“重建生活为本”作业治疗病房延伸训练对脑卒中偏瘫患者上肢功能及日常生活活动能力的影响

目的研究并探讨"重建生活为本"作业治疗病房延伸训练对脑卒中(CVA)偏瘫患者上肢功能及日常生活活动能力的影响。方法 60例CVA偏瘫患者,在计算机中采取随机数字表法分为对照组和观察组,每组30例。对照组采用常规综合康复疗法,观察组在对照组基础上进行"重建生活为本"作业治疗病房延伸训练。比较两组患者治疗前、治疗4周后上肢功能、日常生活活动能力。结果治疗前,两组患者Fugl-Meyer量表(FMA)评分、改良Barthel指数量表(MBI)评分比较差异无统计学意义(P>0.05);治疗4周后,两组患者FMA评分、MBI评分均较本组治疗前升高,且观察组患者FMA评分(43.23±3.92)分、MBI评分(80.68±6.21)分均高于对照组的(30.16±4.32)、(60.98±6.81)分,差异具有统计学意义(P<0.05)。结论 "重建生活为本"作业治疗病房延伸训练有利于增强CVA偏瘫患者的肢体运动功能,促使其日常生活能力大大提升,建议临床推广应用。

PREVENTION OF DISABILITY AND REHABILITATION──RESULTS FROM A COLLABORATIVE PROJECT IN CHINA

Eight different geographical districts in China varying in urban and rural characteristics from 6 provinces and 2 municipalities were selected as pilot areas of the project.The interventions included early detection and treatment of neuritis,self-care training,adapted footwear,surgery,comprehensive treatment of complicated ulcers,and prostheses.Main changes in eye,hand and foot impairments between baseline assessment and assessment at 2 years have been presented in this paper.

Effect of governor vessel-regulating needling combined with rehabilitation training on the activities of daily living of patients with cerebral infarction

Objective To observe the difference in efficacy between governor vessel- regulating needling and conventional acupuncture, and to summarize the clinical efficacy and application rules of governor vessel-regulating needling. Methods Ninety patients with cerebral infarction were randomly divided into 2 groups with 45 cases in each group. Governor vessel-regulating needling combined with rehabilitation training were applied in governor vessel- regulating needling group （observation group）, and conventional acupuncture combined with rehabilitation training were applied in conventional acupuncture group （control group）. Modified Barthel index （MBI）, FugI-Meyer assessment （FMA） and neurological deficit scale （NDS） were adopted to assess the treatment efficacy in the two groups before treatment, after treatment for 2 weeks, and after treatment for 4 weeks, respectively. Results After treatment for 2 weeks, MBI and FMA increased significantly in both groups when compared with the results before treatment （all P〈0.01）, NDS reduced significantly in both groups when compared with the results before treatment （both P〈0.01）, and there was no significant difference in MBI, FMA and NDS between two groups （all P〉0.05）; after treatment for 4 weeks, MBI and FMA in observation group were significantly higher than those in control group （both P〈0.05）, and NDS was significantly lower than that in control group （P〈0.05）. Conclusion Compared with conventional acupuncture, governor vessel- regulating needling can significantly improve the activities of daily living of patients with cerebral infarction.

Clinical Observation on Fu’s Subcutaneous Needling plus Electroacupuncture for Post-stroke Spastic Hemiplegia

Objective： To observe the clinical effect of Fu’s subcutaneous needling plus electroacupuncture on post-stroke spastic hemiplegia. Methods： A hundred and twenty patients with post-stroke spastic hemiplegia were divided into the treatment group and the control group randomly, 60 individuals in each group. Patients in the treatment group received Fu’s subcutaneous needling plus electroacupuncture treatments, while only elecroacupuncture treatment for those in the control group. Limbs spasticity, extremity motor function and activity of daily living （ADL） was respectively evaluated with Ashworth scale, simplified Fugl-Meyer motor function score and modified Barthel index （BI） before treatment and after 30-day treatment. Results： After treatment, Ashworth scale score, Fugl-Meyer motor function score and BI score in the treatment group were much higher than those in the control group （P0.05）. Fu’s subcutaneous needling plus electroacupuncture can release spastic hemiplegia, and it is better than the control group. Conclusion： Fu’s subcutaneous needling plus electroacupuncture can release post-stroke spastic hemiplegia effectively.

Therapeutic efficacy and mechanism of heat-sensitive moxibustion for vascular dementia

Objective:To observe the clinical efficacy of heat-sensitive moxibustion for vascular dementia and explore its mechanism.Methods:A total of 70 patients with vascular dementia were randomized into an observation group and a control group,with 35 cases in each group.The control group was treated with piracetam,and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment of the control group.The treatment lasted for 8 weeks.Before and after the treatment,the mini-mental state examination(MMSE),activity of daily living(ADL)and traditional Chinese medicine(TCM)symptom scores were assessed,and the levels of acetyl choline(Ach)and homocysteine(Hcy)were measured.The efficacy was evaluated after treatment.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the MMSE and ADL scores in the observation group decreased significantly,and were lower than those in the control group(all P<0.05);the TCM symptom score of the observation group decreased significantly(P<0.05),while that of the control group had no significant change(P>0.05);the plasma Ach level in the observation group increased significantly(P<0.05),and the Hcy level decreased significantly(P<0.05),which were statistically different from those in the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus piracetam is effective in treating vascular dementia.It can significantly improve dementia symptoms and ADL,which may be related to the correction of plasma Ach and Hcy levels.

Effect of Acupuncture on Functional Reconstruction of the Wrist Following Cerebral Apoplexy

Objective： To observe the effect of needling different points on functional reconstruction of wrist following cerebral apoplexy. Methods： Forty apoplexy cases were randomly allocated into four groups, 10 in each. Cases in group A were treated by needling the extensor muscle motor points. Cases in group B were treated by needling alternating extensor-flexor muscle motor points. Cases in group C were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10） and Waiguan （TE 5）. Cases in group D were treated by needling Jianyu （LI 15）, Binao （LI 14）, Shousanli （LI 10）, Waiguan （TE 5）, Chize （LU 5） and Neiguan （PC 6）. The motor functions of affected upper limbs were evaluated on the surface electromyography （SEMG）, Fugl-Meyer function scale and Barthel ADL （Activities of Daily Living） indexes. Results： Needling alternating extensor-flexor muscle motor points can significantly increase the peak value （MAX） of the upper limb SEMQ integrated electromyogram （IEMG）, Fugl-Meyer motor function value and Barthel ADL indexes. Conclusion： Needling different points may produce different effects on wrist function following cerebral apoplexy. Needling alternating extensor-flexor muscle motor points can obtain an exact treatment effect.