Transcranial magnetic stimulation for monitoring the rehabilitation of upper-extremity function after stroke / 中华物理医学与康复杂志

Objective To evaluate the effect of the transcranial magnetic stimulation on upper-extremity function rehabilitation and changes in the excitability of cerebral cortex,and to evaluate from the viewpoint of electro-physiology the prognosis so as to guide the rehabilitation treatment of patients after stroke.Methods Forty-six patients in the early stage after a stroke were given TMS examinations of the ipsilateral brain region.Those with the motor evoked potentials (MEPs) amplitudes lower than 50 μV were classified into a motion-induced experimental negative group (the negative group),whiie those whose MEP amplitude reached 50 μV or more were classified as movement-induced positive (the positive group).Both groups were given the same treatment.Before and after 2,4 and 8 weeks of treatment the Fugl-Meyer movement function rating scale was used to assess their bilateral upper limb movement function.TMS technology was used to detect any change in the resting motor threshold (RMT) and the amplitude (Amp) of MEPs in the motor cortex.The incubation period of the cortex (CL) and the central motor conduction time (CMCT) in the contralateral motor cerebral cortex were also observed.Results After 4 weeks of treatment,the average score of the positive group on Fugl-Meyer upper movement function rating scale reached (54.99±2.76),significantly higher than before treatment and significantly higher than the negative group's average (P＜0.05).After 8 weeks of treatment,the average score in the positive group had increased further to 73.11±2.98,still significantly higher than that of the negative group (P＜0.01).After treatment,RMT decreased progressively in both groups,but that of the negative group dropped from (98.35±10.12) to (30.35±7.31) (9＜0.01),with significantly greater decline in amplitude and rate than that of the positive group (P＜0.05).After treatment,the Amp of both groups showed a gradual increasing trend.Amp increased earlier in the positive group,but there was no significant difference in the extent of the increase between the two groups (P＞0.05).After the treatment the CL and CMCT had shortened significantly in the negative group compared to before the treatment (P＜0.05),while there was no significant change in CL and CMCT after the treatment (P＞0.05).Conclusions The excitability of the contralateral motor cortex changes after a stroke.TMS can be used to characterize the MEP to monitor and predict recovery.This should help clinicians prepare more scientific rehabilitation plans.

Observation on Therapeutic Effect of Yin-yang Meridian Acupuncture by Reinforcing-reducing with Patient's Respiration on Lower Limb Function among Post-stroke Patients / 世界科学技术-中医药现代化

This study was aimed to investigate the therapeutic effect of yin-yang meridian acupuncture by reinforc-ing-reducing with patient's respiration on lower limb function among post-stroke patients. A total of 100 stroke pa-tients were enrolled and randomly divided into two groups, which were the control group and the treatment group, with 50 cases in each group. Basic treatment was given in the control group with no related rehabilitation treatment. Basic treatment was given in the treatment group combined with yin-yang meridian acupuncture by reinforcing-re-ducing with patient's respiration. All patients were assessed with kinematics time parameters at the beginning of the treatment and 28 days after the treatment on muscle strength, muscular tension and the change of joint movement of hip joint and knee joint among patients. The results showed that compared with the control group, there was significant difference in treatment group on muscle strength, muscular tension and the change of joint movement of the hip joint and knee joint 28 days after the treatment (P < 0.01). It was concluded that yin-yang meridian acupuncture by reinforcing-reducing with patient's respiration can effectively increase the muscle strength, reduce muscular tension, and improve the change of joint movement, in order to increase the lower limb movement func-tion among stroke patients.

The effect of low frequency repetitive transcranial magnetic stimulation on acute cerebral infarction patients movement function recovery / 中国医师进修杂志

Objective To investigate low frequency repetitive transcranial magnetic stimulation (rTMS) on acute cerebral infarction (ACI) patients movement function recovery,in order to provide certain reference basis about the further research on low frequency rTMS treatment ACI and clinical application.Methods Sixty patients of ACI with unilateral limb movement function disorder were divided into low frequency rTMS group and control group by table of random digit with 30 cases each.Two groups were given the conventional drug treatment and rehabilitation training,low frequency rTMS group added low frequencyrTMS treatment 10 d on the basis of the above.Before treatment and after treatment 10 d and 40 d in patientswith the U.S.national institutes of nerve function defect score (NIHSS),Fugl-Meyer motion scale (FMA)score and Barthel index (BI) score changes were observed.Results Before treatment the NIHSS,BI score,FMA score in low frequency rTMS group were (16.44 ± 3.29),(36.69 ± 5.97),(31.06 ± 7.43) scores,incontrol group were (16.38 ±4.01),(35.98 ±6.41),(30.87 ±8.56) scores,there was no significantdifference between the two groups (P ＞ 0.05).After treatment 10 d the NIHSS,BI score,FMA score in lowfrequency rTMS group were (8.13 ± 2.18),(56.04 ± 5.21),(48.42 ± 7.73) scores,in control group were(11.23 ± 1.97),(50.12 ±4.88),(42.12 ±8.61) scores.After treatment 40 d the NIHSS,BI score,FMAscore in low frequency rTMS group were (3.11 ± 0.53),(73.29 ± 5.34),(61.63 ± 8.36) scores,in controlgroup were (5.62 ±0.98),(63.96 ±4.46),(52.45 ±7.61) scores.The NIHSS in the two groups aftertreatment 10 d and 40 d was significantly lower than that before treatment (P ＜ 0.05),BI score and FMAscore was significantly higher than that before treatment (P ＜ 0.05).There were significant differences in theNIHSS,BI score,FMA score after treatment 10 d and 40 d of two groups (P ＜ 0.05).Conclusion Lowfrequency rTMS on ACI patients movement function recovery has obvious role in promotion.

Effect of community-based rehabilitation training on cognitive disorders of cerebral apoplexy patients / 中国基层医药

Objective To study the effects of community-based rehabilitation on cerebral apoplexy patients with cognitive disorders.Methods 30 cases of cerebral apoplexy patients were enrolled according to relevant standards,who were given standard rehabihtation care in Community Health Service Center(training group) ,while another 30 similar cases from subordinate health service stations (control group) given only rehabilitation guidance once a week.Two groups were not do professional cognitive training.All patients were assessed with Mini Mental State Examination( MMSE), Fugl-Meyer Assessment(FMA) and modified Bathel index rating scale(MBI) to evaluate their cognition ,movement function and activity of daily living(ADL) before training as well as after 4-week and 8-week training.Results There was no signficant difference in cognition,movement functions and ADL between training group and control group before treatment(P>0.05).The differences in the assessment of Brounnstrom scale and MBI between two groups after 4-week training were not significant( P > 0.05 ).The scores of Fugl-Meyer scale, MMSE and Barthel index of the training group after 8-week training were significantly higher than those of control group( all P < 0.05 ).Conclusion Community-based rehabilitation training could improve the movement functions and ADL,and cognitive functions of cerebral apoplexy patients.

Suspension-assisted training of motor function for patients with cerebral infarction / 中华物理医学与康复杂志

Objective o observe the therapeutic effects of suspension-assisted functional rehabilitation training of motor function for patients with cerebral infarction. Methods Ninety-six patients with cerebral infarction were divided randomly into a treatment group and a control group. All patients were given routine medical treatment and routine limb movement therapy. Those in the treatment group also used an electrically-driven suspension device to aid in their functional rehabilitation training. The patients were assessed with a simplified Fugl-Meyer Motor Functional Assessment (S-FMMFA), and using the Postural Assessment Scale for stroke patients ( PASS), the Barthel Index (BI) and the 6-minute walking distance test before and after treatment and at a 6-month foliowup. Results The average S-FMMFA, PASS, BI and the 6-minute walk results in the treatment group were all significantly better than those in the control group. Conclusions Suspension-assisted training can significantly help improve limb movement function and ADL performance in cerebral infarction patients.

Occupational Therapy and Physical Therapy on Upper Limb Function and Activities of Daily Living for Old Stroke / 中国康复理论与实践

@#ObjectiveTo observe occupational therapy combing with physical therapy on the upper limb movement function and the activities of daily living for the old stroke patient.Methods62 stroke patients with hemiplegia were divided into the observation group (occupational therapy with physical therapy) and control group (physical therapy). All patients were evaluated with Bathel Index (BI) and Fugl-Meyer Assessment (FMA) before and 3 months after treatment.ResultsThe scores of BI and FMA increased significantly in the observation group compared with the control group after the treatment (P<0.01).ConclusionOccupational therapy combing with physical therapy can obviously improve the upper limb movement function and the activities of daily living for the old stroke patient.

Research in effect of hand function recovery machine on hand function rehabilitation of hemiplegia patients after stroke / 中国实用护理杂志

Objective To compare the rehabilitation effect of free rehabilitation, the needle therapy and the hand function recovery machine combined with free rehabilitation on movement function, the feeling function as well as the movement pattern of newly stroke patients with hemiplegia. Methods 49 newly stroke patients were divided into the free rehabilitation group, the acupuncture group and the hand function recovery machinegroup, each group received corresponding intervention. The movement function, the feeling function as well as the movement pattern were compared among the three groups using blind method. Results Brunnstrom evaluation for hands feeling-movement function, the Fugl- Meyer evaluation score showed obvious progress compared to before the treatment, score of fine hand - function assessment of Carrshepherd showed no change. Two weeks after treatment,Brunnstrom evaluation for hands feeling-movement function and the Fugl - Meyer evaluation score showed no difference between the free rehabilitation group and the acupuncture group, but the hand function recovery machine group showed better results than the other two groups. One months after treatment,Brunnstrom evaluation for hands feeling-movement function was different among these groups, but not the Fugl-Meyer evaluation score, the hand function recovery machine group showed better results than the other two groups, still score of fine hand-function assessment of Carrshepherd showed no change. Conclusions Acupuncture, free rehabilitation, hand function recov - ery machine all make progress in hand function recovery for newly stroke patients with hemiplegia, but hand function recovery machine combined with free rehabilitation proved to be the best method. Its effect for hand intricate function needs to be enhanced.

Effect of comprehensive rehabilitation therapy on movement function of stroke patients / 中国康复理论与实践

@#ObjectiveTo investigate the effect of comprehensive rehabilitation therapy on movement function of stroke patients.Methods121 cases of acute stroke were randomly divided into the rehabilitation group (n=59) and control group (n=62). Patients of the rehabilitation group were treated with Bobaths and motive relearning method. Cases of the control group were treated with ordinary rehabilitation. All patients were assessed by the clinical neural function-defect assessment, concise Fugl-Meyer assessment (FMA) and modified Barthel index (MBI).ResultsThe scores of the clinical neural function-defect assessment set, FMA, and MBI of two groups were not different before treatment (P>0.05), while there was a significant improvement after treatment (P<0.01), and scores of the rehabilitation group was significantly higher than that of the control group.ConclusionComprehensive rehabilitation therapy can facilitate the function recovery, and gain a good functional prognosis to the stroke patients.

Effect of baclofen on recovery of motor function of stroke patients with hemiplegia / 中国康复理论与实践

@#ObjectiveTo explore the best applying time and effect of baclofen on recovery of motor function of stroke patients with hemiplegia.Methods83 stroke patients with hemiplegia were divided into group A and group B according to the degree of muscle tension, every group was divided into the treatment group and control group. Patients of the four groups were treated with routine rehabilitation training, and baclofen was added to the patients of two treatment groups. Motor ability and activities of daily living (ADL) of patients were evaluated before and after one month treatment.ResultsAfter one month treatment, motor ability and ADL of all patients were improved, but in group A, there were not significant differences existed between treatment group and control group (P>0.05), while, there was a significant difference existed in group B(P<0.01).ConclusionBaclofen is necessary to stroke patients with hemiplegia only when the muscle tension increased obviously (≥Asworth 3).

Effect of facilitation techniques combined with acupuncture in patients with hemiplegia after stroke / 中国康复理论与实践

@#ObjectiveTo study the effect of facilitation techniques combined with acupuncture on movement function and activity of daily living(ADL) of the stroke patients.Methods200 patients with stroke were divided randomly into 4 groups,group A for facilitation techniques with acupuncture,group B for facilitation techniques only,group C for acupuncture therapy only,and group D for control.The recovery grades of the Brunnstrom and Functional Independent Measure(FIM) were applied to assess movement function and ADL before and after treatment.ResultsThe number of patients whose limbs recoveried up to Brunnstrom 4 in group A、B、C after treatment was higher than that in group D as while as the scores of FIM(P<0.05).The FIM scores and the number of patients whose whose limbs recoveried grades(>4 grades) of the Brunnstrom in group B and C were no difference(P>0.05),The FIM scores and the number of patients whose recovery grades(>4 grades) of the Brunnstrom in group A were significant higher than that in group B and C (P<0. 05).ConclusionsFacilitation techniques combined with acupuncture can improve the movement function and ADL of the stroke patients.

Effect of head acupuncture combined with rehabilitation techniques on movement function of upper limbs after stroke / 中国康复理论与实践

@#ObjectiveTo study the effect of head acupuncture combined with rehabilitation techniques on movement function of upper limbs after stroke.Methods80 patients with stroke were divided randomly into four groups, group 1 for head acupuncture and rehabilitation techniques, group 2 for rehabilitation techniques, group 3 for head acupuncture and group 4 for control. Fugl Meyer Assessment(FMA) and Facility Assessment For Function of Upper Limbs were applied to assess movement function before and after treatment.ResultsThe scores of FMA and Facility Assessment For Function of Upper Limbs rised more significantly in group 1,2, and 3 than group 4 (P<0.01) and group 1 outgo group 2,3 yet(P<0.05).Conclusions Head acupuncture combined with rehabilitation techniques can improve the movement function of upper limbs of the stroke patients.

Effect of head acupuncture combined with facilitation techniques on movement function after stroke / 中国康复理论与实践

@#ObjectiveTo study effect of head acupuncture combined with facilitation techniques on movement function, ADL, nervous function and prevention of complication, etc. after stroke.Methods120 stroke patients were divided randomly into four groups, group 1 for head acupuncture with facilitation techniques, group 2 for head acupuncture, group 3 for facilitation techniques, and group 4 for control. Fugl Meyer Assessment(FMA), Clinical Nervous Functional Damage Degree(CNFDD), Quality of Life(QOL), etc. were applied to assess movement and nervous function before and after treatment. ResultsThe scores of FMA, CNFDD and ADL rised more significantly in group 1, 2 and 3 than group 4 (P<0.01). The complications, such as shoulder joint semi dislocation, shoulder hand syndrome, decreased more obviously in group 1 than in group 2, 3 and 4(P>0.05).Conclusions Head acupuncture combined with facilitation techniques can improve the movement function and activity of daily living of the stroke patients, decreasing complication.