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.
Humans ; Music/psychology* ; Music Therapy ; Quality of Life/psychology* ; Stroke/therapy* ; Stroke Rehabilitation

OBJECTIVETo verify the clinical efficacy of acupuncture and moxibustion on depressive states of stroke patients' spouses.

METHODSForty-four subjects who were stroke patients' spouses and according with inclusive criteria with mild or moderate depressive states were randomly divided into an acupuncture-moxibustion group and a blank control group, 22 cases in each group. In the acupuncture-moxibustion group, acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3), and suspended moxibustion was used at Shenque (CV 8), Guanyuan (CV 4) and Zhongwan (CV 12). The treatment was given twice a week for continuous 8 weeks. In the blank control group, neither acupuncture nor moxibustion treatment was given, and the patients were only treated with health and psychological guidance. Before treatment and after 8-week treatment, scores of self-rating depression scale (SDS) and numbers of insomnia severity grade were observed.

RESULTSIn the two groups, the scores of SDS were both reduced than those before treatment (both P<0.05), and the decrease in the acupuncture-moxibustion group was more obvious (P<0.05). After treatment, the number of insomnia severity grade in the acupuncture-moxibustion group was improved than that before treatment (P<0.001), and the improvement was evidently superior to that in the blank control group (P<0.05). The numbers of insomnia severity grade of the blank control group before and after treatment had no statistic significance (P>0.05).

CONCLUSIONThe acupuncture and moxibustion intervention plan has clinical treatment significance on the improvement of mild and moderate depressive states for the stroke patients' primary caregivers who are the patients' spouses.

Aged ; Depression ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Spouses ; psychology ; Stroke ; psychology

Acupuncture therapy for regaining consciousness activates soreness, numbness, distention, heaviness, radiating and moving, electric shock and ant climbing sensations at the specific acupoints in the stroke patients. Radiating and moving sensations are the summary of needling sensations such as soreness, numbness and twitching presenting during lifting and thrusting manipulation. These sensations are the essential factors of the therapeutic effect of regaining consciousness. Radiating sensation refers to the conduction along meridians and radiation of soreness and numbness. Moving sensation refers to the local muscular twitching at acupoints and the involuntary movement of limbs, joints and the distal. Acupuncture at the specific acupoints achieves radiating and moving sensations for promoting the circulation in meridians, regulating qi and mind and balancing yin and yang in stroke patients. This therapy was introduced in the paper in view of acupoint location, needle insertion and manipulation.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Consciousness ; Humans ; Meridians ; Needles ; Stroke ; psychology ; therapy

OBJECTIVE: To compare the clinical effect of Tongdu Xingshen (promoting the governor vessel and regaining consciousness) acupuncture and moxibustion combined with cognitive training and the simple cognitive training for post-stroke mild cognitive impairment (PSMCI). METHODS: Eighty-four patients with PSMCI were randomly divided into an observation group and a control group, with 42 cases in each group (3 cases in the observation group and 2 cases in the control group dropped off). The observation group was treated by Tongdu Xingshen acupuncture and moxibustion combined with cognitive training, acupuncture was given at Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), etc., and moxibustion was given at Shenting (GV 24) , Baihui (GV 20), Shendao (GV 11), Fengfu (GV 16) and Xinshu (BL 15). The control group was only given cognitive training. All the above treatment was given once a day, 5 times a week, for 4 consecutive weeks. The scores of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), activity of daily living (ADL) and stroke-specific quality of life (SS-QOL) were compared between the two groups before treatment, after treatment, 4 weeks and 12 weeks after treatment. RESULTS: After treatment, 4 weeks and 12 weeks after treatment, the MoCA, MMSE and SS-QOL scores of the two groups were all higher than those before treatment (P<0.05), and the ADL scores were lower than those before treatment (P<0.05). In the observation group, the MoCA and MMSE scores were higher than those of the control group after treatment, 4 weeks and 12 weeks after treatment (P<0.05), and the SS-QOL score was higher than that of the control group 12 weeks after treatment (P<0.05). CONCLUSION Both Tongdu Xingshen acupuncture and moxibustion combined with cognitive training and simple cognitive training can improve cognitive function, daily living ability and quality of life in patients with PSMCI, and the combined therapy is superior to simple cognitive training in improving cognitive function and long-term quality of life in patients with PSMCI.
Acupuncture Points ; Acupuncture Therapy ; Cognition ; Cognitive Dysfunction/therapy* ; Humans ; Moxibustion ; Quality of Life ; Stroke/psychology* ; Treatment Outcome

OBJECTIVE: To Investigate the synergic effects of short-term constraint-induced movement therapy (CIMT) and visual biofeedback training (VBT) in subacute stroke patients. METHODS: Thirty-two subacute stroke patients were enrolled and randomly assigned to one of three groups: short-term CIMT with VBT, VBT only, and control groups. We applied CIMT for an hour daily during VBT instead of the ordinary restraint time, referred to as 'short-term' CIMT. Short-term CIMT with VBT group received simultaneous VBT with CIMT, whereas the VBT the only group received VBT without CIMT for an hour a day for 2 weeks. The control group received conventional occupational therapy (OT) alone. Patients underwent the Purdue Pegboard Test, the JAMAR grip strength test, the Wolf Motor Function Test, the Fugl-Meyer Assessment (upper extremity), Motricity index and the Korean version of Modified Barthel Index test to evaluate motor functions of the hemiplegic upper limb at baseline, post-treatment, and 2 weeks after treatment. RESULTS: No significant differences were observed between short-term CIMT with VBT and VBT only groups. Both groups showed significantly higher scores compared to the control group in the WMFT and FMA tests. However, the short-term CIMT with VBT group showed significant improvement (p<0.05) compared with the control group in both grasp and pad pinch at post-treatment and 2 weeks after treatment while the VBT only group did not. CONCLUSION: Short-term CIMT with VBT group did not show significant improvement of hemiplegic upper limb function of subacute stroke patients, compared to VBT only group. Larger sample sizes and different restraint times would be needed to clarify the effect.
Biofeedback, Psychology* ; Hand Strength ; Humans ; Occupational Therapy ; Sample Size ; Stroke* ; Upper Extremity* ; Wolves

A realizaton project of electrical stimulator aimed at motor dysfunction of stroke is proposed in this paper. Based on neurophysiological biofeedback, this system, using an ARM9 S3C2440 as the core processor, integrates collection and display of surface electromyography (sEMG) signal, as well as neuromuscular electrical stimulation (NMES) into one system. By embedding Linux system, the project is able to use Qt/Embedded as a graphical interface design tool to accomplish the design of stroke rehabilitation apparatus. Experiments showed that this system worked well.
Biofeedback, Psychology ; Computers ; Electric Stimulation Therapy ; instrumentation ; Electromyography ; Equipment Design ; Humans ; Software ; Stroke Rehabilitation

PURPOSE: To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers. MATERIALS AND METHODS: Eighteen post-stroke patients, within six months of onset and mini mental status examination score of over 20, participated in this study. Patients were divided into music and control groups. The experimental group participated in the music therapy program for four weeks. Psychological status was evaluated with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) before and after music therapy. Satisfaction with music therapy was evaluated by a questionnaire. RESULTS: BAI and BDI scores showed a greater decrease in the music group than the control group after music therapy, but only the decrease of BDI scores were statistically significant (p=0.048). Music therapy satisfaction in patients and caregivers was affirmative. CONCLUSION: Music therapy has a positive effect on mood in post-stroke patients and may be beneficial for mood improvement with stroke. These results are encouraging, but further studies are needed in this field.
Adult ; Affect/*physiology ; Anxiety/therapy ; Depression/therapy ; Female ; Humans ; Male ; Middle Aged ; *Music Therapy ; Stroke/*psychology ; Treatment Outcome

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Combined Modality Therapy ; Crying ; Female ; Humans ; Laughter ; Male ; Middle Aged ; Stroke ; psychology ; therapy ; Treatment Outcome

INTRODUCTIONEarly initiation of stroke thrombolysis is associated with improved outcomes. Procurement of consent is a key factor in prolonging the door-to-needle duration. This study aimed to determine the attitudes and preferences of stroke patients and their next of kin (NOK) towards decision-making for stroke thrombolysis in Singapore.

MATERIALS AND METHODSWe surveyed acute ischaemic stroke patients (n = 171) who presented beyond the 4.5-hour therapeutic window and their NOK (n = 140) using a questionnaire with scenarios on obtaining consent for intravenous thrombolysis.

RESULTSIn the patient survey, 83% were agreeable for their NOK to decide on their behalf if mentally incapacitated and 74% were agreeable for the doctor to decide if the NOK was absent. In the NOK survey, the majority (81%) wanted to be consulted before mentally capacitated patients made their decision; 72% and 74%, meanwhile, were willing to decide on behalf of a mentally capacitated and mentally incapacitated patient, respectively. In the scenario where a doctor recommended a mentally incapacitated stroke patient to undergo thrombolysis but the family declined, there was a near equal split in preference to follow the family's or doctor's decision in both the patient and NOK surveys.

CONCLUSIONThe survey found that in the decision-making process for stroke thrombolysis, there was no clear consensus on the preference for the decision maker of the mentally incapacitated patient. In Singapore, there is a strong influence of the NOK in decision-making for thrombolysis.

Attitude to Health ; Brain Ischemia ; complications ; psychology ; therapy ; Decision Making ; Dissent and Disputes ; Humans ; Informed Consent ; Mental Competency ; Proxy ; Singapore ; Stroke ; etiology ; psychology ; therapy ; Surveys and Questionnaires ; Thrombolytic Therapy ; Time-to-Treatment

OBJECTIVETo verify the clinical efficacy of acupuncture for mild cognitive impairment of stroke at subacute stage.

METHODSOne hundred patients at subacute stage of cerebral infarction or cerebral hemorrhage with scores of Montreal cognitive assessment (MoCA) less than 26 were randomly divided into an observation group and a control group,50 cases in each one. Based on the regulation of blood pressure and blood sugar and anticoagulation,cognitive rehabilitation training was adopted in the control group. On the basis of treatment in the control group,acupuncture was applied in the observation group. The acupoints were Baihui(GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Yintang(GV 29), Hegu (LI 4) and Taichong(LR 3). Sishencong(EX-HN 1), Shenting (GV 24) and Yintang (GV 29) were connected to electroacupuncture apparatus. The treatment was given once a day,5 times a week, and 8-week treatment was acquired in the two groups. In the 4th week and the 8th week,limbs motor function, daily life ability and cognitive function were evaluated by Fugl-Meyer assessment (FMA) scale,Bathel index and MoCA scale.

RESULTSIn 4 weeks and 8 weeks, the scores of FMA, Bathel index and MoCA in the two groups were improved compared with those before treatment (all P < 0.05). After 8-week treatment, the scores of Bathel index and MoCA in the observation group were better than those in the control group (both P < 0.05).

CONCLUSIONBased on the cognitive rehabilitation training and the conventional treatment, acupuncture can improve the cognitive function and daily life ability of stroke patients at subacute stage with mild cognitive impairment.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cognition ; Cognitive Dysfunction ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; psychology ; therapy