Résumé
Objective To explore the effectiveness of a myoelectricity-driven hand robot on the recovery of hand motor function early after a stroke.Methods Thirty stroke survivors were randomly assigned to either a control group (n=15) or an experimental group (n =15).Both groups received routine rehabilitation exercises,while the experimental group additionally received hand training using a robotic hand exoskeleton.Before and after 4 weeks of treatment,the motor function of the wrist and fingers in both groups were measured using the Fugl-Meyer assessment.Spasticity in the index,middle,ring and little fingers was quantified using the modified Ashworth scale.The muscle force of the fourth finger,thumb and all of the fingers during maximum voluntary extension and flexion were recorded using the robot's surface electromyography system.Results Significant increases in the average Fugl-Meyer scores in both groups were observed after 4 weeks of treatment,but the experimental group's average score was by then significantly higher than that of the control group.The experimental group's average Ashworth score and the average sEMG amplitudes were also significantly better than those of the control group.Conclusion Supplementing routine rehabilitation exercises with a hand robot can improve hand motor function and muscle force significantly,as well as relieving hand spasticity early after a stroke.
Résumé
Objective To observe the effect of high frequency repetitive transcranial magnetic stimulation ( rTMS) on executive function in patients after stroke .Methods Thirty-six stroke patients with executive dysfunction in the Second Affiliated Hospital of Guangzhou Medical University from March 2016 to April 2017 were randomly divided into experimental group ( n=18 ) and control group ( n=18 ) .The experimental group received 10 Hz rTMS of the left dorsolateral prefrontal cortex ( DLPFC ) and cognitive functional training , while the control group received sham rTMS and cognitive functional training , for four weeks.Mini-Mental State Examination(MMSE), Wisconsin Card Classification Test(WCST), Digit Symbol Test( DST) and Digital Span ( DS) were used for cognitive assessment at baseline and therapy completed . Results After a four weeks therapy , the total number of responses showed no significant difference in WCST between two groups.But the control group after treatment showed that MMSE score (17.44 ±4.73) and DST score (4.50 (2.75, 8.25)) were improved compared with that before treatment (MMSE score 15.28 ±4.61, t=-8.371, P=0.000;DST score 4.00 (2.75, 7.25), Z=-2.122, P=0.049), and the DS score and the numbers of correction , classification and continuous errors of WCST showed no significant difference compared with that before treatment .The experimental group after treatment showed that MMSE score (20.67 ±4.59), DST score (7.50(4.75, 12.50)), DS score (recite in order 7.00 (7.00, 8.00), recite in reverse order 3.00 (2.00, 4.00)), the numbers of correction of WCST (24.61 ± 8.30), the numbers of continuous errors (12.17 ±5.08), the numbers of classification (2.00 (2.00, 3.00) were improved compared with that before treatment ( MMSE score 15.50 ±5.24, t=-21.013, P=0.000;DST score 3.00(1.00, 7.00), Z=-3.757, P=0.000; DS score recited in order 6.00(5.00, 6.00), Z=-3.703, P=0.000;DS score recited in reverse order 2.00(1.00, 3.00), Z=-3.494, P=0.000;The numbers of correction of WCST (16.50 ±9.34), t=-6.544, P=0.000); The numbers of continuous errors (18.06 ±5.63, t=9.744, P=0.000); The numbers of classification (1.00 (1.00, 2.00), Z=-3.900, P=0.000 ).And the curative effect was better than that of control group . Conclusion High frequency rTMS combined with cognitive function training can improve the executive dysfunction of stroke patients , and the improvement is better than cognitive functional training alone .
Résumé
Objective To observe the effect of virtual reality robotic hand on hand motor function and activities of daily living of pa-tients after stroke. Methods From June, 2015 to June, 2016, 32 patients with hand motor dysfunction were assigned into experimental group (n=16) and control group (n=16). The experimental group received training with virtual reality robotic hand and hand based rehabilitation, while the control group received hand based rehabilitation only, for four weeks. They were evaluated with Fugl-Meyer Assessment (FMA) of fingers and wrists and modified Barthel index (MBI) before and after treatment. Results The total score and the scores of items of FMA and MBI improved after treatment in the experimental group (Z>3.45 or t>3.45, P2.07 or t>4.18, P2.14 or t>3.20, P<0.05). Conclusion Virtual reality robotic hand training can promote the recovery of hand function and activities of daily living in patients af-ter stroke.
Résumé
Objective To study the effects of the rehabilitation robot-assisted task-oriented training on the hand function in patients after stroke. Methods From June, 2015 to September, 2016, 35 inpatients suffering from stroke were randomly allocated to control group (n=17) and trial group (n=18). Based on the routine rehabilitation, the trial group accepted robot-assisted task-oriented training, while the control group accepted therapist-assisted task-oriented training, for two weeks. They were measured the active range of motion (AROM) of fingers, assessed with fingers motor of Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) invovled with hands before and after train-ing. Results The inpatients dropped three in the control group, two in the trial group. AROM of extension and flexion of all the fingers, the AROM of extension and total of three fingers of thumb, index and middle, and the total AROM of each finger improved in the trial group af-ter training (t>2.937, P2.528, P2.535, P2.000, P2.000, P0.05). The scores of feeding, dressing, toilet transfers, bathing, groom-ing of MBI and the total score of them improved in the trial group after training (Z>2.041, P0.05). Conclusion The rehabilitation robot-assisted task-oriented training can improve AROM of hemiplegic fingers and grip function.
Résumé
Objective To observe the effect of high frequency repetitive transcranial magnetic stimulation ( rTMS) on executive function in patients after stroke .Methods Thirty-six stroke patients with executive dysfunction in the Second Affiliated Hospital of Guangzhou Medical University from March 2016 to April 2017 were randomly divided into experimental group ( n=18 ) and control group ( n=18 ) .The experimental group received 10 Hz rTMS of the left dorsolateral prefrontal cortex ( DLPFC ) and cognitive functional training , while the control group received sham rTMS and cognitive functional training , for four weeks.Mini-Mental State Examination(MMSE), Wisconsin Card Classification Test(WCST), Digit Symbol Test( DST) and Digital Span ( DS) were used for cognitive assessment at baseline and therapy completed . Results After a four weeks therapy , the total number of responses showed no significant difference in WCST between two groups.But the control group after treatment showed that MMSE score (17.44 ±4.73) and DST score (4.50 (2.75, 8.25)) were improved compared with that before treatment (MMSE score 15.28 ±4.61, t=-8.371, P=0.000;DST score 4.00 (2.75, 7.25), Z=-2.122, P=0.049), and the DS score and the numbers of correction , classification and continuous errors of WCST showed no significant difference compared with that before treatment .The experimental group after treatment showed that MMSE score (20.67 ±4.59), DST score (7.50(4.75, 12.50)), DS score (recite in order 7.00 (7.00, 8.00), recite in reverse order 3.00 (2.00, 4.00)), the numbers of correction of WCST (24.61 ± 8.30), the numbers of continuous errors (12.17 ±5.08), the numbers of classification (2.00 (2.00, 3.00) were improved compared with that before treatment ( MMSE score 15.50 ±5.24, t=-21.013, P=0.000;DST score 3.00(1.00, 7.00), Z=-3.757, P=0.000; DS score recited in order 6.00(5.00, 6.00), Z=-3.703, P=0.000;DS score recited in reverse order 2.00(1.00, 3.00), Z=-3.494, P=0.000;The numbers of correction of WCST (16.50 ±9.34), t=-6.544, P=0.000); The numbers of continuous errors (18.06 ±5.63, t=9.744, P=0.000); The numbers of classification (1.00 (1.00, 2.00), Z=-3.900, P=0.000 ).And the curative effect was better than that of control group . Conclusion High frequency rTMS combined with cognitive function training can improve the executive dysfunction of stroke patients , and the improvement is better than cognitive functional training alone .
Résumé
Objective To investigate the effect of alternating cooling and heating whirlpool bath on patients with shoulder-hand syn-drome in stage I after stroke. Methods 60 patients with shoulder-hand syndrome in stage I after stroke were randomly divided into control group (n=30) and observation group (n=30). The control group received comprehensive rehabilitation training including exercise therapy, concentric winding, joint mobilization and ideation training, 30 minutes every time, twice a day, 5 days a week for 4 weeks. The observation group received alternating cooling (12~15℃) and heating (37~43℃) whirlpool bath treatment 20 minutes every time in addition, twice a day, 5 days a week for 4 weeks. Visual Analogue Scale (VAS), hand drainage volume, modified Ashworth Scale (MAS), Fugl-Meyer Assess-ment (FMA) and Barthel Index (BI) were used to assess the upper limb pain, the degree of edema, muscle tension, motor function and activi-ties of daily living. Results Before treatment, there was no significant difference in the scores of VAS, MAS, FMA and BI, and the hand drainage volume between 2 groups (P>0.05). 4 weeks after treatment, all the indexes improved in both groups (P<0.05), and were better in the observation group than in the control group (P<0.01). Conclusion The effect of alternating cooling and heating whirlpool bath may fur-ther improve the symptoms of shoulder-hand syndrome in stage I after stroke.
Résumé
Objective To investigate the effect of rehabilitation professional training. Methods Based on the 10 tertiary hospitals in Guangzhou, Guangdong, the professionals from communitiy hospitals were trained. The scores of knowledge and practice tests were ana-lyzed in 2 terms of training. Results The students performed better in the practice test (82.01±8.91) than knowledge (71.08±10.05) (P<0.01). The score of knowledge tests was better in the second term than the first (P<0.05), no difference between them in the score of practice test. Conclusion Rehabilitation professional training in Guangzhou can improve the ability of service of medical rehabilitation.
Résumé
@# Objective To investigate the effect of rehabilitation professional training. Methods Based on the 10 tertiary hospitals in Guangzhou, Guangdong, the professionals from communitiy hospitals were trained. The scores of knowledge and practice tests were analyzed in 2 terms of training. Results The students performed better in the practice test (82.01±8.91) than knowledge (71.08±10.05) (P<0.01). The score of knowledge tests was better in the second term than the first (P<0.05), no difference between them in the score of practice test. Conclusion Rehabilitation professional training in Guangzhou can improve the ability of service of medical rehabilitation.