Effect of task-oriented training assisted by force feedback hand rehabilitation robot on finger grasping function in stroke patients with hemiplegia: a randomised controlled trial.

BACKGROUND: Over 80% of patients with stroke experience finger grasping dysfunction, affecting independence in activities of daily living and quality of life. In routine training, task-oriented training is usually used for functional hand training, which may improve finger grasping performance after stroke, while augmented therapy may lead to a better treatment outcome. As a new technology-supported training, the hand rehabilitation robot provides opportunities to improve the therapeutic effect by increasing the training intensity. However, most hand rehabilitation robots commonly applied in clinics are based on a passive training mode and lack the sensory feedback function of fingers, which is not conducive to patients completing more accurate grasping movements. A force feedback hand rehabilitation robot can compensate for these defects. However, its clinical efficacy in patients with stroke remains unknown. This study aimed to investigate the effectiveness and added value of a force feedback hand rehabilitation robot combined with task-oriented training in stroke patients with hemiplegia. METHODS: In this single-blinded randomised controlled trial, 44 stroke patients with hemiplegia were randomly divided into experimental (n = 22) and control (n = 22) groups. Both groups received 40 min/day of conventional upper limb rehabilitation training. The experimental group received 20 min/day of task-oriented training assisted by a force feedback rehabilitation robot, and the control group received 20 min/day of task-oriented training assisted by therapists. Training was provided for 4 weeks, 5 times/week. The Fugl-Meyer motor function assessment of the hand part (FMA-Hand), Action Research Arm Test (ARAT), grip strength, Modified Ashworth scale (MAS), range of motion (ROM), Brunnstrom recovery stages of the hand (BRS-H), and Barthel index (BI) were used to evaluate the effect of two groups before and after treatment. RESULTS: Intra-group comparison: In both groups, the FMA-Hand, ARAT, grip strength, AROM, BRS-H, and BI scores after 4 weeks of treatment were significantly higher than those before treatment (p < 0.05), whereas there was no significant difference in finger flexor MAS scores before and after treatment (p > 0.05). Inter-group comparison: After 4 weeks of treatment, the experimental group's FMA-Hand total score, ARAT, grip strength, and AROM were significantly better than those of the control group (p < 0.05). However, there were no statistically significant differences in the scores of each sub-item of the FMA-Hand after Bonferroni correction (p > 0.007). In addition, there were no statistically significant differences in MAS, BRS-H, and BI scores (p > 0.05). CONCLUSION: Hand performance improved in patients with stroke after 4 weeks of task-oriented training. The use of a force feedback hand rehabilitation robot to support task-oriented training showed additional value over conventional task-oriented training in stroke patients with hand dysfunction. CLINICAL TRIAL REGISTRATION INFORMATION: NCT05841108.

Progress in the clinical application of constraint-induced therapy following stroke since 2014.

Stroke is a group of cerebrovascular diseases with high prevalence and mortality rate. Stroke can induce many impairments, including motor and cognitive dysfunction, aphasia/dysarthria, dysphagia, and mood disorders, which may reduce the quality of life among the patients. Constraint-induced therapy has been proven to be an effective treatment method for stroke rehabilitation. It has been widely used in the recovery of limb motor dysfunction, aphasia, and other impairment like unilateral neglect after stroke. In recent years, constraint-induced therapy can also combine with telehealth and home rehabilitation. In addition, constraint-induced therapy produces significant neuroplastic changes in the central nervous system. Functional magnetic resonance imaging, diffusion tensor imaging, and other imaging/electrophysiology methods have been used to clarify the mechanism and neuroplasticity. However, constraint-induced therapy has some limitations. It can only be used under certain conditions, and the treatment time and effectiveness are controversial. Further research is needed to clarify the mechanism and effectiveness of CI therapy.

Misdiagnosis of scalp angiosarcoma: A case report.

BACKGROUND: Angiosarcoma is a rare malignant tumor. Owing to the lack of specific clinical manifestations of this disease, it is difficult to achieve early diagnosis and start early treatment. CASE SUMMARY: A 78-year-old male patient was admitted to the hospital because of a bump on his head that did not heal for 4 mo. The patient was diagnosed with a refractory head wound. The patient underwent neoplasm resection and skin grafting surgery in the Plastic Surgery. The neoplasm was sent for pathological examination during the operation. The final pathological results were confirmed scalp angiosarcoma. CONCLUSION: Our research suggests that pathological examination should be performed for refractory ulcers of the scalp, and physical factor therapy should be used with caution before the diagnosis is clear.

Rehabilitation treatment of multiple sclerosis.

Multiple sclerosis is a slowly progressive disease, immunosuppressants and other drugs can delay the progression and progression of the disease, but the most patients will be left with varying degrees of neurological deficit symptoms, such as muscle weakness, muscle spasm, ataxia, sensory impairment, dysphagia, cognitive dysfunction, psychological disorders, etc. From the early stage of the disease to the stage of disease progression, professional rehabilitation treatment can reduce the functional dysfunction of multiple sclerosis patients, improve neurological function, and reduce family and social burdens. With the development of various new rehabilitation technologies such as transcranial magnetic stimulation, virtual reality technology, robot-assisted gait, telerehabilitation and transcranial direct current stimulation, the advantages of rehabilitation therapy in multiple sclerosis treatment have been further established, and more treatment means have also been provided for patients.

Research progress in extracorporeal shock wave therapy for upper limb spasticity after stroke.

Spasticity is one of the most common complications after stroke. With the gradual intensification of spasticity, stroke patients will have a series of problems such as joint ankylosis and movement restriction, which affect the daily activities and increase the burden on patients' families, medical staff and society. There are many ways to treat post-stroke spasticity before, including physical therapy and exercise therapy, drug therapy, surgery and so on, but not satisfied because of a few shortcomings. In recent years, many researchers have applied extracorporeal shock wave therapy (ESWT) for the treatment of post-stroke spasm and achieved good clinical effect, because it is non-invasive, safe, easy to operate, low cost and other advantages compared with other treatment methods. This article reviews the research progress and existing problems of ESWT in the treatment of post-stroke spasticity.

Highly sensitive visual colorimetric sensor for xanthine oxidase detection by using MnO2-nanosheet-modified gold nanoparticles.

In this study, a highly sensitive colorimetric assay has been constructed for the determination of xanthine oxidase (XOD) activity by the GNP@MnO2 core-shell nanoparticles as probe. In the presence of XOD, xanthine can be oxidized to produce H2O2, which makes the MnO2 shell fallen off. With the single particle detection (SPD) based dark field microscopy (DFM), the scattering color of GNP@MnO2 NP probe shows obvious change before and after etching process. At the single particle level, noticeable color change of the single probe can be easily detected in the existence of trace XOD. This SPD-based colorimetric strategy displays broad linear dynamic range (0.02-4 mU/mL) and low detection limit of 7.82 µU/mL, which is more sensitive than the results from ensemble sample measurement. In addition, we tested the inhibitory effect of quercetin on the activity of XOD and obtained good inhibition effect. As a consequence, this SPD-based colorimetric strategy provides new perception for the ultrasensitive detection of molecules in complex system.

Facile and label-free fluorescence sensing of ß-galactosidase activity by graphene quantum dots.

ß-Galactosidase (ß-Gal), as a glycoside hydrolase, is closely associated with cell senescence and primary ovarian cancer. However, there is still lack of facile and rapid sensing approach to monitor the ß-Gal activity. In this work, a label-free and convenient sensing strategy to detect ß-Gal activity has been proposed based on fluorescent graphene quantum dots (GQDs). In the presence of ß-Gal, 4-nitrophenyl-ß-D-galactopyranoside (NPGal) can be hydrolyzed into 4-nitrophenol (4-NP), which serves as a good quencher to quench the fluorescence of GQDs. The quenching mechanism is proven to be inner filter effect (IFE). Due to the specificity of the enzymatic reaction, this sensing method displays excellent selectivity and high sensitivity. A broad dynamic range from 20 to 200 U L-1 and a detection limit of 4.4 U L-1 for the ß-Gal assay are achieved. Compared with the previously reported methods, this sensing strategy only needs one fluorescent nanomaterial without any modification and avoids time-consuming handling steps. Therefore, the sensing strategy based on fluorescent GQDs offers great potential for the recognition of disease-correlated enzyme activity.

A dual-mode fluorometric/colorimetric sensor for Cu2+ detection based on hybridized carbon dots and gold-silver core-shell nanoparticles.

A fluorometric and colorimetric dual mode sensing platform based on hybridized carbon dots (Cdots) and gold-silver core-shell nanoparticles (Au@Ag NPs) has been established for the sensitive detection of trace Cu2+ ions in aqueous solution. In this system, the fluorescence of Cdots was quenched by Au@Ag NPs due to the surface plasmon-enhanced energy transfer. Due to the fact that Cu2+ could accelerate the etching process of Au@Ag NPs in the presence of thiosulfate, the fluorescence of Cdots was recovered. The limit of detection (LOD) is 4.81 nM for fluorometric measurements and 3.85 nM for colorimetric measurements. The dynamic range from these two modes is 0.005-1 µM. Importantly, Cu2+ in solution can also be directly visualized by this sensor via evident color change from the solution. Therefore, this dual mode nanosensor has potential applications for the efficient detection of Cu2+ ions in aqueous samples with great selectivity and high sensitivity.