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Objective:To investigate the use of intravenous infusion in the rehabilitation of stroke survivors so as to further standardize and reduce the rate of use.Methods:Stroke survivors hospitalized in rehabilitation departments in Shandong Province in the first 5 months of 2021 were the study′s subjects. Data on the use of intravenous infusion were compiled including the medicine administered, the reason for the infusion, as well as the duration and the number of days of infusion. The rehabilitative effect, stroke complications and hospitalization costs were recorded, as well as the attitude toward the use of infusion and any measures taken to reduce their use.Results:The utilization rate of intravenous infusion was 31.72%. The drugs infused were mainly to improve circulation and feed the nerves. Short-term infusion had no adverse effects on functional recovery, but long-term infusion had negative effects and led to complications. The average daily cost of stroke survivors receiving intravenous infusion was significantly lower than that of patients not receiving it, and the proportion of their drug expenditure in the total cost was also significantly higher. There was no significant difference in the average length of hospital stay between patients receiving and not receiving infusion.Conclusions:Intravenous infusion predicts greater drug use, and long-term infusion has a bad effect on rehabilitation and recovery. Various measures should be taken to reduce the utilization of intravenous infusion and standardize its application.
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Brain rehabilitation is a comprehensive rehabilitation method for motor, sensory, cognitive, speech, swallowing and other functional disorders caused by brain diseases(such as stroke, Parkinson's disease, craniocerebral trauma, etc.). Timely and effective brain rehabilitation intervention can effectively improve motor, speech, cognitive and other abilities of elderly patients with cerebrovascular disease, thus improving their ability for daily living activities, improving the quality of life, reducing the burden for their families and society, and achieving the long-term goal of returning to society.In this paper, recent research progress in brain rehabilitation is summarized in order to explore more diversified rehabilitation modes for brain rehabilitation in the elderly.
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Objective:To analyze and compare rehabilitation research funded by China′s National Natural Science Foundation (NSFC) with that funded by America′s National Institutes of Health (NIH) so as to provide references for future funding.Methods:Articles reporting rehabilitation research funded by the NSFC and the NIH were retrieved from the NSFC′s Science Output Service website and the NIH′s Project Report website and analyzed.Results:From 2009 to 2018 the NSFC funded 421 rehabilitation studies which resulted in a published report while the NIH funded 312. In 2018, the NSFC budget (US$3.89 million) was 8.46 times that of 2009 (US$460, 000), while the NIH′s grant budget (US$36.08 million) was 2.17 times that of 2009 (US$16.62 million). The number of published papers resulting from the Chinese and American studies was 1111 and 2571 respectively. Their impact factors mainly ranged between 0 and 3 points. Among the journals with an impact factor of 6 or more, published papers from the United States (297) were much more numerous than those from China (18). The number of SCI papers per million US dollars increased by 2.25 times in China and 0.05 times in the US.Conclusions:Both China and the United States have been investing more in rehabilitation medicine research, and that has resulted in more published papers. There is still a gap in funding and output between the two countries.
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Objective:To investigate research into medical rehabilitation supported by China′s Natural Science Foundation (NSFC) between 2009 and 2018.Methods:Medical rehabilitation research projects supported by the NSFC between 2009 and 2018 were compiled. The project leaders, funding, awardee organization, research area and results were collected and analyzed.Results:There were 348 researchers who were supported in 421 projects during the period studied. They received ￥168.541 million and made 1395 achievements between 2009 and 2018. Neurological rehabilitation was the most popular research area, followed by musculoskeletal rehabilitation, while cardiopulmonary and pain rehabilitation were rarely covered.Conclusions:Rehabilitation medicine has been developed actively, but NSFC support has still been insufficient.
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Objective:To test the effectiveness of electrical stimulation of the median nerve (MNES) for relieving post-stroke cognitive impairment (PSCI) and explore the possible mechanism.Methods:Thirty patients with PSCI were randomly divided into a routine treatment group (the control group) and an MNES group, each of 15. Both groups were given routine rehabilitation treatment, including cognitive rehabilitation training, medications and acupuncture. The MNES group additionally received 30 minutes of MNES on their right hands every day, five times a week for six weeks. One electrode was positioned over the median nerve 2cm up from the rasceta of the right wrist. The other was on the muscles of the thenar eminence. Forty seconds of stimulation were applied with intervals of 20 seconds, for 30 min daily. Before and after 3 and 6 weeks of treatment, both groups were evaluated using the mini-mental state examination (MMSE), the Montreal cognitive assessment (MoCA), the modified Barthel index (MBI) and the Fugl-Meyer assessment (FMA). In another 15 patients oxyhemoglobin levels in the brain before and during the MNES were observed using near-infrared spectroscopy.Results:After 3 weeks of treatment, a significant improvement was observed in the average MMSE, FMA and MBI scores of both groups, and the average MoCA score of the observation group. Three weeks later, the average MMSE, FMA, MBI and MoCA scores of both groups had improved significantly compared with before the treatment, with the average MMSE and MoCA improvements in the MNES group significantly greater than the control group′s averages. After 6 weeks of treatment the significant improvements persisted in both groups. Both group′s average FMA scores had also improved significantly, as had the average MBI score of the control group. After 6 weeks of treatment, the observation group′s average time orientation, location orientation, language instant memory, attention, calculation and short-term memory in MMSE had all improved significantly along with visual space capacity, executive capacity, attention, language, orientation and memory in MoCA. The spectroscopic results showed significantly improved oxyhemoglobin concentration in the bilateral frontal lobes after the MNES.Conclusions:Electrical stimulation of the median nerve can help to improve cognition after a stroke. It increases oxyhemoglobin concentration in the bilateral frontal lobes.
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Objective To investigate the biomechanical and pathological changes in vivo in the taut bands (TB) of biceps femoris in rats after repeated low-frequency electrical stimulation.Methods Twenty-eight Wistar rats were randomly divided into a control group,an electrical intensity-dependent fatigue group,which were subject to electric intensity-dependent fatigue test,and an electrical frequency-dependent fatigue group,which were subject to electrical frequency-dependent fatigue test.After fatigue tests,the taut band of the biceps femoris and the non-taut band of the contralateral biceps femoris were harvested for pathological observation.The maximum contraction force (MCF),electrical intensity-and frequency-dependent fatigue characteristics and any pathological changes in the TBs were assessed and compared to the non-taut band region of the other biceps femoris.Results The MCF at the 15th and 20th stimulation (1.42 ± 0.28 g and 0.93 ± 0.54 g respectively) were significantly lower than that at the 1 st and 5th stimulation of the TBs.High stimulation intensity (HSI) at the 15th and 20th stimulation (3.76 ± 0.71 V and 3.44 ± 0.97 V) were also significantly lower than at the 1st TB stimulation.At the 10th,15th and 20th stimulation of the TBs,MCF and HSI were both significantly lower than in the bands which were not tight.In the frequency-dependent fatigue stimulation tests,the frequency which generated the MCF of the TBs was significantly lower than in the bands which were not tight,while the MCF of the TBs was significantly higher than that of non-TBs.After either intensity or frequency fatigue testing,more severe edema,uneven cytoplasmic death and degeneration of muscle fibers were observed in sections from TBs than from the bands which were not tight.Conclusions Taut muscle bands are significantly less fatigue-resistant than normal muscle fibers.Taut bands may contribute to the fatigue of myofascial pain syndromes.
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Objective To quantify the temporal changes in the volume of blood flow to the skin of the forearm and lower leg during static maximum inspiratory breath-holding of different durations.Methods Blood flow to the skin of the forearm and lower leg were continuously measured with laser Doppler flowmetry in 12 healthy subjects.They were randomly selected to hold their breath for 10,20 or 40 seconds,or as long as possible.The volume of skin blood flow,the onset latency and the recovery latency were measured before,during and after the breath holding.Results Blood flow decreased significantly during each breath-hold with any durations.The magnitude of the decrease and its latencies were similar with all the durations.The average volume of skin blood flow and it's minimum value during each breath-hold were significantly lower in the forearms than in the lower legs.However,the average onset latency (4.41 ±0.44 s) and the average recovery latency (5.95 ±0.59 s) in the forearms were significantly shorter than in the lower legs (4.83 ± 0.70 s for onset and 7.33 ± 0.91 s for recovery).Conclusion The volume of skin blood flow decreases during a static maximum inspiratory breath-hold,and the magnitude of the increase is not related to the duration of the breath-hold.The generalized increase in skin sympathetic vasoconstrictor activity during a static breath-hold is greater in the forearm than in the lower leg.
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Objective To observe the effects of intensive training at different intensities on the expressions of semaphorin 3A ( Sema 3A) and its receptor neuropilin ( NP-1 ) and the cell apoptosis in cerebrum after cerebral ischemia-reperfusion in rats,and to investigate the possible mechanism of intensive training in recovery of motor function after cerebral ischemia-reperfusion in rats.Methods To establish animal model of cerebral ischemia-reperfusion in rats,the intraluminal thread method was applied to cause left middle cerebral artery occlusion (MCAO) for 2 h and before reperfusion.After cerebral ischemia-reperfusion model were established for 24 h,60 male model Wistar rats were randomly divided into training group 1 ( swimming for 5 min once a day),training group 2 ( swimming for 10 min once a day),training group 3 (swimming for 10 min twice a day) and control group (no training) ; another 15 rats assigned to the sham-operation group were subject to no MCAO and no training.Neurological function was evaluated by Garcia scores,and terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) was performed to dectect the cortical cell apoptosis.Expressions of neural growth inhibition factor Sema 3A and its receptor NP-1 were detected by immunohistochemistry.Results The neurological function in sham-operation group was normal.The differences of Garcia scores at different time points beween sham-operation group and control group were significant (P ＜ 0.01 ).Garcia scores in all training groups,were significantly higher than those in controls at the 7th and 14th d after swimming training ( P ＜ 0.01 ),especially in training group 3 the Garcia scores were ( 12.80 ± 0.45 ),( 15.20 ± 0.45 ),( 16.80 ± 0.45 ),respectively,at the 3rd,7th and 14th d after swimming training.The rates of positive cell of Sema 3A,NP-1 and TUNEL indexes in all training groups were lower than those in controls at the 3rd,7th and 14th d after swimming training (P ＜ 0.01 ),especially in the training group 3.At the 3rd,7th and 14th d after swimming training in training group 3,the rates of TUNEL indexes positive apoptosis cells were ( 29.43 ± 1.38 ) ％,( 22.30 ± 1.21 ) ％,( 17.58 ± 1.70) ％,respectively,the positive cell rates of Sema 3A were ( 19.64 ± 1.17) ％,(9.73 ± 3.83)％,(8.24 ± 0.87)％,respectively,the positive cell rates of NP-1 were ( 33.95 ± 6.86) ％,( 27.95 ± 1.29 ) ％,( 18.90 ± 1.44 ) ％,respectively,the reduction of positive cells expressions in training group 3 was significantly more obvious compared with other training groups (P ＜ 0.01 or 0.05).Conclusions Rehabilitation training can reduce the expression of positive cell of Sema 3A,NP-1 and TUNEL indexes in rats after cerebral ischemia-reperfusion and can improve motor function recovery and facilitate neural plasticity.The more intensive the training,the better the effects.
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Objective To observe the clinical efficacy of three-dimensional rapid traction combined with sacral hiatus epidural blocking for the treatment of lumbar disc herniation(LDH). Methods A totsl of 450 patients with LDH were divided into three groups.Group A received conventional slow traction,group B received three-dimensional rapid traction,and group C received sacral hiatus injections for epidural blocking combined with three-dimensional rapid traction.The Japanese Orthopadedic Association(JOA)scale for lumbar disease and a visual analogue scale(VAS)were used to evaluate the treatment effect and the patients'subsequent quality of life.All of the patients were followed up for 1 year and evaluated using standard clinical evaluations. Results The average VAS scores and JOA scores of the three groups were not significantly different before treatment,and all had significantly improved after treatment.The overall effectiveness rates were 63.33% for group A,90.67%for group B and 94% for group C,and these differences were all statistically significant.After one year the recurrence rates in the A,B and C groups were 20.7%,14.0%and 8.7% respectively,and these differences were again statistically significant.Conclusion Sacral hiatus epidural blocking combined with three-dimensional rapid traction showed good therapeutic effect and safety for LDH patients and was superior to simple rapid traction or slow traction.
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Objective: To evaluate the clinical effectiveness of multi-directional mechanical traction (MT) for the treatment of patients with lumbar disc herniation (LDH) compared with longitudinal traction (LT) as control. Method: This prospective, single-blind, randomized clinical trial was performed in Qi Lu Hospital, Shandong University from January 2008 to December 2008. One hundred and twenty outpatients with LDH were randomly divided into MT group or LT group. MT group was treated with computer-controlled multi-directional mechanical traction.LTgroupwastreatedwithlongitudinaltraction.RolandMorrisLowBackPainandDisability Questionnaire (RMDQ), visual analogue scale (VAS), and straight leg raising (SLR) angle were measured for every patient pre-, 4 weeks post-, and 1 year post-treatment.Result: The results of clinical observations showed significant improvements inRMDQ, VAS, and SLR angle assessments (all P＜0.05) in both groups 4 weeks post- and 1 year post-treatment compared with pre-treatment. Score of RMDQ in MT group was significantly lower than that in LT group(P＜0.05), however, there was no significant difference between two groups in VAS score and SLR angle (P＞0.05). The differences in improvement ratios between two groups were not significant (all P＞0.05). The clinical outcomes were negatively correlated with patient's age and disease duration.Conclusion: The effect of MT is equivalent and probably superior to that of LT in improving the symptoms and clinical findings of patients with LDH.
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Objective To investigate the biophysical properties of mechanosensitive(MS) channels in cultured dorsal root ganglion neurons of neonatal rats. Methods MS channels current of cultured dorsal root ganglion neurons of neonatal rats were recorded using cell-attached and inside-out patch-clamp technique.The biophysical properties such as pressure response relationship,current voltage relationship,channel kinetics and ion selectivity were analyzed.Membrane stretch was achieved by the application of negative pressure(suction) to a patch-clamp electrode. Results One type of MS non-selective cation ion channels in the membrane patches tested in cultured dorsal root ganglion neurons of neonatal rats were recorded. Those channels were activated rapidly when suction was applied, and kept active during sustained application of negative pressure and quickly turned off when the suction was released.The MS channels exhibited a nearly linear current voltage relationship in the balance solution.The outward chord conductance was (96.2?3.6)pS (mV is between +40 mV and +60 mV) and the inward slope conductance was (62.5?0.4)pS (mV is between -60 mV and 0 mV). This kind of channels appeared to be outward rectifier.The average reversal potential was (-2.3?0.8)mV.The channel kinetics analysis indicated that suction could significantly increase the duration of short-openings and long-openings and decrease that of long-closings,with no effects on short-closings. Conclusion The results of this study could serve as a reference to the understanding of electric activity of DRG neurons.
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Objective To study the mechanism of analgesic effects of the iontophoresis of aconitine on the rat with adjuvant arthritis. Methods Forty-five Wistar rats were randomly divided into a normal control group, a model group and a therapy group, with 15 rats in each group. The model of rat adjuvant arthritis(AA) was induced by injection of complete Freud′s adjuvant(0.1 ml) into the right ankle joint of the rats. The brain stem, hypothalami and local inflammation tissue of rats in the 3 groups were obtained after 1, 5 and 10 days of treatment, respectively. The concentrations of 5-HT, NE, ?-EP in brain stem, hypothalami and local inflammation tissue were detected with high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). Results It was shown that the 5-HT content in the inflammatory tissues was not significantly different from that in the model group after 1 day of treatment, but significantly lower than that in the model group after 5 to 10 days of treatment (P0.05). After 5 to 10 days of treatment, the brain stem NE content in the therapy group was significantly higher than that in the model group(P
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Objective To observe the morphologic changes of dorsal root ganglion in the lumbar region of rabbits after the nerve root was under chronic compression and inflammatory stimulation. Methods Twenty New Zealand rabbits were recruited for this study, of which 5 served as the control (control group), and the rest were randomized into 3 experimental subgroups: 10d group, 30d group, 90d group, respectively. The autologous nucleus pulposus from the tails (about 5mg) was put into the silastic tube (inner meter of 1.5mm, external diameter 2.5mm and length 12mm), which was inserted into the left L 7 intervertebral foramen to compress the lumbar nerve root. Sham operation was performed with the rabbits in the control group. The nerve root and the dorsal root ganglia were harvested and processed and observed with light microscope and electron microscope after 10d, 30d, 90d, respectively. Results In the 10d group, obvious hyperemia, edema and infiltration of inflammatory cells in the interspace of the intima of the dorsal root ganglia (DRG) could be observed. Pyknosis, degeneration and necrosis were also found in some of the nerve cells. Electron microscopic observation showed that the number of the rough endoplasmic reticulum and mitochondrion decreased, ribosome exfoliated, mitochondrion swelled. In 30d group, typical degeneration and necrosis became more obvious. Electron microscope showed that the number of lysosome and smooth endoplasmic reticulum increased, mitochondrion swelled and its cristae disappeared, nuclei concentrated and deviated. In 90d group, significant proliferation of fibrocyte could be observed. At the same time, dura mater and arachnoid of spinal cord around the nerve root were notably thickened, and became fibrogenesis. Electron microscope also showed the increment of the lysosome and smooth endoplasmic reticulum, the swelling of mitochondrion, the loss of its cristae and the concentration of the nucleolus in the central part of the nuclei. No significant changes were found in the control group. Conclusion Pathological changes of neural degeneration such as edema, inflammatory infiltration could be observed in dorsal root ganglion after the nerve root was under chronic compression and stimulation by autologous nucleus pulposus.
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Objective To investigate the clinical effect of systemic rehabilitation on stiffness of finger joints after hand injury. Methods A total of 213 stiff fingers were observed in patients with hand injury. All the patients were administered with therapeutic exercise, physical modalities and splinting. The improvement of the patients in terms of active range of motion (AROM) and passive range of motion (PROM) of their fingers was graded as excellent, good, adequate or poor according to the standard the authors set. Results With regard to their AROM and PROM, 82.2% and 94.8% of the patients got excellent improvement, 97.7% and 100% of the patients got excellent to adequate improvement, respectively. The finger function was increased from 17% to 56%. Conclusion Systemic rehabilitation can increase the AROM and PROM of stiff finger effectively and improve the patients' hand function.