RESUMO
Objective To investigate the effect of graded motor imagery ( GMI) therapy combined with rou-tine occupational therapy on the recovery of upper extremity function after stroke. Methods Thirty stroke survivors who met inclusion criteria were randomly assigned to a control group ( n=15) or a GMI group ( n=15) . The control group received routine medication, conventional physical therapy and routine occupational therapy ( one hour a day) , while the GMI group received 30 minutes of routine occupational therapy and 30 minutes of graded motor imagery therapy every day in addition to conventional medication and physical therapy. Before and after four weeks of treat-ment, the patients in both groups were evaluated using the Fugl-Meyer Assessment for the Upper Extremities ( FMA-UE) , the Box and Block Test ( BBT) and Brunnstrom arm and hand staging. Surface electromyography of the biceps brachii and triceps brachii was performed as the affected elbow flexed and stretched in maximum isometric contrac-tions, and the co-contraction ratios ( CRs) were calculated. Results After the treatment, the average FMA-UE score, Brunnstrom arm and hand stage, BBT and CR scores in both groups had improved significantly. The average improvement in the GMI group was significantly greater than in the control group. Conclusions Graded motor im-agery therapy can significantly promote motor recovery of the upper extremities of hemiplegic patients after a stroke.
RESUMO
Objective To systematically evaluate the efficacy and safety of duloxetine and sertraline for Chinese depression patients.Methods The randomized controlled trials(RCTs)comparing the efficacy and safety of duloxetine and sertraline in the treatment of depression were retrieved from databases and the quality of literature was evaluated.Meta-analysis was performed with the software Revman 5.2.Results Eighteen RCTs involving 1 557 Chinese depression patients were included.The results of Meta-analysis showed that there were no significant differences in efficacy and cure rate between duloxetine and sertraline groups(OR=1.28, 95%CI:0.94 -1.73, P =0.11; OR =1.25,95%CI:0.97 -1.62,P =0.09, respectively).The Hamilton Depression Scale(HAMD)scores were significantly lower in duloxetine group than those in sertraline group at 1,2 weeks after treatment;however,there were no significant differences at 8-weeks after treatment between duloxetine and sertraline groups.The score of Medical Outcomes Study Pain Measures(MOSPM)in duloxetine group was significantly lower than that in sertraline group(P<0.01). The rate of insomnia in duloxetine group was significantly lower than that in sertraline group(RR=0.57, 95%CI:0.32 -1.00, P=0.04).There were no significant differences in other common side reactions between the two groups(P>0.05).Conclusions Duloxetine has similar long term treatment effect as sertraline,but it has a rapid-action profile.Duloxetine is more effective than sertraline in depression with painful physical symptoms;besides,duloxetine is less likely to induce insomnia.