Influence of hydrotherapy combined with breathing training on lung function and activity ability of patients with thoracolumbar spinal cord injury / 中国综合临床

Objective:To explore the effect of hydrotherapy combined with breathing training on lung function and mobility of patients with thoracolumbar spinal cord injury.Methods:A total of 80 patients with thoracolumbar spinal cord injury admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from April 2018 to March 2020 were selected as observation objects.A prospective cohort study was conducted and randomly divided into observation group and control group with 40 cases in each group.The control group was given routine rehabilitation therapy combined with respiratory training.On the basis of the control group, the observation group was treated with water therapy.The indexes of lung function, motor function, lower limb muscle tension, function evaluation and activities of daily living were compared between the two groups.Results:After intervention, the observation group′s forced vital capacity (FVC) was (3.86±0.82) L, the forced expiratory volume in the first second (FEV1) was (3.76±0.68) L, the maximum ventilation (MVV) was (102.34±10.38) L/min, the maximum suction pressure (MIP) is (50.36±4.62) cmH 2O; the control group FVC was (3.41±0.76) L, and FEV1 was ( 3.35±0.63) L, MVV was (90.67±11.68) L/min, MIP was (44.38±4.85) cmH 2O, the difference between the two groups is statistically significant ( t=2.546, 2.797, 4.723, 5.646, respectively, all P<0.05). After the intervention, the motor function score of the american spinal injury association (ASIA) of the observation group was (58.62±7.56) points, and the modified ashworth scale (MAS) score was (2.74±0.89) points; The ASIA motor function score of the control group was (42.24±6.40) points, and the MAS score was (3.36±0.94) points.The difference between the two groups was statistically significant ( t=10.459 and -3.029, respectively, all P<0.05). After intervention, the observation group′s spinal cord independence measure (SCIM III) score was (75.33±10.72) points, and the modified barthel index (MBI) was (66.64±6.34) points; the SCIM III score of the control group was (68.34±9.55) points, and the MBI score was (57.52±6.77) points, the difference between the two groups was statistically significant ( t=3.079 and 6.219, respectively, all P<0.05). Conclusion:Hydrotherapy combined with breathing training can significantly improve lung function and respiratory muscle strength in patients with thoracolumbar spinal cord injury, and improve motor function and ability of daily living.

Exploration of subprofessional training of rehabilitation therapists based on the model of rehabilitation and clinical medicine integration / 中华医院管理杂志

The demand for rehabilitation therapists is rising in response to social development, disease spectrum changes and population aging. Under the guidance of the integration of rehabilitation and clinical medicine, Beijing Rehabilitation Hospital has carried out a comprehensive scientific design and practice in the sub-professional training mode for new rehabilitation therapists according to the discipline development and clinical needs, strengthened their training of sub-professional skills, and provided an effective way to standardize the profession admission and specialty advancement.

Exploration on an integrated care mode of rehabilitation by both clinicians and physiatrists at a rehabilitation hospital / 中华医院管理杂志

Tertiary rehabilitation hospitals should not only serve patients with systemic and specialized rehabilitations but also have capabilities in diagnosis/treatment,and even emergency responses.This paper introduced an integrated care mode at a rehabilitation hospital,in practicing in-depth and phased integration of clinical service and rehabilitation.Phase 1 (March 2015-March 2016) witnessed the "two-way" model,with coexisting rehabilitation pathway and clinical pathway.The second phase,from April 2016 to September 2017,witnessed the integrated care mode in which clinicians and physiatrists jointly took care of patients.A comparison between the same period of 2016 with data of 2015,and that of 2017 with data of 2016,found average length of stay was shortened by 0.5 day and 3.6 days respectively,the drug ratio fell by 4.63％ and 8.47％ respectively;the rehabilitation effective percentage was increased from 95.2％ to 98.0％.The percentage of cure or improvement for primary diseases was over 97％.The integrated care mode by both clinicians and physiatrists can shorten the length of stay,lower the drug ratio,raise medical efficiency,and encourage a more reasonable ratio of medical expenses.

Effects of focal vibration on the physical properties of the muscles of patients with neck-shoulder pain / 中华物理医学与康复杂志

Objective To evaluate the effects of focal vibration on the physical properties and surface electroyograms of persons with neck-shoulder pain.Methods Thirty-four patients with neck-shoulder pain received 3 to 5 applications of vibratory stimulation of the inner side of the trapezius and scapula for 30 s each time.They reported their pain level using a visual analogue scale.Muscle tone and the elasticity and stiffness of the trapezius muscle were measured bilaterally using a MyotonPRO Muscular Function Evaluation System.Surface electromyography (sEMG) was performed bilaterally during arm extension while standing.The testing was repeated four times:before treatment (baseline),immediately after treatment (IAT),2 hours after treatment (2AT) and 6 hours after treatment (6AT).Results There was a significant reduction in reported pain at IAT and 2AT compared to baseline,but no significant difference was found between the perceived pain at baseline and at 6AT.The values of oscillation frequency,logarithmic decrement and dynamic stiffness had decreased significantly at IAT and 2AT compared to baseline.The average AEMG during upper-arm flexion of the trapezius on the painful side had increased significantly at IAT comparcd to that before the treatment,while the average IEMG and MF were both significantly higher than before the treatment.At 2AT the average AEMG and IEMG were both still significantly higher than at the baseline,but there was no longer a significant difference in the average MF.By 6AT none of the three indicators differed significantly from those before the treatment.Conclusions A single session of focal vibration can relieve pain,increase muscle activation as well as decrease muscle stiffness for people with neck-shoulder pain within 2 hours.

Effect of Robot-assisted Gait Training on Lower Limb Motor Function and Gait Ability in Patients with Hemiple-gia after Stroke / 中国康复理论与实践

Objective To explore the effect of robot-assisted gait training on the lower limb motor function and gait ability in patients with hemiplegia after stroke. Methods From January, 2015 to October 2016, 60 patients with hemiplegia after stroke were randomly divided into control group (n=30) and experimental group (n=30). Both groups received conventional rehabilitation, while the experimental group was given robot-assisted gait training and the control group was given artificial assisted gait training, 30 minutes a day, five days a week for eight weeks. They were evaluated with Fugl-Meyer Assessment-Lower Limb (FMA-LE), muscle strength of hip flexion (L-FORCE/HIP/Flex, FHF) and knee extension (L-FORCE/KNEE/Ext, FKE), Six Minutes Walking Distance and Ten Meters Walking Time before and after training. Results There was no significant difference in general data and all indexes between two groups before training (P>0.05). The scores of all the indexes improved in the experimental group after training (t>2.274, P2.095, P<0.05), except FKE. Conclusion Robot-assisted gait training can effectively improve the lower limb motor function and gait ability of patients with hemiplegia after stroke.

Correlation of Isokinetic Parameter and Modified Ashworth Scale Applied in Evaluation of Ankle Spasticity / 中国康复理论与实践

Objective To study the correlation between isokinetic parameters and modified Ashworth Scale (MAS) in ankle spasticity as-sessment. Methods 18 stroke patients (spasticity group) and 16 healthy subjects (control group) in our hospitals from August 2014 to March 2015 were included. MAS was used to assess the ankle muscular tension. The ankle passive movement of both groups was measured with BIODEX isokinetic motor assessment system under 10 °/s, 60 °/s, 120 °/s, 180 °/s, 240 °/s. The peak torque (PT), peak torque/body weight (PT/BW), average torque (AT), and slopes of the linear regression curve of torque-velocity (SLOPE) were recorded. The correlation of the isokinetic paramenters and the MAS were tested with Spearman correlation analysis. Results The PT, PT/BW and AT were higher in the spasticity group than in the control group (P<0.05). And they increased as the angular velocity increased, and slowed after 120 °/s. The corre-lation coefficient of MAS and PT, PT/BW, AT, SLOPE were from 0.3043 to 0.7632 (P<0.01). Conclusion The isokinetic parameters were speed-dependent and closely related to MAS. 120 °/s was of the highest sensitivity, and the SLOPE under this anglular velocity was highly correlated with MAS.

Relationship between Corticospinal Cord Tract and Upper Limb Function in Stroke Patient: A Diffusion Tensor Imaging Study / 中国康复理论与实践

@#Objective To observe the relationship between injury of corticospinal cord tract (CST) in basal ganglia and upper limb func-tion after stroke using diffusion tensor imaging (DTI). Methods 18 stroke inpatients hospitalized from January, 2013 to July, 2015 accepted DTI, and their upper limb function was evaluated with simple Fugl-Meyer Assessment and Japan Upper Limb Function Test. The fractional anisotropy (FA) of CST in basal ganglia of affected and unaffected sides were compared, and the correlation between FA of affected CST and upper limb motor function were analyzed. Results The FA was significantly less in the affected CST than in the unaffected CST (t=-21.09, P<0.001). The FA of the affected CST correlated with the scores of simple Fugl-Meyer Assessment (r=0.570, P<0.05) and Japan Upper Limb Function Test (r=0.509, P<0.05). Conclusion CST is injured after stroke, which may related to the upper limbs motor function impairment.

Application of Diffusion Tensor Imaging in Stroke Rehabilitation (review) / 中国康复理论与实践

Diffusion tensor imaging is a non-invasive MRI technique which can identify changes of cerebral microstructure that CT and MRI is difficult to find, especially in the change of nerve fibers direction, which can be used for the researches of evaluation, recovery mech-anism and prognosis of neurology. It has been applied in rehabilitation of motor, language and recognition of post-stroke patients.

Clinical Effect of Repetitive Peripheral Magnetic Stimulation on Chronic Non-specific Low Back Pain / 中国康复理论与实践

Objective To observe the clinical effect of repetitive peripheral magnetic stimulation (RPMS) on chronic non-specific low back pain (CNLBP) patients. Methods 43 CNLBP patients were assigned to experimental group (n=22) and control group (n=21). Both groups received routine physical therapy. The experimental group accepted RPMS and core stability training (CST), and the control group accepted sham magnetic stimulation and CST in addition. Clinical effect was evaluated by Visual Analogue Scale (VAS) and Oswestry Dys-function Index (ODI). All the patients were assessed with Modified Clinical Test of Sensory Integration of Balance (mCTSIB) to observe the center of gravity (COG) sway velocity under 4 testing conditions. Results 4 weeks after treatment, the VAS and ODI scores were significant-ly decreased in both groups (P0.05). The scores of VAS and ODI were sig-nificantly lower in the experiment group than in the control group after treatment (P<0.001). The COG sway velocity under eye open foam support and eye close foam support were lower in the experiment group than in the control group after treatment (P<0.05). Conclusion Com-bination of RPMS could improve the clinical symptoms and the posture control ability under complex environment.

Effect of Cervical Stability Training on Cervical Vertigo / 中国康复理论与实践

@#ObjectiveTo investigate the effects of cervical stability training on cervical vertigo. Methods67 patients were divided into 2 groups. The experiment group was treated with Neurac (neuromuscular activation) for cervical stability training, meanwhile, the control ones with manipulation. They were assessed with clinical assessment and fall index before and 14 d after treatment. ResultsThe scores of clinical assessment and value of fall index were significant improved more in experiment group than in controls （P＜0.05）. ConclusionSpecific cervical stability training is effective on cervical vertigo based on cervical instability and proprioceptive disorder.