Stroke represents a severe,widespread,and widely acknowledged health crisis on both national and international levels.It is one of the most prevalent life-threatening conditions.Despite impressive advances in treating...Stroke represents a severe,widespread,and widely acknowledged health crisis on both national and international levels.It is one of the most prevalent life-threatening conditions.Despite impressive advances in treating stroke,in addition to a need for effective patient care services,many sufferers still rely solely on physical interventions.The present paper describes and explains the use of a newly designed gadget for stroke survivors who cannot move their fingers.This is a sophisticated mobile device that enables stroke patients to regain their muscle memory and thus their ability to perform repetitive actions by continuing to tighten and stretch their muscles without the intervention of a physiotherapist.Gamification methodology is used to encourage patients to become involved in the process of rehabilitation.The device also has sensors that take information and transmit it to an app through an ESP32 connection.This enables physicians to view glove usage information remotely and keep track of an individual patient’s health.Communication between app and glove is facilitated by a broker in the Amazon Web Service IoT.With the robotic glove presented here,the recovery rate is found to be 90.23%over four weeks’duration,which represents a significant improvement compared with existing hospital-based rehabilitation techniques.展开更多
BACKGROUND: Acute stroke unit (stroke care unit) is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-...BACKGROUND: Acute stroke unit (stroke care unit) is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital (secondary hospital), where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE: To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility.DESIGN: Non-randomized concurrent controlled observation.SETTING: Department of Neurology, Beijing Longfu Hospital.PARTICIPANTS: Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale (SSS) > 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives: ①treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;② control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS: A same basic treatment was conducted in the patients of the two groups. ① Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet: randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. ② The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians.MAIN OUTCOME MEASURES: The following assessments were conducted on admission and 7 and 28 days after admission: ① Severity of stroke and motor function: scored as 0 to 45 points by SSS, the higher points, the severer damage. ②Activities of daily living: Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. ③Mental status: evaluated by Hopkin’s symptom scale with a 5-point scoring. The symptom was scored with low to high points. ④Cognitive function: Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS: ① Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. ②The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days:(9.73±6.43) points vs. (12.63±7.87) points, t =2.28, P < 0.05;28 days:(7.88±4.81) points vs. (9.84±7.03)points, t =2.04, P < 0.05]. ③ Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days:(54.28±8.38) points vs. (39.76±7.31) points, t =2.206, P < 0.05; 28 days:(89.72±7.94) points vs. (67.34±8.63) points,t =2.812, P < 0.01]. ④ Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups (P > 0.05). ⑤ Totally 160 patients in the two groups accomplished the Hopkin’s test, among them, 94 (58.7%) had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION: ① Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. ② More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. ③ The cognitive function of stroke reconvalescents is not related to age.展开更多
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 st...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.展开更多
There is a growing interest in the use of music therapy in neurological rehabilitation. Of all the major neurological illnesses, stroke rehabilitation has been observed to have some of the strongest potential for musi...There is a growing interest in the use of music therapy in neurological rehabilitation. Of all the major neurological illnesses, stroke rehabilitation has been observed to have some of the strongest potential for music therapy’s beneficial effect. The current burden of stroke has raised the need to embrace novel,cost-effective, rehabilitation designs that will enhance the existing physical, occupation, and speech therapies. Music therapy addresses a broad spectrum of motor, speech, and cognitive deficits, as well as behavioral and emotional issues. Several music therapy designs have focused on gait, cognitive, and speech rehabilitation, but most of the existing randomized controlled trials based on these interventions have a high risk of bias and are statistically insignificant. More randomized controlled trials with greater number of participants are required to strengthen the current data. Fostering an open and informed dialogue between patients, healthcare providers, and music therapists may help increase quality of life, dispel fallacies, and guide patients to specific musical interventions.展开更多
Functional near-infrared spectroscopy(fNIRS)has gained great interest as a noninvasive modality to study the changes in cerebral hemodynamics related to brain activity.The unique and beneficial characteristics of fNIR...Functional near-infrared spectroscopy(fNIRS)has gained great interest as a noninvasive modality to study the changes in cerebral hemodynamics related to brain activity.The unique and beneficial characteristics of fNIRS allow ecologically effective investigations of all ages and conditions in more realistic and clinical environments.In this review,we provide a comprehensive description of fNIRS basics,analytical method developments and applications in stroke rehabilitation.We first review various new methods for the time-series processing and functional analysis of fNIRS data.Then,we review the fNIRS-based application in clinical research for stroke rehabilitation and highlight the exciting developments based on fNIRS.Finally,we discuss the possible technical limitations of the implementation of fNIRS and provide suggestions from different aspects for practical application.展开更多
The rehabilitation training based on motor imagery brain-computer interface(MI-BCI)is considered to be an effective method.We designed a new 2-class unilateral upper limb motor imagery tasks.Data from 15 healthy subje...The rehabilitation training based on motor imagery brain-computer interface(MI-BCI)is considered to be an effective method.We designed a new 2-class unilateral upper limb motor imagery tasks.Data from 15 healthy subjects and 10 stoke patients are collected in the study.The results of event-related desynchronization/synchronization(ERD/ERS)and power spectral density(PSD)analysis showed the significant different features on health subjects and stroke patients.The improved 2-Conv-FBCNET is used to classify Electroencephalogram(EEG)signals and the accuracy is(health:61.0%,stroke:59.4%).The new two types of tasks provide a new training method for MI-BCI rehabilitation training system.展开更多
Background: Brain disorders have become more and more common today, due to both the aging population and the ever-expanding sports community. However, a new therapeutic technology called photobiomodulation (PBM) is gi...Background: Brain disorders have become more and more common today, due to both the aging population and the ever-expanding sports community. However, a new therapeutic technology called photobiomodulation (PBM) is giving hope to thousands of individuals in need. Traumatic brain injury (TBI), dementia, post traumatic stress (PTSD) and attention deficit (ADD) disorders are in many cases quickly and safely improved by PBM. PBM employs red or near-infrared (NIR) light (600 - 1100 nm) to stimulate healing, protect tissue from dying, increase mitochondrial function, improve blood flow, and tissue oxygenation. PBM can also act to reduce edema, increase antioxidants, decrease inflammation, protect against apoptosis, and modulate the microglial activation state. All these effects can occur when light is delivered to the head, and can be beneficial in both acute and chronic brain conditions. Methods: In this case series, we used a high power, FDA-approved superpulsed laser system applied to the head to treat four chronic stroke patients. Patients received as few as three 6 - 9 minute treatments over a one-week period. The follow up time varied, but in one case was two years. Results: Patients showed significant improvement in their speech and verbal skills. Improvements were also noticed in walking ability, limb movement, less numbness, and better vision. Conclusion: The use of PBM in stroke rehabilitation deserves to be tested in controlled clinical trials, because this common condition has no approved pharmaceutical treatment at present.展开更多
Objective:Post-stroke disability and psychosocial disorders cause burdens for the families of stroke patients,including physical and financial burdens.The physical and psychological health of family caregivers determi...Objective:Post-stroke disability and psychosocial disorders cause burdens for the families of stroke patients,including physical and financial burdens.The physical and psychological health of family caregivers determines the quality of care they provide to patients.The purpose of this study was to identify the effectiveness of the Caregiver Empowerment Program Based on the Adaptation Model(CEP-BAM)in increasing the family caregiver’s coping ability against various problems and reducing their burden while caring for the stroke patient.Methods:This research was a quasi-experimental study with pre-and post-test control group design.The intervention group received CEP-BAM,while the control group received a conventional intervention in the form of a discharge planning program for family caregivers in the hospital.The samples were caregivers who care for and facilitate the recovery of stroke patients during their convalescence at home.We selected the samples from the population using the stratified random sampling method.The number of samples completed in the study was 40 in the intervention group and 40 in the control group.Measurement of outcome variables(coping and caregiver burden)was carried out 4 times including pre-test before the intervention,post-test 1 at 4 months after the intervention,post-test 2 at 5 months after the intervention,and post-test 3 at 6 months after the intervention.Results:There were significant differences in caregiver’s coping(P=0.016)and caregiver’s burden(P=0.009)in measurements between the two groups.Conclusions:The CEP-BAM interventions were effective in increasing adaptive coping strategies and reducing the burden of caregivers 4 months and continuing 6 months after the intervention.展开更多
Rehabilitation is the most effective way to reduce motor impairments in post-stroke patients.This process demands several hours with a specialized therapist.Given resources and personnel shortages,the literature repor...Rehabilitation is the most effective way to reduce motor impairments in post-stroke patients.This process demands several hours with a specialized therapist.Given resources and personnel shortages,the literature reports a high interest in robotic assisted rehabilitation solutions.Recently,cable-driven robotic architectures are attracting significant research interest for post-stroke rehabilitation.However,the existing cable-driven robots are mostly unilateral devices allowing the rehabilitation only of the most affected limb.This leaves unaddressed the rehabilitation of bimanual activities,which are predominant within the common Activities of Daily Living(ADL).Thus,this paper presents a specific novel design to achieve bimanual rehabilitation tasks that has been named as BiCAR robot.Specifically,this paper provides a full insight on the BiCAR system as well as on its dedicated developed software BiEval.In particular,BiEval software has been developed as based on a serious game strategy and a virtual reality environment to track the patient exercising duration,motion ranges,speeds,and forces over time for achieving a quantitative assessment of the rehabilitation progress.Finally,the paper presents the BiCAR/BiEval capabilities by referring to a pilot Randomized Controlled Trial(RCT).The clinical trials have been used to validate the BiCAR/BiEval in terms of engineering feasibility and user acceptance to achieve an innovative cost-oriented integrated hardware/software device for the bimanual assistive rehabilitation of post-stroke patients.展开更多
OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language...OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the Keywords of "stroke, basal ganglia aphasia, language rehabilitation" in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually. STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded. Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded. DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded. DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. On the other hand, the method of rehabilitation on basal ganglia aphasia after stroke was explained. CONCLUSION: Basal ganglia aphasia is manifested as atypical aphasic symptom, the mechanism for the structure of basal ganglia in the speech formation should be further confirmed. It is effective to select pertinent language rehabilitation for basal ganglia aphasia after stroke.展开更多
Post-stroke depression(PSD)has negative impacts on the daily life of stroke survivors and delays their neuro-logical recovery.However,traditional post-stroke rehabilitation mainly focused on motor restoration,whereas ...Post-stroke depression(PSD)has negative impacts on the daily life of stroke survivors and delays their neuro-logical recovery.However,traditional post-stroke rehabilitation mainly focused on motor restoration,whereas little attention was given to the affective deficits.Effective management of PSD,including diagnosis,intervention,and follow-ups,is essential for post-stroke rehabilitation.As an objective measurement of the nervous system,electroencephalography(EEG)has been applied to the diagnosis and evaluation of PSD.In this paper,we re-viewed the literature most related to the clinical applications of EEG for PSD and offered a cross-section that is useful for selecting appropriate approaches in practice.This study aimed to gather EEG-based empirical ev-idence for PSD diagnosis,review interventions for managing PSD,and analyze the evaluation approaches.In total,33 diagnostic studies and 19 intervention studies related to PSD and depression were selected from the literature.It was found that the EEG features analyzed by both band-based and nonlinear dynamic approaches were capable of quantifying the abnormal neural responses on the cortical level for PSD diagnosis and interven-tion evaluation/prediction.Meanwhile,EEG-based machine learning has also been applied to the diagnosis and evaluation of depression to automate and speed up the process,and the results have been promising.Although brain-computer interface(BCI)interventions have been widely applied to post-stroke motor rehabilitation and cognitive training,BCI emotional training has not been directly used in PSD yet.This review showed the need for understanding the cortical responses of PSD to improve its diagnosis and precision treatment.It also revealed that future post-stroke rehabilitation plans should include training sessions for motor,affect,and cognitive functions and closely monitor their improvements.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the ex...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1). The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
Objective:Emerging evidence shows the effectiveness of speech and language therapy(SLT);however,precise therapeutic parameters remain unclear.Evidence for the use of adjunctive transcranial direct current stimulation(...Objective:Emerging evidence shows the effectiveness of speech and language therapy(SLT);however,precise therapeutic parameters remain unclear.Evidence for the use of adjunctive transcranial direct current stimulation(t DCS)to treat post-stroke aphasia(PSA)is promising;however,the utility of combining t DCS and electroacupuncture(EA)has not yet been analyzed.This study assessed the therapeutic consequences of EA and t DCS coupled with SLT in subacute PSA patients who were also undergoing hyperbaric oxygen therapy(HBOT).Methods:A retrospective analysis was conducted on subacute(<6 months)PSA patients who were divided into three groups:patients who received EA plus t DCS(acupuncture group),patients who underwent t DCS(t DCS group),and patients who experienced conventional therapy(HBOT+SLT).All subjects underwent 21 days of treatment and also received conventional treatment.The aphasia battery of Chinese(ABC)was used to score pre-and post-intervention status.Results:The analysis comprised 238 patients.Cerebral infarction was the most frequent stroke type(137[57.6%]),while motor(66[27.7%])and global aphasia(60[25.2%])were the most common types of aphasia.After 21 days of intervention,the ABC scores of all patients were improved.The acupuncture group had the highest ABC scores,but only repetition,naming,and spontaneous speech were statistically improved(P<0.01).Post-hoc tests revealed significant improvement in word retrieval in the acupuncture and t DCS groups(P<0.01,P=0.037),while the acupuncture group had additional significant improvement in spontaneous conversation(P<0.01).Conclusion:Combining acupuncture and t DCS as an adjuvant therapy for subacute PSA led to significant spontaneous speech and word retrieval improvements.Future prospective,multi-ethnic,multi-center trials are warranted.展开更多
文摘Stroke represents a severe,widespread,and widely acknowledged health crisis on both national and international levels.It is one of the most prevalent life-threatening conditions.Despite impressive advances in treating stroke,in addition to a need for effective patient care services,many sufferers still rely solely on physical interventions.The present paper describes and explains the use of a newly designed gadget for stroke survivors who cannot move their fingers.This is a sophisticated mobile device that enables stroke patients to regain their muscle memory and thus their ability to perform repetitive actions by continuing to tighten and stretch their muscles without the intervention of a physiotherapist.Gamification methodology is used to encourage patients to become involved in the process of rehabilitation.The device also has sensors that take information and transmit it to an app through an ESP32 connection.This enables physicians to view glove usage information remotely and keep track of an individual patient’s health.Communication between app and glove is facilitated by a broker in the Amazon Web Service IoT.With the robotic glove presented here,the recovery rate is found to be 90.23%over four weeks’duration,which represents a significant improvement compared with existing hospital-based rehabilitation techniques.
文摘BACKGROUND: Acute stroke unit (stroke care unit) is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital (secondary hospital), where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE: To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility.DESIGN: Non-randomized concurrent controlled observation.SETTING: Department of Neurology, Beijing Longfu Hospital.PARTICIPANTS: Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale (SSS) > 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives: ①treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;② control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS: A same basic treatment was conducted in the patients of the two groups. ① Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet: randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. ② The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians.MAIN OUTCOME MEASURES: The following assessments were conducted on admission and 7 and 28 days after admission: ① Severity of stroke and motor function: scored as 0 to 45 points by SSS, the higher points, the severer damage. ②Activities of daily living: Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. ③Mental status: evaluated by Hopkin’s symptom scale with a 5-point scoring. The symptom was scored with low to high points. ④Cognitive function: Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS: ① Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. ②The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days:(9.73±6.43) points vs. (12.63±7.87) points, t =2.28, P < 0.05;28 days:(7.88±4.81) points vs. (9.84±7.03)points, t =2.04, P < 0.05]. ③ Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days:(54.28±8.38) points vs. (39.76±7.31) points, t =2.206, P < 0.05; 28 days:(89.72±7.94) points vs. (67.34±8.63) points,t =2.812, P < 0.01]. ④ Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups (P > 0.05). ⑤ Totally 160 patients in the two groups accomplished the Hopkin’s test, among them, 94 (58.7%) had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION: ① Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. ② More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. ③ The cognitive function of stroke reconvalescents is not related to age.
文摘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.
文摘There is a growing interest in the use of music therapy in neurological rehabilitation. Of all the major neurological illnesses, stroke rehabilitation has been observed to have some of the strongest potential for music therapy’s beneficial effect. The current burden of stroke has raised the need to embrace novel,cost-effective, rehabilitation designs that will enhance the existing physical, occupation, and speech therapies. Music therapy addresses a broad spectrum of motor, speech, and cognitive deficits, as well as behavioral and emotional issues. Several music therapy designs have focused on gait, cognitive, and speech rehabilitation, but most of the existing randomized controlled trials based on these interventions have a high risk of bias and are statistically insignificant. More randomized controlled trials with greater number of participants are required to strengthen the current data. Fostering an open and informed dialogue between patients, healthcare providers, and music therapists may help increase quality of life, dispel fallacies, and guide patients to specific musical interventions.
基金This work was supported by the National Key Research and Development Project Nos.(Grant No.2020YFC2004200)National Natural Science Foundation of China(Grant No.31771071,61761166007)the Fundamental Research Funds for Central Public Welfare Research Institutes(118009001000160001).
文摘Functional near-infrared spectroscopy(fNIRS)has gained great interest as a noninvasive modality to study the changes in cerebral hemodynamics related to brain activity.The unique and beneficial characteristics of fNIRS allow ecologically effective investigations of all ages and conditions in more realistic and clinical environments.In this review,we provide a comprehensive description of fNIRS basics,analytical method developments and applications in stroke rehabilitation.We first review various new methods for the time-series processing and functional analysis of fNIRS data.Then,we review the fNIRS-based application in clinical research for stroke rehabilitation and highlight the exciting developments based on fNIRS.Finally,we discuss the possible technical limitations of the implementation of fNIRS and provide suggestions from different aspects for practical application.
基金This work was supported by National Natural Science Foundation of China[No.61976133]Shanghai Industrial Collaborative Technology Innovation Project[No.2021-cyxt1-kj14]+1 种基金Major scientific and technological innovation projects of Shan Dong Province[No.2019JZZY021010]Science and technology innovation base project of Shanghai Science and Technology Commission,[No.19DZ2255200].
文摘The rehabilitation training based on motor imagery brain-computer interface(MI-BCI)is considered to be an effective method.We designed a new 2-class unilateral upper limb motor imagery tasks.Data from 15 healthy subjects and 10 stoke patients are collected in the study.The results of event-related desynchronization/synchronization(ERD/ERS)and power spectral density(PSD)analysis showed the significant different features on health subjects and stroke patients.The improved 2-Conv-FBCNET is used to classify Electroencephalogram(EEG)signals and the accuracy is(health:61.0%,stroke:59.4%).The new two types of tasks provide a new training method for MI-BCI rehabilitation training system.
文摘Background: Brain disorders have become more and more common today, due to both the aging population and the ever-expanding sports community. However, a new therapeutic technology called photobiomodulation (PBM) is giving hope to thousands of individuals in need. Traumatic brain injury (TBI), dementia, post traumatic stress (PTSD) and attention deficit (ADD) disorders are in many cases quickly and safely improved by PBM. PBM employs red or near-infrared (NIR) light (600 - 1100 nm) to stimulate healing, protect tissue from dying, increase mitochondrial function, improve blood flow, and tissue oxygenation. PBM can also act to reduce edema, increase antioxidants, decrease inflammation, protect against apoptosis, and modulate the microglial activation state. All these effects can occur when light is delivered to the head, and can be beneficial in both acute and chronic brain conditions. Methods: In this case series, we used a high power, FDA-approved superpulsed laser system applied to the head to treat four chronic stroke patients. Patients received as few as three 6 - 9 minute treatments over a one-week period. The follow up time varied, but in one case was two years. Results: Patients showed significant improvement in their speech and verbal skills. Improvements were also noticed in walking ability, limb movement, less numbness, and better vision. Conclusion: The use of PBM in stroke rehabilitation deserves to be tested in controlled clinical trials, because this common condition has no approved pharmaceutical treatment at present.
文摘Objective:Post-stroke disability and psychosocial disorders cause burdens for the families of stroke patients,including physical and financial burdens.The physical and psychological health of family caregivers determines the quality of care they provide to patients.The purpose of this study was to identify the effectiveness of the Caregiver Empowerment Program Based on the Adaptation Model(CEP-BAM)in increasing the family caregiver’s coping ability against various problems and reducing their burden while caring for the stroke patient.Methods:This research was a quasi-experimental study with pre-and post-test control group design.The intervention group received CEP-BAM,while the control group received a conventional intervention in the form of a discharge planning program for family caregivers in the hospital.The samples were caregivers who care for and facilitate the recovery of stroke patients during their convalescence at home.We selected the samples from the population using the stratified random sampling method.The number of samples completed in the study was 40 in the intervention group and 40 in the control group.Measurement of outcome variables(coping and caregiver burden)was carried out 4 times including pre-test before the intervention,post-test 1 at 4 months after the intervention,post-test 2 at 5 months after the intervention,and post-test 3 at 6 months after the intervention.Results:There were significant differences in caregiver’s coping(P=0.016)and caregiver’s burden(P=0.009)in measurements between the two groups.Conclusions:The CEP-BAM interventions were effective in increasing adaptive coping strategies and reducing the burden of caregivers 4 months and continuing 6 months after the intervention.
基金partially funded by UFU,FAPEMIG,CNPQ,and CAPES(Finance Code 001).
文摘Rehabilitation is the most effective way to reduce motor impairments in post-stroke patients.This process demands several hours with a specialized therapist.Given resources and personnel shortages,the literature reports a high interest in robotic assisted rehabilitation solutions.Recently,cable-driven robotic architectures are attracting significant research interest for post-stroke rehabilitation.However,the existing cable-driven robots are mostly unilateral devices allowing the rehabilitation only of the most affected limb.This leaves unaddressed the rehabilitation of bimanual activities,which are predominant within the common Activities of Daily Living(ADL).Thus,this paper presents a specific novel design to achieve bimanual rehabilitation tasks that has been named as BiCAR robot.Specifically,this paper provides a full insight on the BiCAR system as well as on its dedicated developed software BiEval.In particular,BiEval software has been developed as based on a serious game strategy and a virtual reality environment to track the patient exercising duration,motion ranges,speeds,and forces over time for achieving a quantitative assessment of the rehabilitation progress.Finally,the paper presents the BiCAR/BiEval capabilities by referring to a pilot Randomized Controlled Trial(RCT).The clinical trials have been used to validate the BiCAR/BiEval in terms of engineering feasibility and user acceptance to achieve an innovative cost-oriented integrated hardware/software device for the bimanual assistive rehabilitation of post-stroke patients.
文摘OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the Keywords of "stroke, basal ganglia aphasia, language rehabilitation" in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually. STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded. Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded. DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded. DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. On the other hand, the method of rehabilitation on basal ganglia aphasia after stroke was explained. CONCLUSION: Basal ganglia aphasia is manifested as atypical aphasic symptom, the mechanism for the structure of basal ganglia in the speech formation should be further confirmed. It is effective to select pertinent language rehabilitation for basal ganglia aphasia after stroke.
基金funded by the National Natural Science Foundation of China (NSFC 81771959)the University Grants Committee Research Grants Council,Hong Kong (GRF 15207120)the Science and Tech-nology Innovation Committee of Shenzhen,China (2021Szvup142)。
文摘Post-stroke depression(PSD)has negative impacts on the daily life of stroke survivors and delays their neuro-logical recovery.However,traditional post-stroke rehabilitation mainly focused on motor restoration,whereas little attention was given to the affective deficits.Effective management of PSD,including diagnosis,intervention,and follow-ups,is essential for post-stroke rehabilitation.As an objective measurement of the nervous system,electroencephalography(EEG)has been applied to the diagnosis and evaluation of PSD.In this paper,we re-viewed the literature most related to the clinical applications of EEG for PSD and offered a cross-section that is useful for selecting appropriate approaches in practice.This study aimed to gather EEG-based empirical ev-idence for PSD diagnosis,review interventions for managing PSD,and analyze the evaluation approaches.In total,33 diagnostic studies and 19 intervention studies related to PSD and depression were selected from the literature.It was found that the EEG features analyzed by both band-based and nonlinear dynamic approaches were capable of quantifying the abnormal neural responses on the cortical level for PSD diagnosis and interven-tion evaluation/prediction.Meanwhile,EEG-based machine learning has also been applied to the diagnosis and evaluation of depression to automate and speed up the process,and the results have been promising.Although brain-computer interface(BCI)interventions have been widely applied to post-stroke motor rehabilitation and cognitive training,BCI emotional training has not been directly used in PSD yet.This review showed the need for understanding the cortical responses of PSD to improve its diagnosis and precision treatment.It also revealed that future post-stroke rehabilitation plans should include training sessions for motor,affect,and cognitive functions and closely monitor their improvements.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1). The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
文摘Objective:Emerging evidence shows the effectiveness of speech and language therapy(SLT);however,precise therapeutic parameters remain unclear.Evidence for the use of adjunctive transcranial direct current stimulation(t DCS)to treat post-stroke aphasia(PSA)is promising;however,the utility of combining t DCS and electroacupuncture(EA)has not yet been analyzed.This study assessed the therapeutic consequences of EA and t DCS coupled with SLT in subacute PSA patients who were also undergoing hyperbaric oxygen therapy(HBOT).Methods:A retrospective analysis was conducted on subacute(<6 months)PSA patients who were divided into three groups:patients who received EA plus t DCS(acupuncture group),patients who underwent t DCS(t DCS group),and patients who experienced conventional therapy(HBOT+SLT).All subjects underwent 21 days of treatment and also received conventional treatment.The aphasia battery of Chinese(ABC)was used to score pre-and post-intervention status.Results:The analysis comprised 238 patients.Cerebral infarction was the most frequent stroke type(137[57.6%]),while motor(66[27.7%])and global aphasia(60[25.2%])were the most common types of aphasia.After 21 days of intervention,the ABC scores of all patients were improved.The acupuncture group had the highest ABC scores,but only repetition,naming,and spontaneous speech were statistically improved(P<0.01).Post-hoc tests revealed significant improvement in word retrieval in the acupuncture and t DCS groups(P<0.01,P=0.037),while the acupuncture group had additional significant improvement in spontaneous conversation(P<0.01).Conclusion:Combining acupuncture and t DCS as an adjuvant therapy for subacute PSA led to significant spontaneous speech and word retrieval improvements.Future prospective,multi-ethnic,multi-center trials are warranted.
