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@#Objective To investigate the effect of combination of baclofen, tizanidine and eperisone on moderate or severe spasticity after spinal cord injury. Methods 18 inpatients with moderate (n=2) or severe (n=16) spasticity after spinal cord injury were treated with combination of 2 or 3 kinds of drugs for 2 months, and followed up for at least 4 months with modified Ashworth scale (MAS). Their blood pressure, blood and urine routine, liver and kidney function were observed. Results Among the 16 cases of severe spasticity (MAS≥3), MAS reduced 3 grades in 3 cases, 2 grades in 12 cases, 1 grade in 1 case, with alleviation of phantom pain. For the cases of moderate spasticity (MAS=2), the MAS reduced 1 grade with alleviation of phantom pain. Slightly drowsiness was observed in 2 cases. No hepatic or renal dysfunctions was found. Conclusion Combination of baclofen, tizanidine and eperisone is effective on moderate or severe spasticity after spinal cord injury with limited side-effects.
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@#Presented in this Paper is a preliminary report on inter-observer agreement study of comprehensive function evaluation(CFE). one hundred and three normal persons were evaluated by two observers individually. The result revealed significant statistical difference,Kappa = 0. 75,demonstrating the substantial agreement of these two evaluations. The result suggests that the scale has substantial inter-observer agreement and high reliability. The personal comprehensive function could be evaluated completely in the scale. It would be significant not only in practice but also in theory to improve the rehabilitation evaluation.
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@#Presented in this paper is a preliminary report on reliability study of comprehensive function evaluation.One hundred and five normal persons were evaluated twice in the interval of one month.The result revealed significant statistical difference,Kappa=0.79,u=7.938>2.56,P<0.01,demonstrating the substantial agreement of these two evaluations.The result suggests that the scale has substantial intra observer agreement and high reliability.The personal comprehensive function could be evaluated completely in the scale.It would be significant not only in practice but also in theory to improve the rehabilitation evaluation and rehabilitation medical level.
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@#T lymphocyte subset and NK cells in the blood of SCI patients were measured by APAAP(Alkaline Phosphatase Antialkaline Phosphatase) in order to study the change of immune function in SCI patients.The results showed that cell mediated and non specific immune function in SCI patients was decreased. It plays a role in the rehabilitation of SCI patients to increase immune function.
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@#: Rehabilitation medicine is a medical branch which focused on functional recovery. Function Evaluation is very important in assessing the function of patients, the effect of treatment and the efficiency of rehabilitation. Comprehensive Function Evaluation includes evaluation of physical, psychological, speech and society. Vocal, mental and social evaluation have deep cultural and national background. Therefore every country must have its own Function Evaluation Method. Now we present our design for Comprehensive Evaluation. Based on the cooperation of Department of Rehabilitation, Department of Neurology, Department of Spinal Cord Injury, Department of Speech Therapy and Department of Psychology. The advantages of this method are as follows: 1. The style of ADL, speech and thinking are suitable for the condition of our country. 2. The evaluation result adopts hundred work system, it is easy for medical staff, patients and their family to understand and communicate the result. 3. We make it more accurate, comprehensive and reliable by some simple tests on speech pathology and psychology. 4. We overcome some disadvantages of evaluation indexes because it is not correct and is difficult to be understood before. Now every evaluation index has quantity standard. 5. It is simple and practical. Each subtest takes 20 minutes or more. 6. It has been tested by normal people. The norm and severity grade had been developed. 7. The reliability is tested and is proved to be dependable.
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@# Functional electrical stimulation(FES) offers a vast potential for partial restoration of parlayzed movements. In practice,understanding on the underlying mechanism and limitations of electrical activation of nerve is essential to guide a successful deployment of FES technology to clinical utilization. Thisthree part article will review the basic concepts,system design and applications of FES. In part I,conceptssuch as activation threshold,recruitment order are discussed. Part Ⅱ introduces stimulation waveforme,safeparameters and tissue damage,as well as the design principle of stimulators for use with percutaneous electrodes. Part Ⅲ outlines clinical applications of FES,in particular,for restoration of hand grasp function forC5/C6 patients.
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@#Fifteen patients with spasticity were treated by phenol blocks. The results are satisfactory.Phenol blocks has the advantages of high selectivity,few side-effects and low cost. The anthor recommends that phenol blocks could be used in clinical antispasticity treatment.
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@#Surface transcutaneous electric nerve stimulation(TENS) was applied to treat the spasiticity resulting from spinal cord injury(SCI) in the acupoints of the subjects with SCI in order to oberve thetranscient and long-term effect of the treatment Fand its mechanism will be discussed in this paper. The results show that: 1 )more significant effect in relieving the spasiticiy was got by stimulating in high frequencyfor 30minutes,while less effect in low frequency(2Hz) ; 2)the effect in high frequency was partially ostracized by naloxone; 3)the effect in high frequency lasted for a long time i 4)compared with lumbar and sacralstimulation,the acupoint stimulation lasted for the longest time. This study also gets a hypothesis that highfrequency TENS in acupoints improves dynorphin in CSF to release and significantly relieve the spasiticityby kappa opioid receptor which decreases the excitment of anterior motor neuron.
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@# Presented in this paper is a report on the Quadriplegia Index of Function(QIF) in usewith 16 cases of quadriplegic patients.Compared with the Barthel Index and Japan ADL Scale,QIF wasfound to be more sensitive and effective to document the small but significant funtional gains made byquadriplegics during medical rehabilitation,therefore,authors suggest that QIF should be widely usedin the rehabilitation evaluation of quadriplegic patients.