Test-retest Reliability and Inter-rater Reliability of Numerical Rating Scale for Abnormal Sensation Points of Patients with Spinal Cord Injury / 中国康复理论与实践

Objective:To investigate the test-retest reliability and inter-rater reliability of Numerical Rating Scale (NRS) for abnormal sensation points of patients with spinal cord injury (SCI). Methods:From October, 2016 to December, 2018, 69 patients with SCI were enrolled. Their impaired sensory points were measured with NRS. The score of sensory points was tested by examiner A firstly, and examiner B did the same work next day. Then, the examiner A retested the same patients after three weeks. Results:The Pearson correlation coefficients and intraclass correlation coefficient (ICC) of the test-retest reliability and inter-rater reliability for sensory score of both sides were all above 0.88 and 0.93 respectively (P < 0.001). The Pearson correlation coefficients and ICC of the sensory score of the different injury levels were all above 0.88 and 0.93 respectively (P < 0.001). Conclusion:NRS has high test-retest reliability and inter-rater reliability for the assessment at abnormal sensation points of patients with SCI.

The effect of functional electrical stimulation after cerebral infarction on the expression of N-methyl-D-aspartate receptors in the brain / 中华物理医学与康复杂志

Objective To investigate whether functional electrical stimulation (FES) can improve the expression of proteins in the NMDAR1-pGLuR1 pathway so as to promote the recovery of motor function and sensation after stroke.Methods Eighty-one Wistar rats were used to make a photochemical brain model of local ischemia.Rats were randomly assigned into a sham, placebo stimulation or FES group.Rats in the placebo and FES groups had local ischemia induced in the M1 zone of the brain using the photosensitive dye Bengal rose.It was administered intravenously and a laser beam was then stereotactically positioned on the skull.The rats in the FES groups were stimulated for 30 minutes (10 minutes on, 10 minutes off, then 10 minutes on).The placebo group's treatment was similar, but without the electric current.The rats in the sham group received no intervention.The cylinder test and the adhesive-removal test were used to test the rats' motor function and sensation before the operation and before they were sacrificed.Cohorts were sacrificed after 3, 7 and 14 days of intervention.NMDA receptor and AMPA receptor were detected in the peri-ischemic cortex using western blotting.Results After 7 and 14 days the index of forelimb motor function in the cylinder test of the FES group was significantly better than that of the placebo group.The average adhesive-removal time of the FES group was also significantly faster compared with the placebo group.After 7 days the average expression of NMDAR1 in the FES group was significantly higher than in the placebo group.The average expression of GluR1 and pGluR1 in the FES group was significantly higher than in the placebo group after 14 days.Conclusion Functional electrical stimulation can improve motor function after ischemia through the NMDARAMPAR signal pathway, at least in rats.

Investigate repairing effect of Lugua polypeptide on patients’ sensory and motor function with spinal cord injury / 中国生化药物杂志

Objective To study repairing effect of Lugua polypeptide on patients with spinal cord injury and the related mechanism. Methods From August 2012 to August 2013,79 cases patients with thoracolumbar spinal cord injury as the research objects,and they were divided into two groups randomly.The control group (n=38)received conventional treatment,and the observation group (n=41)received intravenous drip of Lugua polypeptide on the basis of conventional treatment.The course is three months.The American spinal injury association(ASIA)sensory score,ASIA motor score and Bathel index (BI )were recorded in two groups before and after treatment.Analyse the repairing effect on patients with spinal cord injury. Results ASIA sensory score,ASIA motor score and Bathel index in two groups after treatment improved ,and the observation group improved significantly compared with control group(P<0.05).Conclusion Lugua polypeptide can improve sensory and motor function with spinal cord injury ,it has clinical value.

Clinic research into the effects of SPR on the sensory function of lower extremities / 中华显微外科杂志

Objective To explore the reason why the SPR could make the changes of Sensory Function of Lower extremities,and the clinical significance of these changes.Methods From February,2012 to August,2014,24 patients with spastic cerebral palsy who were consistent with the indications of SPR,had normal intelligence development,and express competence,and could cooperate with the test.To test the changes of Sensory Function of lower extremities preoperatively,1 week after SPR,such as haptics,superficial algaesthesis,temperature sensation,cinaesthesia,topesthesia,pallesthesia,deep pain sense,tactile localization sense,two point discrimination and pattern sense.Results There were 6 patients who present with skin paresthesia of lower extremities among the 24 patients after the SPR.Of the 6 patients,4 became normal 2 weeks later,1 became normal 3 weeks later,and the longest 1 became normal 6 weeks later.No instances with permanent sensory deprivation and anaesthesia were found.The proportions of the excised root of spinal nerves during the SPR in the groups with skin anaesthesia of lower extremities and without skin anaesthesia of lower extremities were 0.268 ± 0.049 and 0.193 ± 0.074 (P ＜ 0.05 respectively).The former was significantly higher than the latter.The changes of haptics,cinaesthesia,topesthesia,deep pain sense,tactile localization sense,two point discrimination,pallesthesia preoperatively,1 week after SPR were not significantly different (P ＞ 0.05).There were significant differences in the superficial algaesthesis,pattern sense and temperature sensation preoperatively and postoperatively (P ＜ 0.05).Both of them decreased compared with those of 1 week after SPR.Conclusion The slight damage to sensory function of lower extremities resulted from SPR may not affect the protectant sensory function of the body.The skin anaesthesia of lower extremities is probably concerned with the proportion of the excised root of spinal nerves during the SPR,but not associated with the age.The impaired symptoms of the sensory function of lower extremities resulted from SPR can spontaneous recover in 2-6 weeks after SPR.SPR is safely with the clinic research on the sensory function of lower extremities.

Rehabilitation for Brainstem Lesion: Non-Motor Symptoms

The brainstem is a compact, stalklike structure. It carries nearly all information between the brain and the remainder of body. It is a corridor to all major sensory, motor, cerebellar, cranial nerve pathways but it is not simply a conduit for information. It has numerous nuclei of the cranial nerves. Therefore, when a patient has a lesion in the brainstem, he or she will demonstrate a variety of symptoms regarding level of consciousness, motor control, muscle tone, posture, vegetative function and other essential function. Here, we will discuss about the non-motor symptoms caused by the brainstem lesions and the strategy for the rehabilitation.

Reconstruction of sensory function of thumb and forefinger pulp by the lateral island flap with neurovascular pedicle of finger / 中国康复理论与实践

@#ObjectiveTo explore the effect of the lateral island flap with neurovascular pedicle of finger on reconstruction of the sensory function of thumb and forefinger pulp.MethodsSensory functions of 9 thumb pulps and 7 forefinger pulps were reconstructed by the lateral island flap with neurovascular pedicle of ring finger and middle finger.ResultsAll 16 island flaps were survived. Follow-up survey was 6 months to 2 years. The appearance and texture of flaps were satisfactory with sensory function being S3-S3+ grade.ConclusionThe lateral island flap with neurovascular pedicle of ring finger and middle finger is a good and reliable method to reconstruct the sensory function of thumb and forefinger pulp.

Clinical effect of early surgery in infantile exotropia

To evaluate the effects of early surgical intervention in infantile exotropia on the motor and sensory functions, we reviewed the records of 17 subjects diagnosed with exotropia before the age of 12 months, receiving surgery before the age of 24 months, with a follow-up period greater than one year, between 1996 and 2000. Of the 17 subjects (6 intermittent, 11 constant), 14 (82%) (6 intermittent, 8 constant) had a final horizontal deviation of <10 PD, with 3 (18%) needing a re-operation. Fusion and gross binocularity were developed in 7 (4 intermittent, 3 constant), and 11 (6 intermittent, 5 constant) subjects, respectively. Seven subjects developed stereopsis of 200 seconds or better, and 5 of the 6 with intermittent exotropia (83%) being involved. In conclusion, over 80% of the successful alignments were obtained with surgery before the age of 24 months in infantile exotropia, which was similar to previous studies. Furthermore, early surgical intervention, particularly in the intermittent phase, resulted in more effective sensory function.