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OBJECTIVE: To assess the effectiveness of a comprehensive rehabilitation approach combining Traditional Chinese Medicine Daoyin with lower limb robotics during the recovery phase of stroke patients. METHODS: Stroke patients meeting the specified criteria were randomly assigned to one of four groups using a random number table: Control group, Daoyin group, lower limb robot group (LLR group), and Daoyin and lower limb robot group (DLLR group). Each group received distinct treatments based on conventional rehabilitation training. The treatment duration spanned two weeks with two days of rest per week. Pre- and post-intervention assessments included various scales: Fugl-Meyer Assessment (FMA), Berg balance scale (BBS), Barthel index (BI), Fatigue Scale-14 (FS-14), Pittsburgh sleep quality index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). RESULTS: Statistically significant differences were observed in the lower limb function measured by FAM between the Control group (15 ± 5) and the DLLR group (18 ± 5) (P = 0.049). In the Barthel index, a statistically significant difference was noted between the Control group (54 ± 18) and the DLLR group (64 ± 11) (P = 0.041). Additionally, significant differences were found in the Berg balance scale between the Control group (21 ± 10) and the DLLR group (27 ± 8) (P = 0.024), as well as between the Control group (21 ± 10) and the LLR group (26 ± 10) (P = 0.048). CONCLUSION: The findings of this study suggest that the combined use of Daoyin and robotics not only enhances motor function in stroke patients but also has a positive impact on fatigue, sleep quality, and mood. This approach may offer a more effective rehabilitation strategy for stroke patients.
Subject(s)
Drugs, Chinese Herbal , Lower Extremity , Robotics , Stroke Rehabilitation , Stroke , Humans , Male , Middle Aged , Female , Robotics/instrumentation , Aged , Lower Extremity/physiopathology , Stroke/physiopathology , Stroke Rehabilitation/methods , Drugs, Chinese Herbal/therapeutic use , Treatment Outcome , AdultABSTRACT
ObjectiveTo summarize the current situation, hot spots and frontiers of the application of functional near-infrared spectroscopy (fNIRS) in rehabilitation in recent ten years. MethodsLiterature related to the application of fNIRS in rehabilitation was retrieved from the core collection of Web of Science from January, 2003 to December, 2022, and the visualized analysis was performed by CiteSpace 6.1.R6 software. ResultsA total of 828 literatures were included. The annual publication volume was on the rise. The most prolific author was LI Zengyong. The most published country was the United States. And the most published institution was Karolinska Institute. Hot keywords included children, stroke, activation, quality of life, cerebral palsy, etc. The hot keywords of bursting intensity included early intervention, speech perception, cerebral palsy, plasticity, spinal cord injury, physical therapy, visual feedback, Parkinson's disease, etc. Cluster analysis suggested that in the past decade, the application of fNIRS in rehabilitation involved physical therapy, speech therapy, occupational therapy, pre-rehabilitation and early rehabilitation of surgery, mainly focusing on six themes: the rehabilitation of motor dysfunction after stroke, cognitive impairment, hearing and speech dysfunction, children with cerebral palsy, cardiopulmonary function monitoring in severe diseases and long-term nursing of chronic diseases. Among them, the application of fNIRS in neurological rehabilitation of stroke patients occupied a large proportion, which might be the current research hot spot and trend. ConclusionThe application of fNIRS in rehabilitation is on the rise. In the future, more attention should be paid to the application of fNIRS in the study of the injury and recovery mechanism of neurological disorders, especially the effects of various rehabilitation interventions on cortical plasticity and the etiology of neurological disorders.
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As a kind of mature non-invasive brain stimulation technology, transcranial direct current stimulation (tDCS) has shown sig-nificance in clinic. Recently, DCS has been applied over the scalp to the spinal cord, named transcutaneous spinal direct current stimulation (tsDCS), that may modulate the spinal cord tracts and spinal cord loop electrical activity at segmental level, and may benefit in the treatment of chronic pain and motor dysfunction after injury of nervous system. This paper reviewed physiological effects, safety considerations and potential clinical applications of tsDCS.
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Recent studies show that post-activation depression is highly correlated with the severity of spasticity in patients with stroke or cerebral palsy, which may be potentially used in the evaluation of spasticity. This article reviewed the concept, mechanism and related fac-tors of post-activation depression.
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@#Recent studies show that post-activation depression is highly correlated with the severity of spasticity in patients with stroke or cerebral palsy, which may be potentially used in the evaluation of spasticity. This article reviewed the concept, mechanism and related factors of post-activation depression.
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@#Difference between transcranial magnetic stimulation and transcranial direct current stimulation in theory, safety, detection of brain function and clinic treatment were reviewed in order to help reasonably select and effectively apply them in clinic.
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@# The treatment of Parkinson's disease remains a problem in neurology, and rehabilitation can play a certain role. Recently, some new rehabilitation approaches are being studied and applied in the treatment of Parkinson's disease. This article reviewed these advancement.
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@#Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on motor recovery in patients with incomplete spinal cord injury （SCI）. Methods 22 patients with T5～T12 incomplete spinal cord injury (ASIA C) were randomly divided into rTMS group and control group. 12 ptients in rTMS group were treated with 10Hz rTMS （10×5 s with 2 min interval) on motor cortex and rehabilitation. 10 patients in control group treated with rehabilitation only. They were assessed with ASIA motor score, ASIA pin prick score, ASIA light touch score, range of motion (ROM) of legs in antigravitation position, walking index for spinal cord injury Ⅱ (WISCIⅡ) and functional independence measure (FIM) score before and 4 weeks after treatment. Results There was no difference between two groups with the clinical assessment before treatment （P>0.05）. The ASIA motor score, ROM of legs and FIM score improved in both groups after treatment （P<0.05）. The score of WISCIⅡ also improved in rTMS group （P<0.05）, and ASIA motor score improved more in rTMS group than that of control group （P<0.05）. Conclusion rTMS can facilitate the recovery of the motor and walking function in patient with incomplete spinal cord injury.
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@# Objective To explore the role of architecture of the human muscle in treatment of spasticity after stroke with BTX.Methods40 patients with spasticity hemiplegia after stroke were involved,whose scores of Modified Ashworth Scale beyond 3.They were divided in 2 groups:control group and observed group,in which BTX dose and injection points designed without or with architecture of the human muscle.All muscles injected were located with electrical stimulator.They were evaluated with Modified Ashworth Scale and the incidence of brace wearing were observed 2 weeks after treatment.ResultsThe Ashworth scores for wrist flexors were(1.3±0.9234)in observed group,(1.9±0.8522)in control group(P<0.05);for the triceps surae,they were(1.6±0.8826)and(2.25±0.7864)respectively(P<0.05).10 cases wore brace for upper limbs in observed group and 14 cases in control group;for the brace for lower limbs,there were 12 in observed group and 16 in control group(P>0.05).ConclusionBTX dose and injection points designed by Architecture of the Human Muscle in Treatment of spasticity after stroke is better than routine way,but the brace wearing for patients showed no significant improvement.
