were (68.7 ± 17.9) mL and (105.9 ± 19.5) mL respectively, and they were (122.4 ± 23.1) mL and (257.2 ± 36.4) mL respectively in the control group. There were significant different differences in intraoperative blood loss and postoperative drainage volume between the two groups ( t = 15.928 and 18.797, both P < 0.05). The excellent and good rate of breast cosmetic effect in the study group was significantly higher than that in the control group (93.6% vs. 83.8% , χ2 = 5.584, P < 0.05). After treatment, the difference in the upper arm circumference between the healthy and affected sides, and shoulder abduction and shoulder function score in the study group were (0.5 ± 0.1) cm, (123.7 ± 6.6) ° and (75.9 ± 4.9) points respectively, and they were (0.7 ± 0.1) cm, (120.1 ± 6.1) °, (73.5 ± 4.4) points, respectively in the control group. There were significant differences in these indices between the two groups ( t = 11.432, 12.450, 12.647, all P < 0.05). The incidence of complications in the study group was significantly lower than that in the control group (12.9% vs. 38.8%, χ2 = 6.309, P < 0.05). Conclusion:Sentinel lymph node biopsy can help improve therapeutic effects, shorten the operative time, reduce the amount of intraoperative bleeding, shorten the extubation time, and reduce the incidence of complications in breast cancer patients.

Effects of Combined Repetitive Peripheral Magnetic Stimulation and Occupational Therapy on Upper Limb Paresis and ADL in a Chronic Infarct Patient：A Case Report / The Japanese Journal of Rehabilitation Medicine

The lack of a definitive approach for improving severe upper extremity (UE) paresis after stroke makes it difficult to achieve full recovery. Thus, we investigated the effects of repetitive peripheral magnetic stimulation (rPMS) on UE paresis and activities of daily living in the chronic phase of stroke. We present the case of a 65-year-old female patient who developed right UE paresis 6 years after stroke. She received 20 min of rPMS per session on her affected UE prior to the standard care. She underwent a total of nine rPMS sessions in 3 months. Outcome measures included UE motor section of the Fugl-Meyer Motor Assessment scale，Wolf Motor Function Test, and Box and Block Test. All measurements have improved. After the intervention, she used the affected UE more frequently and positively in her daily life than she did prior to the intervention. The outcomes of the case demonstrate the benefits of rPMS for UE paresis even in the chronic phase of stroke, with shorter duration and lower dose of intervention.

Funcionalidad de prótesis de mano impresa en 3D en adolescentes con amputación congénita parcial de mano: una serie de casos / 3D-printed hand prostheses function in adolescents with congenital hand amputation: a case series

Resumen: Objetivo: Describir el efecto de la prótesis impresa en 3D Cyborg Beast en la funcionalidad de miembros superiores (MMSS) en adolescentes con amputación congénita parcial de mano. Casos Clínicos: Se seleccionaron 5 pacientes entre 12 y 17 años con amputación congénita parcial de mano en el Instituto Teletón Santiago. Los pacientes fueron entrenados en el uso de la prótesis por 4 sesiones. Se evaluó la función basal (sin prótesis), al mes y los 4 meses de uso de la prótesis con la pauta Bilan 400 points modificada y la percepción de funcionalidad de MMSS sin y con prótesis con la "Upper Extremity Function Index (UEFI)". Al mes y 4 meses de uso, el porcentaje de cambio para funcionalidad de mano fue de -11% y -4% para la extremidad no afectada y de -9% y -2% para la afectada. El porcentaje de cambio para la percepción de funcionalidad de MMSS fue de -62%. Conclusiones: El uso de la prótesis de mano Cyborg Beast no fue una solución funcional para los 5 pacientes incluidos en este estudio. Futuras investigaciones son necesarias para poder mejorar la funcionalidad de estos diseños de prótesis impresa en tecnología 3D.

Abstract: Objective: To describe the effect of the 3D-printed Cyborg Beast prosthesis on upper limbs function in adolescents with congenital hand amputation. Clinical Cases: Five patients aged between 12 and 17 years, with congenital hand amputation were selected. All patients were from the Teletón Institute in Santiago, Chile. The patients were trained for prosthesis use in four sessions. Hand function was evaluated without prosthesis, at 1 and 4 months of use with the modified Bilan 400 points scale, and upper limb function perception was evaluated with the 'Upper Extremity Functional Index (UEFI)'. At 1 month and 4 months of use, the percentage change for hand functionality for the unaffected limbs was between -11% and -4%; and -9% and -2% for the affected limb. The percentage change for the upper limbs perceived function was -62%. Conclusions: The use of the 3D-printed Cyborg Beast prosthesis was not a functional solution for the 5 patients included in this study. Future research is needed to improve the functionality of these types of 3D-printed hand prostheses.

Clinical observation of dynamic scalp acupuncture combined with task-oriented mirror therapy for upper limbs function impairment in patients with hemiplegia after ischemic stroke / 中国针灸

OBJECTIVE@#To explore the effect of dynamic scalp acupuncture combined with task-oriented mirror therapy (TOMT) for upper limb motor function and activity ability of daily living in patients with hemiplegia after ischemic stroke.@*METHODS@#Seventy-eight patients with hemiplegia after ischemic stroke were randomly divided into a dynamic scalp acupuncture group, a TOMT group, and a scalp acupuncture group, 26 cases in each group (1 case dropped off in the TOMT group and the scalp acupuncture group respectively). All three groups received routine rehabilitation training and medication treatment. The TOMT group was treated with TOMT for 40 min a day, 5 days a week for 8 weeks. The scalp acupuncture group was treated with TOMT after the scalp acupuncture, and the dynamic scalp acupuncture group was treated with TOMT during the scalp acupuncture treatment. The scalp acupuncture treatment was applied at ipsilateral up 1/5 and mid 2/5 of and , and the needles were retained for 40 min. The scalp acupuncture treatment was given once a day, 5 days a week for 8 weeks. Before treatment and after 4 weeks and 8 weeks of treatment, the functions of upper limb and hand were evaluated by simplified Fugl-Meyer assessment (FMA) scale upper limb part and functional test for the hemiplegic upper extremity-Hong Kong version (FTHUE-HK) grade, the muscle tension of the upper extremity flexor elbow muscle group was assessed by modified Ashworth scale (MAS) and the activity ability of daily living was assessed by modified Barthel index (MBI).@*RESULTS@#After 4 weeks and 8 weeks of treatment, the FMA scores, FTHUE-HK grades and MBI scores in the three groups were better than those before treatment (<0.01, <0.05), and MAS scores after 4 weeks of treatment in the three groups were better than those before treatment (<0.05). After 4 weeks and 8 weeks of treatment, the FMA scores, FTHUE-HK grades and MBI scores in the dynamic scalp acupuncture group were better than those in the TOMT group and the scalp acupuncture group (<0.05), and these items in the scalp acupuncture group were better than those in the TOMT group (<0.05).@*CONCLUSION@#The dynamic scalp acupuncture combined with TOMT treatment can effectively improve the upper limb function and the activities ability of daily living in patients with hemiplegia after ischemic stroke, which is better than TOMT after scalp acupuncture and simple TOMT treatment.

Rehabilitation Treatment after Extensive Tumor Resection Including Triceps Resection for a Malignant Right Arm Soft Tissue Tumor：A Case Report / The Japanese Journal of Rehabilitation Medicine

Wide resection of malignant bone and soft tissue tumors of the extremities may require resection of muscles, which correspondingly impairs limb movements. We describe a 67-year old man with a malignant soft tissue tumor of the right upper arm. Preoperatively, there was no impairment of right upper extremity function. The patient underwent wide resection of the tumor and triceps muscle. Postoperative rehabilitation included range of motion exercises, residual muscle strength exercises, and activities of daily living (ADL) exercises. One week postoperatively, the patient could independently perform the ADL exercises. Two weeks postoperatively, the patient scored 2 during manual muscle testing (MMT) for elbow extension, indicating a complete range of motion in a gravity-eliminated position. However, the patient could not raise the arm without bending it. Considering the needs of the patient, we prescribed an elbow extension brace to support the upper limb while being raised. With this brace, the patient was able to sustain elbow extension during upper limb elevation. Three months postoperatively, the patient's elbow joint extension remained MMT 2, grip strength was 28 kg, and the International Society of Limb Salvage and Musculoskeletal Tumor Society score was 76.7％．Although the triceps muscle was resected, there was no problem with the patient's ADL. However, the patient could not maintain elbow extension in an anti-gravity position while raising the upper limb. In such cases, prescribing an elbow brace may be useful.

Contra-Lateral Unintended Upper Arm Movement during Unimanual Tasks in Children with Cerebral Palsy

PURPOSE: To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks and to identify factors related to ARs in children with cerebral palsy (CP).MATERIALS AND METHODS: This was a prospective, cross-sectional study of 35 children with CP. The extent of ARs of the contra-lateral, non-task hand was assessed while performing three unimanual tasks (opening and clenching the fist, a finger opposition task, and tapping fingers). The occurrence of ARs in each trial was evaluated separately for each task using a four-point scale (total scores ranged from 0 to 12). Surface electromyography (SEMG) was used to measure the firing activity of the muscles of the opposite arm during the task. The Manual Ability Classification System and Melbourne Assessment 2 (MA-2) were used to evaluate upper limb function.RESULTS: AR scores were higher in the more-affected limb than in the less-affected limb. SEMG data on the non-task hand showed motor overflow up to the elbow muscles in the more-affected limb. Root mean square ratios of EMG signals were significantly higher in children with ARs than in children without ARs. Multiple regression analysis showed both age and MA-2 to be significant factors related to ARs in the more-affected limb.CONCLUSION: Children with visible ARs showed motor overflow in the non-task limb during unimanual hand tasks. Age and upper limb function were significantly related to the extent of ARs in the more-affected limb of children with CP.

Advance in Repetitive Transcranial Magnetic Stimulation for Patients with Upper Extremity Motor Dysfunction after Stroke (review) / 中国康复理论与实践

Repetitive transcranial magnetic stimulation (rTMS) can achieve neuroplasticity through repeated stimulation of specific cortex, and may be in the ways of inter-hemisphere inhibition or compensation, or both. The various combination of frequency, intensity and duration of stimulation may effect the upper limb function after stroke in different ways.

Effects of Horticultural Therapy on Upper-limb Function and Cognition in Stroke Hemiplegic Patients / 中国康复理论与实践

Objective:To explore the effects of horticultural therapy on upper limb function and cognitive impairment of hemiplegic patients after stroke. Methods:From June, 2017 to March, 2019, 60 hemiplegic stroke patients were randomly divided into control group(n = 30) and experimental group (n = 30). All the patients accetped routine rehabilitation, while the experimental group received group-based horticulture therapy in addition, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE), modified Barthel Index (MBI) and Montreal Cognition Assessment (MoCA) before and after intervention. Results:The scores of all the assessment improved in both groups after intervention (|t| > 8.077, P < 0.001), and improved more in the experimental group than in the control group (|t| > 2.293, P < 0.05). Conclusion:Horticultural therapy can promote the recovery of upper-limb and cognitive function after stroke.

Rehabilitation Treatment after Extensive Tumor Resection Including Triceps Resection for a Malignant Right Arm Soft Tissue Tumor：A Case Report / The Japanese Journal of Rehabilitation Medicine

Wide resection of malignant bone and soft tissue tumors of the extremities may require resection of muscles, which correspondingly impairs limb movements. We describe a 67-year old man with a malignant soft tissue tumor of the right upper arm. Preoperatively, there was no impairment of right upper extremity function. The patient underwent wide resection of the tumor and triceps muscle. Postoperative rehabilitation included range of motion exercises, residual muscle strength exercises, and activities of daily living (ADL) exercises. One week postoperatively, the patient could independently perform the ADL exercises. Two weeks postoperatively, the patient scored 2 during manual muscle testing (MMT) for elbow extension, indicating a complete range of motion in a gravity-eliminated position. However, the patient could not raise the arm without bending it. Considering the needs of the patient, we prescribed an elbow extension brace to support the upper limb while being raised. With this brace, the patient was able to sustain elbow extension during upper limb elevation. Three months postoperatively, the patient’s elbow joint extension remained MMT 2, grip strength was 28 kg, and the International Society of Limb Salvage and Musculoskeletal Tumor Society score was 76.7％．Although the triceps muscle was resected, there was no problem with the patient’s ADL. However, the patient could not maintain elbow extension in an anti-gravity position while raising the upper limb. In such cases, prescribing an elbow brace may be useful.

Utility of Chedoke arm hand activity inventory in the Indian population: mixed method research sequential explanatory

Background: One of the most common manifestations of stroke is hand function affectation. This can have a negative impact on daily, social and leisure activities. A formal evaluation protocol will be able to identify specific needs of a patient. The objective was to find out the stability of the Chedoke arm hand activity inventory in sub-acute and chronic stroke patients in India Method.Methods: This was an observational study with sample size 29 and the sampling was convenience sampling. Participant criteria were sub-acute and chronic stroke patients, male and female, patients who follow commands, stable vitals, CMSA score of hand and leg function with stage 3, foot with stage 2, postural control with 6 or 7 and ability to walk 25 meters indoor. Recurrent stroke and hand dysfunction due to any reason other than stroke were excluded. Twenty-nine stroke patients, sub-acute and chronic where CMSA score taken prior to administration of CAHAI. A score of 1-7 for each task in CAHAI 13, total score of minimum 13 and maximum 91 with other considerations where “unsafe for the patient” was considered as score 1. Data analysis were done using SPSS version 22.0 and Pearson’s correlation coefficient.Results: A total of 29 participants included where the test retest reliability was r=0.98 with significance <0.001.Conclusions: CAHAI found to be a highly reliable outcome measure.

Effect of visual feedback training using mirror neuron theory on limb function and activities of daily living in patients with hemiplegia during early stroke / 中国基层医药

Objective@#To explore the effect of visual feedback training using mirror neuron theory in patients with hemiplegia in early stroke.@*Methods@#From July 2014 to July 2017, 122 early stroke patients with hemiplegic stroke in the First People's Hospital of Wenling were selected in the study.After the patients' condition was stable, visual feedback training based on mirror neuron theory was performed.The functional status of upper limbs before and after treatment was evaluated by the simplified Fugl-Meyer motor function evaluation.The modified Ashworth scale was used to evaluate the upper limb muscle tension before and after treatment.The Barthel index was used to evaluate the ability of daily living activities before and after treatment.@*Results@#The FMA score of patients after treatment was (35.74±11.24)points, which was significantly higher than that before treatment [(28.81±9.68)points, t=5.160, P=0.000]. The BI score after treatment was (76.24±14.77)points, which was significantly higher than before treatment[(52.93±12.28)points, t=13.404, P=0.000]. After treatment, the muscle tension of the flexor elbow muscle group was (1.57±0.76)grades, which was significantly lower than before treatment [(3.24±0.72)grades, t=17.619, P=0.000]. The forearm pronation muscle group muscle tension grade was (2.14±0.96)grades, which was significantly lower than before treatment [(3.28±0.75)grades, t=10.336, P=0.000].@*Conclusion@#Visual feedback training based on mirror neuron theory can help improve the upper limb function of patients with hemiplegia in early stroke, alleviate the symptoms of paralysis, improve the ability of daily living activities of patients, and has positive effect on promoting their rehabilitation.

Effect of visual feedback training using mirror neuron theory on limb function and activities of daily living in patients with hemiplegia during early stroke / 中国基层医药

Objective To explore the effect of visual feedback training using mirror neuron theory in patients with hemiplegia in early stroke.Methods From July 2014 to July 2017,122 early stroke patients with hemiplegic stroke in the First Peopleˊs Hospital of Wenling were selected in the study.After the patientsˊcondition was stable, visual feedback training based on mirror neuron theory was performed.The functional status of upper limbs before and after treatment was evaluated by the simplified Fugl －Meyer motor function evaluation.The modified Ashworth scale was used to evaluate the upper limb muscle tension before and after treatment.The Barthel index was used to evaluate the ability of daily living activities before and after treatment.Results The FMA score of patients after treatment was (35.74 ±11.24)points,which was significantly higher than that before treatment [(28.81 ±9.68)points,t＝5.160, P＝0.000].The BI score after treatment was (76.24 ±14.77) points,which was significantly higher than before treatment[(52.93 ±12.28) points,t＝13.404,P＝0.000].After treatment,the muscle tension of the flexor elbow muscle group was (1.57 ±0.76)grades,which was significantly lower than before treatment [(3.24 ±0.72)grades, t＝17.619,P＝0.000].The forearm pronation muscle group muscle tension grade was (2.14 ±0.96)grades,which was significantly lower than before treatment [(3.28 ±0.75) grades,t＝10.336,P＝0.000].Conclusion Visual feedback training based on mirror neuron theory can help improve the upper limb function of patients with hemiplegia in early stroke,alleviate the symptoms of paralysis ,improve the ability of daily living activities of patients ,and has positive effect on promoting their rehabilitation.

Effects of Hand Robot-assisted Training Based on Motor Imagery on Upper Limb Function of Stroke Patients / 中国康复理论与实践

Objective To investigate the effect of hand robot-assisted training based on motor imagery on upper limb function of stroke patients.Methods From November, 2016 to May, 2018, 55 hemiplegic patients with upper limb dysfunction were randomly assigned to control group (n = 25) and experimental group (n = 30). The control group received routine hand motor training, while the experimental group received hand robot-assisted training, for four weeks. They were assessed with simplified Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT) and Modified Barthel Index (MBI) before treatment (t0), one week of treatment (t1), immediately after treatment (t2) and 2 months after treatment (t3).Results The score of WMFT improved in the experimental group at t1 (P ＜ 0.05), with no significant difference between groups (Z =-0.901, P＞ 0.05). The scores of FMA, WMFT and MBI improved in both groups at t2 and t3 (P ＜ 0.05), and the scores of FMA and MBI improved more in the experimental group than in the control group (Z＞-2.073, t＞ 2.034, P ＜ 0.05).Conclusion Hand robot-assisted training based on motor imagery can promote recovery of upper limb function in stroke patients more effective than routine hand function training.

Transcranial magnetic stimulation can improve upper limb function after a stroke / 中华物理医学与康复杂志

Objective To explore any changes in the patterns of cortical activation after repetitive transcra-nial magnetic stimulation ( rTMS) using functional near-infrared spectroscopy when rTMS is used to treat paralyzed upper limbs. Methods Thirty hemiplegic stroke survivors were randomly divided into a treatment group and a con-trol group, each of 15. Those in the treatment group received 1 Hz rTMS on the M1 area of the unaffected hemisphere for 21 days, while the control group was given sham stimulation. The Fugl-Meyer motor assessment ( FMA-UE) was used to assess the paralyzed upper limbs before the treatment and after 7, 14 and 21 days of treatment. Oxy-hemoglo-bin ( HbO2 ) levels were measured in the premotor cortex, the supplementary motor area and the sensorimotor areas ( SMCs) of the affected and unaffected hemispheres before and after the treatment using the functional near-infrared spectroscopy. Results Before the treatment there was no significant difference between the two groups in their aver-age FMA-UE scores. The average FMA-UE scores of both groups increased significantly after 14 and 21 days of treat-ment, with the average scores at 21 days significantly better than after 14 days for both groups. But after 14 and 21 days the treatment group's average score was significantly better than that of the control group. The average HbO2 level in the SMC area of the unaffected hemisphere in the treatment group had decreased significantly after 21 days of treat-ment, and it was then significantly lower than the same level in the control group. Conclusion Twenty-one days of rTMS of the unaffected hemisphere can decrease cortical activation in the unaffected SMC area and promote the recov-ery of upper limb function.

Mirror therapy improves the upper limb function of hemiparetic stroke survivors: A meta-analysis / 中华物理医学与康复杂志

Objective To evaluate systematically the efficacy of mirror therapy for improving the upper limb function, daily life and pain of stroke survivors. Methods The PubMed, EBSCO, Web of Science, Ovid, Co-chrane Library, Open Gray, China Biological Medicine, China National Knowledge Infrastructure, GoogleScholar, VIP and Wan Fang Data databases were searched for reports of randomized and controlled trials ( RCTs) of mirror therapy for improving the upper limb function of stroke survivors. Only papers published before December 2015 were surveyed. The relevant references of the primary studies were also searched. The literature screening, data extraction and assessments were conducted by two reviewers independently. The meta-analysis was performed using version 5.2 of the RevMan software. Results A total of 22 RCTs involving 823 patients were discovered, some not dealing with mirror therapy. Comparing the studies with and without visual feedback, there were significant differences in upper limb motor function as measured by the Fugl-Meyer, ARAT and Brunnstrom instruments. The average Barthel indexes and visual analogue scale were also significantly different. Conclusion Mirror therapy can improve upper limb function and ability in the activities of daily living, and also relieve pain among stroke survivors to some degree, though its long-term efficacy is still unclear. Large-sample, multi-center, high-quality RCTs are required to verify these conclusions.

Effects of mirror therapy combined with imagination therapy on upper limb function after stroke / 中华物理医学与康复杂志

Objective To observe the effect of mirror therapy (MT) combined with movement imagination therapy (MI) on the upper limb function of hemiplegic stroke patients.Methods Ninety stroke survivors with hemiplegia were randomly divided into three groups:A,B and C.Their routine rehabilitation was supplemented with MI in group A,with MT in group B and in group C with both for 8 weeks.The evaluations used the Fugl-Meyer motor function assessment (FMA),Carroll's upper extremity function evaluation (UEFT) and the modified Barthel index (MBI).Results After 4 and 8 weeks of treatment,significant improvement was observed in the average FMA,UEFT and MBI scores of all three groups compared with before the treatment.After 4 and 8 weeks all of the average scores in group B were significantly higher than those of group A at the same time point,For group C,their average scores were significantly better than those of both of the other groups.Conclusion Mirror therapy is superior to exercise imagination therapy,but their combination is more effective in promoting upper limb function and improving ability in daily activities than either alone.Longer treatment has better effects.

Application of microsurgery and conventional surgery in the repair of tendon rupture and the effect of postoperative adhesion prevention / 中国综合临床

Objective To compare the effect of microsurgery and conventional surgery in the repair of tendon rupture and the effect of postoperative adhesion prevention. Methods From February 2011 to December 2016,seventy?two patients with finger tendon rupture treated in Dongfeng Hospital Affiliated to Hubei Medical College were selected as the research objectand then randomly divided into the observation group and the control group,36 cases in each group. The observation group was treated with microsurgery treatment,the control group was treated with the traditional surgical treatment to record postoperative prognosis and adhesion of the two groups. Results At 12 weeks after operation,the recovery rate of tendon in the observation group and the control group were 94. 4％ (34/36)and 75％(27/36),respectively,the data in the observation group was significantly higher than that in the control group (χ2=5. 552, P<0. 05 ) . At the same time, Carroll score of upper limb function in the observation group at 4 weeks and 12 weeks after the surgery were (85. 55±8. 29) and (102. 49 ±10.82),significantly higher than those in the control group ( (74.25±8.53)％,(91.44±12.49) ),the differences were statistically significant (t=6. 948,5. 323,P<0. 05). At 12 weeks after operation,the adhesion rate of tendon in the observation group was 2. 8％ ( 1/36 ) , significantly lower than that of the control group ( 16. 7％ ( 6/36) ) , ( P<0. 05 ) . Conclusion Compares with the conventional surgery, microsurgery in the treatment of tendon rupture repair can promote the repair of tendon tissue,improve the upper limb function,and reduce the occurrence of postoperative tendon adhesion.