Objective： To investigate the clinical significance of treating post-apoplectic limb spasm by puncturing the acupoints of Governor Vessel as a main therapy. Methods： Twenty- nine patients with post-apoplectic limb s...Objective： To investigate the clinical significance of treating post-apoplectic limb spasm by puncturing the acupoints of Governor Vessel as a main therapy. Methods： Twenty- nine patients with post-apoplectic limb spasm were treated by puncturing the acupoints of Governor Vessel plus the acupoints adjacent to joints, together with another 29 patients treated by conventional acupoints for comparison of the curative effects. Results： Before treatment, there was no significant difference in Ashoworth limb tension score and Fugl-Meyer motor function score between the two groups of patients （P〉0.05）. After treatment, there was significant difference in tension score between the two groups （P〈0.05）. Motor function score significantly increased as compared with that before the treatment in both groups （P〈0.01）, but limb motor function improved more obviously in the treatment group than in the control group （P〈0.05）. Conclusion： To puncture the acupoints of Governor Vessel as a main therapy can significantly improve the curative effect in the treatment of post-apoplectic limb spasm than conventional acupuncture method.展开更多
Background:To investigate the effects of acupuncture on post-stroke limb spasm model rats and the underlying mechanism.Methods:A total of 50 Sprague-Dawley rats were randomly divided into three groups,Control group(10...Background:To investigate the effects of acupuncture on post-stroke limb spasm model rats and the underlying mechanism.Methods:A total of 50 Sprague-Dawley rats were randomly divided into three groups,Control group(10),Model group(20)and Zhishen Tiaoxing(ZSTX)acupuncture group(20).Middle cerebral artery occlusion was conducted in SD rats to establish post-stroke limb spasm rats,which were treated with ZSTX acupuncture.Behavioral assays were determined by the Narrow ally test,the limb muscle tension was detected by the BL-420S test system,and infarct volume was assessed after the cerebral infarction by 2,3,5-triphenyltetrazolium chloride staining.Heterogeneous neurotransmitterγ-aminobutyric acid(GABA)and its receptors GABAA and GABAB in the cerebral cortex of the infarct area were determined by immunofluorescence assay.The release of Trkb and K-Cl cotransporter isoform 2 was detected by an immunofluorescence double labeling study.Western Blot was utilized to measure the expression of BDNF and Trkb.Results:The results showed that the behavioral assays in post-stroke limb spasm rats were significantly improved by the treatment of ZSTX acupuncture.14 days of ZSTX acupuncture can effectively inhibit muscle tone and decrease Infarct volume,which was measured with BL-420S biological function experiment system and triphenyltetrazolium chloride.Meanwhile,the results of Double-Label Immunofluorescence Assays showed that ZSTX acupuncture improved the expression of GABA,GABAA,GABAB,BDNF,and K-Cl cotransporter isoform 2.Double-Label Immunofluorescence Assays and WB results showed that 14 days ZSTX acupuncture declined the expression of Trkb.Conclusions:Our results suggest that 14 days of ZSTX acupuncture can significantly improve post-stroke limb spasm.Meanwhile,the pathogenesis of post-stroke limb spasm and the efficacy of ZSTX acupuncture involve metabolic pathways of neurotransmitters,and electro-acupuncture can treat post-stroke limb spasm by regulating BDNF/Trkb-KCC2 signaling pathway.展开更多
BACKGROUND: The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living. Several factors are needed in the self-recovery of the patients, and the most imp...BACKGROUND: The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living. Several factors are needed in the self-recovery of the patients, and the most important one is to reduce spasm. Some mechanical repetitive movements can affect and change the excitability of motor neurons. OBJECTIVE: To observe the effect of repetitive training on ameliorating spasm of upper limbs of hemiplegic patients. DESIGN: A self-controlled observation before and after training. SETTING: Department of Rehabilitation, Xuanwu Hospital of Capital Medical University. PARTICIPANTS: Seven hemiplegic patients induced by brain injury were selected from the Department of Rehabilitation, Xuanwu Hospital, Capital Medical University from March to June in 2005. Inclusive criteria: ① Agreed and able to participate in the 30-minute training of hand function; ② Without disturbance of understanding. The patients with aphasia or apraxia, manifestation of shoulder pain, and severe neurological or mental defects. For the 7 patients, the Rivermead motor assessment (RMA) scores ranged 0-10 points, the Rivermead mobility index (RMI) ranged 1-3, and modified Ashworth scale (MAS) was grade 2-4. Their horizontal extension of shoulder joint was 0°-30°, anteflextion was 0°-50°, internal rotation was 50°-90°, external rotation was 0°-10°; and the elbow joint could extend for 15°-135°. METHODS: The viva 2 serial MOTOmed exerciser (Reck Company, Germany) was used. There were three phases of A-B-A. ① The phase A lasted for 1 week. The patient sat on a chair facting to the MOTOmed screen, and did the circumduction of upper limbs forwardly, 30 minutes a day and 5 days a week. ② The phase B lasted for 3 weeks. The training consisted of forward circumduction of upper limbs for 15 minutes, followed by backward ones for 15 minutes and 5-minute rest. ③ The training in the phase A was performed again for 2 weeks. The extensions of upper limbs were recorded at phase A, the extension and flexion of elbow joints were recorded at phase B, and the extensions were recorded at the second A phase. All the patients were evaluated by the same therapeutist. ① RMA was used to evaluate the motor function completely, including the motor control of both upper and lower limbs, but only the data of upper limbs were recommended to be used. The flexibility and concordance of upper limbs were described by detecting the ability of hand to move objects with 15 items, 2 grades for each item: 0 for could not complete and 1 for could complete. ② RMI was used to measure the flexion and extension of elbow joint and shoulder joint, the scores ranged from 0 (no movement and no obvious muscle contraction) to 5 (close to normal movement). ③ MAS was used to evaluate the muscle tension in clinic. Grade 1 for without abnormal increase of muscle tension, and grade 5 for muscle rigidity, and it was unable for passive movement. ④ Ranges of motion of elbow joint and should joint were measured using protractor. MAIN OUTCOME MEASURES: ① The strength of each limb to persist for 40 s recorded by two hand pedals; ② Changes of muscle tensions detected by the two hand pedals; ③ Changes of muscle contraction at the flexion and extension of ipsilateral limb recorded by EMG; ④ Minimal moment of iplateral end foot; ⑤ RMA; ⑥ RMI; ⑦ MAS; ⑧ Ranges of motion of elbow joints and shoulder joints. RESULTS: The functions were evaluated at 6 weeks after training. ① The strength of each limb to persist for 40 s was recorded, and the strength of the ipsilateral limb changed obviously from 20%-40% to 50%-70%. ② The muscle tensions detected by the two hand pedals changed from 2.2-4.0 N·m to 0.2-1.0 N·m. ③ EMG displayed that along with the enhancement of fast movements, the strength curve increased (the EMG for the extension of elbow joints were obvious). ④ The minimal moment of iplateral end foot was 5.0 N·m. ⑤ The RMA scores ranged 15-30 points. ⑥ The RMI ranged 4-5. ⑦ MAS were grades 0-2. ⑧ For shoulder joints, the ranges of motion were 90°-180° for external extension, 90° for anteflexion, 90° for internal rotation and 50°-75° for external rotation; For elbow joints, the extension of active movements was close to 0°. CONCLUSION: After repetitive movements, the strength of upper limb increased, the range of motion enlarged, and spasm reduced.展开更多
Objective: To describe the latest progress in the use of botulinum neurotoxin for post-stroke limb spasm. Methods: This paper looks up the relevant research literatures in recent years in PubMed, Web of Science, Sprin...Objective: To describe the latest progress in the use of botulinum neurotoxin for post-stroke limb spasm. Methods: This paper looks up the relevant research literatures in recent years in PubMed, Web of Science, Springer, Ovid, CNKI, WanFang databases and summarizes them. Results: The latest progress in the use of botulinum neurotoxin for post-stroke limb spasm was studied from the following aspects: the action mechanism of botulinum neurotoxin;efficacy evaluation;injection dose;target muscle selection;guiding technology;combination therapy. Conclusion: Botulinum neurotoxin is the first-line treatment for post-stroke limb spasm. We need to make continuous improvement and progress from the treatment period, injection dose, target muscle selection, guiding technology and efficacy evaluation to improve the quality of life of the majority of post-stroke survivors in China.展开更多
Background:To apply CiteSpace software to the hotspot,trend and cutting-edge dynamics of limb spasm after stroke in nearly 20 years.Methods:From 2000 to 2018,spasming literature in the Web of Science database were sea...Background:To apply CiteSpace software to the hotspot,trend and cutting-edge dynamics of limb spasm after stroke in nearly 20 years.Methods:From 2000 to 2018,spasming literature in the Web of Science database were searched,and cooperative analysis of authors'national institutions was conducted by using CiteSpace software,keyword analysis and cluster analysis,citation analysis of authors'literature journals,and visual map.Results:2005 articles were retrieved,and the number of articles increased year by year,and the country with the most articles was the United States.Keyword analysis shows that mechanistic research and clinical treatment of spasticity are research hotspots in this field.The most posts are Northwestern Univ and Univ Verona.Conclusion:Through the CiteSpace software analysis of spasticity literature,it is found that the research focus is embodied in the nerve regeneration technology and the standardized clinical study of botulinum toxin type A application,which has certain reference significance for the future research direction of spasticity.展开更多
文摘Objective： To investigate the clinical significance of treating post-apoplectic limb spasm by puncturing the acupoints of Governor Vessel as a main therapy. Methods： Twenty- nine patients with post-apoplectic limb spasm were treated by puncturing the acupoints of Governor Vessel plus the acupoints adjacent to joints, together with another 29 patients treated by conventional acupoints for comparison of the curative effects. Results： Before treatment, there was no significant difference in Ashoworth limb tension score and Fugl-Meyer motor function score between the two groups of patients （P〉0.05）. After treatment, there was significant difference in tension score between the two groups （P〈0.05）. Motor function score significantly increased as compared with that before the treatment in both groups （P〈0.01）, but limb motor function improved more obviously in the treatment group than in the control group （P〈0.05）. Conclusion： To puncture the acupoints of Governor Vessel as a main therapy can significantly improve the curative effect in the treatment of post-apoplectic limb spasm than conventional acupuncture method.
基金the National Key R&D Program of China(Grant No.2019YFC1709900)National Natural Science Foundation of China(Grant No.71804022)+1 种基金Natural Science Foundation of Henan province(Grant No.232300420256)Medical technologies R&D Program of Henan province(Grant No.LHGJ20220348).
文摘Background:To investigate the effects of acupuncture on post-stroke limb spasm model rats and the underlying mechanism.Methods:A total of 50 Sprague-Dawley rats were randomly divided into three groups,Control group(10),Model group(20)and Zhishen Tiaoxing(ZSTX)acupuncture group(20).Middle cerebral artery occlusion was conducted in SD rats to establish post-stroke limb spasm rats,which were treated with ZSTX acupuncture.Behavioral assays were determined by the Narrow ally test,the limb muscle tension was detected by the BL-420S test system,and infarct volume was assessed after the cerebral infarction by 2,3,5-triphenyltetrazolium chloride staining.Heterogeneous neurotransmitterγ-aminobutyric acid(GABA)and its receptors GABAA and GABAB in the cerebral cortex of the infarct area were determined by immunofluorescence assay.The release of Trkb and K-Cl cotransporter isoform 2 was detected by an immunofluorescence double labeling study.Western Blot was utilized to measure the expression of BDNF and Trkb.Results:The results showed that the behavioral assays in post-stroke limb spasm rats were significantly improved by the treatment of ZSTX acupuncture.14 days of ZSTX acupuncture can effectively inhibit muscle tone and decrease Infarct volume,which was measured with BL-420S biological function experiment system and triphenyltetrazolium chloride.Meanwhile,the results of Double-Label Immunofluorescence Assays showed that ZSTX acupuncture improved the expression of GABA,GABAA,GABAB,BDNF,and K-Cl cotransporter isoform 2.Double-Label Immunofluorescence Assays and WB results showed that 14 days ZSTX acupuncture declined the expression of Trkb.Conclusions:Our results suggest that 14 days of ZSTX acupuncture can significantly improve post-stroke limb spasm.Meanwhile,the pathogenesis of post-stroke limb spasm and the efficacy of ZSTX acupuncture involve metabolic pathways of neurotransmitters,and electro-acupuncture can treat post-stroke limb spasm by regulating BDNF/Trkb-KCC2 signaling pathway.
文摘BACKGROUND: The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living. Several factors are needed in the self-recovery of the patients, and the most important one is to reduce spasm. Some mechanical repetitive movements can affect and change the excitability of motor neurons. OBJECTIVE: To observe the effect of repetitive training on ameliorating spasm of upper limbs of hemiplegic patients. DESIGN: A self-controlled observation before and after training. SETTING: Department of Rehabilitation, Xuanwu Hospital of Capital Medical University. PARTICIPANTS: Seven hemiplegic patients induced by brain injury were selected from the Department of Rehabilitation, Xuanwu Hospital, Capital Medical University from March to June in 2005. Inclusive criteria: ① Agreed and able to participate in the 30-minute training of hand function; ② Without disturbance of understanding. The patients with aphasia or apraxia, manifestation of shoulder pain, and severe neurological or mental defects. For the 7 patients, the Rivermead motor assessment (RMA) scores ranged 0-10 points, the Rivermead mobility index (RMI) ranged 1-3, and modified Ashworth scale (MAS) was grade 2-4. Their horizontal extension of shoulder joint was 0°-30°, anteflextion was 0°-50°, internal rotation was 50°-90°, external rotation was 0°-10°; and the elbow joint could extend for 15°-135°. METHODS: The viva 2 serial MOTOmed exerciser (Reck Company, Germany) was used. There were three phases of A-B-A. ① The phase A lasted for 1 week. The patient sat on a chair facting to the MOTOmed screen, and did the circumduction of upper limbs forwardly, 30 minutes a day and 5 days a week. ② The phase B lasted for 3 weeks. The training consisted of forward circumduction of upper limbs for 15 minutes, followed by backward ones for 15 minutes and 5-minute rest. ③ The training in the phase A was performed again for 2 weeks. The extensions of upper limbs were recorded at phase A, the extension and flexion of elbow joints were recorded at phase B, and the extensions were recorded at the second A phase. All the patients were evaluated by the same therapeutist. ① RMA was used to evaluate the motor function completely, including the motor control of both upper and lower limbs, but only the data of upper limbs were recommended to be used. The flexibility and concordance of upper limbs were described by detecting the ability of hand to move objects with 15 items, 2 grades for each item: 0 for could not complete and 1 for could complete. ② RMI was used to measure the flexion and extension of elbow joint and shoulder joint, the scores ranged from 0 (no movement and no obvious muscle contraction) to 5 (close to normal movement). ③ MAS was used to evaluate the muscle tension in clinic. Grade 1 for without abnormal increase of muscle tension, and grade 5 for muscle rigidity, and it was unable for passive movement. ④ Ranges of motion of elbow joint and should joint were measured using protractor. MAIN OUTCOME MEASURES: ① The strength of each limb to persist for 40 s recorded by two hand pedals; ② Changes of muscle tensions detected by the two hand pedals; ③ Changes of muscle contraction at the flexion and extension of ipsilateral limb recorded by EMG; ④ Minimal moment of iplateral end foot; ⑤ RMA; ⑥ RMI; ⑦ MAS; ⑧ Ranges of motion of elbow joints and shoulder joints. RESULTS: The functions were evaluated at 6 weeks after training. ① The strength of each limb to persist for 40 s was recorded, and the strength of the ipsilateral limb changed obviously from 20%-40% to 50%-70%. ② The muscle tensions detected by the two hand pedals changed from 2.2-4.0 N·m to 0.2-1.0 N·m. ③ EMG displayed that along with the enhancement of fast movements, the strength curve increased (the EMG for the extension of elbow joints were obvious). ④ The minimal moment of iplateral end foot was 5.0 N·m. ⑤ The RMA scores ranged 15-30 points. ⑥ The RMI ranged 4-5. ⑦ MAS were grades 0-2. ⑧ For shoulder joints, the ranges of motion were 90°-180° for external extension, 90° for anteflexion, 90° for internal rotation and 50°-75° for external rotation; For elbow joints, the extension of active movements was close to 0°. CONCLUSION: After repetitive movements, the strength of upper limb increased, the range of motion enlarged, and spasm reduced.
文摘Objective: To describe the latest progress in the use of botulinum neurotoxin for post-stroke limb spasm. Methods: This paper looks up the relevant research literatures in recent years in PubMed, Web of Science, Springer, Ovid, CNKI, WanFang databases and summarizes them. Results: The latest progress in the use of botulinum neurotoxin for post-stroke limb spasm was studied from the following aspects: the action mechanism of botulinum neurotoxin;efficacy evaluation;injection dose;target muscle selection;guiding technology;combination therapy. Conclusion: Botulinum neurotoxin is the first-line treatment for post-stroke limb spasm. We need to make continuous improvement and progress from the treatment period, injection dose, target muscle selection, guiding technology and efficacy evaluation to improve the quality of life of the majority of post-stroke survivors in China.
文摘Background:To apply CiteSpace software to the hotspot,trend and cutting-edge dynamics of limb spasm after stroke in nearly 20 years.Methods:From 2000 to 2018,spasming literature in the Web of Science database were searched,and cooperative analysis of authors'national institutions was conducted by using CiteSpace software,keyword analysis and cluster analysis,citation analysis of authors'literature journals,and visual map.Results:2005 articles were retrieved,and the number of articles increased year by year,and the country with the most articles was the United States.Keyword analysis shows that mechanistic research and clinical treatment of spasticity are research hotspots in this field.The most posts are Northwestern Univ and Univ Verona.Conclusion:Through the CiteSpace software analysis of spasticity literature,it is found that the research focus is embodied in the nerve regeneration technology and the standardized clinical study of botulinum toxin type A application,which has certain reference significance for the future research direction of spasticity.
