Objective To assess applicability of the Rehabilitation Nursing Activity of Daily Living (RNADL) scale in the rehabilitation training in stroke patients. Methods The abilities of daily life (ALD) in 68 stroke patients were evaluated with the RNADL scale on admission, 1 month after treatment and at discharge. All the patients were treated with the individualized protocol. Results ALDs were improved significantly in all the subjects, the average RNADL score was improved from 37.73?3.61 on admission to 81.79?18.69 at discharge (P

Objective To observe the effect of acupuncture combined with integrated Chinese-Western neuromuscular facilitation technique on persistent vegetative state (PVS).Methods41 PVS cases were randomly divided into the observation group (n=21) and control group (n=20). The observation group was treated with acupuncture, neuromuscular facilitation technique combined with reasonable obligatory exercise, neuromuscular electrical stimulation, manipulation treatment and Chinese medicine. The control group was treated with the Western and Chinese medicines, and hyperbaric oxygen.ResultsAfter 1～3 months treatment, 7 cases cured,8 cases were markedly effective, 5 cases were effective, 1 cases were ineffective in the observation group with a total markedly effective rate (71.4%) and effective rate (95.2%). While, in the control group, 3 cases cured, 5 cases were markedly effective, 6 cases were effective, 6 cases were ineffective and total markedly effective rate was 40%, effective rate was 70%. There was a significant difference between the two groups in the total markedly effective rate and the effective rate ( P<0.05). The average PVS score increased by 7.46±1.22 in the observation group and 4.59±1.21 in the control group. Also there was a significant difference between the two groups ( P<0.001).ConclusionThe therapy of acupuncture combined with integrated Chinese-Western neuromuscular facilitation technique can markedly promote PVS patients coming round and improve patients' prognosis.

BACKGROUND:Among the pathogenic factors of cervical spondylosis,herniation of the intervertebral disc,dislocation of the facet joint and the stenosis of the intervertebral foramen are important factors leading to symptoms in patients.Moreover,inappropriate manipulation may aggravate the possibility of cervical disc rupture,leading to exacerbation of symptoms in patients. OBJECTIVE:To compare the effect between sagittal cervical manipulation and traditional cervical rotation manipulation on the area of the intervertebral disc,facet joint and intervertebral foramen at the operative segment by the finite element analysis. METHODS:The neck CT data of a male volunteer with a normal neck were selected and imported into Mimics 17.0 three-dimensional reconstruction software.Geo-magic Studio 12.0,Solidworks 2017 and Ansys Workbench 17.0 software were used for the construction of the finite element model of cervical vertebrae(C3-6)including intervertebral disc and articular cartilage.The lower end plate of the C5 vertebral body was fixed.A uniformly distributed vertical downward 50 N load was applied on the upper surface of the upper vertebral body(C3).The stress,deformation and deformation direction of the C4-5 intervertebral disc,joint capsule stress,the displacement of facet joints and the area of bilateral intervertebral foramen were compared between sagittal cervical manipulation and traditional rotation reduction. RESULTS AND CONCLUSION:(1)When using the rotation technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 8.06 MPa;the total deformation was 1.05 mm,and the fiber ring expanded to the left and outside.When using the sagittal tip lifting technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 2.60 MPa;the total deformation was 0.90 mm,and the fiber ring expanded to the left and back.Compared with the rotation technique,the pressure of the cervical manipulation technique on the disc was less(about 32.3%of the rotation technique),and the deformation degree of the disc was also light(about 85.7%of the rotation technique).(2)When the rotation technique was used,the maximum stresses of the left and right articular capsule ligaments were 0.37 MPa and 1.69 MPa,respectively.The overall displacement of the facet joint was 2.21 mm.The area of the right intervertebral foramen decreased by about 3.8%and the area of the left intervertebral foramen increased by about 0.9%.When the sagittal end lifting manipulation was performed,the maximum stresses of the left and right articular capsule ligaments were 0.27 MPa and 1.70 MPa,respectively;the overall displacement of the facet joint was 1.63 mm;the area of the right intervertebral foramen increased by about 2.6%,and the area of the left intervertebral foramen decreased by about 0.9%.Compared with rotation manipulation,sagittal end lifting manipulation had fewer changes in the displacement of facet joint,joint capsule stress and intervertebral foramen area,so it was safer to operate.(3)In conclusion,compared with cervical rotation manipulation,sagittal end lifting manipulation has fewer changes in facet joint displacement,intervertebral disc stress/deformation degree,joint capsule stress,and foraminal area.In clinical practice,more appropriate manipulation should be selected based on biomechanical results after an accurate assessment of patients'conditions.