Unilateral spatial neglect is recognized as a significant disabling deficit, clinically defined as a failure to report, respond or orient to novel stimuli presented on the side opposite to a brain lesion. It is a predictor of poor functional outcome following right hemisphere lesion. Many different rehabilitation techniques or treatments have been put forward to alleviate, reduce or remediate spatial neglect. In the following review, we described, explained these Methods in terms of their underlying or motivatng mechanisms and evaluated in terms of the current evidence base for their effectiveness for clinical rehabilitation.

BACKGROUND: Cervical spondylosis is a common disease in middleaged and elderly people. There are many methods of rehabilitative treatment such as traction, massage, medical gymnastics, acupuncture and local blocking, etc.OBJECTIVE: To observe the effects of rehabilitative exercise on patients with cervical spondylosis by way of quantitative generalized boxing exercise combined with local cervical medical exercise.DESIGN: Self-control study on patients with cervical spondylosis in the community for 3 monthsSETTING: Department of Rehabilitation Medicine, Huashan Hospital Affiliated to Fudan University PARTICIPANTS: The indoor questionnaire investigation about chronic diseases in community was carried out on 1 457 inhabitants with the age from 35 to 74 in a community of South Nanjing district, Shanghai in order to check out the patients with cervical spondylosis who had been diagnosed confirmatively by hospital and exclude the patients with the disease of spinal cord type. There were total 114 patients volunteering to participate in the 3-month rehabilitative treatment with an informed content, including of 12 with cervical type of the disease, 39 with nerve root type, 23 with vertebroarterial type, 5 with sympathetic nerve type, 35 with mixed type and none with spinal cord type.METHODS: 3-month rehabilitative exercise was carried out for the 114 patients with cervical spondylosis.① One or several kinds of generalized boxing exercise such as shadow boxing, eighteen-gesture training practice and joint exercise were chosen by the patients according to their own in terest and physical energy. It was required that patient exercise was done for 3 months with one time a day, and each time for no less than 30 minutes, with the intensity after each exercise arriving to the target heart rate level of 170 subtracting their age. ② Aiming to exercise the cervicalshoulder part and to relax its related functions, the local cervical medical exercise has 12 procedures including turning left and right, moving neck around, shrinking head and relaxing shoulders, stretching neck and extending back, turning head and watching the moon, waving arms, putting up arms, lifting chest and squaring elbows, and trying hard to stretch neck.It was required that each procedure be repeated 5 to 10 times at the beginning and later more times increasing gradually, and the whole set of exercise be practiced for 3 months with lor 2 times each day and each time lasted at least 10 minutes.③No other treatment was performed by the patients except for the above exercise intervention. The effects were evaluated after 3 months.MAIN OUTCOME MEASURES: ①The evaluated results of the curative effect in all patients with 3-month rehabilitative exercise.② Relationship between types of cervical spondylosis and curative effect ③ Relationship between course of disease and curative effect RESULTS: According to the intention-to-treat analysis, all the 114 patients persisting in the 3-month exercise intervention entered the result analysis. The curative effect evaluation: among the 114 patients, 44 were with the general curative effect, 40 with marked improvement, 25 with improvement, 5 with inefficacy. The percentage of the general curative and marked improved is 73.7%, and that of total improvement is 95.6% The clinical manifestations of all patients with cervical spondylosis including cervicoscapulargia, radioactive numb and pain in unilateral or bilateral upper arms, dizziness, tinnitus, headache, etc.were distinctively improved ② Relationship between the types of cervical spondylosis and curative effect: after 3-month treatment of rehabilitative exercise, the percentage of the general curative effect and marked improvement in patients with cervical type and nerve root type was higher than that in patients with verteboarterial type, sympathetic nerve type and mixed type (91.7%,97.4%, 47.8% ,20.0% ,65.7% respectively and p value below 0.01). ③ Relationship between the course of cervical spondylosis and curative effects: the percentage of the general curative effect and marked improvement in patients with the course of less than one year is 90.9% and that in patients with the course of 1 to 5 years is 88.6%, which were all higher than that in patients with a course of 5 more years (p value below 0.01).CONCLUSION: Quantitative generalized boxing exercise combined with local cervical medical exercise is helpful to improve the radiculopathy symptoms, but only combined with other treatments could patients with vertebroarterial type receive the best curative effect. In addition, there is a certain relation between the course of disease and curative effect, and patients with cervical spondylosis should be treated with rehabilitative exercise as early as possible, which suggestes that it is worthy of popularization that patients with cervical spondylosis are organized to practice quantitative boxing exercise combined with cervical medical exercise in the community.

To understand the present situation of sport participation in community residents of Shanghai，study infecting factors to the regular sport participation rate and evaluate recognition degree of the relationship of sport and chronic disease，we carried out questionnaire survey indoors among the permanent residents,aged 35～74,in East Nanjing Road community, including survey on chronic disease and sport participation situation. The material was statistically analyzed and the related factors were proved by x2 test. The results showed that in 1457 permanent residents,470 regularly participat in sport, and were classified as sport population. The prevalence was 32.3%.The gender, age, education level, occupation and chronic disease had statistical significance (P<0.05) and they were probably infecting factors of the regular sport participation rate. Currently,the regular sport participation rate in community is relatively high and the purpose of sport participation was evident, however, the age structure of sport population was imbalance. The sport participation in residents was individualized and without proper scientific instruction.

Objective To explore the factors influencing the functional recovery of patients with spinal cord injury (SCI) at discharge. Methods A total of 105 patients with SCI admitted to the rehabilitation medicine department at Huashan Hospital between December 2004 and October 2009 were studied. Data on eleven variables were collected including the patients' medical history, physical examination results and American Spinal Injury Association (ASIA) scores at admission. Functional status was registered according to the modified Barthel index (MBI) assessed at admission and before discharge. Linear regression analysis was used to assess the influence of the variables.Results After rehabilitation, average MBI and ASIA scores were significantly higher. The multiple regression analysis revealed that injury grade, motor and pinprick sensation scores at admission were related to MBI before discharge.The duration of rehabilitation, the rehabilitation treatment course and motor scores at admission were related to MBI increases during hospitalization. Conclusions Patients with different ages, injury levels and severity can improve their functional abilities through rehabilitation treatment, especially patients with better initial motor ability, longer treatment and earlier intervention.

ObjectiveIn order to study the effect of three-month rehabilitation on motor function in hemiplegics after stroke. Methods125 patients were randomly divided into two groups, rehabilitation group (72 cases)and control group(53 cases).Patients in the rehabilitation group were given clinical treatment,electric stimulation therapy(EST) and regularly physical therapy, while those in control group were given clinical treatment and unguided self-training, and the evaluation was done in pre-treatment and post-three-month respectively. Motor function was assessed in Fugl-Meyer Assessment(FMA).ResultsMotor scores in each group had a more significant difference(P<0.001)before and after treatment, the process of scores in the rehabilitation group was obviously superior to that in the control group(P<0.001). Conclusions Rehabilitation training on hemiplegics after stroke may obviously improve motor function, depressing the disability and increasing the living quality.

Objective To investigate the underlying mechanism of motor recovery of the hemiplegic lower extremity in stroke patients. Methods The brain activation pattern during sequential extension-flexion of the affect-ed knee of 7 stroke patients and 8 healthy subjects was observed by blood-oxygen- level-dependent fMRI (BOLD-fM-RI) and analyzed by microsoft SPM5. Results When executing unilateral knee flexion-extension, contralateral paracentral lobe and contralateral supplementary motor area and right temporal gyms and inferior parietal lobes of both sides were significantly activated in all the healthy subjects, while the ipsilateral parietal lobe BA7 and BA5 were sig-nificantly activated in 6 of the 7 stroke patients. Conclusions Sequential extension-flexion of the affected knee of stroke patients was probably dependent on the activation of BA7 and BA5 in the intact side. Compensatory activation of the intact hemisphere might be one of the main mechanisms for the paretic lower extremity motor recovery in stroke patients.

Objective To explore the factors influencing the recovery of ability in the activities of daily living (ADL) after intracerebral hemorrhage. Methods A total of 108 patients with intracerebral hemorrhage admitted for rehabilitation to the rehabilitation medicine department of Huashan Hospital between January 2007 and June 2011 were studied.Twelve items of clinical data were collected with regard to the patients' medical history,physical status,modified Barthel index (MBI) score and Brunnstrom stage at admission.Functional status was classified according to the MBI scores and Brunnstrom stages assessed at admission and before discharge.Linear regression analysis was used to relate the variables. Results After rehabilitation,the MBI scores and Brunnstrom stages had improved relative to the scores at admission.Factors influencing the MBI improvements included the intervention timing of rehabilitation and the course of therapy employed. Conclusions It is very important to comprehend the factors influencing the recovery of ADL ability after cerebral hemorrhage in order to design effective rehabilitation strategies,better predict functional outcomes and improve patients' ADL ability effectively.

Objective To investigate the effect of early rehabilitation on rats' motor performance after moderate or severe experimental traumatic brain injury (TBI).Methods After adult Sprague-Dawley rats had received moderate or severe TBI,they were randomly assigned to either a 24 hour exercise group (group A),a 3-day exercise group (group B),a 7-day exercise group (group C) or a control group.Each group was composed of 8 rats.The exercise group endured forced treadmill training on an electric treadmill for 14 consecutive days initiated 24 hours,3 days or 7 days post TBI.The foot-fault and cylinder tests were performed on the 6th,12th,18th,24th and 28th day post injury.On the 28th day the rats were sacrificed and the brains were removed and frozen.The frozen coronal brain sections were stained with cresyl violet (CV) for quantitative evaluation of cortical lesion volume.Results The rats in groups B and C showed significant decreases in the percentage of left forelimb foot faults compared with the control group at the 18th,24th and28th day after injury.In addition,the rats of group C demonstrated significant decreases in the percentage of left forelimb foot-fault at the 12th day after injury.There was no significant difference between group A and the control group in terms of foot fault scores in any of the subsequent test sessions.In the cylinder test the forelimb use asymmetry scores of neither group A nor group B were significantly different from the control group.Group C showed marked locomotor asymmetry improvement at day 28 post-injury.There was no significantly different loss of hemispheric tissue between those groups.Conclusion After treadmill exercise for 14 consecutive days initiated at 3 or 7 days following moderate or severe TBI,rats' motor function improved.The cortical lesion volume was not associated with recovery of motor function.

Objective To analyze the effects of rehabilitation training,acupuncture and the combination of these two therapies on the motor function of stroke survivors,and to evaluate their health economics.Methods Two hundred and five stroke survivors were randomly divided into a rehabilitation group (64 cases),an acupuncture group (69 cases) and a combined group (72 cases).The rehabilitation group received conventional rehabilitation training for 28 days,while the acupuncture group received scalp needling combined with body acupuncture.The combined group received both the training and the acupuncture.The clinical neural functional deficiency scale (NDS) and functional comprehensive assessments (FCA) were evaluated at baseline and on the 28th day after treatment and 28th day after the treatment had ended.The total cost including the direct medical costs,direct non-medical costs and indirect costs were calculated and analyzed.Results The NDS and FCA scores showed no significant difference between the three groups at baseline.At the 28th day after treatment and and 28th day after the treatment had ended,both the NDS and FCA scores had improved significantly in all groups compared with the baseline.However,there was no significant difference between the groups.At the 28th day there was a significant difference in the NDS results of the combined group compared to the other two groups.Significant differences in NDS results among all three groups had appeared by the 56th day,but there was still no significant difference in average FCA scores.At the 28th day no significant difference in cost was observed among the three groups,but the combined group spent significantly less in total cost,direct medical costs,direct non-medical costs and indirect costs for a one point NDS decrement.However,there was no significant difference in the cost of producing a one point increment in FCA among the three groups.Conclusion Combining rehabilitation training with acupuncture is more economical and effective than either treatment alone.

Objective To investigate whether physical training can activate the PI3K/Akt (phosphatidyli-nositol 3-kinase/Protein Kinase B) signal transduction pathway after focal brain isehemia, leading to the reduction ofendothelial cell apoptosis. Methods Twenty-four male adult Sprague-Dawley rats (2 ～ 3 month old, n = 24) weresubjected to 60-min right middle cerebral artery occlusion (MCAO). All rats were randomly assigned to one of thethree groups: physical training group, control group and sham operation group. 24 hours after MCAO ,physical train-ing group underwent 30 min treadmill training per day for 2 weeks. Results After two weeks, the phosphorylationlevel of PI3K/Akt in the physical training group was significantly higher when compared with that in the control group(P <0.05), while the expression level of Bax in physical training group was lower when compared with that in thecontrol group( P < 0.05 ). Conclusion Physical training can activate PI3K/Akt signal transduction pathway,which may be associated with the neurological recovery.