Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’bala...Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.展开更多
Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiple...Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.展开更多
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 qu...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.展开更多
Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action o...Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action of the piston technique for hip joints (PTH), which is a method for improving hip joint extension range of motion. We then evaluated the efficacy of PDH on 10 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in walking speed.展开更多
There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior...There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles,we investigated a potential method of nerve repair using the L4 nerve roots.Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule.The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs.We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage.In a beam-walking test and ladder rung walking task,model rats exhibited an initial high number of slips,but improved in accuracy on the paretic side over time.At 17 weeks after surgery,rats gained approximately 58.2%accuracy from baseline performance and performed ankle motions on the paretic side.At 9 weeks after surgery,a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots.In addition,histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord.Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved.These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints,particularly of the distal ankle.Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage.All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(No.IACUC-1906009)in June 2019.展开更多
OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke...OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.展开更多
Objective: To describe the clinical and etiological characteristics of hemiplegia in the northern region of Burkina Faso. Methodology: This was transversal with a descriptive and analytical study of one hundred and ni...Objective: To describe the clinical and etiological characteristics of hemiplegia in the northern region of Burkina Faso. Methodology: This was transversal with a descriptive and analytical study of one hundred and ninety-six hemiplegic patients in charge of general medicine at the Ouahigouya Regional University Hospitalfrom November 2015 to November 2017. Results: The majority of patients had a brutal hemiplegia predominant on the right. The sample consisted mainly of male patients with a mean age of 58 years. High blood pressure was the main factor of vascular risk. The cerebrovascular accident (58.7%) was the main pathology diagnosed. Most patients received symptomatic management. Physiotherapy was performed in 29.6% of patients. The clinical outcome at discharge was marked by the persistence of hemiplegia in more than 90.8% of patients. There was an improvement in the average MIF score at the exit. Conclusion: The lack of computed tomography and neuro-resuscitation unit were the main factors limiting the management of hemiplegia in our context.展开更多
Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using upper extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessme...Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using upper extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessment of the patients’ activities of daily lioing (ADL) (Barthel index). The upper extremity median nerve SEP on the affected and normal sides was determined. By using Kovindha standard, upper extremity median nerve SEP was graded in accordance with N20. The correlation between the differences of SEP N20 amplitude and the latencies on the both sides and the Barthel index scores was analyzed. A Spearman correlation analysis was made between the median nerve SEP N20 grades and Brunnstrom stages in hand or ADL on the affected side. The results showed that upper extremity median nerve SEP grades were positively correlated with those of the Brunnstrom stages in hand (r 1=0.6925, P 1<0.01). The correlation coefficient between SEP N20 grades and patients’ ADL grades was r 2=0.5015, P 2<0 01. It was concluded that upper extremity median nerve SEP could be used as a sensitive electrophysiological predictor to clinically assess hemiplegic hand function. SEP N20 might play a role in predicting the ADL of the patients with hemiplegia to some extent, but could not be used as a sensitive predictor to directly observe and predict the ADL of the patients.展开更多
Sixty-one patients of ischemic apoplectic hemiplegia were randomly divided into group ofneedling around the ipsilateral projective area on the scalp of the fOcus (group A) and group of scalpacupuncture (group B). Afte...Sixty-one patients of ischemic apoplectic hemiplegia were randomly divided into group ofneedling around the ipsilateral projective area on the scalp of the fOcus (group A) and group of scalpacupuncture (group B). After 30 treatments, there is a significant difference between the therapeuticeffects of two groups (P < 0. 05 ), the former is better than the latter. It suggests that the method ofneedling around the projective area on the scalp of the focus is an effective and a feasible展开更多
100cases of apoplectic hemiplegia were randomly divided into two groups, andtreated by the scalp acupuncture. Group A received two sessions each day, while Group B re-ceived one session each day, the others were all t...100cases of apoplectic hemiplegia were randomly divided into two groups, andtreated by the scalp acupuncture. Group A received two sessions each day, while Group B re-ceived one session each day, the others were all the same. One therapeutic course consisted of 10days, and the therapeutic effects were assessed after two courses. The results show that the clini-cal therapeutic effect in the Group A is superior to that in the Group B; the myodynamia and painthreshold of the skin have different improvements, but the effects in the Group A are better thanthat in the Group B, etc.. That is to say the therapeutic effects are correlated with stimulatingquantity.展开更多
In the present study,33 cases of apopletic hemiplegia were treated with combinedtherapies of scalp-,body-acupuncture and restoring consciousness needling;besides,electroacupuncture（EA）stimulation was added.The treat...In the present study,33 cases of apopletic hemiplegia were treated with combinedtherapies of scalp-,body-acupuncture and restoring consciousness needling;besides,electroacupuncture（EA）stimulation was added.The treatment was given once daily,six days constitutea therapeutic course with an interval of 1—2 days between courses.After 5 courses of treatment,10cases（30.30％）were cured,15（45.45％）markedly effective,7（21.21％）effective and 1（3.03％）was ineffective.The total effective rate was 96.96％.展开更多
[Objectives] To evaluate the efficacy and safety of two different treatment regimens( Buyang Huanwu Decoction combined with acupuncture and Buyang Huanwu Decoction alone) in the treatment of apoplectic hemiplegia. [Me...[Objectives] To evaluate the efficacy and safety of two different treatment regimens( Buyang Huanwu Decoction combined with acupuncture and Buyang Huanwu Decoction alone) in the treatment of apoplectic hemiplegia. [Methods]Electronic databases: China Knowledge Infrastructure( CNKI),Wanfang database( Wan Fang Data),VIP database( VIP),China Biomedical Literature Database( CBM),MEDLINE,The Cochrane Library,Pubmed,Chinese Journal of Integrative Medicine,and Journal of Traditional Chinese Medicine were searched. The published randomized controlled trials( RCT) of Buyang Huanwu Decoction combined with acupuncture and Buyang Huanwu Decoction alone in the treatment of apoplectic hemiplegia were screened. The Jadad scale was used to evaluate the methodological quality of the included literature. The data was extracted and the meta-analysis was carried out with reference to the Systematic Evaluation,Meta-analysis Design and Implementation Method. [Results]A total of 8 articles were included,a total of 765 patients,and there were 8 articles with Jadad scores lower than 4 points. Meta-analysis results indicate that The experimental group of Buyang Huanwu Decoction combined with acupuncture treatment improved the comprehensive clinical efficacy OR = 3. 89,95% CI[2. 58,5. 86]( P < 0. 000 01),BI score SMD = 2. 35,95% CI[2. 04,2. 66]( P <0. 000 01) was better than the control group. [Conclusions]The treatment regimen of Buyang Huanwu Decoction combined with acupuncture can improve the daily activities of patients with apoplectic hemiplegia and improve the clinical efficacy. It is better than the treatment regimen of Buyang Huanwu Decoction alone.展开更多
Alternating hemiplegia of childhood is a rare neurodevelopmental disorder.Most cases are reported as sporadic disorder due to de novo variants,and few with family members involved.Two boys were hospitalized due to epi...Alternating hemiplegia of childhood is a rare neurodevelopmental disorder.Most cases are reported as sporadic disorder due to de novo variants,and few with family members involved.Two boys were hospitalized due to epileptic seizures occurred initially at age of six to seven months.During the course of the disease,there were repeated episodes of paroxysmal weakness or paralysis affecting one side of the body.Genetic testing showed that both patients carried heterozygous missense mutations in the ATP1A3 gene(OMIM:614820):c.3025(exon 22)A>G(p.K1009E)and c.2443(exon 18)G>A(p.E815K).Flunarizine can significantly improve the paroxysmal motor symptoms of pediatric patients with alternating hemiplegia.展开更多
We evaluated the efficacy of the piston device simulating manual piston technique for hip joints (PTH) on 8 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid im...We evaluated the efficacy of the piston device simulating manual piston technique for hip joints (PTH) on 8 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in the results of the Time up and Go test and walking speed.展开更多
BACKGROUND: For many years, the extremities of stroke patients are divided into affected side and unaffected side according to clinical symptoms and body signs. Moreover, previous rehabilitation function training is d...BACKGROUND: For many years, the extremities of stroke patients are divided into affected side and unaffected side according to clinical symptoms and body signs. Moreover, previous rehabilitation function training is developed simply aiming to the dysfunction manifested by unaffected extremity. Problems of unaffected extremity are always ignored, such as left- and right- side connection dysfunction, abnormal muscular tension of unaffected side and so on. OBJECTIVE: To observe neurophysiological change characteristics of unaffected extremity of stroke patients with hemiplegia by electromyographical method. DESIGN: Case-control observation. SETTING: First Hospital, Jilin University. PARTICIPANTS: Eighty stroke patients with hemiplegia confirmed by skull CT or MRI, who firstly hospitalized in the Department of Neurology, First Hospital, Jilin University between July 2004 and March 2005, were retrieved. They were scored > 8 points in Glasgow Coma Scale and had stable vital sign. Nineteen normal persons who received healthy examination in the clinic were involved in normal control group. Following the classification criteria of Brunnstrom's Recovery Stages of Stroke (BRSS), 80 stroke patients with hemiplegia were assigned into 3 groups: BRSS Ⅰ-Ⅱ group (n =36), BRSS Ⅲ-Ⅳ group (n =23) and BRSSⅤ-Ⅵ (n =21). METHODS: F-wave parameters of median nerve of unaffected extremity were detected by electromyographical technique. The recording electrode (muscular belly of abductor pollicis brevis) and reference electrode (first finger bone) were connected with grounding electrode. Stimulating electrode was placed in the median part of wrist joint with stimulation intensity of 130% that of threshold stimulation, stimulation frequency of 2 Hz, current pulse width of 0.2 ms, time course of 5 ms and sensitivity of 2 mV. The F-wave of median nerve of affected extremity under the resting stage (static status) and that of unaffected extremity under the maximum resistant contracted state were detected in order. The amplitude and appearance percentage of F wave were recorded. MAIN OUTCOME MEASURES: Comparison of F-wave parameters of median nerve between the unaffected extremity of stroke patients with hemiplegia and the extremity of control subjects under different status. RESULTS: All the patients accomplished the detection, and all of them participated in the final analysis. ①Under dynamic status, the amplitude and appearance percentage of F wave of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group were significantly higher than those in the normal control group, respectively[(0.803 9±0.157 3) mV vs. (0.406 7±0.170 3) mV; (0.856 1±0.266 8)% vs. (0.650 0±0.197 6)%, P < 0.05]. Under static status, there were no significant differences in F-wave parameters of median nerve in the unaffected extremity of patients between BRSS Ⅰ-Ⅱ group and BRSS Ⅴ-Ⅵ group (P > 0.05). ②F-wave parameters of median nerve of unaffected extremity of patients in BRSS Ⅰ-Ⅱ group and BRSS Ⅴ-Ⅵ group under dynamic statewere higher than those under static status, without significant difference (P > 0.05), while the amplitude and appearance percentage of F wave of median nerve of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group under dynamic statewere significantly higher than those under static state[(0.803 9±0.157 3) mV vs. (0.391 7±0.131 6) mV; (0.856 1±0.266 8 )% vs.(0.639 1 ±0.259 4)%,P < 0.05]. ③ There was no significant difference in F wave parameters among groups under static state(P > 0.05). However, under dynamic status, the amplitude and appearance percentage of F wave parameters of median nerve of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group [(0.803 9±0.157 3) mV,(0.856 1±0.266 8)%] were significantly lower than those in the other two groups [(0.395 1±0.148 8),(0.437 1±0.157 6) mV;(0.612 5±0.232 8)%,(0.657 1±0.232 5)%,P < 0.05]. CONCLUSION: With the development of disease condition and the increase of muscular tension at anesthetic side, combination motor of affected extremity is caused following movement and muscular tension enhances to non-anesthetic-side. Therefore, F-wave parameters increase under dynamic status.展开更多
Objective:rupture of liver metasta-ses with disturbance of consciousness accompanied by aggravation of hemiplegia is very rare.We describe the clinical features of a case of spontaneous rupture of liver metastasis tum...Objective:rupture of liver metasta-ses with disturbance of consciousness accompanied by aggravation of hemiplegia is very rare.We describe the clinical features of a case of spontaneous rupture of liver metastasis tumors with disturbance of consciousness and progression of right limb hemiplegia.Methods:collect the patient's medical history,conduct a detailed physi-cal examination,timely improve the relevant laboratory and imaging examination,formulate a comprehensive treatment plan,and track the changes of the disease and the treatment effect.Results:the patient presented with blurred consciousness,hemiplegia of the right limb,and epigastric tenderness when admitted to the hospital.No evident new lesions were found on cranial computed to-mography(CT).Blood routine examination showed that hemoglobin decreased significantly compared with be-fore.Abdominal CT showed tumor rupture and bleeding.The patient in critical condition did not have operation conditions,but improved after conservative treatment.Conclusion:when patients with liver metastasis tumors suddenly have a disturbance of consciousness and prog-ress of hemiplegia,they should not only be considered to have acute cerebrovascular diseases,but also the possi-bility of rupture of liver metastasis tumors.If only treated according to acute stroke,it will endanger their lives.For the liver metastasis tumor rupture,if there is no oppor-tunity for embolotherapy,timely conservative treatment with drugs can also achieve good results.展开更多
Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018...Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018 to March 2020 were selected for the present study.Twenty patients in each group were divided into two groups by random number table method,either in experimental group or control group.Routine nursing was used in the control group,while early rehabilitation nursing was carried out in the experimental group.The clinical nursing effect of the two groups of patients was compared.Results:After nursing,the neurological function of the patients was significantly improved(P<0.05),the improvement of the experimental group was better than that of the control group(P<0.01),the daily activities of the patients in the experimental group were significantly improved,and the score of the experimental group was higher than that of the control group(P<0.05).After nursing,anxiety and depression scores in the experimental group were significantly lower than those in the control group(P<0.05),and the recovery of limb function in the experimental group was better than that in the control group(P<0.05).Conclusion:The implementation of early rehabilitation nursing measures plays an important role in the recovery of stroke patients with hemiplegia by promoting the recovery of neurological function,improving the psychological state of patients,and promoting the recovery of limbs.展开更多
Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs,namely collateral shock in the brain.Contralateral needling is the insertion of needles into acupoints on the relative healt...Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs,namely collateral shock in the brain.Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy.However,there is little well-designed and controlled clinical evidence for this practice.This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke.These patients were randomly assigned to three groups:45 in the contralateral needling group,receiving acupuncture on the unaffected limbs;45 in the conventional acupuncture group,receiving acupuncture on the hemiplegic limbs;and 16 in the control group,receiving routine treatments without acupuncture.Acupuncture at acupoints Chize(LU5)in the upper limb and Jianliao(TE14)in the lower limb was performed for 45 minutes daily for 30consecutive days.The therapeutic effective rate,Neurological Deficit Score,Modified Barthel Index and Fugl-Meyer Assessment were evaluated.The therapeutic effective rate of contralateral needling was higher than that of conventional acupuncture(46.67%vs.31.11%,P<0.05).The neurological deficit score of contralateral needling was significantly decreased compared with conventional acupuncture(P<0.01).The Modified Barthel Index and Fugl-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture(both P<0.01).The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.展开更多
文摘Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.
文摘Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.
文摘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.
文摘Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action of the piston technique for hip joints (PTH), which is a method for improving hip joint extension range of motion. We then evaluated the efficacy of PDH on 10 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in walking speed.
基金the National Natural Science Foundation of China,No.81171147(to LXL)“Key Medical Talents of Qiangwei Project”Research Foundation of Health Department of Jiangsu Province,No.ZDRCA2016010(to LXL)+3 种基金“Xingwei Project”Key Personal Medical Research Foundation of Health Department of Jiangsu Province,No.RC201156(to LXL)Jiangsu Province’s Key Discipline of Medicine,No.XK201117(to LXL)the Priority Academic Program Development of Jiangsu Higher Education Institutions,PAPD(to LXL)the Natural Science Foundation of Jiangsu Province,No.BK20171064(to BSH).
文摘There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles,we investigated a potential method of nerve repair using the L4 nerve roots.Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule.The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs.We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage.In a beam-walking test and ladder rung walking task,model rats exhibited an initial high number of slips,but improved in accuracy on the paretic side over time.At 17 weeks after surgery,rats gained approximately 58.2%accuracy from baseline performance and performed ankle motions on the paretic side.At 9 weeks after surgery,a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots.In addition,histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord.Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved.These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints,particularly of the distal ankle.Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage.All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(No.IACUC-1906009)in June 2019.
文摘OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.
文摘Objective: To describe the clinical and etiological characteristics of hemiplegia in the northern region of Burkina Faso. Methodology: This was transversal with a descriptive and analytical study of one hundred and ninety-six hemiplegic patients in charge of general medicine at the Ouahigouya Regional University Hospitalfrom November 2015 to November 2017. Results: The majority of patients had a brutal hemiplegia predominant on the right. The sample consisted mainly of male patients with a mean age of 58 years. High blood pressure was the main factor of vascular risk. The cerebrovascular accident (58.7%) was the main pathology diagnosed. Most patients received symptomatic management. Physiotherapy was performed in 29.6% of patients. The clinical outcome at discharge was marked by the persistence of hemiplegia in more than 90.8% of patients. There was an improvement in the average MIF score at the exit. Conclusion: The lack of computed tomography and neuro-resuscitation unit were the main factors limiting the management of hemiplegia in our context.
文摘Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using upper extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessment of the patients’ activities of daily lioing (ADL) (Barthel index). The upper extremity median nerve SEP on the affected and normal sides was determined. By using Kovindha standard, upper extremity median nerve SEP was graded in accordance with N20. The correlation between the differences of SEP N20 amplitude and the latencies on the both sides and the Barthel index scores was analyzed. A Spearman correlation analysis was made between the median nerve SEP N20 grades and Brunnstrom stages in hand or ADL on the affected side. The results showed that upper extremity median nerve SEP grades were positively correlated with those of the Brunnstrom stages in hand (r 1=0.6925, P 1<0.01). The correlation coefficient between SEP N20 grades and patients’ ADL grades was r 2=0.5015, P 2<0 01. It was concluded that upper extremity median nerve SEP could be used as a sensitive electrophysiological predictor to clinically assess hemiplegic hand function. SEP N20 might play a role in predicting the ADL of the patients with hemiplegia to some extent, but could not be used as a sensitive predictor to directly observe and predict the ADL of the patients.
文摘Sixty-one patients of ischemic apoplectic hemiplegia were randomly divided into group ofneedling around the ipsilateral projective area on the scalp of the fOcus (group A) and group of scalpacupuncture (group B). After 30 treatments, there is a significant difference between the therapeuticeffects of two groups (P < 0. 05 ), the former is better than the latter. It suggests that the method ofneedling around the projective area on the scalp of the focus is an effective and a feasible
文摘100cases of apoplectic hemiplegia were randomly divided into two groups, andtreated by the scalp acupuncture. Group A received two sessions each day, while Group B re-ceived one session each day, the others were all the same. One therapeutic course consisted of 10days, and the therapeutic effects were assessed after two courses. The results show that the clini-cal therapeutic effect in the Group A is superior to that in the Group B; the myodynamia and painthreshold of the skin have different improvements, but the effects in the Group A are better thanthat in the Group B, etc.. That is to say the therapeutic effects are correlated with stimulatingquantity.
文摘In the present study,33 cases of apopletic hemiplegia were treated with combinedtherapies of scalp-,body-acupuncture and restoring consciousness needling;besides,electroacupuncture（EA）stimulation was added.The treatment was given once daily,six days constitutea therapeutic course with an interval of 1—2 days between courses.After 5 courses of treatment,10cases（30.30％）were cured,15（45.45％）markedly effective,7（21.21％）effective and 1（3.03％）was ineffective.The total effective rate was 96.96％.
基金Supported by Project of National Natural Science Foundation of China(81573938)Key Laboratory System Program of Basic Research in Traditional Chinese Medicine of Guangxi(KJT14006&KJT15008)
文摘[Objectives] To evaluate the efficacy and safety of two different treatment regimens( Buyang Huanwu Decoction combined with acupuncture and Buyang Huanwu Decoction alone) in the treatment of apoplectic hemiplegia. [Methods]Electronic databases: China Knowledge Infrastructure( CNKI),Wanfang database( Wan Fang Data),VIP database( VIP),China Biomedical Literature Database( CBM),MEDLINE,The Cochrane Library,Pubmed,Chinese Journal of Integrative Medicine,and Journal of Traditional Chinese Medicine were searched. The published randomized controlled trials( RCT) of Buyang Huanwu Decoction combined with acupuncture and Buyang Huanwu Decoction alone in the treatment of apoplectic hemiplegia were screened. The Jadad scale was used to evaluate the methodological quality of the included literature. The data was extracted and the meta-analysis was carried out with reference to the Systematic Evaluation,Meta-analysis Design and Implementation Method. [Results]A total of 8 articles were included,a total of 765 patients,and there were 8 articles with Jadad scores lower than 4 points. Meta-analysis results indicate that The experimental group of Buyang Huanwu Decoction combined with acupuncture treatment improved the comprehensive clinical efficacy OR = 3. 89,95% CI[2. 58,5. 86]( P < 0. 000 01),BI score SMD = 2. 35,95% CI[2. 04,2. 66]( P <0. 000 01) was better than the control group. [Conclusions]The treatment regimen of Buyang Huanwu Decoction combined with acupuncture can improve the daily activities of patients with apoplectic hemiplegia and improve the clinical efficacy. It is better than the treatment regimen of Buyang Huanwu Decoction alone.
基金Research Fund of Anhui Medical University(Grant Number:2019xkj176).
文摘Alternating hemiplegia of childhood is a rare neurodevelopmental disorder.Most cases are reported as sporadic disorder due to de novo variants,and few with family members involved.Two boys were hospitalized due to epileptic seizures occurred initially at age of six to seven months.During the course of the disease,there were repeated episodes of paroxysmal weakness or paralysis affecting one side of the body.Genetic testing showed that both patients carried heterozygous missense mutations in the ATP1A3 gene(OMIM:614820):c.3025(exon 22)A>G(p.K1009E)and c.2443(exon 18)G>A(p.E815K).Flunarizine can significantly improve the paroxysmal motor symptoms of pediatric patients with alternating hemiplegia.
文摘We evaluated the efficacy of the piston device simulating manual piston technique for hip joints (PTH) on 8 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in the results of the Time up and Go test and walking speed.
文摘BACKGROUND: For many years, the extremities of stroke patients are divided into affected side and unaffected side according to clinical symptoms and body signs. Moreover, previous rehabilitation function training is developed simply aiming to the dysfunction manifested by unaffected extremity. Problems of unaffected extremity are always ignored, such as left- and right- side connection dysfunction, abnormal muscular tension of unaffected side and so on. OBJECTIVE: To observe neurophysiological change characteristics of unaffected extremity of stroke patients with hemiplegia by electromyographical method. DESIGN: Case-control observation. SETTING: First Hospital, Jilin University. PARTICIPANTS: Eighty stroke patients with hemiplegia confirmed by skull CT or MRI, who firstly hospitalized in the Department of Neurology, First Hospital, Jilin University between July 2004 and March 2005, were retrieved. They were scored > 8 points in Glasgow Coma Scale and had stable vital sign. Nineteen normal persons who received healthy examination in the clinic were involved in normal control group. Following the classification criteria of Brunnstrom's Recovery Stages of Stroke (BRSS), 80 stroke patients with hemiplegia were assigned into 3 groups: BRSS Ⅰ-Ⅱ group (n =36), BRSS Ⅲ-Ⅳ group (n =23) and BRSSⅤ-Ⅵ (n =21). METHODS: F-wave parameters of median nerve of unaffected extremity were detected by electromyographical technique. The recording electrode (muscular belly of abductor pollicis brevis) and reference electrode (first finger bone) were connected with grounding electrode. Stimulating electrode was placed in the median part of wrist joint with stimulation intensity of 130% that of threshold stimulation, stimulation frequency of 2 Hz, current pulse width of 0.2 ms, time course of 5 ms and sensitivity of 2 mV. The F-wave of median nerve of affected extremity under the resting stage (static status) and that of unaffected extremity under the maximum resistant contracted state were detected in order. The amplitude and appearance percentage of F wave were recorded. MAIN OUTCOME MEASURES: Comparison of F-wave parameters of median nerve between the unaffected extremity of stroke patients with hemiplegia and the extremity of control subjects under different status. RESULTS: All the patients accomplished the detection, and all of them participated in the final analysis. ①Under dynamic status, the amplitude and appearance percentage of F wave of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group were significantly higher than those in the normal control group, respectively[(0.803 9±0.157 3) mV vs. (0.406 7±0.170 3) mV; (0.856 1±0.266 8)% vs. (0.650 0±0.197 6)%, P < 0.05]. Under static status, there were no significant differences in F-wave parameters of median nerve in the unaffected extremity of patients between BRSS Ⅰ-Ⅱ group and BRSS Ⅴ-Ⅵ group (P > 0.05). ②F-wave parameters of median nerve of unaffected extremity of patients in BRSS Ⅰ-Ⅱ group and BRSS Ⅴ-Ⅵ group under dynamic statewere higher than those under static status, without significant difference (P > 0.05), while the amplitude and appearance percentage of F wave of median nerve of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group under dynamic statewere significantly higher than those under static state[(0.803 9±0.157 3) mV vs. (0.391 7±0.131 6) mV; (0.856 1±0.266 8 )% vs.(0.639 1 ±0.259 4)%,P < 0.05]. ③ There was no significant difference in F wave parameters among groups under static state(P > 0.05). However, under dynamic status, the amplitude and appearance percentage of F wave parameters of median nerve of unaffected extremity of patients in BRSS Ⅲ-Ⅳ group [(0.803 9±0.157 3) mV,(0.856 1±0.266 8)%] were significantly lower than those in the other two groups [(0.395 1±0.148 8),(0.437 1±0.157 6) mV;(0.612 5±0.232 8)%,(0.657 1±0.232 5)%,P < 0.05]. CONCLUSION: With the development of disease condition and the increase of muscular tension at anesthetic side, combination motor of affected extremity is caused following movement and muscular tension enhances to non-anesthetic-side. Therefore, F-wave parameters increase under dynamic status.
基金Scientific Research Program of Hubei Provincial Department of Education in 2019(Q20192103).
文摘Objective:rupture of liver metasta-ses with disturbance of consciousness accompanied by aggravation of hemiplegia is very rare.We describe the clinical features of a case of spontaneous rupture of liver metastasis tumors with disturbance of consciousness and progression of right limb hemiplegia.Methods:collect the patient's medical history,conduct a detailed physi-cal examination,timely improve the relevant laboratory and imaging examination,formulate a comprehensive treatment plan,and track the changes of the disease and the treatment effect.Results:the patient presented with blurred consciousness,hemiplegia of the right limb,and epigastric tenderness when admitted to the hospital.No evident new lesions were found on cranial computed to-mography(CT).Blood routine examination showed that hemoglobin decreased significantly compared with be-fore.Abdominal CT showed tumor rupture and bleeding.The patient in critical condition did not have operation conditions,but improved after conservative treatment.Conclusion:when patients with liver metastasis tumors suddenly have a disturbance of consciousness and prog-ress of hemiplegia,they should not only be considered to have acute cerebrovascular diseases,but also the possi-bility of rupture of liver metastasis tumors.If only treated according to acute stroke,it will endanger their lives.For the liver metastasis tumor rupture,if there is no oppor-tunity for embolotherapy,timely conservative treatment with drugs can also achieve good results.
文摘Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018 to March 2020 were selected for the present study.Twenty patients in each group were divided into two groups by random number table method,either in experimental group or control group.Routine nursing was used in the control group,while early rehabilitation nursing was carried out in the experimental group.The clinical nursing effect of the two groups of patients was compared.Results:After nursing,the neurological function of the patients was significantly improved(P<0.05),the improvement of the experimental group was better than that of the control group(P<0.01),the daily activities of the patients in the experimental group were significantly improved,and the score of the experimental group was higher than that of the control group(P<0.05).After nursing,anxiety and depression scores in the experimental group were significantly lower than those in the control group(P<0.05),and the recovery of limb function in the experimental group was better than that in the control group(P<0.05).Conclusion:The implementation of early rehabilitation nursing measures plays an important role in the recovery of stroke patients with hemiplegia by promoting the recovery of neurological function,improving the psychological state of patients,and promoting the recovery of limbs.
基金partially funded by a grant from Ningxia Science and Technology Support Project,No.2012ZYS207
文摘Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs,namely collateral shock in the brain.Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy.However,there is little well-designed and controlled clinical evidence for this practice.This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke.These patients were randomly assigned to three groups:45 in the contralateral needling group,receiving acupuncture on the unaffected limbs;45 in the conventional acupuncture group,receiving acupuncture on the hemiplegic limbs;and 16 in the control group,receiving routine treatments without acupuncture.Acupuncture at acupoints Chize(LU5)in the upper limb and Jianliao(TE14)in the lower limb was performed for 45 minutes daily for 30consecutive days.The therapeutic effective rate,Neurological Deficit Score,Modified Barthel Index and Fugl-Meyer Assessment were evaluated.The therapeutic effective rate of contralateral needling was higher than that of conventional acupuncture(46.67%vs.31.11%,P<0.05).The neurological deficit score of contralateral needling was significantly decreased compared with conventional acupuncture(P<0.01).The Modified Barthel Index and Fugl-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture(both P<0.01).The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.
