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 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 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 assess the contraction and coordination changes in the anterior and posterior thigh muscles of patients recovering from cerebral infarction,and to provide objective references for targeted rehabilitation programs. Methods Eighteen cerebral infarction patients with mild hemiparesis (the patient group) and eighteen age- and sex-matched healthy volunteers (the healthy group) were investigated. The surface-electromyographic (sEMG) signals of their vastus medialis,rectus femoris,vastus lateralis,biceps femoris,semitendinosus and semimembranosus were recorded during knee joint flexion and extension in the prone position.The sEMG signals from both legs were recorded for the patient group,but only from the left leg in the healthy group.The standardized root mean square (stRMS) signals and the co-contraction ratios (CRs) were compared and analysed, Results The stRMSs of the rectus femoris,vastus lateralis and vastus medialis on the patients' affected side during knee extension were significantly higher than those in the healthy group at baseline and follow-up.The stRMSs of the biceps femoris and semitendinosus-semimembranous on the patients' unaffected side were significantly higher than those of the affected side and the healthy group during knee flexion at baseline.The CRs during knee flexion on the patientsˊ affected side at baseline and follow-up were significantly higher than those of the unaffected side at baseline. Conclusions After cerebral infarction,the functioning of both the anterior and posterior thigh muscles on the affected side are impaired.The rectus femoris are the most severely impaired knee extensors,and the biceps femoris,semitendinosus and semimembranous are impaired equally in knee flexion.The thigh flexors and extensors lose their normal antagonist-agonist contraction modes.The functions of both the anterior and posterior thigh muscles should be emphasized during rehabilitation to improve abnormal contraction.

Objective To observe the effects of bolus volume on pharyngeal and upper esophageal sphincter pressures and durations in healthy volunteers by using high-resolution manometry (HRM).Methods Twentyfour health subjects were recruited and asked to swallow three volumes of bolus (3 ml,5 ml and 10 ml) in the neutral head position.Pressure and duration measurements were acquired by utilizing a high-resolution solid-state manometer,with an emphasis on the hypopharynx and upper esophageal sphincter (UES).Variables including UES residual pressure,UES relaxation duration,maximum hypopharygeal pressure and hypopharyngeal pressure duration were analyzed across bolus volumes and consistencies by using three-way repeated measures analysis of variance (ANOVA) to investigate influence of bolus volume.Results UES residual pressure [-1.71 mmHg(3 ml thick liquid)vs.-4.68 mmHg(10 ml thick liquid)],UES relaxation duration[590.45 ms(3 ml thick liquid) vs.702.49 ms (10 ml thick liquid)],maximum hypopharygeal pressure [169.91 mmHg (3 ml thick liquid) vs.204.42 mmHg (10 ml thick liquid)] and hypopharyngeal pressure duration(P ＜0.05) varied significantly across bolus volumes when swallowing water or thick liquid.The UES relaxation duration,UES residual pressure and maximum hypopharyngeal pressure had a direct positive relationship with bolus volume.There was significant differences with regard to UES relaxation duration [685.75 ms(3 ml paste)vs.772.27 ms (10 ml paste)] but not to UES residual pressure (P ＞ 0.05) and maximum hypopharyngeal pressure (P ＞ 0.05) across bolus volume when swallowing paste.Conclusions Difference in hypopharyngeal pressure and duration,UES residual pressure and duration were detected across varying bolus volumes.Consideration of these variables is paramount in understanding normal and pathological swallowing.

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 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.

Objective To explore the changes in muscle activity patterns in the lower leg during ankle dorsiflexion and plantarflexion in stroke patients. Methods Ten recovering stroke patients with hemiparesis(Pa- tient group)and ten age-and sex-matched healthy volunteers(Healthy control group)were studied.The subjects performed ankle dorsiflexion and plantarflexion synchronized with a visual cue while supine.Surface electrodes were applied over the anterior tibialis(TA),caput laterale musculi gastrocnemius(IGM),caput mediale musculi gas-troenemius(mGM)and soleus muscles(SOL)for integrated electromyography(iEMG).Results During ankle dorsiflexion,the TA,lGM,mGM and SOL of the affected side showed a significantly lower iEMG signal than the unaffected side.Activity of the lGM,mGM and SOL of the affected side were significantly lower than in the healthy controls.During ankle plantaflexion,the TA,lGM and mGM on the affected side had significantly lower activity than those of the healthy controls.The mGM of the affected side showed significantly lower muscle activity than the unaffeeted side.The SOL contraction ratio on the affected side was significantly higher than on the unaffected side and in the healthy control group. Conclusion Except for the soleus,there is an obvious decline in muscle activi-ty in the affected lower extremities of stoke patients during ankle dorsiflexion and plantaflexion.The soleus on the affected side becomes the primary plantarflexor in patients with stroke,rather than the caput laterale musculi gas-trocnemius or caput mediale musculi gastroenemius as in healthy subjects.

Objective To evaluate the reliability and criteria validity of the Chinese Cambridge Prospective Memory Test (C-CAMPROMPT) for testing Chinese patients with acquired brain injury. Methods The CAMPROMPT was translated into Chinese. The translated Version was then used with 30 'normal persons' and 39 with acquired brain injury and memory problems. Correlation analysis and Cronbach's a were used to evaluate reliability and criteria validity of the C-CAMPROMPT. Results Correlation and Cronbach's a were in the range 0.697 to0.951.The total and event-based scores were positively corrlated with all three field Chinese Version of Rivermead Behavior Memory Test scores. Time-based C-CAMPROMPT scores,however,were negatively correlated with Chinese Version of the Stroop Word-Color Test results. Conclusion The reliability and validity of the C-CAMPROMPT were high enough to be used to test the prospective memory of acquired brain injury patients in the clinic.