1.Clinical Characteristics and Efficacy Analysis of Children with Cerebral Palsy and Neuronal Migration Disorders
Yong ZHAO ; Bingxu JIN ; Zhenhuan LIU
Chinese Journal of Rehabilitation Theory and Practice 2017;23(4):433-437
Objective To discuss the clinical characteristics and efficacy analysis of children with cerebral palsy and neuronal migration disorders (NMD) by retrospective analysis. Methods From June, 2005 to June, 2015, 32 children with cerebral palsy and NMD were en-rolled as NMD group, while 60 children with cerebral palsy with periventricular leukomalacia (PVL) as PVL group. Both groups received comprehensive rehabilitation for three months. Their clinical classification, complications of epilepsy or epileptiform discharges, the score of Gross Motor Function Measure (GMFM), and development quotient (DQ) were compared, as well as the follow-up results of six months. Results There was significant difference in the clinical classification of cerebral palsy between two groups (χ2=24.529, P<0.001). The inci-dence of epilepsy and epileptiform discharges was higher in NMD group than in PVL group (χ2>4.605, P<0.05). After treatment, the score of GMFM improved with time in both groups (Ftime=6.850, P=0.010), and was significantly lower in NMD group than in GMFM group (Fgroup=29.885, P<0.001);the scores of DQ in all the functional areas improved with time in both groups (Ftime>25.041, P<0.001), and were signifi-cantly lower in NMD group than in GMFM group (Fgroup>32.347, P<0.001). Conclusion Children with cerebral palsy and NMD are charac-terized by mental retardation, epilepsy and spastic hemiplegia, and poor outcome.
2.Effect of Needling the Meridian Muscle Regions on Lower Limb Spasticity in Spastic Cerebral Palsy
Yong ZHAO ; Bingxu JIN ; Zhenhuan LIU
Shanghai Journal of Acupuncture and Moxibustion 2016;35(9):1049-1052
Objective To observe the clinical efficacy of needling the meridian muscle regions in treating the lower limb spasm in spastic cerebral palsy.Method Eighty patients with spastic cerebral palsy were randomized into a treatment group and a control group, 40 cases in each group. The two groups were both intervened by conventional rehabilitation. Besides, the treatment group was given acupuncture at the meridian muscle regions including Chengshan (BL 57) point and the point 1 cun above the upper margin of the Achilles-tendon attachment, while the control group was given acupuncture majorly at points from the Yangming Meridian of the affected lower limb. The modified Ashworth Scale (MAS), Composite Spasticity Scale (CSS), and Gross Motor Function Measure (GMFM) were evaluated before intervention and after 3 treatment courses.Result The MAS, CSS, and GMFM scores were significantly changed after intervention in both groups (P<0.01). After treatment, the MAS, CSS, and GMFM scores of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Needling the meridian muscle regions can effectively improve the lower limb spasticity in spastic cerebral palsy, and it can help correct clubfoot and enhance the gross motor function.
3.Clinical Study on Needling LIN’s Three Temporal Acupoints for Children with Autism
Yong ZHAO ; Bingxu JIN ; Zhenhuan LIU
Shanghai Journal of Acupuncture and Moxibustion 2015;(8):754-757
ObjectiveTo observe the treatment efficacy of needling LIN’s three temporal acupoints in treating children with autism by using a randomized controlled study method.MethodSixty-eight patients with autism were randomized into an observation group and a control group. Because of dropouts and rejects, 33cases were finally recruited into the observation group, and 32 into the control group. The two groups both received speech training and special education. In addition, the control group received acupuncture at Shenting (GV24), Benshen (GB13), Sishenzhen (Extra), Emotional zone, Speech zone 1, Speech zone 2, and Speech zone 3; while the observation group received acupuncture at LIN’s three temporal acupoints based on the points selected in the control group except for Speech zone 3. Twisting needles and electroacupuncture were also applied in both groups. The treatment was performed once every other day, 10 sessions as a treatment course, with a 15-day interval between two courses, and the therapeutic efficacy was evaluated after 3 courses. Gesell test and Autism Behavior Checklist (ABC) were adopted for evaluation before and after the intervention.ResultBefore treatment, there were no significant between-group differences in comparing the social adaptation, speech and social intercourse ability from Gesell test and ABC score (P>0.05); after treatment,the social adaptation, speech, intercourse ability, and ABC scorewere significantly improved in both groups (P<0.01);there were no significant between-group differences in comparing the social adaptation and speech ability (P>0.05), while theimprovement of social intercourse ability and ABC scoreinthe observation group were more significant than thatinthe control group (P<0.05). ConclusionNeedling LIN’s three temporal acupoints possibly has a specialtreatment effect in improving social intercourse ability and abnormal behavior in autism patients.
4.Impacts on adductor muscle tension in children of spasmodic cerebral palsy treated with acupuncture at the three-spasm-needle therapy.
Bingxu JIN ; Yong ZHAO ; Nuo LI
Chinese Acupuncture & Moxibustion 2015;35(3):217-220
OBJECTIVETo explore the effective therapeutic method for reducing adductor muscle tension in the children of spasmodic cerebral palsy.
METHODSOne hundred and forty cases of spasmodic cerebral palsy met the inclusive criteria were randomized into an observation group and a control group, 70 cases in each one. In the control group, the conventional physical therapies (Bobath therapy and lower extremities therapy) and scalp acupuncture (seven-intelligent needles, motor area, sensory area, foot-motor-sensory area and balance area) were adopted. In the observation group, on the basis of the treatment as the control group, the three-spasm-needle therapy was applied to Jiejian, Xuehaishang and Houxuehai. The physical therapies were given once every day, acupuncture was given once every two days, the treatment of 20 days made one session. There were 15 to 20 days at the interval among the sessions and 3 sessions were required totally. Separately before and after treatment, the modified Ashworth scale was used to evaluate the adductor muscle tension, and measure the adductor muscle angle, and D and E regions of gross motor function measure (GMFM-88) were adopted for clinical efficacy evaluation.
RESULTSAfter treatment, the scores of the adductor muscle tension were decreased to different extends in the two groups (both P<0.01), the adductor muscle angle was increased as compared with that before treatment (both P<0.01) and the scores of D and F regions in GMFM-88 were all improved (all P<0.01). The efficacy in the observation group was more significant than that in the control group (all P<0.01).
CONCLUSIONThe three-spasm-needle therapy effectively reduces adductor muscle tension and improves the range of motion in hip joint, independent walking, running and jumping abilities in the children of spasmodic cerebral palsy.
Acupuncture Points ; Acupuncture Therapy ; Cerebral Palsy ; physiopathology ; therapy ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Muscle Contraction ; Muscle Strength ; Muscles ; physiopathology ; Treatment Outcome
5.Clinical study on acupuncture combined with low-frequency electric stimulation for scissor gait in children with spastic cerebral palsy
Wenjie FU ; Bingxu JIN ; Yong ZHAO ; Zhenhuan LIU
Journal of Acupuncture and Tuina Science 2015;(3):150-155
Objective:To observe the clinical effect of acupuncture combined with low-frequency electric stimulation on scissor gait in children with spastic cerebral palsy. Methods:A total of 60 spastic cerebral palsy kids were allocated into two groups by random number table, 30 in each group. Cases in the control group were treated with physical exercise therapy, massage and hydrotherapy. Based on the therapies given to the control group, cases in the observation group were supplemented with acupuncture combined with low-frequency electric stimulation. Selected points included Zusanli (ST 36), Sanyinjiao (SP 6), Yanglingquan (GB 34), Jiexi (ST 41), Chengshan (BL 57), Naoqing [Extra, locates at 2 cun directly above Jiexi (ST 41)] and Genping (Extra, locates at the midpoint of the line connecting medial and lateral malleolus). The treatment was done once every other day and 10 d made up a treatment course. The low-frequency electric stimulation was applied to anterior tibia, 6 times a week and 20 times made up a treatment course. Cases were treated for a total of 3 courses and there was a 15-20 d interval between two courses. The low limb functions were assessed before and after treatment using the modified Ashworth scale (MAS) and composite spasticity scale (CSS). In addition, the ankle dorsiflexion angles were measured before and after treatment. Results:After treatment, the ankle dorsiflexion angles and CSS scores in the observation group were better than those in the control group, showing statistical significances (P<0.05); the effective rate in the observation group calculated by MAS and ankle dorsiflexion angle were both higher than that in the control group, showing a statistical significance (P<0.05). Conclusion:Rehabilitation training combined with acupuncture and low-frequency electric stimulation can achieve better effect than rehabilitation training alone in improving scissor gait in kids with spastic cerebral palsy.
6.Different courses of topical tacrolimus 0.1% ointment for facial corticosteroid-dependent dermatitis: a clinical observation
Xianting XU ; Xiaomin LIN ; Die XU ; Yongzhen JIN ; Bingxu LI
Chinese Journal of Dermatology 2011;44(12):885-887
Objective To evaluate the clinical efficacy and safety of different courses of topical tacrolimus 0.1% ointment in facial corticosteroid-dependent dermatitis and to observe the rebound in patients after treatment with these regimens.Methods A total of 104 patients with facial corticosteroid-dependent dermatitis were randomly divided into 3 groups to be treated with topical tacrolimus 0.1% ointment twice daily for 4,8 and 16 weeks respectively.The patients were followed up every 2 weeks within the early 4 weeks of treatment and every 4 weeks thereafter.The rebound phenomena was observed in patients on week 4 after the withdrawal of tacrolimus.Results Finally,90 patients completed this trial,including 32 patients in the 4-week group,29 patients in the 8-week group and 29 patients in the 16-week group.No significant differences were observed between the 4-,8- and 16-week groups in the total reponse rate (75.00%,82.76%,86.21%,respectively,x2 =1.35,P > 0.05).The rebound rate in the 16-week group significantly differed from that in the 4- and 8-week group (20.69% vs.46.88% and 41.38%,both P< 0.05),while no statistical difference was noted between the 4- and 8-week groups.Local burning and itching were reported in 31.73% of these patients,and all of these irritant reactions occurred within the first week of treatment.Conclusions Topical tacrolimus 0.1% ointment is safe and effective for the treatment of facial corticosteroid-dependent dermatitis.The total response rate does not increase with the extended treatment course,and 4 weeks of treatment is enough for the marked and stable improvement of facial corticosteroid-dependent dermatitis,but the rebound rate is likely to be reduced by extended treatment course.
7.Clinical observation on scalp acupuncture for diffusion tensor imaging in cerebral palsy children with periventricular leukomalacia
Wenjian ZHAO ; Zhenhuan LIU ; Nuo LI ; Yong ZHAO ; Wenjie FU ; Bingxu JIN
Journal of Acupuncture and Tuina Science 2017;15(1):36-41
Objective:To observe the effect of Governor Vessel-unblocking and mind-refreshing needling technique on diffusion tensor imaging (DTI) in cerebral palsy (CP) children with periventricular leukomalacia (PVL) and investigate the underlying mechanism.
Methods:A total of 18 CP children with PVL received modern rehabilitation training and scalp acupuncture. The before-after study was conducted to compare the fractional anisotropy (FA) of the white matter fiber tracts, gross motor function measure (GMFM) score, Gesell developmental scale and changes in muscle tone.
Results:For the comparison before and after the first course of treatment, there were no statistical differences in DTI findings and FA values (both P>0.05); there were statistical differences in GMFM dimensions A and B (bothP<0.05) and no statistical differences in dimensions C, D and E (allP>0.05); and there were statistical differences in six items of Gesell development test (P<0.01 orP<0.05). For the comparison before and after two courses of treatment, there were statistical differences in DTI findings and FA values in 8 cases between before and after 30 and 60 treatments (bothP<0.05); there were statistical differences in GMFM dimensions A, B and C between before and after 30 and 60 treatments and between 30 and 60 treatments (allP<0.05); there were no statistical differences in GMFM dimensions D and E (allP>0.05); and there were statistical differences in six items of Gesell developmental test between before, after 30 and 60 treatments and between 30 and 60 treatments (P<0.05 or P<0.01).
Conclusion:The Governor Vessel-unblocking and mind-refreshing scalp acupuncture has no significant efficacy on the repair and regeneration of white matter fibers in children with PVL and CP in a short period of time; however, it gradually works along with the prolonged treatment time. In addition, it can improve the motor function and mental development and the efficacy is closely associated with the time of treatment.
8.Application of Comprehensive Function Assessment for Disabled Children in Family Care for Children with Cerebral Palsy
Yuxiu LI ; Jieshan XIE ; Yueming HE ; Zhuoting LIN ; Bingxu JIN ; Xiaolan YAN ; Mengtao ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2017;23(9):1113-1116
Objective To apply the Comprehensive Function Assessment for Disabled Children in family care for children with cerebral palsy. Methods From May, 2014 to May, 2015, 120 cerebral palsy children were equally divided into control group and observation group. The control group accepted routine rehabilitation, and the observation group accepted targeted family rehabilitation program based on the evaluation of Comprehensive Function Assessment for Disabled Children. They were assessed with Comprehensive Function Assessment for Disabled Children before and three months after rehabilitation. Results The scores of cognitive function, language function, exercise abil-ity, self-care movement and social adaptation ability improved in both groups after rehabilitation (t>2.498, P<0.05), and improved more in the observation group than in the control group (t>2.062, P<0.05). Conclusion The application of Comprehensive Function Assessment for Disabled Children may help to plan a targeted rehabilitation nursing program for the nurses and the parents, that benefits the rehabilitation for children with cerebral palsy.
9.Clinical observation on acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy
Xiaoru TAN ; Zhenhuan LIU ; Ruhong LI ; Jieshan XIE ; Yili ZHAO ; Guanjun LUO ; Wenjian ZHAO ; Bingxu JIN
Journal of Acupuncture and Tuina Science 2016;14(5):328-332
Objective: To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods:A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 (PDMS-2) and modified Ashworth scale (MAS) before and after treatment. Results:After treatment, the standard score for grasping (Grs), standard score for visual-motor integration (Vis), fine motor quotient (FMQ) and modified Ashworth scale (MAS) were significantly improved in both groups (P<0.05). The improvement in the treatment group was more obvious than that in the control group (P<0.01). Conclusion:Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.
10.Clinical observation on Governor Vessel-unblocking and brain-refreshing scalp acupuncture for cerebral palsy complicated with intellectual disabilities
Nuo LI ; Zhenhuan LIU ; Jieling LI ; Bingxu JIN ; Yong ZHAO ; Wenjie FU ; Biqi LIANG ; Chouping HAN
Journal of Acupuncture and Tuina Science 2017;15(2):131-135
Objective:To observe the clinical efficacy of Governor Vessel-unblocking and brain-refreshing scalp acupuncture for cerebral palsy (CP) complicated with intellectual disabilities. Methods:A total of 300 CP cases aged between 1 and 5 years were randomly allocated into a treatment group (n=150) and a control group (n=150). Patients in the treatment group were treated with Governor Vessel-unblocking and brain- refreshing scalp acupuncture combined with rehabilitation training, whereas patients in the control group received rehabilitation training alone. The Beijing Gesell developmental (Gesell) scale and gross motor function measure (GMFM) scale were used to assess the motor and intellectual development before and 3 months after the treatment. In addition, the head CT/MRI examination was applied to assess the brain nerve repair before and after the treatment. Results:After the treatment, the total effective rate in the treatment group was 78.0%, versus 42.7% in the control group, showing a statistical significance (P<0.05). As for scores of five subscales in the Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05); and the scores in the treatment group were significantly better than those in the control group (allP<0.05). As for scores of five dimensions in GMFM scale, there were significant intra-group differences in the treatment group (allP<0.05); and the scores in the treatment group were significantly better than those in the control group (allP<0.05). According to the head CT/MRI findings, the total effective rate was 73.3% in the treatment group, versus 62.0% in the control group, showing a statistical significance (P<0.05). Conclusion:When used in combination with rehabilitative training, Governor Vessel-unblocking and brain-refreshing scalp acupuncture can significantly improve the clinical efficacy for cerebral palsy complicated with intellectual disabilities. It can also improve the patients' motor function, intelligence and language ability.