OBJECTIVETo study the effect of prosthetic replacement in treatment of femoral neck fractures on the hemiplegia side in the elderly.

METHODSFrom May 1990 to May 2000, 189 elderly patients with femoral neck fractures were treated with prosthetic replacement in my hospital. Twenty-nine hemiplegia patients, who suffered from stroke previously, had Garden type III and type IV femoral neck fractures on the hemiplegia side. Thirty non-hemiplegia patients were chosen randomly. The two groups were followed-up for 27-98 months (average: 59 months). The age, hospitalization days, operating time, blood loss, blood transfusion, complications during perioperative period and long-term complications were compared between the two groups and the results of femoral head replacement and total hip replacement in the hemiplegia group were also compared.

RESULTSAll the patients of the two groups survived the perioperative period. No significant difference was found in the age, hospitalization days, operation time, blood loss and blood transfusion and long-term complications between the two groups (P>0.05). However there was significant difference in complications during perioperative period between the two groups (P<0.05). Five patients died in the hemiplegia group with the mortality of 17.2% and two died in the non-hemiplegia group with the mortality of 6.7% 11 months to 5 years after operation. There was significant difference in long-term complications between the femoral head replacement and the total hip replacement in the hemiplegia group (P<0.05). The result of the total hip replacement was better than that of the femoral head replacement.

CONCLUSIONSProsthetic replacement is a reliable method in treatment of Garden type III and type IV femoral neck fractures on the hemiplegia side in the elderly, and patients are safe during perioperative period. More complications during perioperative period occur in the hemiplegia group, and long-term complications are insignificantly different between the two groups. The mortality rate is higher in the hemiplegia group than in the non-hemiplegia group within 5 years after operation. Since the result of the total hip replacement is better than that of the femoral head replacement, total hip replacement should be chosen firstly to treat Garden type III and type IV femoral neck fractures on the hemiplegia side in the elderly if the muscular strength of the hip is beyond IV degree.

Aged ; Arthroplasty, Replacement, Hip ; Female ; Femoral Neck Fractures ; etiology ; surgery ; Hemiplegia ; complications ; Humans ; Male

Analysis from anatomy and physiology indicates that causes of shoulder pain are (1) decline and after-constriction of the scapula;(2) the adduction and intorsion of the humerus; (3) the spasm of the upper limb flexor. The acupuncture and moxibustion prescriptions stipulated for prevention and treatment of shoulder pain are Jianjing (GB 21), Jianzhongshu (SI 15), Jugu (LI 16), Tianzong (SI 11), Jianliao (SJ 14), Jiquan (HT 1) at the flaccid hemiplegia, and Jugu (LI 16), Jianyu (LI 15), Tianzong (SI 11), Jianliao (SJ 14), Xiaoluo (SJ 12), Shanglian (LI 9), Wenliu (LI 7) at the spastic hemiplegia , in combination with cupping at the Urinary Bladder Meridian on the back and around shoulder. Thus, it is indicated that shoulder pain not only is involved in the shoulder joint but also in all muscle groups of the shoulder girdle and the upper limb extensor at the affected side.
Acupuncture Therapy ; Hemiplegia ; complications ; Humans ; Moxibustion ; Shoulder Pain ; etiology ; prevention & control ; therapy

Epilepsy ; etiology ; Hemiplegia ; complications ; genetics ; Humans ; Infant ; Male ; Mutation ; Sodium-Potassium-Exchanging ATPase ; genetics

Child, Preschool ; Hemiplegia ; etiology ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; complications ; Male

OBJECTIVE: To evaluate the clinical curative effect of acupuncture on unilateral spatial neglect (USN) after stroke. METHODS: Sixty-four patients with left hemiplegia after the first stroke and diagnosed with unilateral spatial neglect after stroke in the right hemisphere were randomly divided into an observation group and a control group, 32 cases in each group. In the control group, conventional acupuncture was used at Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Huantiao (GB 30), Yanglingquan (GB 34), Zusanli (ST 36) and Sanyinjiao (SP 6) on the affected side. In the observation group, acupuncture was applied at Baihui (GV 20), Fengfu (GV 16), Fengchi (GB 20), Xuanzhong (GB 39) and . The treatment was given once a day, 5 times as one course for 4 courses in both groups. The cancellation test, digit cancellation test, bisection line test, clock drawing test, and copying drawing test were used to assess the degree of unilateral spatial neglect, and the Fugl-Meyer motor function scores and the modified Barthel index (MBI) scores were compared before and after treatment in the two groups. RESULTS: After treatment, the scores of cancellation test, digit cancellation test, bisection line test, clock drawing test and copying drawing test were significantly lower than those before treatment in the two groups (all <0.05), and the scores of the above unilateral spatial neglect after treatment in the observation group were lower than those in the control group (all <0.01). After treatment, the scores of Fugl-Meyer motor function and MBI in the two groups were significantly higher than before treatment (all <0.05), and the difference of MBI scores before and after treatment in the observation group was higher than that in the control group (<0.01). CONCLUSION acupuncture can improve the cognition of unilateral spatial neglect in stroke patients with unilateral spatial neglect, improve the degree of bilateral spatial neglect and the motor function of hemiplegic limbs, and positively promote the improvement of cognitive impairment and self-care ability in daily life.
Acupuncture Points ; Acupuncture Therapy ; Hemiplegia ; etiology ; therapy ; Humans ; Stroke ; complications ; Treatment Outcome

Central nervous system is often involved by herpes zoster but it is very rarely seen that contralateral hemiparesis or hemiplegia developed after herpes zoster ophthalmicus. We report a case of herpes zoster ophthalmicus followed by the delayed contralateral hemiparesis. A 33-year-old man developed acute cerebral infarction and resultant right hemiparesis 44 days after herpes zoster ophthalmicus in the left side. Brain CT disclosed hypodense area in the left basal ganglia. Cerebral angiography revealed segmental narrowing of M1 portion of the right middle cerebral artery.
Adult ; Cerebral Angiography ; Cerebral Arteries/pathology ; Cerebral Infarction/*etiology/radiography ; Dominance, Cerebral ; Hemiplegia/*etiology ; Herpes Zoster Ophthalmicus/*complications ; Humans ; Male ; Tomography, X-Ray Computed ; Vasculitis/etiology

OBJECTIVETo probe the effect and mechanism of the nuchal acupuncture and abdominal acupuncture for treatment of stroke patients with spastic hemiplegia.

METHODSSixty cases were randomly divided into an observation group and a control group, 30 cases in each group. Nuchal acupuncture and abdominal acupuncture treatment was used and Fengfu (GV 16), Fengchi (GB 20), Tianzhu (BL 10), Zhongwan (CV 12) and Guanyuan (CV 4) etc. were selected in observation group, routine acupuncture was applied on Binao (LI 14), Quchi (LI 11), Huantiao (GB 30) and Futu (ST 32) etc. in control group. The scale of Ashworth and score of Fugel-Meyer of the spastic lateral upper and lower limbs and the changes of the EMG F-wave in spastic upper limb of patients in two groups were observed before and after treatment.

RESULTSThe Ashworth scale and Fugel-Meyer score of the upper and lower limbs were obviously improved, the amplitude was decreased, the duration was shorten and the threshold of the EMG F-wave of the spastic upper limb was increased (all P < 0.01) in the observation group. The observation group was superior to the control group in Fugel-Meyer score of the upper and lower limbs of the patients the Ashworth scale of the lower limb, and the amplitude, duration and threshold of the EMG F-wave of the spastic upper limb (all P < 0.01). The total effective rate of 90.0% in observation group was superior to that of 50.0% in control group (P < 0.01).

CONCLUSIONThe nuchal acupuncture and abdominal acupuncture treatment can decrease the muscle tension of the stroke patients with spastic hemiplegia.

Abdomen ; Acupuncture Therapy ; Aged ; Female ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo assess the clinical efficacy of acupuncture at key acupoints combined with the routine rehabilitation training of limb function on spasmodic hemiplegia after cerebral infarction.

METHODSEighty-six cases were randomized into an acupuncture combined with rehabilitation group (group A, 44 cases) and a rehabilitation group (group B, 42 cases). In group A, the key acupoints were selected from head, face, chest, abdomen, shoulder, back, hands, feet and ankles such as Cuanzhu (BL 2), Danzhong (CV 17), Jianyu (LI 15) and Yanglao (SI 16) were stimulated with acupuncture. In combination, the routine limb rehabilitation training was applied, once every day. In group B, the routine limb rehabilitation training was applied alone. In both groups, 10 treatments made one session and 2 sessions were required totally. Before and after treatment, Fugl-Meyer scale and functional independent measurement (FIM) scale were adopted to assess the limb motor level and the activity of daily life in the patients respectively. The modified Ashworth scale was used to assess the effect of anti-spasm.

RESULTSThe total effective rate of anti-spasm was 90.9% (40/44) in the group A, which was superior to 73.8% (32/42) in the group B (P < 0.05). After 2 sessions of treatment, Fugl-Meyer score and FIM score were all improved in both groups (all P < 0.05) and the results in the group A were better than those in the group B (all P < 0.05). Additionally, the improvement of FIM score after the 1st session of treatment in the group A was better as compared with the group B, indicating the significant difference (P < 0.05).

CONCLUSIONAcupuncture at key acupoints combined with rehabilitation therapy effectively relieves the spasmodic condition of the patients with post-stroke spasmodic hemiplegia, improves the limb function and the life activity of the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cerebral Infarction ; complications ; Female ; Hemiplegia ; etiology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

PURPOSE: The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke. METHOD: For this study, the grounded theory method was utilized. RESULTS: After constant comparative analysis, the core category emerged as 'rebuilding the body which was ruined'. In addition, the causal conditions were 'restriction of physical function', and 'loss of roles'. The adjustment process consisted of the 'facing reality phase', 'overcoming depression phase', 'overcoming physical limits phase' and 'reestablishing roles phase'. The main strategies in the facing reality phase were 'holding on to a glimmer of hope', 'getting away from the harsh reality' and 'facing up to the reality'. The main strategies in the overcoming depression phase were 'soothing oneself', 'Self-introspection' and 'restoring self-esteem'. In addition, the main strategies in the self-initiative overcoming physical limits phase was 'discovering personal strategies and striving to recover'. The main strategies in the reestablishing roles phase were 'reestablishing a parents' role', 'reestablishing a spouse's role' and 'reestablishing social roles'. CONCLUSION: In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.
*Adaptation, Psychological ; Adult ; *Attitude to Health ; Female ; Hemiplegia/etiology/*psychology ; Humans ; Male ; Middle Aged ; Self Efficacy ; Stroke/complications/*psychology

OBJECTIVETo provide reliable evidence of "J in three-needle therapy" for treatment of stroke.

METHODSMulti-central randomized controlled trials were adopted, 180 hemiplegia patients of ischemic stroke were randomly divided into a fin three-needle group (90 cases) and a routine acupuncture group (90 cases). Two groups were both treated with basic neurology therapies, and J in three-needle group was treated with J in three-needle therapy, three acupoints of tempora, hand and foot etc. were selected; the routine acupuncture group was treated with traditional acupuncture, Quchi (LI 11), Huantiao (GB 30), Futu (ST 32) etc. were selected. Both groups were treated with acupuncture for 5 weeks. The cognitive function score of functional comprehensive assessment scale (FCA), the scores of mini-mental state examination scale (MMSE) and modified Barthel index (BI) were compared before and after treatment between two groups. Results After treatment, the scores of FCA, MMSE and BI in both groups were significantly improved compared to those before treatment (P < 0.01, P < 0.05); the improvement of FCA score, MMSE score and BI score in the J in three-needle group were superior to those of the routine acupuncture group after treatment (P < 0.01, P < 0.05). The total effective rate of 85.4% in the J in three-needle group was superior to tohat of 70.0% in the routine acupuncture group (P < 0.05).

CONCLUSIONJ in three-needle acupuncture treatment can obviously improve the cognitive function and activity ability of daily life of hemiplegia patients after stroke, and the therapeutic effect of J in three-needle therapy is superior to that of traditional acupuncture treatment.

Activities of Daily Living ; Acupuncture Therapy ; Adult ; Aged ; Cognition ; Female ; Hemiplegia ; etiology ; psychology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications