Mechanism of acupuncture for limb spasm of post-stroke spasticity based on GABA and BDNF/Trkb-KCC2 signaling pathway

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.

Analysis of the Effect of Limb Rehabilitation Therapy Combined with Transcranial Magnetic Stimulation Therapy on Muscle Activity in Patients with Upper Limb Dysfunction After Cerebral Infarction

Objective:To analyze the effect of limb rehabilitation therapy combined with transcranial magnetic stimulation therapy on muscle activity in patients with upper limb dysfunction after cerebral infarction(CI).Methods:320 patients with upper limb dysfunction after CI were selected,all of whom were treated in our hospital between June 2021 and June 2023.They were randomly grouped according to the lottery method into the control group(limb rehabilitation therapy,160 cases)and the intervention group(transcranial magnetic stimulation therapy+limb rehabilitation therapy,160 cases).The upper limb function scores,neuro-electrophysiological indicators,daily living ability scores,and quality of life scores of the two groups were compared.Results:Compared with the control group,upper limb function scores and daily living ability scores in the intervention group were higher after treatment,and the neuro-electrophysiological indicators of the intervention group were lower after treatment(P<0.05).Conclusion:Transcranial magnetic stimulation therapy combined with limb rehabilitation therapy has significant effects in patients with upper limb dysfunction after CI and is worthy of promotion and application.

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.

Latest Advances in the Treatment of Post-stroke Limb Spasm with Botulinum Neurotoxin

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.

Application of MET Technique after Upper Limb Dysfunction after Breast Cancer Surgery

Object:Explore the application and actual effect of MET(Muscle Energy)technology after breast cancer surgery with upper limb dysfunction.Methods:Taking 40 female breast cancer patients who underwent surgical treatment in our hospital from September 2017 to June 2019 as the research objects,all of them successfully completed modified radical mastectomy for breast cancer.According to different nursing methods,the patients were randomly divided into two groups.The experiment There were 20 cases in each group and the control group.The control group was given routine functional recovery exercise intervention after the operation,and the experimental group added MET technology to the base of the control group.One month after the operation,the functional recovery of the affected limbs of the two groups of patients was effectively assessed.The upper limb dysfunction of the two groups was compared by statistical methods,and the shoulder joint range of motion(ROM)was used for performance.Results:Through early functional recovery training and MET technology,19 cases of ROM in the experimental group showed compliance(95%),compared with only 14 cases(70%)in the control group.The difference in upper limb dysfunction between the two groups is very obvious with statistical significance(P<0.05).Conclusions:Early functional recovery training combined with muscle energy technology can promote the recovery of upper limb dysfunction after breast cancer surgery faster and better,which is conducive to the recovery of patients as soon as possible and improve the quality of life.

Clinical observation of body acupuncture combined with FANG’s scalp acupuncture for limb dysfunction in the remission stage of stroke

Objective:To observe the clinical efficacy of body acupuncture combined with FANG’s scalp acupuncture in treating limb dysfunction in the remission stage of stroke and explore the mechanism.Methods:Sixty patients in the remission stage of stroke with limb dysfunction were divided into a control group and a treatment group using the random number table method,with 30 cases in each group.The control group was treated with ordinary acupuncture based on the conventional rehabilitation treatment,and the treatment group was additionally offered FANG’s scalp acupuncture.The interventions were conducted once daily with 10 sessions as 1 course.The Fugl-Meyer assessment(FMA)and Barthel index(BI)scores and serum malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared after 2 treatment courses,and the clinical efficacy was evaluated.Results:After treatment,the FMA and BI scores increased in both groups(P<0.05)and were higher in the treatment group than in the control group(P<0.05).Both groups showed a decreased MDA level and an increased SOD level after the intervention,all showing statistical significance(P<0.05);there were significant differences between the two groups(P<0.05).Conclusion:Based on the conventional rehabilitation treatment,ordinary acupuncture used alone or in combination with FANG’s scalp acupuncture can lower the oxidative stress level and improve limb function in treating limb dysfunction in the remission stage of stroke;body acupuncture plus FANG’s scalp acupuncture can produce better results.

经颅直流电刺激对慢性期脑卒中偏瘫患者上肢运动功能的疗效分析

目的:研究双侧经颅直流电刺激(dual-hemispheric transcranial direct current stimulation,Dual-tDCS)对慢性期脑卒中患者上肢运动功能的影响,为治疗慢性期脑卒中上肢功能障碍提供基于神经机制的理论依据。方法:选取某院24例慢性期脑卒中上肢运动功能障碍患者,按照随机数字表法将其分为研究组(n=13)和对照组(n=11)。对照组采用tDCS伪刺激联合常规康复治疗,研究组采用Dual-tDCS联合常规康复治疗。治疗前后,采用Fugl-Meyer运动功能评定量表上肢部分(Fugl-Meyer assessment upper limb scale,FMA-UL)及日常生活活动能力(activities of daily living,ADL)测评量表对患者活动能力进行评估。对比治疗前后初级运动皮层(M1区)与全脑功能连接(functional connectivity,FC)的变化。使用SPSS 24.0统计学软件进行数据分析。结果:治疗后,2组患者的FMA-UL、ADL评分比治疗前均显著提高,且研究组评分明显高于对照组,差异有统计学意义(P<0.05)。M1区与全脑FC分析显示,治疗后对照组健侧M1区到患侧枕中回、健侧舌回、健侧角回FC降低(P<0.01);患侧M1区未见FC变化脑区。治疗后研究组健侧M1区到健侧小脑、健侧小脑蚓部FC降低,到患侧中央前回FC增加(P<0.01);患侧M1区到患侧小脑、患侧颞中回FC增加,到健侧中央前回FC降低(P<0.01)。结论:Dual-tDCS对大脑的神经调控作用可改善慢性期卒中患者运动和非运动相关脑区的FC,可能是慢性期脑卒中上肢运动功能障碍的康复机制。

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。

神经肌肉电刺激系统联合康复训练在脑卒中后肢体功能障碍患者康复中的应用价值

目的:探究神经肌肉电刺激系统联合康复训练在脑卒中后肢体功能障碍患者康复中的应用价值。方法:选取2022年1—12月第九〇九医院收治的95例脑卒中后肢体功能障碍患者作为研究对象。按照随机数字表法分为对照组(n=47)和观察组(n=48)。观察组行康复训练联合神经肌肉电刺激系统干预,对照组仅接受康复训练干预,两组均持续干预3个月。比较两组干预前后改良Ashworth量表(MAS)评分、患肢各关节主动活动度、脑卒中康复运动功能评定量表(STREAM)评分。结果:干预前,两组MAS评分、患肢各关节主动活动度、STREAM评分比较,差异均无统计学意义(P>0.05);干预后,两组患侧上肢肌肉痉挛、下肢肌肉痉挛评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05);干预后,两组肩关节外展、肘关节屈曲、腕关节掌屈、手掌指关节屈曲、髋关节内外旋、膝关节屈伸主动活动度均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预后,两组上肢运动、下肢运动、基本活动评分及总分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。结论:在脑卒中后肢体功能障碍患者康复中应用神经肌肉电刺激系统联合康复训练可以有效缓解其肌肉痉挛情况,改善关节活动度,提高肢体运动功能。

上肢康复机器人任务导向性训练对肩关节功能障碍患者的疗效观察

目的:观察上肢康复机器人任务导向性训练治疗肩关节功能障碍的疗效。方法:选取肩关节功能障碍患者58例,随机分为观察组和对照组各29例。2组均接受物理因子与关节松动术联合治疗,在此基础上,对照组增加肌力训练,观察组增加上肢康复机器人任务导向性训练。在治疗前和治疗4周后,采用Constant-Murley肩功能评分量表(CMS)评定比较2组疗效。结果:治疗4周后,2组CMS总分及疼痛、功能活动、关节活动范围、肌力4个分项的评分均高于治疗前(P<0.01);观察组CMS总分及疼痛、关节活动范围、肌力评分3个分项的评分均高于对照组(P<0.05),2组功能活动评分差异无统计学意义。结论:上肢康复机器人的任务导向性训练可以有效减轻患者肩关节疼痛,提高患者的上肢运动功能和康复效果。

弹力带抗阻训练对脑卒中下肢运动功能障碍患者肌力水平和运动耐力的影响

目的 探讨弹力带抗阻训练对脑卒中下肢运动功能障碍患者肌力水平、运动耐力的影响。方法 选择2021-06—2022-12在南京市江宁医院接受治疗的80例脑卒中下肢运动功能障碍患者进行研究,采用随机数表法分为试验组(n=40)和对照组(n=40)。对照组给常规运动指导治疗,试验组加用弹力带抗阻训练治疗。比较2组临床疗效、肌力水平、峰值摄氧量(VO_(2)peak)、无氧阈值(AT)、6 min步行距离、步态参数及Barthel指数、平衡功能评分变化情况。结果 治疗后,试验组总有效率85%,高于对照组的65%,差异有统计学意义(P<0.05);试验组下肢肌力评分低于对照组[(1.40±0.23)分比(1.98±0.63)分],Fugl Meyer运动量表评分高于对照组[(29.87±3.58)分比(24.15±3.74)分],差异均有统计学意义(P<0.05);试验组VO_(2)peak、AT及6 min步行距离分别为(20.42±1.71)m L/(min·kg)、(13.89±1.01)mL/(min·kg)、(140.56±23.78)m,均高于对照组的(18.46±1.23)m L/(min·kg)、(13.02±1.21)mL/(min·kg)、(116.58±29.61)m,差异均有统计学意义(P<0.05);试验组步长、步速、步频及单支撑相水平分别为(36.87±4.71)cm、(57.78±7.23)cm/s、(69.31±5.41)step/s、(31.05±3.01)%,均高于对照组的(31.52±3.67)cm、(52.84±6.09)cm/s、(63.05±6.08)step/s、(27.21±3.08)%,差异均有统计学意义(P<0.05);试验组Barthel指数、平衡功能评分分别为(78.61±5.61)分、(41.15±2.31)分,均高于对照组的(67.59±6.13)分、(32.56±5.47)分,差异均有统计学意义(P<0.05)。结论 在脑卒中下肢运动功能障碍患者中弹力带抗阻训练治疗有较好的效果,可有效改善肌力水平、运动耐力水平。

烧伤肢体功能障碍患者康复运动方案的最佳证据总结

目的 总结烧伤肢体功能障碍患者康复运动方案的最佳证据。方法 按“6S”模型系统检索国内外数据库和专业网站中有关烧伤肢体功能康复的证据,包括指南、专家共识、证据总结、临床决策、推荐实践及系统评价。检索时限为建库至2023年6月15日。由2名研究者独立对纳入的文献进行质量评价,并对符合条件的文献进行证据提取。结果 共纳入17篇文献,包括13篇指南、1篇专家共识、1篇推荐实践、2篇系统评价,从运动的必要性、运动计划、早期活动与康复、运动评估、运动方式、运动处方实施、早期下床活动、特殊部位的护理、运动安全监测、注意事项、效果评价、随访12个方面汇总了41条证据。结论 本研究总结了烧伤肢体功能障碍患者康复运动方案的最佳证据,可用于临床烧伤肢体功能康复运动过程中,但建议医务工作者应用证据时需结合临床情景,充分考虑患者情况和意愿制定个体化的康复运动方案。

针刺联合川平法治疗脑卒中后上肢功能障碍的疗效及电生理特征研究

目的观察针刺联合川平法治疗脑卒中后上肢功能障碍的疗效及对电生理特征的影响。方法筛选2022年1月—2022年12月,康复科及神经科收治住院的脑卒中后上肢功能障碍患者135例作为研究对象,采用随机数表法分为针刺组、川平组与联合组,每组45例。3组患者均给予常规药物治疗及康复训练。针刺组在常规治疗的基础上给予针刺治疗,川平组在常规治疗的基础上给予川平法(反复促通技术)(Repetitive facilitative exercise, RFE)治疗,联合组在常规治疗的基础上给予针刺联合川平法治疗,均为每日治疗1次,每周连续5 d休息2 d,共治疗8周。分别在治疗前、治疗4周、治疗8周后,比较3组的上肢运动功能[简化Fugl-Meyer评定量表(FMA)],上肢肌张力[改良Ashworth量表(MAS)],手活动功能[Wolf手活动功能测试(WMFT)]及日常生活活动能力[改良Barthel指数(MBI)评分];比较3组的肱二头肌、肱三头肌及腕背伸肌的最大收缩时肌电信号(Electromyography, EMG)界限值,采用生物反馈治疗仪进行测定。结果治疗4周和治疗8周后,3组的简化FMA评分、WMFT评分和MBI评分整体比较差异均有统计学意义(P<0.05),治疗后均较治疗前显著提升(P<0.05),且联合组显著高于针刺组和川平组(P<0.05);3组的改良MAS评分整体比较亦有差异有统计学意义(P<0.05),治疗后均较治疗前显著降低(P<0.05),且联合组显著低于针刺组和川平组(P<0.05)。治疗4周和治疗8周后,3组间肱二头肌、肱三头肌和腕背伸肌的最大收缩时EMG界限值整体比较均有统计学意义(P<0.05),3组的EMG界限值均较治疗前显著提升(P<0.05),且联合组显著高于针刺组和川平组(P<0.05)。结论针刺联合川平法治疗脑卒中后上肢功能障碍,能够有效提高患者上肢及手部主要肌群的最大收缩时EMG界限值,改善患者上肢及手部肌肉的收缩能力,从而显著提升患者的上肢和手部运动功能,缩小上肢肌张力,改善患者的日常生活活动能力。

上肢康复机器人的发展及应用综述

介绍了康复机器人的理论基础,综述了上肢康复机器人的研究现状,阐述了上肢康复机器人在脑卒中、脑瘫、脊髓损伤、多发性硬化、帕金森等疾病康复中的应用现状,分析了应用上肢康复机器人进行康复训练的优势和不足,指出了实现更高自由度、选材轻量化、提高设备运行安全性、研发智能控制技术、实现较低成本生产、扩大覆盖率是上肢康复机器人未来发展的方向。

脑卒中肢体功能障碍患者康复护理需求的范围综述

目的全面检索国内外脑卒中肢体功能障碍康复护理相关研究,对脑卒中肢体功能障碍患者康复护理需求现状、内容进行总结分析,以期为今后相关研究提供参考。方法采用范围综述法,系统检索中国知网(CNKI)、万方(Wanfang Data)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed等中英文数据库,检索时间为建库至2021年7月26日,并基于《国际功能、残疾和健康分类》(ICF)框架对纳入文献进行主题分析。结果最终纳入19篇文献,结果显示脑卒中肢体功能障碍患者康复护理需求种类较多,且较为复杂,主要包括疾病及康复知识信息需求、活动参与需求、肢体功能恢复、社会环境需求以及心理支持需求5个需求主题。结论脑卒中肢体功能患者康复护理需求满足率较低,医护人员需注重为患者提供多元化的知识教育,并结合多学科团队,为脑卒中肢体功能障碍患者制定个体化且科学全面的康复护理计划。

滋水涵木针法联合头穴透刺治疗卒中后上肢运动功能障碍临床研究

目的探讨滋水涵木针法联合头穴透刺治疗卒中后上肢运动功能障碍的疗效。方法选取2020年9月—2022年2月医院治疗的卒中后上肢运动功能障碍患者100例,随机分为对照组(53例,头穴透刺疗法)和观察组(47例,滋水涵木针法联合头穴透刺疗法),对比两组治疗后临床疗效、Fugl-Meyer运动功能评分上肢部分(Fugl-Meyer assessment-upper extremity,FMA-UE)评分、改良Barthel指数(modified Barthel index,MBI)评分和沃尔夫运动功能测试(Wolf motor function test,WMFT)评分、Brunnstrom偏瘫上肢肌力分级及运动诱发电位皮质潜伏期(cortical latency,CL)和中枢运动传导时间(central motor conduction time,CMCT)值变化。结果观察组治疗有效率较对照组明显较高(P<0.05);两组治疗后FMA-UE评分、MBI评分和WMFT评分较治疗前均明显升高(P<0.05),且观察组较对照组升高更显著(P<0.05);治疗前两组Brunnstrom偏瘫上肢肌力分级间差异无统计学意义(P>0.05);治疗后两组Brunnstrom偏瘫上肢肌力分级较治疗前显著改善(P<0.05);且观察组与对照组相比较改善更明显(P<0.05);两组治疗后CL和CMCT值较治疗前显著降低(P<0.05);且观察组降低更明显(P<0.05)。结论采用滋水涵木针法联合头穴透刺治疗卒中后上肢运动功能障碍具有较好的疗效,能够改善上肢运动功能,提高上肢肌力。

头针联合三维步态分析训练系统治疗脑梗死患者下肢运动功能障碍疗效观察

目的 探讨头针联合三维步态分析训练系统治疗脑梗死患者下肢运动功能障碍的临床疗效。方法 选择2022年6月—2023年6月皖北煤电集团总医院收治的脑梗死后下肢运动功能障碍患者60例,随机分成对照组和观察组各30例。对照组给予常规康复训练+三维步态训练治疗,观察组在对照组治疗基础上联合头针治疗,2组均治疗4周。观察比较2组患者治疗前后步态分析参数、改良Asworth肌张力量表评分、徒手肌力评定量表(MMT)评分、改良Barthel指数(MBI)评分、运动学参数、脑血流动力学参数,评估2组临床疗效。结果 2组患者治疗后步速、步频、跨步长、步长、步宽及MMT评分、MBI评分均明显增高,最大髋关节屈曲角度、最大膝关节屈曲角度、最大踝关节背屈和跖屈角度均明显增大,双侧大脑中动脉最大峰值流速(Vs)、平均流速(Vm)均明显加快,且观察组上述各指标较对照组改善更明显,差异均有统计学意义(P均<0.05);2组患者治疗后步态周期、双支撑时间、Asworth评分、血管阻力指数(RI)均明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);观察组总有效率明显高于对照组[93.3%(28/30)比70.0%(21/30),P<0.05]。结论 头针联合三维步态分析训练系统能够明显提高脑梗死后下肢运动功能障碍患者下肢肌张力、肌力及生活能力,并能明显改善脑血流动力学,从而促进患者运动功能恢复。

下肢康复机器人联合IPC对脑损伤后肢体运动功能障碍患者下肢深静脉血栓预防效果

目的探讨下肢康复机器人联合间歇充气加压装置(IPC)对脑损伤后肢体运动功能障碍患者下肢深静脉血栓形成(DVT)的预防效果。方法通过便利抽样法选取本院2020年12月—2021年12月住院的脑损伤后肢体运动功能障碍患者90例,根据治疗方法的不同将其分为对照组和观察组,每组45例。对照组给予常规康复训练及IPC治疗,观察组在对照组基础上给予下肢康复机器人治疗,两组均在治疗3月后进行效果评价,比较两组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、改良Barthel指数(MBI)评分、凝血-纤溶系统指标、下肢深静脉血流动力学参数、DVT发生率。结果观察组临床总有效率高于对照组(P<0.05)。观察组治疗后NIHSS评分低于对照组(P<0.05),观察组治疗后MBI评分高于对照组(P<0.05)。观察组治疗后D-二聚体(D-D)、纤维蛋白降解产物(FDP)均低于对照组,观察组治疗后凝血活酶时间(APTT)、凝血酶原时间(PT)均高于对照组(P<0.05)。观察组治疗后下肢腘静脉、股静脉、髂外静脉平均血流速度(Vm)均高于对照组(P<0.05)。观察组DVT发生率低于对照组(P<0.05)。结论下肢康复机器人联合IPC可有效改善脑损伤后肢体运动功能障碍患者神经功能及下肢血液流动速度,提高日常生活能力,纠正血液高凝状态,降低DVT发生率,值得借鉴。

基于MRI的腰痛功能障碍自动评估方法研究

基于腰痛患者的MRI,通过图像预处理,提取能够反映腰痛患者功能障碍的MRI影像特征,并结合机器学习方法,提出了一种基于算法多样性的stacking模型集成算法,为腰痛患者的肢体功能障碍精准评估提供可靠方法和实现手段。