https://www.cjrtponline.com/CN/abstract/abstract2426.shtml

Objective To explore the method of rehabilitation training for post-stroke spasmodism model dysarthria and its efficacy.Methods 45 patients with post-stroke spasmodism model dysarthria were treated with verbal psychotherapy.Modified Frenchay dysarthric measurement was applied to assess rehabilitation efficacy.Results After rehabilitation training,the total effective rate of 45 patients was 93% after the therapy.The effective rate was 100%,96% and 85% respectively for the patients with the disease course of less than one month,between one and three months as well as more than three months.Conclusion Verbal psychotherapy is effective for post-stroke spasmodism model dysarthriaspasm,the early the training starts,the better the curative effect will be.

Objective To observe the effect of occupational therapy(OT) on unilateral spatial neglect(USN) in stroke patients.Methods 108 stroke patients with USN were randomly divided into OT group(54 cases) with OT and other rehabilitation therapy and control group(54 cases) without OT.They were assessed with line bisection test,number cancellation test,copying drawing test and clock-drawing before and 2 months after treatment.Results The incidence of USN of both groups were significantly reduced after treatment(P<0.01),while that of the OT group were lower than of the control group(P<0.01).Conclusion OT can significantly improve the USN after stroke.

Objective To explore the effect of occupational therapy (OT) on hemianesthesia and hand function after stroke. Methods 50 stroke patients with hemianesthesia were divided into OT group (n=25) and control group (n=25). The OT group accepted OT combined with routine therapy and the control group accepted routine therapy only. They were assessed with upper extremity sense of Fugl-Meyer Assessment (FMA) and evaluation of hand function before and after treatment. Results The scores of FMA and hand function improved significantly in both groups 2 months after treatment, and improved more in the OT group than in the control group (P<0.05). Conclusion OT can improve the sense and the hand function in stroke patients with hemianesthesia

ObjectiveTo observe the effect of Integrated Chinese-western three-stage rehabilitation on activities of daily living (ADL) in stroke patients. Methods60 stroke patients were randomly divided into the trial group and control group with 30 cases in each group. Patients of control group were treated with routine neurological interventions and three-stage rehabilitation, while those of trial group were administered resuscitating acupuncture therapy, scalp and body acupuncture in addition. All the patients were assessed with modified Barthel index (MBI) at the beginning, 1 month, 3 months, 6 months respectively after stroke. ResultsThere was no significant difference in ADL between the trial and control groups at the beginning, and both improved at the following period (P<0.01). At each of the following period, either the ADL scores (P<0.05) or the increase of the ADL scores (P<0.05) of the trial group were significant higher than those of the control group. ConclusionIntegrated Chinese-western three-stage rehabilitation could improve the ADL further for the stroke patients.

ObjectiveTo explore the effect of the intervention by the family members on the rehabilitation of dysfunction of the patients with hemiplegia after acute cerebral infarction.MethodsSixty patients of hemiplegia caused by acute cerebral infarction were randomly divided into two groups, observing group and control group(30 patients for eaeh group).Patients in the observing group received family members' intervention in addition to the regular drug and rehabilitation treatment,which was used in control group only.The change of scores of Fugl-Meyer Assessment(FMA) and Modified Barthel Index(MBI) before and after treatment was evaluated respectively.ResultsThe scores of FMA and MBI in both groups rose very significantly eight weeks after treatment(P<0.001). But the scores of the obersevertion group were higher than that of the control group(P<0.05).ConclusionProper intervention by the family members plays an important role in enhancing the rehabilitation of acute cerebral infarction dysfunction and developing the patiennts' ability to take care of themselves in daily life.

Objective To explore the effect of occupational therapy (OT) on the depressive mood and activity of daily living (ADL) in patients with post stroke depression (PSD). Methods 42 patients with PSD were divided into OT group (n=21) and control group (n=21).Both 2 groups received routine therapy, and OT group received ADL training, selective recreation and sport and appreciation of music in addition.They were evaluated by modified Bathel index (MBI) and Hamilton Self-rating Scale for Depression (HAMD) before and after treatment.Results The scores of MBI increased and the scores of HAMD decreased significantly after 4 weeks in both 2 groups (P<0.001), especially in the OT group (P<0.01). Conclusion OT can improve not only ADL, but also the depressive mood in patients with PSD.

Objective To observe the surface electromyography (sEMG) characteristics of pharyngeal swallowing muscles in different swallowing modes in asymptomatic lacunar infarction (LI) patients. Methods From January, 2015 to January, 2017, a total of 32 asymptom-atic LI patients (LI group) aged over 60 years were consecutively collected, and 30 normal old subjects matched with age and gender (nor-mal group) were also enrolled. The amplitudes of sEMG activity of infrahyoid muscles and submental muscles in different swallowing modes were recorded, and the root mean square (RMS) was analyzed. Results Significant difference was found in both muscle groups in dif-ferent swallowing modes in both groups (F>110.67, P<0.001). There was no significance in the RMS in both two muscle groups in rest and dry swallowing modes between two groups (t<1.484, P>0.05). In the 20 ml water swallowing mode, the RMS was lower in the submental muscles in the LI group than in the normal group (t=3.334, P<0.01), and no significant difference was found in the infrahyoid muscles (t=1.871, P>0.05). In the 100 ml continuous drinking mode, the RMSs were significantly lower in both two muscle groups in LI group than in the normal group (t>3.118, P<0.01). Conclusion Swallow abilities decrease in asymptomatic LI. sEMG could be used to evaluate their swallowing function.

Objective To observe the effect of surface electromyographic biofeedback on the pharyngeal phase activities in patients with dysphagia after stroke. Methods Seventy-six consecutive patients with pharyngeal dysphagia after stroke admitted to the departments of rehabilitation and neurology,brain hospital affiliated to nanjing medical university from August 2014 to February 2015 were enrolled retrospectively. After excluding 40 patients,the remaining 36 patients were divided into either a conventional training group (n =19)or a biofeedback group (n =17)by using the random number table. The patients of the conventional training group received swallowing function training only,while those of the biofeedback group also received the surface electromyographic biofeedback treatment on the basis of the therapy program of the conventional training group. The patients of both groups were treated 6 times a week for 4 weeks. The assessment of swallowing angiography,the digital measurement and analysis were performed before and after treatment. The outcome measures included the degree of openness of upper esophageal sphincter (UES),0pharyngeal transit time (PTT),and the maximum displacement of the hyoid bone (HmaxD). Results (1)The proportions of UES complete opening of the conventional training group before and after training were 26. 3% (5 / 19)and 47. 4% (9 / 19)respectively. There was significant difference between before and after training (χ2 = 5. 08, P =0.020). The proportions of UES complete opening of the biofeedback group before and after training were 47.1% (8/ 17)and 82.4% (14/ 17)respectively. There was significant difference between before training and after training (χ2 =11.46,P = 0. 001). There was no significant difference in the degrees of UES complete opening before training between the conventional training group and the biofeedback group (P >0. 05). There was significant difference in the degree of UES complete opening after training between the 2 groups (χ2 =4. 63,P = 0. 040). (2)PTT of the conventional training group before and after training was 0.24 ±0.07 and 0.19 ±0.06 s respectively. PTT of the biofeedback before and after training was 0.23 ±0.06 and 0. 15 ± 0. 05 s. There was significant difference between before training and after training (F = 154. 50,P = 0. 000). There was no significant difference in PTT before training between the conventional training group and the biofeedback group (P > 0. 05). There was significant difference in PTT after training between the 2 groups (F =4.66,P = 0. 038). (3)The HmaxD distances of the conventional training group before and after training were 0. 5 ± 0. 4 and 0. 9 ± 0. 4 cm respectively,the PTT of the biofeedback training before and after training was 0. 6 ± 0. 4 and 1. 3 ± 0. 6 cm respectively. There was significant difference between before training and after training (F = 137. 56,P = 0. 000). There was no significant difference in the HmaxD distance of the conventional training group and the biofeedback training group before training (P > 0. 05). There was significant difference in the HmaxD distance after training between the 2 groups (F = 4. 29,P = 0. 033). Conclusion The surface electromyographic biofeedback therapy in combination with the conventional swallowing training for the treatment of dysphagia after stroke has the synergistic efficacy.

Objective To assess the optimal visiualization capacity of brachial plexus with three-dimensional nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation imaging (3D SHINKEI), exploring the feasibility of preliminary diagnostic value on brachial plexus diseases. Methods MRI scans were performed on 24 healthy volunteers with no history of brachial plexus injury, and 46 patients whose outcomes of lesions had been verified as post-ganglionic brachial plexus injuries by surgery or clinical follows-up . The scan series consist 3D SHINKEI, STIR in the coronal plane as well as DW-MRN in the axial plane using a 3.0 T MR system. The source and post-processed images of 3D SHINKEI and DW-MRN were scored according to the optimal visibility on brachial plexus, in the meanwhile, contrast-to-noise ratio of the original images in the 3D SHINKEI and STIR sequences were calculated separately. Two radiologists blindly compared the detection rate of positive brachial plexus injuries between 3D SHINKEI and STIR in 46 patients. And then analyze the outcomes by means of Kappa test, Mann-Whitney test , independent sample t test, and Chi-square test. Results Post-ganglionic brachial plexus showed high intensity in the 3D SHINKEI sequence. In the 24 healthy volunteers, the scores by the two radiologists were 3.6 ± 0.6, 3.5 ± 0.6, 3.0 ± 0.2, 2.9 ± 0.1, respectively. There was statistical difference between the two sequences (Z=2.667,P=0.008,P<0.05). And the Kappa was 0.8 and 0.6 with favorable consistency. The CNR of 3D SHINKEI and STIR were 0.61 ± 0.07, 0.42 ± 0.03 (t=12.78, P=0.001, P<0.05). The positive detection rates of post-ganglionic brachial plexus injuries on 3D SKINKEI and STIR were, 78.3%, 52.2%(χ2=9.421, P<0.05). Conclusions 3D SHINKEI sequence demonstrates robust visibility consistently and can clearly display the structures and signals of post-ganglionic abnormality, compared with DW-MRN and STIR. This technique can be helpful to provide more complementary information to further confirm the diagnosis of brachial plexus injuries.