Clinical Efficacy of Physical Factors Combined with Early Psychological Intervention in Treatment of Patients with Chronic Limb Pain.

BACKGROUND: To investigate the clinical efficacy of physical factors combined with early psychological intervention in treatment of patients with chronic limb pain. METHODS: A total of 132 patients with chronic limb pain admitted to Affiliated Hospital of Hebei University, Baoding, China from June 2014 to June 2017 were enrolled. The patients were divided into control group (n=66) and observation group (n=66) according to the random number table method. Both groups of patients were treated with physical factors, and the patients in the observation group were also treated with early psychological intervention. PHQ-15 pain factor score, visual analog pain score (VAS score), Hamilton depression rating scale (HAMD) and clinical efficacy were compared between two groups. RESULTS: Difference of PHQ-15 pain factor score, VAS score and HAMD score between two groups before treatment were not statistically significant (P=0.091, 0.161, 0.078). At the end of treatment and at 8 weeks of follow-up, PHQ-15 pain factor score, VAS score, and HAMD score of observation group were lower than those of control group, and the differences were statistically significant (P=0.045, 0.014; 0.011, 0.025; 0.030, 0.015). Total clinical effective rates of observation group and control group were 92.43% and 86.37%, respectively, and the differences were statistically significant (P=0.019). CONCLUSION: Compared with physical factors alone, combination of physical factors and early psychological intervention can significantly alleviate the pain and improve the depression of patients with chronic limb pain. It should be promoted in clinical practices.

[Deep acupuncture of Lianquan (CV23) and Yifeng (TE17) in combination with conventional acupuncture of other acupoints is superior to swallowing rehabilitation training in improving post-stroke dysphagia in apoplexy patients].

OBJECTIVE: To observe the therapeutic effect of acupuncture therapy in the treatment of dysphagia in apoplexy patients. METHODS: A total of 104 patients with post-stroke dysphagia were randomized into a control (conventional swallowing rehabilitation training) group and an acupuncture group (n＝ 52 cases in each one). In the control group, the conventional swallowing rehabilitation training was conducted, twice daily, 6 times a week for 4 weeks. In the acupuncture group, deep needling of main acupoints Lianquan (CV23) and Yifeng (TE17), and conventional acupuncture of adjuvant acupoints as Fengchi (GB20) and Fengfu (GV16), Wangu (GB12), Lieque (LU7), Jinjin (EX-HN12), Yuye (EX-HN13), etc. as well as electroacupuncture stimulation (15－20 Hz, 5 mA, and duration of 30 min) of ipsilateral CV23-GV16, TE17-GB20, and bilateral Neidaying acupoints were conducted. The acupuncture treatment was given once daily, 6 times a week for consecutive 4 weeks. In addition, patients of the two groups also received routine symptomatic treatment with drugs for anti-platelet aggregation, nourishing cranial nerve, lowering blood pressure, controlling blood glucose, improving cerebral circulation, etc. Before and after the treatment, the standard swallowing assessment (SSA, 18－46 points) and Kubota water swallowing test (WST, 1－5 grades) were conducted to evaluate the patient's swallowing function. The comprehensive therapeutic effect was assessed in accordance with the SSA and Kubota WST, and adverse reactions were recorded. RESULTS: After the treatment, the SSA score was considerably reduced in the two groups relevant to their own pre-treatment (both P<0.05), and was significantly lower in the acupuncture group than in the control group (P<0.05). The Kubota WST grade was evidently increased in the number of patients with grade Ⅰ (P<0.05) and reduced in the numbers of patients with grade Ⅲ－Ⅴ in both groups relevant to their own pre-treatment, and was more patients with grade Ⅰ in the acupuncture group than in the control group (P<0.05). Outcomes of the comprehensive therapeutic effect indicated that of the two 52 cases in the control and acupuncture groups, 8 (15.38%) and 19 (36.53%) were cured, 7 (13.46%) and 15 (28.45%) had marked improvement, 17 (32.69%) and 12 (23.08%) were effective, and 20 (38.46%) and 6 (11.54%) failed in the treatment, with the effective rate being 61.54% and 88.46%, respectively. The total effective rate of the acupuncture group was significantly higher than that of the control group (P<0.05). The adverse reactions such as regional hematoma (in 3 cases) and pain (in 2 cases) in the acupuncture group, and choking-coughing in the control group were seen, being 9.62% and 11.54% in the incidence rate, respectively. CONCLUSION: Deep needling of main acupoints Lianquan (CV23) and Yifeng (TE 17) in combination with conventional acupuncture of other acupoints is effective in improving local glossopharyngeal function in apoplexy patients with dysphagia, which is obviously superior to conventional swallowing rehabilitation training in the therapeutic effect and is applicable in clinical practice.

[Difference analysis of muscle fatigue during the exercises of core stability training].

The present study was carried out with the surface electromyography signal of subjects during the time when subjects did the exercises of the 6 core stability trainings. We analyzed the different activity level of surface electromyography signal, and finally got various fatigue states of muscles in different exercises. Thirty subjects completed exercises of 6 core stability trainings, which were prone bridge, supine bridge, unilateral bridge (divided into two trainings, i.e. the left and right sides alternatively) and bird-dog (divided into two trainings, i.e. the left and right sides alternatively), respectively. Each exercise was held on for 1 minute and 2 minutes were given to relax between two exercises in this test. We measured both left and right sides of the body's muscles, which included erector spina, external oblique, rectus abdominis, rectus femoris, biceps femoris, anterior tibial and gastrocnemius muscles. We adopted the frequency domain characteristic value of the surface electromyography signal, i.e. median frequency slope to analyze the muscle fatigue in this study. In the present paper, the results exhibit different fatigue degrees of the above muscles during the time when they did the core stability rehabilitation exercises. It could be concluded that supine bridge and unilateral bridge can cause more fatigue on erector spina muscle, prone bridge caused Gastrocnemius muscle much fatigue and there were statistical significant differences ( P<0.05) between prone bridge and other five rehabilitation exercises in the degree of rectus abdominis muscle fatigue. There were no statistical significant differences ( P>0.05) between all the left and right sides of the same-named muscles in the median frequency slope during all the exercises of the six core stability trainings, i.e. the degree which the various kinds of rehabilitation exercises effected the left and right side of the same-named muscle had no statistical significant difference ( P>0.05). In this research, the conclusion presents quantized guidelines on the effects of core stability trainings on different muscles.

The Activity of Surface Electromyographic Signal of Selected Muscles during Classic Rehabilitation Exercise.

Objectives. Prone bridge, unilateral bridge, supine bridge, and bird-dog are classic rehabilitation exercises, which have been advocated as effective ways to improve core stability among healthy individuals and patients with low back pain. The aim of this study was to investigate the activity of seven selected muscles during rehabilitation exercises through the signal of surface electromyographic. Approaches. We measured the surface electromyographic signals of four lower limb muscles, two abdominal muscles, and one back muscle during rehabilitation exercises of 30 healthy students and then analyzed its activity level using the median frequency method. Results. Different levels of muscle activity during the four rehabilitation exercises were observed. The prone bridge and unilateral bridge caused the greatest muscle fatigue; however, the supine bridge generated the lowest muscle activity. There was no significant difference (P > 0.05) between left and right body side muscles in the median frequency slope during the four rehabilitation exercises of seven muscles. Conclusions. The prone bridge can affect the low back and lower limb muscles of most people. The unilateral bridge was found to stimulate muscles much more active than the supine bridge. The bird-dog does not cause much fatigue to muscles but can make most selected muscles active.

The sEMG characteristics of the low back muscles during aerobic cycling.

More and more people suffer from lumbar muscle strain due to lack of exercise. Cycling serves as both a stylish model of fitness and a training method in exercise and rehabilitation. A few of previous studies have examined the changes in lower extremity muscle activities during indoor cycling, but fewer data pertain to the low back muscles. This study aims to analyze the functional status of erector spinae during cycling by learning the regularity and characteristics of changes in sEMG frequency domain index-mean frequency (MF) within ten minutes. The statistical results showed that the values of 70% subjects fluctuated within the range of (0.04688 ± 0.00125) Hz within the first 30 s and the values raised rapidly to the (150 ± 10) Hz range after the 30 s. Moreover, the values trended to decline slowly in a fluctuating way after a while. However, no obvious regularity was observed among the remaining 30% of the subjects. Results of this study demonstrated that the muscle fatigue with a smaller level of low back began to emerge gradually after 30 s. Moreover, it is evident that cycling can be an incentive to the low back muscles in most people.

[Experiment study on ultrashort wave for treating vascular crisis after rat tail replantation].

OBJECTIVE: To explore the effect and mechanism of ultrashort wave (USW) for prevention and treatment of vascular crisis after rat tail replantation. METHODS: Eighty 3-month old female Sprague Dawley rats (weighing 232.8-289.6 g) were randomly divided into 5 groups. In each group, based on the caudal vein and the coccyx was retained, the tail was cut off. The tail artery was ligated in group A; the tail artery was anastomosed in groups B, C, D, and E to establish the tail replantation model. After surgery, the rats of group B were given normal management; the rats of group C were immediately given intraperitoneal injection (3.125 mL/kg) of diluted papaverine hydrochloride injection (1 mg/mL); the rats of groups D and E were immediately given the local USW treatment (once a day) at anastomotic site for 5 days at the dosage of 3 files and 50 mA for 20 minutes (group D) and 2 files and 28 mA for 20 minutes (group E). The survival rate of the rat tails was observed for 10 days after the tail replantation. The tail skin temperature difference between proximal and distal anastomosis was measured at pre- and post-operation; the change between postoperative and preoperative temperature difference was calculated. The blood plasma specimens were collected from the inner canthus before operation and from the tip of the tail at 8 hours after operation to measure the content of nitric oxide (NO). RESULTS: The survival rates of the rat tails were 0 (0/14), 36.4% (8/22), 57.1% (8/14), 22.2% (4/18), and 75.0% (9/12) in groups A, B, C, D, and E, respectively, showing significant overall differences among 5 groups (chi2 = 19.935, P = 0.001); the survival rate of group E was significantly higher than that of group B at 7 days (P < 0.05), but no significant difference was found between the other groups by pairwise comparison (P > 0.05). At preoperation, there was no significant difference in tail skin temperature difference among 5 groups (P > 0.05); at 8 hours, 5 days, 6 days, and 7 days after operation, significant overall difference was found in the change of the skin temperature difference among groups (P < 0.05); pairwise comparison showed significant differences after operation (P < 0.05): group B > group D at 8 hours, group C > group D at 5 days, groups A, B, and C > group D at 6 days, groups B and C > groups A and E, and group B > group D at 7 days; but no significant difference was found between the other groups at the other time points (P > 0.05). Preoperative plasma NO content between each group had no significant difference (P > 0.05). The overall differences had significance in the NO content at postopoerative 8 hours and in the change of the NO content at pre- and post-operation among groups (P < 0.05). Significant differences were found by pairwise comparison (P < 0.05): group D > groups A, B, and C in the plasma NO content, group D > groups A and B in the change of the NO content at pre- and post-operation; but no significant difference was found between the other groups by pairwise comparison (P > 0.05). CONCLUSION: Rat tail replantation model in this experiment is feasible. USW therapy can increase the survival rate of replanted rat tails, reduce skin temperature at 7 days, improve blood supply, increase the content of nitric oxide at the early period and prevent vascular crisis.

[Linear features analysis of human body balance regulation under passive movement].

In order to find the linear region of adjustment process about human body balance under the passive movement, and provide the basis for the unified evaluation criteria of passive balance test, an equipment was built with pulsed excitation source and wave detector of gravity's center. The pulsed excitation source was a multi-dimensional motion platform with high accuracy. The wave detector was a force platform. Human body and force platform were treated as a whole object, and the dynamic model of the object was built using the method of system identification. The balance ability was evaluated by setting time. In the pulse excitement range from 2mm to 20 mm with 2mm increments, balance ability of 5 students was evaluated and analyzed respectively. Results showed that response curve of human balance regulation was a typical second order linear system characteristic, and in a large enough linear region, the evaluating result had good consistency.