Objective To study the effectiveness and feasibility of low intensity of aerobic bicycle ergometer training on hemiplegic stroke patients unable to perform assistive or independent ambulation.Methods Thirty stroke patients unable of assistive or independent ambulation were randomly divided into a control group and a aerobic training group.Patients in the aerobic training group performed low intensity of aerobic bicycle ergometer training for 30 min,3 times a week for 6 weeks in addition to a routine rehabilitation regime.The training duration and course of routine rehabilitation training were the same in both groups.The related cardiovascular response in aerobic training and changes in motor performance as well as the risk factors for stroke were observed in both groups.Results Twenty-four patients(12 patients in each group)completed the experiment.Patients in aerobic training group performed all training regime safely without any adverse response.Their motor function(including FMA score,Rivermead index,BI ADL ability),exercise endurance duration in exercise test,glucose level at 2 h in oral glucose tolerance test,fasting insulin level and HOMA-IR index all improved greatly as compared to the control group(P ＜ 0.05).Conclusion Low intensity of aerobic bicycle ergometer training can be safely and effectively administered in hemiplegic stroke patients unable of assistive ambulation or independent ambulation.

Objective To observe the effect of different ways of balloon catheter dilation techniques on cricopharyngeal achalasia and its mechanisms.Methods Thirty patients with deglutition disorder after brain stem infarction,whose cricopharyngeal achalasias were proven by videofluoroscopic swallowing study(VFSS),were randomly divided into three groups: No.14 conventional catheter group A,No.14 modified bicavitary silica-gel catheter group B and No.22 conventional catheter group C with 10 cases in each group,respectively.All the patients of 3 groups received multiple times corresponding balloon catheter dilatation per nasal or per os(No.22 conventional catheter group C only per os).Results After an average of 30 d of balloon catheter dilatation,the level of dysphagia and VFSS evaluation of all patients improved significantly(P ＜ 0.05).However,the No.14 conventional catheter group A and No.22 conventional catheter group C improved to a greater extent than No.14 modified bicavitary silica-gel catheter group B(P ＜ 0.05).The saccule perimeter,saccule diameter and saccule intracapsular pressure of No.14 conventional catheter group A and No.22 conventional catheter group C increased significantly(P ＜ 0.05)when compared to those of No.14 modified bicavitary silica-gel catheter group B,but there was no significant diffference beween No.14 conventional catheter group A and No.22 conventional catheter group C(P ＞ 0.05).Conclusions The balloon catheter dilation technique can significantly improve swallowing function of deglutition disorders patients with cricopharyngeal achalasia after brain stem infarction,which is related positively to saccule diameter and saccule intracapsular pressure.

Objective To observe the changes of expressions of brain-derived neurotrophic factor (BDNF)and its receptor tyrosine kinase B(TrkB)and in rats with hemitransectional spinal cord injury(SCI)after electroacupuncture on Du Meridian and rehabilitation training.Methods The animal model of acute hemitransectional lesion at the right half of T11 spinal cord was established in 96 adult female rats,which were then divided randomly into an electroacupuncture group,a rehabilitation training group,an electroacupuncture combined with rehabilitation training group and a control group.All the groups received treatment on the 3rd d after operation.The electroacupuncture group and rehabilitation training group were given electroacupuncture on points of Du Meridian and rehabilitation training,respectively,and the combined group was given Du Meridian electroacupuncture in addition to rehabilitation training.Basso-Beattie-Bresnahan(BBB)scale was used to evaluate motor function every week.Twelve rats of each group were sacrificed 4 and 8 weeks after operation,respectively,and their spinal cord tissues were extracted.The polymerase chain reaction(PCR),reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemical techniques were used to detect the expressions of BDNF and TrkB.Results BBB grade increased gradually as time went on.There were significant differences between control group and other groups at the same time point(P ＜ 0.05).The scores increased obviously in electroacupuncture combined with rehabilitation training group compared with electroacupuncture group and rehabilitation training group(P ＜ 0.05).The result of immunohistochemical observation and RT-PCR also showed that there were significant differences of expressions of BDNF and TrkB among control group and other groups at the same time(P ＜ 0.05).The effects in electroacupuncture combined with rehabilitation training group were much more obvious than those in electroacupuncture group and rehabilitation training group(P ＜ 0.05),but there was no significant difference between electroacupuncture group and rehabilitation training group (P ＞ 0.05).Conclusions Electroacupuncture on Du Meridian combined with rehabilitation training had synergic effect on rat's SCI,and could obviously improve the restoration of rat's motor function; the mechanism maybe related to the upregulation of expressions of BDNF and TrkB.

Objective To observe the effect of electromyographic biofeedback therapy(EMGBFT)on dysphagia in stroke patients.Methods Fifty-three stroke patients with dysphagia were divided randomly into an EMGBFT group and a control group.The patients of EMGBFT group were given EMGBFT,electrical stimulation therapy (EST)and dysphagia training,while those in the control group were given EST and dysphagia training.All the patients were assessed with Kubota drinking test before treatment and 30 days after treatment.Results After treatment swallowing function of patients in both groups improved(P ＜0.05).The effective rate was 76.92％ in EMGBFT group and 55.56％ in control group,with statistically significant difference between the two groups(P ＜ 0.05).It showed that the EMGBFT group has significantly better outcome than the control group after treatment(P ＜ 0.05).Conclusions EMGBFT combined with regular rehabilitation therapy can improve patient's motor and swallowing function.

Objective To observe the application of dysphagia ventilation swallowing and speaking valve inchildren with swallowing disorder after tracheostomy.Methods Four children with tracheostomy done and swallowing disorders(3 with brainstem encephalitis caused by hand,foot and mouth disease and 1 post-surgery case of cerebellar astrocytoma)were observed.Videofluoroscopic swallowing studies(VFSS)showed cricopharyngeal achalasia and silent aspiration.After VFSS assessments,ventilation swallowing and speaking valves(Passy-Muir,USA,PMVs)were applied to the 4 children.After that they received comprehensive swallowing trainings including balloon dilatation,breathing exercises,sensory stimulation and electrical stimulation.Results Four children could pronounce with PMVs immediately.After(36.50 ± 35.63)d of comprehensive intervention,all of them could live without tracheostomy tube or nasal feeding tube,their swallowing function improved obviously and could take food per os.Conclusions The application of PMVs combining with swallowing training is effective for children with swallowing disorder and dysphonia after tracheostomy.It is helpful to decrease the risk of aspiration,to open the cricopharyngeus muscle and to restore pronunciation.

Objective To investigate insula cortex activation evoked by stimulating different acupoints of lower extremity.Methods Twenty healthy male right-handed subjects were recruited to receive functional magnetic resonance imaging(fMRI)examination with a whole-body 3T Siemens Trio system for whole-brain imaging.Participants were at rest during scanning and were instructed to relax with their eyes closed,without falling asleep.A blockdesigned method was applied for acupoint stimulation.The examined acupoints on the right lower extremity were stimulated,respectively,resulting in 4 experimental conditions.Stimulation was performed by brushing the subject's skin over each acupoint with a sponge at a frequency of approximately 2 Hz.Images were analyzed using SPM5 software package.Group analysis was performed with the mixed-effects model.Small volume correction was used to investigate insula cortex activation under each condition at a threshold of P ＜ O.01,with a 6-mm radius centered on the local maxima of activation in insula cortex.The scope of insula cortex was determined with SPM anatomy toolbox.Results All the examined acupoints induced activation in contralateral insula cortex.Activation clusters evoked by different acupoints presented various types of locations and shapes,and all of them located in the posterior part of insula cortex.Activation in the ipsilateral insula cortex was not found for all examined acupoints.Conclusions Stimulating lower extremity acupoints can activate posterior insula cortex.This effect may promote the recovery of dysphagia via several mechanisms including facilitating the initiation of swallowing,improving oral and pharyngeal sensation,and reducing taste disturbance.

Objective To observe the concentration effects of alcohol in perineurial block on the structure and function of sciatic nerve and it's innervated muscles in rats so as to provide the basis for clinical application of chemical neurolysis.Methods One hundred and fifty female Sprague-Dawley rats were used and randomly assigned into a blank group(BG,n =6),a control group(CG,n =36),a 50％ alcohol group(50G,n =36),a 75％ alcohol group(75G,n =36)and a 99.9％ alcohol group(99.9G,n =36).The CG received physiological saline injection,the 50G,75G,99.9G received corresponding concentrations alcohol perineurial block,respectively.Changes of motor function was assessed,electrophysiological and histomorphological observations of sciatic nerve and its innervated muscles were conducted before and at 24 h,72 h,1 week,4 week,12 week after block.Results(① Hypokinesia and decrease of motor conduction velocity(MCV)were observed at 24 h after block,and peaked at 72 h after block; at 1 week after block,the motor function and MCV improved,the improvement persisted to the 12th week (P ＜ 0.05); but at the 12th week,MCV was still slower than that before block(P ＜ 0.01).②There were significant differences with regard to motot function and MCV of sciatic nerve among 99.9G and the other groups at e ery time point after block(P ＜0.05); ③ Reversible dengeneration of sciatic nerve and hind limb muscle,nonreversible necrosis of muscle occurred more seriously with the increase of alcohol concentration,and the cicatrization in 99.9G was more obvious than that in 50G and 75G at the 12th week; ④Structural lesion of sciatic nerve occurred at 24 h after block and peaked at the 72th h,myelinated axonal sprouts appeared at 1 week after block and persisted to the 12th weck.Conclusions ① The effects of 99.9 ％ alcohol perineural block on the structural lesion,motor function and MCV of sciatic nerve and its related muscle were more obvious than those of 50％ and 75％ alcohol; ② The destructive effect of alcohol block would maintain more than 12 week and neural restoration would maintain more than 12 weeks too.

Objective To investigate the symptom characteristis as well as the clinical assessment methods of dysphagia and oral motor function in children with cerebral palsy(CP).Methods A total of 116 children with CP,aged 18 months to 96 months(66 boys and 50 girls),treated in Qingdao Rehabilitation Center for Disabled Children from June 2009 to September 2010,were included in the study.Diagnosis and subtype of CP were determined by neuropaediatrician,the dysphagia disorders survey(DDS)as well as oral motor assessment were conducted by the speech therapists.Results Of the 116 cases,22.4％ of the cases were with mild dysphagia and 34.5％ with moderate to severe dysphagia,resulting in a prevalence of dysphagia of 56.9％.The main problems of these cases occurred during oral phase and pharyngeal phase,including inadequate feeding skills(involving sucking,biting,chewing or/and swallowing),coughing,vomiting and choking during feeding,cry/overextension of neck and head during feeding,drooling,hypertonic tongue and inadequate tongue lateralization.The severe dysphagia was encountered frequently in children with spastic quadriplegic,dyskinetic or mixed type CP children.Of the 116 cases,90 cases(77.59％)were with oral motor dysfunction(including all spastic quadriplegic,dyskinetic or mixed type children).The oral motor scores of CP children were significantly lower than those of the controls(P ＜ 0.01).Conclusions Oral phase dysphagia and oral motor disorder might be considered as the common clinical problems among the patients with CP,and could be assessed by using DDS combined with oral motor assessment,but for dysphagia during pharyngeal or esophagus phase,the videofluoroscopic modified barium swallow should be used for further evaluation.

Objective To investigate the effects of transcranial electrotherapy stimulation (TES)on patients with generalized anxiety disorder (GAD). MethodsA total of 62 patients with GAD were randomly divided into two groups,the study group (treated with TES and venlafaxine) and the control group (treated with venlafaxine only).TES was administered 1 time per day for 14 days,while venlafaxine was administered with oral intake of 75-150mg/d for 4 weeks.The clinical effects were assessed by using Hamilton anxiety scale (HAMA).ResultsThere was no difference between the two groups in average HAMA total scores,psychic and somatic factor scores before the treatments (P ＞ 0.05).The effective rate of study group was significantly higher ( P ＜ 0.05 ) at the end of the 1 st week after treatment than,but similar at the end of the 2nd and 4th week after treatment (P ＞ 0.05 ) to that,of control group,with regard to HAMA total score and psychic factor score.With regard to the HAMA somatic factor score,the effective rate of study group was not significantly different from that of control group at the end of the 1st,2nd and 4th week after treatment (P ＞ 0.05).ConclusionTranscranial electric stimulation in conjunction with venlafaxine may improve the symptoms of anxiety of patients.

Objective To study the test-retest reliability in quantitative measurement of proprioception using Tecnobody rehabilitation system.Methods Nine healthy volunteers [4 males,5 females,averaged age (22.8 ±0.68) years] participated in three consecutive measurements on both feet by using Tecnobody rehabilitation system for computerized proprioceptive assessment.Standard error of measurement(SEM),correlation coefficient and intraclass correlation coefficient(ICC) obtained from the three consecutive measurements were used to analyze the Timeused in each measuring session,and the average track error (ATE) of the measurements.ResultsSEM values of Time in left foot and right foot were 3.07 ～ 3.83 and 6.65 ～ 8.44 respectively.ATE values in left foot and right foot were 1.33 ～ 1.97 and 1.39 ～ 1.91 respectively.The Time and ATE correlation coefficients of left foot / right foot were 0.919/0.6 and 0.808/0.831,respectively.The Time ICC values were 0.893/0.639 for left foot / right foot,respectively ; and the ATE ICC values were 0.716/0.734 for left foot / right foot,respectively. Conclusion The Tecnobody rehabilitation system provided a fairly good reliability in both relative andabsolute values in quantitative evaluation of proprioception in the feet.These data in a larger amount may be useful for setting up variables and the standard values of the local population for reference in proprioceptive rehabilitation.