The main objectives of this study was to compare the sensorimdt afar Performance of the unaffected upper extremity of elderly stroke patients with that of healthy elderly people. Methods: The groupof stroke patients was of 30 hemiplegic subjects who had had a cerebrovasculai accident at least 6 monthsearlier. A group of 30 healthy subjects matched for age and sex was used for comparison. The main parameters of the performance of the unaffected upper extremity of the stroke subjects and of the same side of the healthy subjects were measured with valid,reliable instruments. Some variables potentially related to theunaffected upper extremity were also measured:length of time since the stroke,activity level,etc.Results;Statistical analyses showed significant deficits in the unaffected upper extremity of hemiplegic subjecs compared with normal subjects with regard to the following parameters: gross manual dexterity, fine manualdexterity, motor coordination,global performance (P<0. 05 to P<0. 0001 ). No significant clinical or statistical difference was found for grip strength,two-- point discrimination and kindethesia.-- Conclusions: Manyfactors (frequency of use of the unaffected hand sensorimotor interaction task,sevrity of the the deficits in corticifugal projection and deficits in postural stabilization)could interact to provide the clinical picture obtainedin the present study.

Objective To compare the effects of semi conductor laser nasal cavity irradiation with He Ne laser intravenous irradiation therapy on patients with brain lesion. Methods Ninety six cases of cerebral infarction(CI), traumatic brain injury(TBI) were randomly divided into semi conductor laser group (group A, n =50, ?=650nm , 2.4mW, 30mins/nasal cavity), He Ne laser group (group B, n =46, ?=632.8nm, 2.5mW, 40mins/ intermedia cubiti vein or basilic vein). The changes of the blood lipids, hemorheology parameters, scores with Fugl Meyer movement scale and Barthel index assessment were compared after the semi conductor laser and He Ne laser irradiation. Results After laser irradiation,The CHOL, TG, LDL, ESR and HCT were significantly reduced in both groups( P 0.05). The brain damage area was reduced in all the patients as revealed by CT examination. Conclusion The influence of the two kinds of laser irradiation therapies is similar when applied in patients with brain injury. But semi conductor laser nasal cavity irradiation is a simple, safe, inexpensive therapy for the patients.

Objective To explore the characteristics of prospective memory ( PM ) deficit in acute stroke patients with cognitive impairment.MethodsSixty patients suffering from acute stroke who met the inclusion criteria in screening with the neurobehavioral cognitive status examination (NCSE) were enrolled into the experimental group. Sixty healthy participants who matched the experimental group in gender distribution and average age and education level were assigned as a control group. All the participants completed several neuropsychological evaluations,including the Chinese version of the Cambridge prospective memory test ( C-CAMPROMT), the Chinese version of the Rivermead behavior memory test (C-RBMT), a digit-span test (DS), the Chinese version of Stroop's word-color test (C-SWCT) and a color trail test (CTT).ResultsTime-based PM (TBPM) scores in the control group were significantly higher than in the experimental group. At the intention initiation stage TBPM scores in the control group were also significantly better than in the experimental group. The TBPM performance of the experimental group was significantly worse than that of the controls when PM performance was compared with other cognitive functions controlled for.ConclusionsThe acute stroke patients with cognitive impairment showed greater TBPM performance deficits than the controls. This may have resulted from impairment at the intention initiation stage. TBPM deficits may exist independently. If so, they could serve as an assessment of cognitive impairment after stroke.

Objective To test the reliability and validity of the brief International Classification of Functioning, Disability and Health (ICF) core sets for Chinese stroke patients using Rasch model analysis. Methods The body functions of 38 Chinese stroke patients were measured using the brief ICF core sets. The qualifiers of the 20items were measured by two raters and analyzed using FACETS statistical software. The intra-rater reliability and validity were tested by using the separation index and separation reliability and fit analysis. Results The brief ICF core sets had good internal consistency and reliability (person separation index = 6.02, person separation reliability = 0.94 ) with these Chinese patients. The raters showed significantly different strictness in rating, but their ratings had good internal self-consistency. The construct validity was good for the body functions of the ICF component ( separation index = 10.50, separation reliability = 0.80) , but misfitting and overfitting were found in items b117, b152and b755. Conclusion The body function of the brief ICF core sets has good reliability and validity for Chinese stroke patients. A many-facet Rasch measurement model can provide comprehensive information and has good application prospects for testing the reliability and validity of ICF core sets.

AIM To determine whether botulinum toxin A (BTXa) is an effective and safe treatment for lower limb spasticity and improve walking ability after stroke or traumatic brain injury. METHODS 27 cases with stroke or traumatic brain injury affecting the muscles of lower extremity were selected to receive local intramuscular injection. The injected dose is between 50～100 U?(muscle) -1. All patients received rehabilitation therapy that focused on walking training. Patients were assessed at entry, and 2, 4 weeks post-treatment. The muscle tone was assessed by the modified Ashworth Scale, the changes of time-distance parameters was measured by footprint gait analysis. The correlation relationship between muscles tone and gait parameters was analysed. RESULTS Compared to pretreatment values, the total muscles spasticity, walking distance, and speed were significantly improved in all groups respectively, decrease in the modified Ashworth Score (P

Objective To evaluate the feasibility and safety of double-lumen balloon catheter applied in patients with achalasia of cricopharyngeal muscle. Method Fifty patients with achalasia of cricopharyngeal muscle were randomly divided into experimental group and control group. All the patients received routine drug treatment,swallowing function training,feeding training and low frequency VitalStim electric stimulation. In addition,double-lumen balloon catheter and #14 urinary catheters were applied to patients in the experimental group and control group,respectively. The swallow water tests and video fluoroscopy swallowing study(VFSS) were used to evaluate the treatment effects,the electron-nasopharyngolaryngoscope was used to assess bleeding and swelling of mucous membrane,and VRS-5 was used to assess pain. Result After treatment,the scores of swallow water tests and VFSS were significantly better than those before treatment in both groups(P<0.05). There was no significant difference between the two groups(P>0.05). However,the incidence of complications was significantly higher in the control group than that of experimental group(P<0.05). Conclusion Both treatment methods can effectively relieve the achalasia of cricopharyngeal muscle,but modified double-lumen balloon catheter can reduce the incidence of complications.

Objective To evaluate the effect of the modified balloon dilatation intervention on the pharyngeal constriction function of the brainstem stroke survivors with dysphagia using videofluoroscopy-based digital analysis.Methods Thirty brainstem stroke survivors with pharyngeal dysphagia were recruited and randomly divided into a treatment group and a control group,with 15 in each.The treatment group was treated with the modified balloon dilatation in addition to the routine treatment of 30min,respectively,once a daily,3 days a week,whiled a control group was treated with routine treatment of 30min twice a day,3 days a week.Before and after the treatment,the rate and duration of pharyngeal constriction were measured in both groups.Results After the treatment,the rate of pharyngeal constriction in the treatment group was (0.20 ± 0.030),(0.14 ± 0.05) and (0.15 ± 0.04) when swallowing thin liquid,thick liquid and pasty food,significantly better than before the treatment.The duration of the pharyngeal constriction was (990.34 ±96.14),(1010.47 ± 133.64) and (1180.10 ± 121.27) ms,respectively,also significantly better than before the treatment.In the control group,significant differences were also observed in the rate and duration of pharyngeal constriction before and after the treatment.Conclusions Digital analysis based on videofluoroscopy can be used to quantify swallowing function effectively,and the rate and duration of pharyngeal constriction can be used to evaluate the pharyngeal function before and after treatment.

Objective To explore the rehabilitation for dysphagia in young patient after tracheotomy and cricopharyngeal achalasia with-out cough reflex. Methods A child was reviewed, who accepted tracheotomy after resection of cerebellar pilocytic astrocytoma for dyspha-gia. The features characterized as severe silent aspiration and failure of cricopharyngeus muscle relaxation. Therapies included Passy-Muir valve placement, breathing exercises, balloon dilatation, surface electromyography biofeedback, and electrical stimulation. Results The aspi-ration was observed when she drank thin liquid with weak cough reflex, and disappeared as eating thick liquid and paste food, with complete cricopharyngeus muscle opening, 7 weeks after treatment. She was removed the tracheotomy tube and nasal feeding tube 11 weeks after treatment, and got sufficient nutrition by fully oral intake. Conclusion The application of Passy-Muir valve and comprehensive swallowing training is helpful for patient post tracheotomy with silent aspiration in decreasing the risk of aspiration, improving cough reflex and prompt-ing swallowing function.

Objective To investigate the effects of using a catheter balloon to treat crieopharyngeal achala-sia in patients with brainstem lesions. Methods Thirty cases of dysphagia caused by brainstem lesions were diag-nosed as crieopharyngeal achalasia through videofluoroscopy of swallowing.The cases were divided into a treatment group and a control group randomly.The treatment group was treated with balloon dilatation and routine dysphagia re-habilitation training once daily,while the control group was treated with routine dysphagia rehabilitation training only.The treatment end point was either the patient resuming an oral diet or after 4 weeks of treatment.All eases were evaluated videofluoroscopically with a drinking test pre-and pest-treatment.Results After 10 to 24 balloon dilata-tions,10 of the 15 patients in the treatment group regained the ability to take solid food and water orally,thoush 2 of them could take pasty food only.Only 2 of the 15 patients in the control group regained the ability to take common food by mouth,though 5 of them could take pasty food.The other patients had no improvement.There wag a signifi-cant difference between the two groups.The cricopharyngeal aehalasia of 12 patients in the ffeatment group improved from incomplete relaxation/opening to complete relaxation/opening.Pooling and residue in the pyriform sinus or val-leculae was reduced and no misaspiration was observed.In the control group only 7 patients had some improvement.The mesn time for the bolus passing the pharynx after treatment was significantly shortened from 0.23 s to 0.15 s in the treatment group,but not significantly in the control group.Conclusions Catheter balloon dilatation is effective for cricopharyngeal achalasia caused by brainstem injury and is helpful for relieving the symptoms in the pharynx phase and the esophagus phase of dysphagia.

Objective To compare 76% meglucamine diatrizoate solution with 60%barium sulphate suspen-sion for use in videofluoroscopic swallowing studies(VFSSs).Methods Forty-nine cases of dysphagia caused by brain injury.brainstem lesion ir nasopharyngeal carcinoma(NPC)were recruited for this study.They were divided into a meglucamine diatrizoate group of 22 patients who were administered 76% meglucamine diatrizoate solution as a contrast agent,and a barium sulphate group of 27 patients with whom 70%barium sulphate suspension was used.All the Datients were treated by balloon dilatation and other routine dysphagia rehabilitation procedures.The treatment end point was either the patient's resuming an oral diet or after 4 weeks of treatment. All cases were evaluated by VFSS pre-and post-treatment.Results The patients in the meglucamine diatrizoate group showed significant pre-and post-treatment differences in terms of the pharynx transit times of brain injury and brainstem lesion victims.NPC patients showed no significant differences.In the barium sulphate group there were significant pre-and post-treatment differences in Dharynx transit time for patients with all three conditions. Conclusions Using 76%meglucamine di-atrizoate solution as a contrast agent decreases the sensitivity of VFSS. Using 60% barium sulphate suspension in VFSS is recommended.