Spasticity is a common problem in upper motor neuron lesions.Assessment of spasticity is extremely valuable in quantifying the effects of a therapeutic intervention.But it is,in other hand,a difficult and challenging problem.Objective:The present study was undertaken to determine the feasibility of quantifying spasticity by the pendulum test using the isokinetic dynamometric technique.We suggest that this machine can be used to perform pendulum test to quantify spasticity.Method:We studied the lower limb muscle tone in 34 spastic subjects,and in 9 flaccid paralysis control subjects,and 10 normal control subjects.Result:Typical pendulun test goniograms of each group were obtained and 5 parameters are extracted from the goniograms to evaluate the degree of spasticity. They are:Al(the flexion angle of the first drop)、R1(relaxation index)、R2(amplitude ratio)、T(time of swings)、F(frequency of swings).The correlation coefficients are calculated to determine the reliability of the parameters(>0.90 for three consecutive test;>0.80 for different days).The validity is determined by t test(p<0.01).Conclusion:The method of using isokinetic dynamometric technique combining pendulum test to quantify spasticity is a reliable,valid,accurate and convenient method of assessing spasticity.

Objective To determine the effect of walking in water on patients with spinal cord injury~SCI). Methods Twenty SCI patients were recruited in this study, and these patients were randomly divided into a control group ~10 cases) and an experiment group~10 cases).The patients of the experiment group were administered aqua-walking and conventional physical therapy~PT),and the patients of control group were administered the conventional PT only. Results After 10 weeks of therapy, the muscle tone, motor index score and functional ambulation classification of experiment group were ameliorated significantly in comparison with the control group(P

Objective To explore the effect of early administration of alendronate (ALN) and pulsed electromagnetic fields (PEMFs) on bone mass of rats after spinal cord injury(SCI). Methods Sixty-two healthy female SD rats aged 3 months were randomly allocated into 5 groups: a Sham group, a SCI group, a SCI+ALN group, a SCI+PEMFs group and a SCI+PEMFs+ALN group. Rats in the Sham group underwent laminectomy, while the rats in the other 4 groups underwent complete spinal cord transection, and the remained 3 groups were treated with ALN and/or PEMFs 1 week after SCI. All rats were sacrificed 8 weeks after operation. The bone mineral density(BMD), biomechanical parameters of the femurs, and histomorphometric parameters of proximal tibias were mea-sured, respectively. The data were analyzed with one way-ANOVA and factorial design-ANOVA. Results After early treatment of ALN and/or PEMFs, the BMD of femur was significantly increased as compared with that of rats in the SCI group; the elastic load, maximal load of femur were significantly increased as compared with those of rats in the SCI group; the percent trabecular bone area and trabecular bone width of tibias were significantly increased when compared to those of rats in the SCI group. Conclusion Early treatments of ALN and PEMFs can reduce the loss of bone, improve biomechanical properties of the femur, and inhibit the decay of microstructure of upper part of tibia. The study suggests that ALN and PEMFs may help prevent osteoporosis after SCI.

BACKGROUND: The rehabilitation outcome varies in stroke patients,and there are differences in the literatures about the influence of factors on the functional recovery in such patients.,OBJECTIVE: To evaluate the pre-rehabilitative and post-rehabilitative effects of stroke patients by functional independence measure (FIM) that is widely used, and analyze the influence of gender, age, motor and cognitive functions at admission, time interval from stroke onset to arrival at rehabilitative admission, comorbidity occurrence, laterality of lesion on the functional recovery of stroke patients.DESIGN: Before-after control observationSETTING: Center of Rehabilitation Medicine, Shandong Provincial Hospital; Faculty of Rehabilitation Medicine, Capital University of Medical SciencesPARTICIPANTS: From March 2000 to December 2002, 55 stroke patients were selected from Shandong Provincial Hospital. They were all first episode, and patients whose bilateral cerebral hemisphere were involved were excluded.METHODS: After the vital signs were steady, the stroke patients got through risk phase (31-75 days) and were treated with medicine improving microcirculation and providing neurotrophic factor for nerves. In addition, they accepted comprehensive rehabilitation training of Bobath technique, PNF technique and Rood method mainly, with 1-2 hours per day and five times per week.MAIN OUTCOME MEASURES: The patients were evaluated within 7days after admission and reassessed 3 days before discharge using FIM,including 18 items of motor and cognitive functions and 126 total scores (108-126 as elementarily or completely independent, 72-107 as mildly dependent, 54-71 as moderately dependent, 36-53 as severely dependent,18-35 as extremely or completely dependent). Multiple stepwise regression equation was applied to analyze the relation of above factors and functional recovery (increased value of FIM total score).RESULTS: Totally 55 patients were involved into the result analysis.①FIM total score of patients was significantly higher at discharge than at admission (93.8±12.0, 68.8±11.6, P ＜ 0.001), and motor function and cognitive function at discharge also increased compare with at admission (P ＜ 0.001).②Mean value of FIM motor score increased everyday was identical with that of total score (0.56±0.21, 0.59±0.21), and higher than mean value of cognitive score (0.03±0.03).Multiple stepwise regression analysis showed,scores of motor and cognitive status at admission, age, time interval from stroke onset to arrival at rehabilitative admission all affected the increased value of FIM total scores. No significant association between gender, comorbidity, laterality lesion of paralysis and functional recovery was observed (P ＞ 0.05). The most influential factors were orderly motor function,cognitive function at admission, age and time interval from stroke onset to arrival at rehabilitation admission.CONCLUSION: Motor and cognitive function at admission, age and time interval from stroke onset to arrival at rehabilitative admission have a no table relationship with functional recovery of stroke patients, especially motor function at admission is positively related. Thus we should not neglect the influence of these factors when conducting rehabilitative treatment.

To introduce a rehabilitation program for total hip replacement (THR), including muscle strength training; rehabilitation for scar and adhesion, scoliosis, hip control, etc. The principle and the cautions were discussed.

Mechanical loading provides an anabolic stimulus for bone. Low frequency vibration is a kind of mechanic stimulus, which can promote osteogenesis in certain frequency, mode and intensity. The osteogenesis promotion of low frequency vibration may be associated with the membrane ion channels, integrin-cytoskeleton complex triggering mitogen activated protein kinase (MAPK) signal and second messengers regulating RANK-RANKL-OPG axals.

ObjectiveTo discuss the causes, preventions and treatments of fractures after spinal cord injury (SCI).MethodsA retrospective survey was carried out in the clinical data of 22 patients who suffered fractures after SCI in China Rehabilitation Research Center (CRRC) during 1988-2001.ResultsAll the patients showed osteoporosis or osteopenia in different degrees,fractures occured unconsciously or during minor force,without symptoms after fractures.It was difficult to discover and often was neglected. 15 patients were cured by surgical operation.Conclusions Osteoporosis is the pathological base of fractures after SCI, excess loading stress in the diaphysis is the main cause during joint movement passively, it is important to emphasize preventions and treatments of osteoporosis on early stage and the health propaganda and education is needed.

ObjectiveTo observe the effect of extracorporeal shock wave therapy (ESWT) on managing heel pain. Methods22 patients were divided into 2 groups,12 cases in treatment group who accepted ESWT, 10 cases in control group.The intensity of morning pain on weight bearing, pain triggered by prolonged walking/standing, pain on tension and palpation tests were assessed by Visual Analogue Scale (VAS) before and after each treatment session, including the follow-up session,3 weeks after treatment. In addition, Mayo Clinical Scoring System (MCSS) was used to evaluate the treatment outcomes. ResultsAfter 3 weeks of treatment and 3 weeks' follow-up, the intensity of pain on tension test(P<0.05)as well as that on palpation test (P<0.01)decreased, the maximum duration of prolonged walking or standing (P<0.05)and MCSS scores (P<0.05)improved. Conclusions ESWT seems to be a more effective treatment modality for managing heel pain.

This paper introduced a system for rehabilitation residency training, including the object, courses, assessment, and the structure.

Objective To investigate the effect of conductive education applied in water exercise on cerebral palsy. Methods 58 children with cerebral palsy who could accept conductive education were divided into observation group (n=29) and control group (n=29) randomly. All the children accepted routine rehabilitation, and the observation group accepted water exercise in the model of conductive education. They were assessed with muscular strength, muscular tension (modified Ashworth Scale) and the Gross Motor Function Measure (GMFM) before and after training. Results The score of GMFM improved more in the observation group than in the control group (P<0.05), as well as the incidence of improvement of muscle tension (released 1 grade or more, 75.9% vs. 44.8%, P<0.05) and muscle strength (increased 1 grade or more, 82.8% vs. 58.6%, P<0.05). Conclusion Water exercise with the conductive education model can improve the gross motor function and muscle strength, release the spasticity in children with cerebral palsy.