Intervention Effect of Lower Limb Rehabilitation Robot with Task-Oriented Training on Stroke Patients and Its Influence on KFAROM Score

Objective: To explore the effect of lower limb rehabilitation robot combined with task-oriented training on stroke patients and its influence on KFAROM score. Methods: 100 stroke patients with hemiplegia admitted to our hospital from January 2023 to December 2023 were randomly divided into two groups, the control group (50 cases) was given task-oriented training assisted by nurses, and the observation group (50 cases) was given lower limb rehabilitation robot with task-oriented training. Lower limb balance, lower limb muscle strength, motor function, ankle function, knee flexion range of motion and walking ability were observed. Results: After treatment, the scores of BBS, quadriceps femoris and hamstrings in the observation group were significantly higher than those in the control group (P Conclusion: In the clinical treatment of stroke patients, the combination of task-oriented training and lower limb rehabilitation robot can effectively improve the lower limb muscle strength, facilitate the recovery of balance function, and have a significant effect on the recovery of motor function, which can improve the walking ability of stroke patients and the range of motion of knee flexion, and achieve more ideal therapeutic effectiveness.

Analysis of the Effect of Transcutaneous Electrical Stimulation of Acupoints Combined with Rehabilitation Training in The Treatment of Upper Limb Dysfunction After Stroke

Objective:To analyze the effect of combining transcutaneous electrical acupoint stimulation(TEAS)with rehabilitation training in patients with upper limb dysfunction after stroke(ULDAS).Methods:A total of 130 ULDAS patients who were hospitalized and rehabilitated in Wuxi Xinwu District Rehabilitation Hospital from May 2021 to May 2023 were selected and randomly divided into Group A(65 cases,rehabilitation training)and Group B(65 cases,rehabilitation training+TEAS).The effects of the two groups were compared.Results:After treatment,the upper limb functional indexes of Group B were better than those of Group A(P<0.05).The rate of muscle tone grades 0-4 in Group B was higher than those of Group A(P<0.05).Conclusion:The function of upper limbs and muscle strength of ULDAS patients improved by combining TEAS with rehabilitation training.

A Clinical Randomized Controlled Study of Low-Frequency rTMS Therapy on Lower Limb Motor Dysfunction after Stroke

Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.

Application of cross-migration theory in limb rehabilitation of stroke patients with hemiplegia

BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration,an increase in bilateral muscle strength,and an improvement in lower limb motor function.METHODS We randomly divided 120 patients with hemiplegic stroke into two groups:Eexperimental and control groups,with 60 patients in each group.Both groups received routine rehabilitation treatment,while the experimental group additional-ly received ankle dorsiflexion resistance training on the healthy side for 6 wk.We measured the maximum voluntary contract(MVC),changes in surface electromyography(EMG),and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale(FMA)before and within 1 wk after training.RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score(P<0.05).The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before(P<0.05).Furthermore,the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group(P<0.05).CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle,indicating a cross-migration phenomenon of strength training.Furthermore,this type of training can also improve lower limb motor function,providing a new exercise method for improving early ankle dorsiflexion dysfunction.

Correlation study between motor rehabilitation level and psychological state in patients with limb movement disorders after stroke

BACKGROUND The psychological state of patients with post stroke limb movement disorders undergoes a series of changes that affect rehabilitation training and recovery of limb motor function.AIM To determine the correlation between motor rehabilitation and the psychological state of patients with limb movement disorders after stroke.METHODS Eighty patients with upper and lower limb dysfunction post stroke were retrospectively enrolled in our study.Based on Hospital Anxiety and Depression Scale(HADS)scores measured before rehabilitation,patients with HADS scores≥8 were divided into the psychological group;otherwise,the patients were included in the normal group.Motor function and daily living abilities were compared between the normal and psychological groups.Correlations between the motor function and psychological status of patients,and between daily living ability and psychological status of patients were analyzed.RESULTS After 1,2,and 3 wk of rehabilitation,both the Fugl-Meyer assessment and Barthel index scores improved compared to their respective baseline scores(P<0.05).A greater degree of improvement was observed in the normal group compared to the psychological group(P<0.05).There was a negative correlation between negative emotions and limb rehabilitation(-0.592≤r≤-0.233,P<0.05),and between negative emotions and daily living ability(-0.395≤r≤-0.199,P<0.05).CONCLUSION There is a strong correlation between motor rehabilitation and the psychological state of patients with post stroke limb movement disorders.The higher the negative emotions,the worse the rehabilitation effect.

Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients

Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.

Mechanism of Kinect-based virtual reality training for motor functional recovery of upper limbs after subacute stroke

The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains un- clear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The FugI-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sen- sorimotor cortex.

Slacklining and stroke: A rehabilitation case study considering balance and lower limb weakness

To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting. The introduction of slacklining as an adjunct therapy was made 12 mo post incident. Slacklining involves balance retention on a tightened band where external environmental changes cause a whole-body dynamic response to retain equilibrium. It is a complex neuromechanical task enabling individualized self-developed response strategies to be learned and adapted. This facilitates the innate process of balance retention, lower-limb and core muscle activation, and stable posture through a combination of learned motor skills and neurological system down regulation. Individuals adopt and follow established sequential motor learning stages where the acquired balance skillsare achieved in a challenging composite-chain activity. Slacklining could be considered an adjunct therapy for lower limb stroke rehabilitation where function is compromised due to decreased muscle recruitment, decreased postural control and compromised balance. Initial inpatient rehabilitation involved one-month acute-care, one-month rehabilitation, and one-month transitional care prior to home discharge. A further six months of intensive outpatient rehabilitation was provided with five hourly sessions per week including:supervised and self-managed hydrotherapy, plus one individual and two group falls' prevention sessions. These were supported by daily home exercises. At 12 mo post incident, recovery plateaued, then regressed following three falls. Rehabilitation was subsequently modified with the hydrotherapy retained and the group sessions replaced with an additional individual session supplemented with slacklining. The slacklining followed stages one and two of a standardized five-stage protocol. Self-reported functional progression resumed with improvement by 14 mo which further increased and was sustained 18 mo(Students' t test P < 0.05). Slacklining's external stimulations activate global-body responses through innate balance, optimal postural and potentially down-regulated reflex control. Incorporated into stroke rehabilitation programs, slacklining can provide measurable functional gains.

Different frequencies of repetitive transcranial magnetic stimulation combined with local injection of botulinum toxin type A for post-stroke lower limb spasticity:study protocol for a prospective,single-center,non-randomized,controlled clinical trial

No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest research indicates that when combined with local injections of botulinum toxin type A,it is more effective on post-stroke muscle spasticity than local injections of botulinum toxin type A alone.We designed a prospective,single-center,non-randomized,controlled clinical trial to investigate the safety and effica cy of different frequencies of repetitive transcranial magnetic stimulation combined with local injections of botulinum toxin type A in treating post-stroke lower limb muscle spasticity to determine an optimal therapeutic regimen.This trial will enroll 150 patients with post-stroke muscle spasticity admitted to the Department of Rehabilitation Medicine at the First Affiliated Hos pital of China Medical Unive rsity.All enrolled patients will undergo ro utine rehabilitation training and will be divided into five groups in-30 per group) according to the particular area of cerebral infa rction and treatment methods.G roup A:Patients with massive cerebral infarction will be given local injections of botulinum toxin type A and low-frequency(1 Hz)repetitive transcranial magnetic stimulation on the contralate ral side;G roup B:Patients with non-massive cerebral infarction will be given local injections of botulinum toxin type A and high-frequency(10-20 Hz) re petitive transcranial magnetic stimulation on the affected side;G roup C:Patients with massive/non-massive cerebral infarction will be given local injections of botulinum toxin type A;G roup D:Patients with massive cerebral infarction will be given low-frequency(1 Hz) repetitive transcranial magnetic stimulation on the contralate ral side;and G roup E:Patients with non-massive cerebral infa rction will be given high-frequency(10-20 Hz) repetitive transcranial magnetic stimulation on the affected side.The primary outcome measure of this trial is a modified Ashwo rth scale score from 1 day before treatment to 12 months after treatment.Secondary outcome measures include Fugl-M eyer Assessment of Lower Extremity,Visual Analogue Scale,modified Barthel index,and Berg Balance Scale scores for the same time as specified for primary outcome measures.The safety indicator is the incidence of adverse events at 3-12 months after treatment.We hope to draw a definite conclusion on whether there are diffe rences in the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation combined with botulinum toxin type A injections in the treatment of patients with post-stroke lower limb spasticity under strict grouping and standardized operation,thereby screening out the optimal therapeutic regimen.The study protocol was approved by the Medical Ethics Committee of the First Affiliated Hospital of China Medical University(approval No.[2021] 2021-333-3) on August 19,2021.The trial was registe red with the Chinese Clinical Trial Registry(Registration No.ChiCTR2100052180) on October 21,2021.The protocol version is 1.1.

Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.

Therapeutic Application of High-Frequency rTMS Combined with Intensive Occupational Therapy for Pediatric Stroke Patients with Upper Limb Hemiparesis: A Case Series Study

Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) applied to the non-lesional hemisphere is reported to significantly improve motor function of the affected upper limb in adult stroke patients with hemiparesis. For pediatric stroke patients, the beneficial effects of LF-rTMS have been already confirmed in a randomized controlled study. However, there is no report of therapeutic application of high-frequency rTMS (HF-rTMS) in this patient population. In this case series study, we introduced HF-rTMS combined with intensive occupational therapy (OT) in two pediatric hemiparetic patients. We studied two children (8- and 9-year-old boys, both right-handed) with post-stroke upper limb hemiparesis (chronic phase). Both patients underwent 22 treatment sessions of HF-rTMS/OT during 15-day hospitalization. The HF-rTMS was applied over the lesional motor cortex at a frequency of 10Hz for 15 minutes in each session. One session of intensive OT consisted of 30-min one-to-one training and 30-min self-exercise. Motor function of the affected upper limb was serially evaluated with Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Simple Test for Evaluating hand Function (STEF), and Ten-second Test. Neither of the patients showed any adverse effects. Both patients showed improvement of motor function in the affected upper limb and were able to use the affected upper limb in some activities of daily living. In the two post-stroke pediatric patients, HF-rTMS/OT was safe and improved upper limb muscle function. Confirmation of these effects in a larger population is needed.

Effects of Water Weight-Loss Walking Training on Lower Limb Motor Function and Gait in Stroke Patients

Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.

Evaluation of the Curative Effect of "Xingnao Kaiqiao" Acupuncture Based on Brunnstrom Staging on Upper Limb and Hand Motor Function in the Recovery Period after Stroke

Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.

The Recovery of Complicated Upper Limbs Movement Functions of Poststroke Patients

In chronic stage of stroke, it is necessary to pay attention to the complex spatial movements training along with the traditional restoration of balance, strength of particular muscles, and paretic limb joints mobility. The aim of the study was to evaluate the effectiveness of robotic therapy in the recovery of upper limb function in the chronic stage of stroke. The study involved 52 patients with ischemic stroke in the middle cerebral artery. The patients were divided randomly into 2 groups. All patients （5 days/wk × 3 wk） got gymnastics by the standard technique, massage, laser, and pulsed currents therapy. Main group patients （n = 36） extra received complex spatial movements, speed, fluidity, precision and agility training by the robotic electromechanical device Multi Joint System （MJS） （40 minutes, 5 days/wk × 3 wk）. Analysis of the results of the study showed a statistically significant difference in improving ROM of the elbow and shoulder joints, speed and accuracy of movement in the main group compared with the control. Hardware recovery of complex spatial upper limb movements in the chronic stage of stroke increases the functionality and independence of the patient＇s domestic skills.

Early application of percutaneous neuromuscular electric stimulation in interfering motor function of limbs and difference in temperature of axilla of patients with ischemic stroke

BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.

Warm-needle acupuncture for limb spasticity post-stroke:a systematic review

Background:Warm acupuncture,or warm-needle acupuncture,is a traditional external treatment widely used in China for thousands of years.However,the effects of different treatment times on limb spasticity post-stroke have not been evaluated.Methods:We searched PubMed,Embase,the Cochrane Library,the Web of Science,the China National Knowledge Infrastructure,the Chinese Scientific and Journal Database,the Wanfang database,and the Chinese Biomedical Literature Database from inception to May 21st,2020,to seek information regarding randomized controlled trials studying warm-needle acupuncture for limb spasticity post-stroke.Two authors selected 24 studies fitting the eligibility criteria and developed this systematic review and meta-analysis.Results:Warm-needle acupuncture is shown to be more effective than other treatments used in the control groups(odds ratio(OR)=3.61,95%confidence intervals(CI)(2.51,5.19),P<0.001).This treatment decreased limb spasticity as assessed with the Modified Ashworth Scale(mean differences(MD)=−0.78,95%CI(−1.00,−0.56),P<0.001)and the Clinic Spasticity Index(MD=1.06,95%CI(0.51,1.60),P=0.0002),improved sensorimotor impairments according to the Fugl-Meyer Assessment(MD=9.51,95%CI(6.99,12.03),P<0.001),and improved activities of daily living according to the Barthel Index(MD=9.70,95%CI(6.27,13.12),P<0.001).Subgroup analysis based on the length of the treatment using the Modified Ashworth Scale,Fugl-Meyer Assessment,and Barthel Index showed better outcomes for patients who received more than 20 days of treatments(P<0.001).Conclusion:Warm-needle acupuncture is an effective treatment for limb spasticity post-stroke.A treatment frequency of more than 20 days appears to have better effectiveness than that of less than 20 days.

Bibliometric and visual analysis of limb spasm after stroke based on Citespace software

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.

头针联合上肢功能性电刺激对脑卒中后上肢运动功能影响的随机对照研究

目的:探讨头针联合功能性电刺激(FES)对脑卒中患者上肢运动功能的影响。方法:本研究采取单盲随机对照研究,纳入符合标准的脑卒中上肢功能障碍患者60例,使用信封法随机分为头针联合FES组、FES组和常规康复组,每组各20例。给予5次/周,连续4周的干预。比较三组在干预第2周、第4周,及治疗结束后的第4周随访时的上肢运动功能变化情况。采用Fugl-Meyer运动功能评定量表-上肢部分(FMA-UE)、Wolf运动功能评价量表及Brunnstrom分期进行干预效果的评价。结果:(1)三组一般资料及结局指标治疗前对比均无显著性差异(P>0.05);(2)治疗4周后及出院4周进行随访时,FMA-UE评分:头针联合FES组较FES组、常规康复组在FMA-UE评分明显提升,差异具有显著性意义(P<0.05);(3)三组间Wolf评分及Brunnstrom分期在干预后及随访中均无显著性差异(P>0.05)。结论:头针联合上肢FES治疗可以提高脑卒中患者的上肢运动功能。

多元化护理宣教对脑卒中偏瘫患者康复的影响

目的 探讨多元化护理宣教对脑卒中偏瘫患者焦虑、抑郁情绪及肢体功能障碍恢复的影响。方法 选择柳州市人民医院神经内科2020年7月—2022年6月符合诊断标准且自愿进入临床研究的住院120例脑卒中偏瘫患者作为研究对象,按照组间基线资料均衡可比的原则分为观察组和对照组,每组60例。对照组进行常规护理干预,观察组在常规护理的基础上进行多元化护理宣教护理干预。对比两组患者功能锻炼依从率,出院前、出院1个月、3个月、6个月时的肢体运动功能评分、日常活动能力评分,血压、血脂、血糖达标率及焦虑、抑郁情绪。结果 观察组患者功能锻炼依从性高于对照组,两组比较差异有统计学意义(P<0.05)。两组患者出院1个月、3个月、6个月时的肢体运动功能评分、日常活动能力评分逐渐升高,差异有统计学意义(P_(时间)<0.05);各时点肢体运动功能评分、日常活动能力评分观察组均高于对照组,差异有统计学意义(P组间<0.05);随着观察时间的延长,两组肢体运动功能评分、日常活动能力评分差别逐渐增大,差异有统计学意义(P_(交互)<0.05)。观察组患者血压、血脂、血糖达标率高于对照组,两组比较差异有统计学意义(P<0.05)。观察组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分均低于对照组,两组比较差异有统计学意义(P<0.05)。结论 多元化护理宣教对缓解脑卒中偏瘫患者焦虑、抑郁情绪及促进其肢体功能障碍恢复均有积极的影响。

“手脑感知-手脑运动”理论在脑卒中后上肢康复中的应用

上肢运动功能障碍是脑卒中后患者面临的主要问题,寻求更多有效的康复技术对减轻患者功能障碍程度、提升生活质量具有重要意义。本研究关注感觉功能对上肢运动功能恢复的重要作用,并对“手脑感知-手脑运动”理论开展进一步的解读。在该理论的指导下,课题组就手脑感知康复评估与训练系统创建手脑感知训练五步法(感觉评估、感觉宣教、感觉训练、任务导向性训练和感觉认知)、手脑感知-脑机接口训练范式、手脑感知-镜像疗法训练范式和“手脑感知-手脑运动”理论的其他应用进行阐述,分析了“手脑感知-手脑运动”理论与“中枢-外周-中枢”闭环康复理论的关系,以期为康复医务人员在治疗脑卒中后上肢感觉、运动功能障碍提供参考依据与启发。