Combining extracorporeal shock wave treatment with proprioceptive neuromuscular facilitation can improve the lower limb motor function of stroke survivors with foot drop / 中华物理医学与康复杂志

Objective:To observe any effect of combining extracorporeal shock wave stimulation with proprioceptive neuromuscular facilitation (PNF) on the lower limb motor function of stroke survivors with foot drop.Methods:Thirty-six stroke survivors with foot drop were randomly divided into an extracorporeal shock wave group, a PNF group and a combination group, each of 12. The extracorporeal shock wave group and PNF group were given those therapies alone, while the combination group was provided with both. The extracorporeal shock wave therapy protocol was 2000 times on each muscle at an intensity of 2.5 bar and a frequency of 10Hz, twice a week for 4 weeks, while the PNF was provided at least 3 times per week for 4 weeks. Before and after the intervention, all of the participants were evaluated using the modified Ashworth scale (MAS), the 10-metre walk test (10 MWT) and the Fugl-Meyer lower limb motor function scale (FMA). Active range of the ankle joint and toe out angle were also observed.Results:After the intervention the lower limb muscle tone had decreased significantly in 8 of the PNF group members and in 9 of those in the extracorporeal shock wave group, but it has decreased significantly in all 12 members of the combination group. And the average magnitude of the improvement was also significantly greater in the combination group than in the other two groups. Moreover, significant differences were observed in the active range of the ankle joint after the treatment in the combination group, but not in the other two groups. After the intervention the average 10 MWT times and FMA scores of the PNF and combination groups had improved significantly, but not those of the extracorporeal shock wave group, but significant improvement in toe out angles was observed in all three groups, though the average improvement in the combination group was significantly greater than in the other 2 groups.Conclusion:Combining extracorporeal shock waves with PNF can effectively improve the lower limb motor function of stroke survivors with foot drop.

Effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury / 浙江大学学报·医学版

OBJECTIVES@#To investigate the effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury.@*METHODS@#A total of 80 patients with incomplete spinal cord injury caused by thoracolumbar fracture admitted in Ningbo Yinzhou No.2 Hospital from April 2020 to December 2021 were randomly divided into control group and study group, with 40 cases in each group. In addition to routine training, the control group received torso training on stable surface and the study group received torso training on unstable surface. The gait, lower limb muscle strength, balance function, lower limb function, mobility and nerve function of the two groups were compared.@*RESULTS@#After treatment, the stride length, stride frequency and comfortable walking speed improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05). The muscle strength of quadriceps femoris, gluteus maximus, hamstring, anterior tibialis and gastrocnemius were improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05); the total trajectories of static eye opening and static eye closing gravity center movement in the two groups were significantly shorter (all P<0.05), and the improvements in the study group were more significant (all P<0.05). The dynamic stability limit range and the American Spinal Injury Association (ASIA) lower extremity motor score, Berg balance scale, modified Barthel index scale in the two groups were significantly higher (all P<0.05), and these scores in study group were significantly higher than those in the control group (all P<0.05). Both groups showed a significant improvement in ASIA grade (all P<0.05), and the improvement in the study group was significantly better (P<0.05).@*CONCLUSIONS@#Torso training on unstable surface can effectively improve the gait and lower limb muscle strength of patients with incomplete spinal cord injury and improve the lower limb motor function.

An exoskeleton robot can help improve the walking ability of stroke survivors / 中华物理医学与康复杂志

Objective:To explore the efficacy of a flat ground exoskeleton robot in improving the walking ability of stroke survivors.Methods:Fifty-eight stroke survivors with mobility difficulties were randomly divided into a robot group ( n=29) and a control group ( n=29). In addition to routine rehabilitation, the control group received conventional walking training, while the robot group underwent exoskeleton robot-assisted gait training. The 30-minute training sessions were held twice a day, 5 days per week for 5 weeks. Before as well as after 2 and 4 weeks of treatment, everyone′s walking ability was tested using the 6-minute walk test (6MWT) and functional ambulation scale (FAC). General lower limb motor function was quantified using the Fugl-Meyer Lower Extremity assessment (FMA-LE). Moreover, gait analysis was conducted before and after 4 weeks of treatment. Results:After 2 and 4 weeks of treatment, the average 6MWT times of both groups were significantly better than before the treatment, with the improvement of the robot group significantly greater than that of the control group after 2 weeks. After 2 and 4 weeks the average FMA-LE and FAC scores of both groups had improved significantly compared with before treatment. After 4 weeks the stride frequency and gait cycle of both groups had improved significantly.Conclusions:Exoskeleton robot-assisted gait training can improve walking ability and lower limb motor function of stroke survivors about as well as conventional walking training.

Advances on selective posterior rhizotomy for lower limb function in patients with cerebral palsy / 中国骨伤

Cerebral palsy is a common clinical syndrome of neurological disability in childhood, which seriously affects the quality of life of children and their families, and brings a heavy economic burden to the society. Domestic and foreign scholars had a long history of the application of selective posterior rhizotomy for the treatment of spastic cerebral palsy or mixed cerebral palsy with limb paralysis. It is effective in improving the lower extremity spasm of patients with cerebral palsy, and there are few cases with recurrences. After rehabilitation therapy, the muscle strength of patients with cerebral palsy was significantly improved compared with the previous one. The range of motion was significantly improved after operation, and there is no rebounded in aspect of joint activety in the long-term follow-up. The overall gait of the patient was significant improved. The author thought that selective posterior rhizotomy is effective in improving the motor function of lower limbs in patients with cerebral palsy, and it is worth being spread. However, it has to follow the principle of selecting appropriate cases before surgery, precise operation during operation, and timely and effective rehabilitation treatment after surgery, in order to achieve a better curative effect.

Posture analysis and intervention can improve the lower limb motor function of hemiplegic stroke survivors / 中华物理医学与康复杂志

Objective To investigate the effect of the posture analysis and intervention on the lower limb motor function of hemiplegic stroke survivors. Methods Forty hospitalized stroke survivors with hemiplegia were di-vided at random into a control group and an experimental group. The control group (n＝20) received conventional re-habilitation training. The experimental group (n＝20) additionally received therapy based on posture analysis. Before the treatment and after 2 and 4 weeks of treatment, Holden walking function grading was applied, along with Fugl-Meyer motor function rating, and the timed up and go test ( TUGT) was administered. Results After 2 weeks of treatment there were no statistically significant differences between the groups in terms of any of the measures. After 4 weeks of treatment the average Holden and Fugl-Meyer scores of the experimental group were significantly better than those of the control group, though there was still no significant difference in the two groups' average TUGT times. Conclusion Posture analysis-based intervention can improve the lower limb motor function of stroke patients with hemiplegia.

Effects of Balance Acupuncture Combined with Motor Relearning for Lower Limb Motor Function of Stroke Patients with Hemiplegia / 针刺研究

OBJECTIVE: To investigate the effect of balance acupuncture combined with motor relearning training on lower limb motor function in stroke patients with hemiplegia. METHODS: Eighty stroke patients were randomly assigned to motor relearning training group and balance acupuncture plus motor relearning group (n＝40 cases in each). The motor relearning training program consisting of upper-limb functional training, lying supine, bedside sitting, sitting-balancing, standing up and down, standing-balancing, walking, orofacial functional training, etc. was given to patients of the two groups. Balance acupuncture stimulating was applied to Piantan-， Jiantong-， Xitong-， Tuntong- and Huaitong-points for 30 min, once daily, 5 times a week for 8 weeks. The lower limb motor performance ability was assessed by using Fugl-Meyer Assessment (FMA-L) scale, the balance function assessed by using Berg balance scale (BBS), the motor ability evaluated by using Rivermead motor index (RMI), and the gait (walking speed, cadence, and step length) evaluated by using Brunnstrom hemiplegia gait evaluation scale. RESULTS: After the treatment, the scores of FMA-L, BBS, RMI and hemiplegia gait were significantly increased in the two groups compared with their own pre-treatment (P<0.05), and were significantly higher in the balance acupuncture plus motor relearning group than in the motor relearning training group (P<0.05). CONCLUSION: The balance acupuncture combined with motor relearning can improve lower limb motor function and balance function, and has a better effect than simple motor relearning training.

The treatment of continuous passive motion on lower motor function in patients with stroke / 安徽医科大学学报

Objective To observe the treatment of continuous passive motion ( CPM) on lower motor function in pa-tients with stroke.Methods 60 patients were evenly randomized into control group and treatment group .The control group received conventional rehabilitation treatment , while the treatment group received conventional rehabilitation and CPM therapy .They were assessed with modified Ashworth scale ( MAS) ,Fugl-Meyer assessment ( FMA) ( lower limb,hip,knee and ankle) and 10-meter walking time.Results After treatment,the scores of MAS,FMA and 10-meter walking time were both improved when compared with those before treatment (P<0.05),and between the two groups ,the scores of MAS , FMA and 10-meter walking time were much better in the treatment group with signifi-cant difference ( P<0.05 ) .Conclusion CPM can alleviate muscle spasms ,and enhance the muscle group coordi-nation on foot .Furthermore,CPM can contribute to the balance and lower limb motor function , and strengthen gait of patients with stroke .

Motor imagery therapy supplemented with scalp acupuncture for improving lower limb motor function after stroke / 中华物理医学与康复杂志

Objective To investigate the effect of motor imagery therapy supplemented with scalp acupuncture for improving the lower limb motor function of stroke patients with hemiplegia.Methods A total of 120 hemiplegic stroke patients were randomly divided into an experimental group and a control group with 60 patients in each.All were given routine medical care and scalp acupuncture (stimulating the posterior and anterior oblique line of the parietal-temporal lobe contralateral to the hemiplegic limb).The treatment was given daily for 3 weeks as one session,and 2 sessions were administered to both groups.The experimental group was given motor imagery therapy in addition.Each treatment took about 25 min every day for 3 weeks as one session,and again 2 consecutive sessions were administered.The temporal and spatial gait parameters (10m maximum walking speed,stride length and cadence) of all of the patients were assessed,the Fugl-Meyer lower extremity assessment (FMA-L) was conducted and functional ambulation classifications (FACs) were assigned before therapy and at the end of the 6 weeks.Results After 6 weeks of treatment,all of the measures had improved significantly for both groups.The experimental group,however,had improved significantly more than the control group.Conclusion Motor imagery therapy can supplement scalp acupuncture to improve lower limb motor function in hemiplegic stroke patients.

The effects of cycling on the lower limb motor function and walking ability of hemiplegic stroke patients / 中华物理医学与康复杂志

Objective To investigate the effects of exercising on a cycle ergometer on lower limb motor function and the walking ability of hemiplegic stroke patients.MethodsSixty hemiplegic stroke patients were randomly divided into a treatment group and a control group with 30 in each. Both groups were treated with routine rehabilitation, but the treatment group also undertook cycle ergometer training. The training lasted for 10-20 min/d, 6 d/week for 6 weeks. All patients were assessed with the Fugl-Meyer lower limb assessment ( FMA), functional ambulation category (FAC) classification and the modified Barthel index (MBI) pretreatment and 6 weeks post treatment.ResultsBefore intervention there was no significant difference between the two groups in any of the assessments. Six weeks post treatment, the average FMA, FCA classification and MBI results in the treatment group were significantly better than those pretreatment and better than those in the control group.ConclusionsCycling exercise combined with routine rehabilitation training can distinctly improve the motor function of the lower limbs and the walking ability of hemiplegic stroke patients.

Relationship between Motor Function and Balance for Spastic Hemiplegia after Stroke / 中国康复理论与实践

@#ObjectiveTo discuss the relationships among spastic paralysis and motor function, balance function and other clinical variables after stroke.MethodsAssessed the clinical spastic index of hemiplegic lower limbs with CSI scale, motor function with Fugl-Meyer Assessment, and balance function with Berg Equilibrium Scale, respectively. And then analyzed the relationship between clinical spasm index with motor function, balance function of the hemiplegic lower limbs with Pearson correlation analysis. Finally, ascertained which was the most important factor affecting the clinical spasm index of spastic lower limbs with stepwise regression analysis.ResultsThere is negative correlation between clinical spasm index with motor function and balance function, respectively. Tendon reflex, muscular tension and clonus are the deciding factors to motor function(P<0.05) and balance function(P<0.05) of the hemiplegic lower limbs.ConclusionThe clinical spasm index of hemiplegic limbs can affect the recovery of motor function and balance function significantly. So, assessing and improving the clinical spasm index of paralytic lower limbs can optimize the rehabilitation program to stroke patients.