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Objective:To investigate the effect of body weight-supported treadmill training on neuropathic pain and expression of glutamate decarboxylase-65/67 (GAD-65/67) in spinal dorsal horn of rats with spinal cord injury (SCI). Methods:A total of 24 Sprague-Dawley rats were randomly divided into sham group, SCI-sedentary (SCI-Sed) group and SCI-Exercise (SCI-Ex) group, with eight rats in each group. Allen's method was used to make T10 incomplete SCI model. Seven days after SCI, SCI-Ex group was given body weight-supported treadmill training. Before SCI, and seven days, 14 days, 21 days, 28 days and 35 days after SCI, the von Frey filaments and thermal stimulation pain tester were used to evaluate the mechanical and thermal pain thresholds. Then, Western blotting and immunohistochemical analysis were performed on the spinal cord of all rats to detect the expression of GAD-65 and GAD-67. Results:The mechanical and thermal pain thresholds were higher in SCI-Ex group than in SCI-Sed group 21 days, 28 days and 35 days after SCI (P < 0.01). Compared with the sham group, the expression of GAD-65 and GAD-67 decreased in SCI and SCI-Ex groups (P < 0.05), and increased in SCI-Ex group compared with that of SCI-Sed group (P < 0.05). Conclusion:Body weight-supported treadmill training could increase the synthesis of GAD-65/67 in the distal spinal cord dorsal horn of incomplete SCI rats, and improve the pain thresholds of hind limbs in rats with SCI.
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Objective To observe the effect of body weight supported treadmill training ( BWSTT) on func-tion of lower extremities in stroke survivors, and analyze the influence of quadriceps femoris muscle tone on the thera-peutic effect of BWSTT. Methods Thirty-six stroke survivors were randomly divided into a BWSTT group and a conventional therapy group ( CT group) according to a random number table, each of 18. Both groups were given rou-tine rehabilitation training, while the BWSTT group was additionally provided with BWSTT for 4 weeks. Before and af-ter the treatment, Fugl-Meyer assessment for lower extremity (FMMS-LE), Berg balance scale (BBS) and Holden walking function rating scale ( Holden) were used to assess the motor function of lower extremities, balance function and walking ability of both groups. Meanwhile, the patients in BWSTT group were further divided into a mild-spasm subgroup and a seriously-spasm subgroup according to the modified Ashworth scale assessment result of quadriceps muscle, and the results of their efficacy indexes were further compared. Results No significant difference was found in the average FMMS-LE, Berg and Holden scores between the BWSTT group and CT group before the treat-ment ( P>0.05) . However, significantly improvement was found in all the above measurements of both groups after the treatment ( P<0.05) . Further comparison found that the FMMS score of the lower extremities and Holden grading in the BWSTT group improved more significantly compared with the CT group ( P<0.05) , while no significant differ-ences were found in the Berg score between the two groups ( P>0.05) . The change of FMMS (△FMMS) and Holden (△Holden) after treatment in the mild-spasm subgroup increased more significantly compared with those in the seri-ously-spasm subgroup, but no significant differences were observed regarding the change of Berg (△Berg) between the two subgroups. Conclusions BWSTT can significantly improve the motor function of lower extremities, balance function and walking ability of stroke survivors. However, hypertone of quadriceps femoris might have adverse effects on the therapeutic effect of BWSTT.
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Objective To explore the effect of functional electrical stimulation (FES) on hemiplegic gait of acute stroke patients. Meth-ods 41 stroke patients were randomly divided into treatment group (n=21) and control group (n=20). All the patients received conventional rehabilitation and body weight supported treadmill training, and the treatment group received FES in addition. The patients were evaluated with the Composite Spasticity Scale (CSS), the Berg Balance Scale (BBS) and the Functional Ambulation Category (FAC) before and 8 weeks after intervention. Results There was no significant difference in all the assessment between two groups before intervention (P>0.05). The scores of CSS, FAC and BBS improved in both groups 8 weeks after intervention (P<0.001), and improved more in the treatment group than in the control group (P<0.05). Conclusion FES could further improve ambulation of stroke patients.
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@#Objective To explore the effect of functional electrical stimulation (FES) on hemiplegic gait of acute stroke patients. Methods 41 stroke patients were randomly divided into treatment group (n=21) and control group (n=20). All the patients received conventional rehabilitation and body weight supported treadmill training, and the treatment group received FES in addition. The patients were evaluated with the Composite Spasticity Scale (CSS), the Berg Balance Scale (BBS) and the Functional Ambulation Category (FAC) before and 8 weeks after intervention. Results There was no significant difference in all the assessment between two groups before intervention (P>0.05). The scores of CSS, FAC and BBS improved in both groups 8 weeks after intervention (P<0.001), and improved more in the treatment group than in the control group (P<0.05). Conclusion FES could further improve ambulation of stroke patients.
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@#Objective To explore the effect of functional electrical stimulation (FES) on hemiplegic gait of acute stroke patients. Methods 41 stroke patients were randomly divided into treatment group (n=21) and control group (n=20). All the patients received conventional rehabilitation and body weight supported treadmill training, and the treatment group received FES in addition. The patients were evaluated with the Composite Spasticity Scale (CSS), the Berg Balance Scale (BBS) and the Functional Ambulation Category (FAC) before and 8 weeks after intervention. Results There was no significant difference in all the assessment between two groups before intervention (P>0.05). The scores of CSS, FAC and BBS improved in both groups 8 weeks after intervention (P<0.001), and improved more in the treatment group than in the control group (P<0.05). Conclusion FES could further improve ambulation of stroke patients.
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@#Objective To explore the effect of functional electrical stimulation (FES) on hemiplegic gait of acute stroke patients. Methods 41 stroke patients were randomly divided into treatment group (n=21) and control group (n=20). All the patients received conventional rehabilitation and body weight supported treadmill training, and the treatment group received FES in addition. The patients were evaluated with the Composite Spasticity Scale (CSS), the Berg Balance Scale (BBS) and the Functional Ambulation Category (FAC) before and 8 weeks after intervention. Results There was no significant difference in all the assessment between two groups before intervention (P>0.05). The scores of CSS, FAC and BBS improved in both groups 8 weeks after intervention (P<0.001), and improved more in the treatment group than in the control group (P<0.05). Conclusion FES could further improve ambulation of stroke patients.
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Objective To investigate the clinical efficacy of body weight supported treadmill training (BWSTT) for the recovery of walking ability and comprehensive function after thoracolumbar spinal cord injury (SCI).Methods Sixty patients with SCIs in a thoracolumbar segment were assigned to a treatment group or a control group with 30 in each.Both groups received similar conventional rehabilitation training,but the patients in the treatment group were additionally treated with BWSTT (30 to 40 min,once daily,5 d/week,30 days for a course,a total 3 courses).The American Spinal Injury Association lower-extremity motor function assessment (ASIA),a functional comprehensive assessment (FCA),the walking ability assessment from the FCA (WA) and the modified Barthel index (MB1) were used in the assessment of the two groups before and after treatment.Results There were no significant differences in the two groups＇ average ASIA,FCA,WA or MBI results before treatment.After treatment ASIA,FCA,WA and MBI scores had all increased significantly in the treatment group compared with before treatment,and were significantly higher than in the control group.Conclusion As a supplement to conventional rehabilitation,BWSTT can improve walking ability and comprehensive function significantly after thoracolumbar spinal cord injury.
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Objective To explore the outcome of body-weight-supported treadmill training on the kinetic data of lower limb in early stage of stroke.Methods Twenty-seven hemiplegic stroke patients at early stage were recruited and randomized to an experimental group(n =15) and a control group (n =12).Both groups were administered with routine neurological interventions.In addition,the control group was treated with conventional physiotherapy and over-ground walking training,while the experimental group was treated with body-weight-supported treadmill training.The speed of the treadmill walking was started at 0.22 m/s and increased to 0.60 ～ 0.80 m/s gradually.The percentage of the body-weight being supported was not more than 30％,the training time was 5 min per session at the beginning and was increased gradually to 20 ～ 40 min.Kinetic parameters were measured by using two force plates (AMT) and six cameras capture svstem (Vicon Nexus),and motor function was evaluated using Fugl-Meyer Assessment (FMA) at baseline and after three-week's therapy.Peak moment of lower limb joints,ground reaction force and motor function were analyzed.Results FMA scores were significantly improved (P ＜ 0.05) in both groups after treatment,but there was no significant differences (P ＜ 0.05) between the two group.Ground reaction force was significantly increased (P ＜ 0.05) after treatment in the experiment group,but not in control group (P ＞ 0.05).It showed that the hip extension moment at the affected side was significantly lower (P ＜ 0.05) in experiment group than in the control group,the ankle joint flexion and extension moment peak were improved to a significantly larger extend in the experimental group (P ＜ 0.05) than in the control group.In addition,the peak flexion and extension moment of the hip-knee joint and peak flexion and extension moment of the knee-ankle joint were also significantly different from those of the control group (P ＜ 0.05).Conclusion Body-weight-supported treadmill training can facilitate motor recovery of paretic extremity by increasing ground reaction force and load support of the affected lower limb,and help normalize the abnormal gait pattern of lower extremity of stroke patients.
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Objective To investigate the clinical effects of repetitive transcranial magnetic stimulation (rTMS) combined with body-weight-supported treadmill training (BWSTT) on patients with incomplete spinal cord injury (SCI).Methods Four patients with chronic incomplete SCI participated in this study.They were first treated with rTMS and then BWSTT training.They were assessed with clinical measures of function.Two of the four patients were assessed in terms of their H reflex,and using functional magnetic resonance imaging (fMRI) and a balance performance monitor (BPM).Results In two of the four patients,American spinal injury association (ASIA) clinical measures of motor and sensory function improved,as did 10 m walking speed and their sense of effort.In static balance tests,the sway path and sway area of the two patients both decreased.These improvements lasted for 3 weeks after the intervention.The two patients' maximum H reflex amplitude and the H/M amplitude ratio decreased.The fMRI results showed progressive enlargement of the activation volume of the movement-related M1 region after treatment.Conclusion High-frequency rTMS combined with BWSTT may improve motor function,elevate excitability of spinal motor neurons and improve the plasticity of the cerebral cortex in chronic incomplete SCI patients.
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Objective To observe the effects of a rehabilitation robot and body weight supported treadmill training (BWSTT) on the walking ability of hemiplegic patients after stroke.Methods Sixty hemiplegic patients were divided randomly into treatment and control groups (n=30 in each).The treatment group received training assisted by a leg rehabilitation robot for 10-20 min once daily,6 days per week for 8 weeks in addition to conventional treatments and BWSTT.The control group was only given conventional treatments and BWSTT once daily for 8 weeks.Their lower extremity functions,balance and walking ability were assessed with a simplified Fugl-Meyer assessment (FMA) and using the Berg balance scale (BBS) and Functional Ambulation Categories (FACs).Results After training,both groups showed significant improvements in terms of FMA,BBS and FAC results.The treatment group showed significantly better improvements in lower extremity function,balance and walking ability compared with the control group.Conclusions The lower-limb rehabilitation robot and BWSTT could together improve balance and walking ability.
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Objective To observe the effect of body-weight supported treadmill training (BWSTT) on the lower limb motor function of elderly hemiplegia patients with acute cerebral infarction using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods Seven patients with cerebral infarction were given comprehensive rehabilitation therapy for 10 weeks in three stages: a baseline period of 2 weeks ( conventional rehabilitation therapy), an intervention period of 6 weeks ( conventional rehabilitation therapy plus BWSTT) and a withdrawal period of 2 weeks (conventional rehabilitation therapy). During the intervention period the exercise duration increased gradually from 15 to 30 minutes, once a day, 5 times a week,for 6 consecutive weeks. Dynamic changes in rCBF in the cortex were observed with SPECT before and after treat ment. Results During the baseline period there was no significant change in average MWS (maximum walking speed) or BBS ( Berg balance scale) scores. During the intervention period both scores improved significantly. During the withdrawal period there were some changes in MWS and BBS scores, but they were not significant. There was a significant change in average rCBF in the cortex after treatment compared with before. Conclusions BWSTT is effective for improving the walking speed and balance of elderly patients with acute cerebral infarction. There is a positive correlation between the recovery of lower limb motor function and changes in rCBF in the cortex.
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Objective To observe the effect of electroacupuncture and body-weight supported treadmill training in the treatment of spinal cord injury (SCI) after fractures of the thoracolumbar segment of the spine.Methods Forty-three patients with SCI after fractures of the thoracolumbar segment of the spine were randomly divided into a treatment group (22 cases) and a control group (21 cases). The patients in the treatment group were treated with electroacupuncture and body-weight supported treadmill training, while those in the control group were treated mainly with drugs. Patients were scored with the American Spinal Injury Association (ASIA) assessment and the modified Barthel index (MBI) initially and after 6 months. Results The ASIA and MBI scores of all patients were significantly higher after 6 months than before treatment, but those in the treatment group were significantly higher than those in the control group. Excellent and good ratings were applied to 77% of the treatment group, while only 48% of the control group, a statistically significant difference. Conclusions Electroacupuncture and body-weight supported treadmill training can effectively improve ability in the activities of daily living, sensation and locomotor abilities after thoracolumbar vertebral fractures.
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@# ObjectiveTo explore the effect of partial body-weight supported treadmill training(BWSTT) on gross motor function measure, walking ability and efficiency, and functional ambulation categories in children with cerebral palsy(CP).Methods35 children with cerebral palsy were assigned into 3 groups, BWSTT group(BWSTT with PT, n=11), TT group(treadmill training with PT, n=12), and PT group (n=12). Assessments were performed before treatment and 8 weeks and 12 weeks after treatment respectively. The evaluation items included the D & E dimensions of the gross motor function measures (GMFM), walking ability(WA), walking efficiency(WE)and Functional ambulation categories (FAC).ResultsNo statistically significant differences were found in age, gender, body height, as well as clinical assessments (GMFM, WA, WE and FAC) before treatment between 3 groups(P>0.05). There was statistically significant difference in each group 12 weeks after treatment, and BWSTT group showed statistical significant difference in GMFM, WA, WE and FAC.ConclusionBWSTT could significantly improve the walking ability and walking efficiency, and also the standing and walking ability of children with CP.
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Objective To investigate the effects of locomotor training on improving locomotor function after spinal cord injury(SCI)and the mechanism of spinal cord plasticity.Methods A model of complete thoracic cord transection was established using 84 adult female rats divided into sham,SCI and treadmill training(BWSTT) groups.The hind limb locomotor function of all the rats was evaluated.The fluorescence intensities due to (EphA4),vesicular glutamate transporter 2(VGluT2)and EphA4/VGluT2 double-positive neurons in the ventromedial area of the anterior horn of the lumbar COrd were detected using immunofluorescence double labeling and laser confocal microscopy.Results The rats in the BWSTT group showed better functional recovery in their hind limbs than those in the SCI group.BWSTT was correlated with markedly increased EphA4.VGIuT2 and EphA4/VGluT2 intensities in the ventromedial area.Conclusion BWSTT improves hind limb locomotor function in rats with thoracic cord transections by elevating the expression of EphA4/VGluT2,promoting neuronal plasticity in the lumbar anterior horn.
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@#Objective To investigate the effects of body-weight support treadmill training(BWSTT) on function of lower limbs.Methods 46 hemiplegic patients after stroke were randomly divided into the therapy group(n=23) and control group(n=23).The subjects of both groups were administered with standardized rehabilitation program.The therapy group was also given BWSTT in addition.Both groups were evaluated before and after treatment using Functional Ambulation Category(FAC),Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS).Results Before treatment,there was no significant difference between these 2 groups in terms of scores with FAC,FMA and BBS.After treatment,both groups were significantly improved regard to their scores with FAC,FMA and BBS(P<0.01),with the therapy group scored significantly better than the control group(P<0.01).Conclusion BWSTT can significantly improve walk ability and balance function of the hemiplegic patients after stroke.
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OBJECTIVE: To determine the effectiveness of body weight- supported treadmill training on gait pattern in children with cerebral palsy METHOD: Seventeen children with cerebral palsy were given with body weight-supported treadmill training. The gait training was offered on treadmill and they were trained five times a week, 20 minutes a session for three weeks. To evaluate the ambulatory function, we estimated the walking distance for one minute and gait analysis before and after the treatment. Gait analysis was done for 11 children with Vicon 370 computerized gait analyzer and linear parameters, kinematic and kinetic data were obtained. RESULTS: Walking distance for one minute increased from 6.74+/-6.16 m to 11.06+/-7.98 m. In linear parameters by gait analysis, gait speed (0.15+/-0.18 m/sec to 0.23+/-0.24 m/sec, p<0.05), cadence (53.0+/-26.3 steps/min to 65.9+/-35.7 steps/min, p<0.05), and stride length (0.30+/-0.17 meters to 0.35+/-0.18 meters, p<0.05) increased following body weight-supported treadmill training. Also, there was a significant difference in knee flexion during loading response. CONCLUSION: In rehabilitation of cerebral palsy, body weight- supported treadmill training improved gait pattern. So, we recommend this gait training method for children with cerebral palsy.
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Criança , Humanos , Paralisia Cerebral , Marcha , Joelho , Reabilitação , CaminhadaRESUMO
Objective To investigate the effect of partial body-weight supported treadmill training ( PBW- STT) on function of lower limbs, walk function, ADL performance and quality of life of hemiplegic patient induced by cerebral infarction. Methods A total of 132 cerebral infarction patients were divided into a control group (n = 69) and a training group( n = 63) randomly. Both groups accepted routine rehabilitation therapy, and the training group accepted PBWSTT at the same time in addition. Both groups were evaluated with regard to their walking ability, func- tion of lower limbs, ADL performance and their quality of life by using Functional Ambulation Category (FAC) , Fugl-Meyer assessment (FMA) , Barthel index (BI) and SF-36 before and after rehabilitation treatment. Results The function of lower limb, walking ability, ADL performance and the quality of life of both groups were improved significantly after treatment, and those in the training group were improved to a significantly greater extent than those in the control group ( P
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Objective To investigate the effects of partial body weight supported treadmill training (BW- STT) on post-stroke depression (PSD) and on patients' quality of life.Methods Sixty patients with PSD were re- cruited and divided into a training group (n=30,male 17,female 13) and a control group (n=30,male 16,fe- male 14).All patients were treated with routine internal medication and rehabilitation.The patients of the training group also received BWSTT in addition to their routine treatment.All patients' neurological impairment was evaluated using the Modified Edinburgh-Scandinavian Stroke Scale (MESSS).The Hamilton depression scale (HAMD) was used for evaluating the degree of depression.The Fugl-Meyer scale and the Barthel index were used to assess ambula- tion and balance,and facility in the activities of daily living.All patients were assessed before and after the treat- ment.Results After four weeks of treatment,depression in the training group had improved significantly more than in the control group.Conclusion BWSTT intervention is very important for patients with PSD:it can reduce the degree of depression and improve the quality of life.