Correlations between Motor Ability with Gait Speed and Cognitive Functions in Rehabilitation Users

Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extension, gait speed, MMSE, and subjective health feeling for 36 rehabilitation users and 22 healthy elders were assessed. We compared and examined motor and cognitive functions in rehabilitation users who need support and healthy elders. Results: The percentage of MMSE scores with 27 points or higher and that of subjective health feeling with 3 points or higher were significantly higher in healthy elders than in rehabilitation users. Systolic and diastolic blood pressure were significantly higher in rehabilitation users than in healthy elders. Gait speed and MMSE scores were significantly higher in healthy elders than rehabilitation users. Conclusion: Gait speed could be used for physical fitness in elders. Gait speed was the best physical fitness measurement for elders. Gait speed of rehabilitation users was strongly related to MMSE scores. Gait speed could be a determinant of MMSE scores.

Improvement of learning and memory abilities and motor function in rats with cerebral infarction by intracerebral transplantation of neuron-like cells derived from bone marrow stromal cells

BACKGROUND： Transplantation of fetal cell suspension or blocks of fetal tissue can ameliorate the nerve function after the injury or disease in the central nervous system, and it has been used to treat neurodegenerative disorders induced by Parkinson disease. OBJECTIVE： To observe the effects of the transplantation of neuron-like cells derived from bone marrow stromal cells （rMSCs） into the brain in restoring the dysfunctions of muscle strength and balance as well as learning and memory in rat models of cerebral infarction. DESIGN ： A randomized controlled experiment.SETTING ： Department of Pathophysiology, Zhongshan Medical College of Sun Yat-sen University.MATERIALS ： Twenty-four male SD rats （3-4 weeks of age, weighing 200-220 g） were used in this study （Certification number：2001A027）. METHODS： The experiments were carried out in Zhongshan Medical College of Sun Yat-sen University between December 2003 and December 2004. ① Twenty-four male SD rats randomized into three groups with 8 rats in each： experimental group, control group and sham-operated group. Rats in the experiment al group and control group were induced into models of middle cerebral artery occlusion （MCAO）. After in vitro cultured, purified and identified with digestion, the Fischer344 rMSCs were induced to differentiate by tanshinone IIA, which was locally injected into the striate cortex （18 area） of rats in the experimental group, and the rats in the control group were injected by L-DMEM basic culture media （without serum） of the same volume to the corresponding brain area. In the sham-operated group, only muscle and vessel of neck were separated. ② At 2 and 8 weeks after the transplantation, the rats were given the screen test, prehensile-traction test, balance beam test and Morris water-maze test. ③ The survival and distribution of the induced cells in corresponding brain area were observed with Nissl stained with toluidine blue and hematoxylin and eosin （HE） staining in the groups.MAIN OUTCOME MEASURES ： ① Results of the behavioral tests （time of the Morris water-maze test screen test, prehensile-traction test, balance beam test）; ② Survival and distribution of the induced cells.RESULTS： All the 24 rats were involved in the analysis of results. ① Two weeks after transplantation, rats with neuron-like cells grafts in the experimental group had significant improvement on their general muscle strength than those in the control group [screen test： （9.4±1.7）, （4.7±1.0） s, P 〈 0.01]; forelimb muscle strength [prehensile-traction test： （7.6±1.4）, （5.2±1.2） s, P 〈 0.01], ability to keep balance [balance beam test： （7.9±0.74）, （6.1±0.91） s, P 〈 0.01] and abilities of learning and memory [latency to find the platform： （35.8±5.9）, （117.5±11.6） s, P 〈 0.01; distance： （623.1±43.4）, （1 902.3±98.6） cm, P 〈 0.01] as compared with those in the control group. The functional performances in the experimental group at 8 weeks were better than those at two weeks, which were still obviously different from those in the sham-operated group （P 〈 0.05）. ② The HE and Nissl stained brain tissue section showed that there was nerve cell proliferation at the infarcted cortex in the experiment group, the density was higher than that in the control group, plenty of aggregative or scattered cells could be observed at the site where needle was inserted for transplantation, the cells migrated directively towards the area around them, the cerebral vascular walls were wrapped by plenty of cells; In the control group, most of the cortices were destroyed, karyopyknosis and necrosis of neurons were observed, normal nervous tissue structure disappeared induced by edema, only some nerve fibers and glial cells remained.CONCLUSION： The rMSCs transplantation can obviously enhance the motor function and the abilities of learning and memory in rat models of cerebral infarction.

Effects of Interactive Dynamic Scalp Acupuncture on Motor Function and Gait of Lower Limbs after Stroke:A Multicenter,Randomized,Controlled Clinical Trial

Objective:To evaluate the effects of interactive dynamic scalp acupuncture(IDSA),simple combination therapy(SCT),and traditional scalp acupuncture(TSA)on motor function and gait of the lower limbs in post-stroke hemiplegia patients.Methods:A total of 231 patients with post-stroke hemiplegia was randomly divided into IDSA(78 cases),SCT(78 cases),and TSA(75 cases)groups by a random number table.Scalp acupuncture(SA)and lower-limb robot training(LLRT)were both performed in the IDSA and SCT groups.The patients in the TSA group underwent SA and did not receive LLRT.The treatment was administered once daily and 6 times weekly for 8 continuous weeks,each session lasted for 30 min.The primary outcome measures included Fugl-Meyer Assessment of the Lower Extremity(FMA-LE),Berg Balance Scale(BBS),Modified Barthel Index(MBI),and 6-min walking test(6 MWT).The secondary outcome measures included stride frequency(SF),stride length(SL),stride width(SW),affected side foot angle(ASFA),passive range of motion(PROM)of the affected hip(PROM-H),knee(PROM-K)and ankle(PROM-A)joints.The patients were evaluated before treatment,at 1-and 2-month treatment,and 1-,and 2-month follow-up visits,respectively.Adverse events during 2-month treatment were observed.Results:Nineteen patients withdrew from the trial,with 8 in the IDSA group,5 in the SCT group,and 6 in the TSA group.The FMA-LE,BBS,6 MWT and MBI scores in the IDSA group were significantly increased after 8-week treatment and2 follow-up visits compared with the SCT and TSA groups(P<0.05 or P<0.01).Compared with pre-treatment,the grade distribution of BBS and MBI scores in the 3 groups were significantly improved at 1,2-month treatment and 2 follow-up visits(P<0.05 or P<0.01).The SF,PROM-H,PFOM-K and PROM-A in the IDSA group was significantly increased compared with the SCT and TSA groups after 8-week of treatment(P<0.05 or P<0.01).Compared with the SCT group,ASFA of the IDSA group was significantly reduced after 8-week of treatment(P<0.05).SF,SL,PROM-K and PROM-A were significantly increased at the 2 nd follow-up visit whereas the ASFA was significantly reduced in the IDSA group compared with the SCT groups at 1 st follow-up visit(P<0.05 or P<0.01).The SF was significantly increased in the SCT group compared with the TSA group after 8-week treatment(P<0.05).Compared with the TSA group,PROM-K,PROM-A were significantly increased at the 2 nd follow-up visit(P<0.05).Conclusions:The effects of IDSA on lower-limb motor function and walking ability of post-stroke patients were superior to SCT and TSA.The SCT was comparable to TSA treatment,and appeared to be superior in improving the motion range of the lower extremities.(Registration No.ChiCTR1900027206)