Exercise combined with rehmannia polysaccharide can restore neurological functioning after cerebral ischemia and reperfusion / 中华物理医学与康复杂志

Objective:To explore the effect of combining exercise training with the administration of rehmannia polysaccharide on the recovery of neurological function after cerebral ischemia and reperfusion, and its mechanism.Methods:Sixty Sprague-Dawley rats were randomly divided into a sham operation group, a model group, an exercise training group, a rehmannia polysaccharide 10mg group, a rehmannia polysaccharide 20mg group and a rehmannia polysaccharide 40mg group, each of 10. The cerebral ischemia-reperfusion injury model was induced in all of the rats except those of the sham operation group. After the modelling, the rats not receiving rehmannia polysaccharide were given normal saline solution daily for 6 weeks. The other rats received rehmannia polysaccharide at 10mg, 20mg or 40mg dosage as appropriate. All of the rats exercised. After the intervention, the 6 groups were evaluated through neurological deficit scoring, and their learning and memory ability was assessed using the Morris water maze test. The levels of interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNF-α) in serum as well as superoxide dismutase (SOD) levels were measured using enzyme-linked immunosorbent assays. Protein, methylene dioxyamphetamine (MDA) and nitric oxide levels were detected using the bicinchonininc acid method, the nitrate reductase method and the thiobarbituric acid method respectively. Western blotting was used to detect the expression of phosphorylated p65 (p-p65) and phosphorylation of nuclear factor κB inhibitor protein α (p-IκBα).Results:After 6 weeks of treatment the average neurological deficit scores of all groups except the sham operation group had improved significantly. Compared with the model group, the average neurological deficit scores of the training group and the drug groups had decreased significantly. Compared with the exercise training group, the average neurological deficit scores of the three rehmannia polysaccharide groups had decreased significantly. The average latency of the model group was at that point significantly longer than that of the sham operation group, while its memory ability was significantly weaker. However, the average learning latencies of the exercise training group and the 3 drug groups were significantly lower than that of the model group, while their memory was significantly better. The average learning latencies of the 3 drug groups were all significantly shorter than that of the exercise training group, while their memory was significantly better. After the 6 weeks of medication the average IL-6, IL-1β and TNF-α levels of the model group were significantly higher than those of the other 5 groups. Those of the 3 drug groups were significantly different from that of the exercise training group. The average SOD activity in the brain tissue of the model group was significantly lower than that of the sham operation group, while the average levels of NO and MDA were significantly higher. Compared with the model group, the average SOD activity in the exercise group′s brain tissue and that of the three rehmannia glutinosa groups had increased significantly, while the levels of NO and MDA had decreased significantly. The average SOD activity of the three drug groups was significantly higher than that of the exercise training group, while the average levels of NO and MDA were significantly lower. After 6 weeks of medication, compared with the sham operation group, the average levels of p-p65 and p-IκBα protein in the brain tissue of the model group had increased significantly, while compared with the model group, the average levels of p-p65 and p-IκBα protein in the exercise training group and the three drug groups had decreased significantly. Moreover, those levels in the three drug groups were significantly lower than in the exercise training group.Conclusion:Combining exercise with polysaccharide administration can better restore neurological function after cerebral ischemia and reperfusion, at least in rats. It improves learning ability and memory, perhaps by reducing oxidative stress, inhibiting activation of the NF-κB pathway, and slowing the inflammatory response.

Botulinum toxin type A injection in the treatment of dystonia after a stroke / 中华物理医学与康复杂志

Objective To observe the effect of injecting botulinum toxin type A on muscle tension,disability level and ability in the activities of daily living in patients with post-stroke dystonia.Methods Thirty-two patients with post-stroke dystonia were divided into an observation group (n =16) and a control group (n =15).The patients in the observation group were injected with 200-600 U of botulinum toxin type A in the relevant muscles,while the patients in the control group were given 12 mg diphenhydrazole hydrochloride tablets orally.Before and 2,6 and 12 weeks after the treatment,spasticity,disability and daily living ability were evaluated in both groups using the modified Ashworth scale (MAS),a disability assessment scale (DAS) and the modified Barthel index (MBI).Results After the treatment,the average MAS,DAS and MBI scores of both groups were significantly better than before the treatment.And the average MAS,DAS and MBI scores of the observation group were significantly better than those of the control group.Conclusion Botulinum toxin A injection can significantly improve dystonia and relieve disability among stroke survivors.

Surface functional electrical stimulation combined with electroacupuncture in treating neurogenic bladder after the spinal cord injury / 中华物理医学与康复杂志

Objective To observe the therapeutic effect of surface functional electrical stimulation combined with electroacupuncture on neurogenic bladder after the spinal cord injury.Methods Forty cases of neurogenic bladder after the spinal cord injury were randomly divided into a control group (n =20) and a combination group (n =20).The combination group was treated with surface functional electrical stimulation combined with electroacupuncture on the basis of internal urethral catheterization,while the control group was treated with surface functional electrical stimulation on the basis of internal urethral catheterization.The bladder urination was tested using urodynamic study before and after two months of treatment.Results There was no significant difference between the 2 groups in the average maximum bladder capacity,detrusor pressure at filling time,maximal urethral closure pressure,maximum urine flow rate and residual urine volume before the treatment.After the treatment,however,the average maximum bladder capacity,maximal urethral closure pressure and maximum urine flow rate in the combination group were significantly higher than those of the control group,while the average detrusor pressure at filling time and the residual urine volume of the combination group were significantly lower than the control group.Conclusion Surface functional electrical stimulation combined with electroacupuncture could remarkably improve bladder function of patients with the neurogenic bladder after the spinal cord injury.

The risk factors of deep vein thrombosis in the lower extremities among acute spinal cord injury patients / 中华物理医学与康复杂志

Objective To identify the risk factors for deep vein thrombosis(DVT) in the lower extremities during hospitalization for acute spinal cord injury(SCI).Methods Retrospective data analyses were performed for 49 SCI patients admitted within a week after they were diagnosed.The patients were divided into a DVT-free(n =40) group and a DVT group(n =9) according to their lower limbs' color Doppler ultrasound results.And the subjects' gender,age,chronic diseases (diabetes,hypertension and hyperlipidemia,etc.),complications (pulmonary infection,urinary tract infections and pressure sores,etc.),the history of cancer,smoking history and lower extremity fractures were recorded.Intermittent pneumatic compression treatment,the early rehabilitation intervention,antithrombotic therapy,history of venous catheterization,operative intervention,blood transfusion history,muscle strength of lower extremity and time from onset to being transfered to rehabilitation department were also recorded Single factor analysis,was conducted,followed by Binary logistic regression to pick out the risk factors for DVT.Results The result of the binary logistic regression analysis showed that gender (OR 6.87 ; 95％ CI 1.09-43.22 ;P ＜ 0.05) and intermittent pneumatic compression treatment (OR 12.47 ; 95％ CI 1.09-142.36 ; P ＜ 0.05) were significant predictors of DVT.Conclusion Gender and intermittent pneumatic compression treatment are related with DVT risk for patients with acute SCI.

The effects of proprioception training and intra-articular injections of sodium hyaluronate on knee osteoarthritis in the elderly / 中华物理医学与康复杂志

Objective To observe any therapeutic effect of proprioception training and intra-articular injection of sodium hyaluronate on knee osteoarthritis (KOA) in the elderly.Methods Forty-five patients with KOA were randomly divided into a treatment group (23 cases) and a control group (22 cases).The arthritic knees of both groups were treated with sodium hyaluronate injections,but the patients in the treatment group also received proprioception training.Before treatment,and after 5 weeks and 3 months of treatment,knee function was assessed against Lysholm's assessment standard.Results There was no significant difference in the average Lysholm scores of the two groups before treatment.After 5 weeks and 3 months the patients in each group scored significantly higher than before treatment.After 3 months the average score of the treatment group was significantly higher than that of the control group.Conclusion Proprioception training and sodium hyaluronate injections together constitute a useful method to treat KOA in elderly patients.

Effects of exercise on memory of mice with dementia and possible mechanisms / 中华物理医学与康复杂志

Objective To investigate the effects of exercise on memory impairment in demented mice and possible molecular mechanisms.Methods Thirty Kunming nice were divided into a normal control group,a dementia group and a dementia plus exercise training group (exercise training group),10 mice/group. Dementia models were established by intraperitoneal injection of scopolamine.Exercise training was begun 30 min after the injection and lasted for a 6-week period. A water maze test was performed after the exercise training. Brain-derived neurotrophic factor (BDNF) expression and protein kinase (Akt) phosphorylation in the hippocampus were detected by Western blot analysis.Nitric oxide (NO) content and superoxide dismutase (SOD) activity in the hippocampus were also measured.ResultsDementia models were successfully induced as indicated by prolonged escape latency in the water maze test.After exercise training the escape latency had shortened significantly and hippocanpal BDNF expression and Akt phosphorylation had increased.NO content increased and SOD activity decreased after the injections,but these effects were partially reversed after exercise training.Conclusions Exercise can improve spatial memory significantly after scopolanine-induced dementia in mice.The increased hippocampal BDNF expression and Akt phosphorylation,increased SOD activity and decreased NO content may partially explain the behavior improvement induced by exercise.