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The effects of transcutaneous electrical nerve stimulation on pulmonary function, airflow, dyspnea, exercise capacity and TNF-α levels in patients with pulmonary obstruction

Yiqun SHOU ; Huiqing GE ; Zening DAI ; Ting YAN ; Wenjun CHEN

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(9):705-708. doi:10.3760/cma.j.issn.0254-1424.2014.09.014

Objective To observe any effect of transcutaneous electrical nerve stimulation (TENS) on pul monary function,airflow obstruction,dyspnea,exercise capacity and levels of tumor necrosis factor-α (TNF-α) in the sputum of patients with chronic obstructive pulmonary disease (COPD).Methods Thirty patients with stage Ⅰ or Ⅱ COPD were randomly divided into a treatment group and a control group with 15 cases in each.TENS applied at the Feishu acupuncture point (BL13) was used in the treatment group,while sham stimulation of the same point without current output was used in the control group.The treatment was administered 40 minutes once daily,5 days a week for a total of 4 weeks.The outcome measures were measured before and after 4 weeks of treatment.Results FVC,FEV1,FEV1％,and peak expiratory flow rate (PEFR) all improved significantly in the treatment group after 4 weeks of treatment.After treatment,the average TNF-α level in induced sputum and exercise capacity as indicated by the average BODE index had both improved significantly in the treatment group.Compared with the control group,pulmonary function,TNF-α and the BODE index in the treatment group were all significantly better.There was no significant difference in pulmonary function,BODE index or TNF-α before and after treatment in the control group.Conclusion TENS at the Feishu acupoint can reduce airway inflammation,improve pulmonary function and exercise capacity,and decrease TNF-α levels in patients with stage Ⅰ or Ⅱ COPD.This treatment should be very useful for enhancing their ability in the activities of daily living.

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The mechanical changes of finger tendons under use of dynamic orthosis

Lianchu LI

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(10):737-739. doi:10.3760/cma.j.issn.0254-1424.2014.010.001

Objective To study the mechanical changes of extensor and flexor tendons during use of dynamic orthosis after repair operation on the flexor tendons of hand.Methods An experiment model was established in eight groups (at different stages) using eight descarded fresh and integral human fingers which were broken from the distal plane to the proximal plane of metacarpal bone,thereby while using a dynamic orthosis the extension and flexion movement of extensor and flexor tendons of fingers were induced.An initial tensile force (F) of 0.2 N ～ 0.5 N was exerted on the flexor tendons of each group to simulate the extension and flexion movement of the muscle and a tensometer was connected to the extensor tendon exerting a tensile force (F2) and pulling the finger to the proximal interphalangeal joint at various positions of 20° ～ 50°,thus the tensile force (Fx) of flexor tendons and the tensile force (F2) of extensor tendons were measured.A rubber band was fixed at the distal end of the finger nails to simulate the dynamic orthosis and was pulled toward the proximal-end of the finger,while exerting an initial traction force (F1) of 0.1 N ～ 0.4 N and pull the extensor tendons with the tensometer to cause the finger extension until they reach the same position as that before the simulated dynamic orthosis was employed.Then the tensile force (Fx') of flexor tendons of each group as well as the tensile force (F2') of extensor tendons were measured,after which a statistical comparison was made with regard to the tensile force Fx and Fx' of flexor tendons and the tensile force F2 and F2' of extensor tendons before and after the simulated dynamic orthosis was employed.Results The tensile force (Fx') of flexor tendons during the simulated orthosis was used was compared with the tensile force (Fx) during the simulated orthosis was not used,it showed no statistical significant (P ＞ 0.05) ; in the meantime,by comparing the tensile force F2' and F2 of extensor tendons,it was found that the difference statistically significant (P ＜ 0.001) ; after the orthosis was used the tensile force of extensor tendons F2' increased remarkably with the increase of the initial tensile force F1 during the dynamic orthosis of rubber band was used.Conclusion The tensile force of flexor tendons would not be changed during a dynamic orthosis was used after repair operation on the flexor tendon of hand;however,with the increase of extensor tensile force,the resistance of finger extension would be multiplied and cause more difficulty to do exercise.

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The effects of conductive education on gross motor function and Gesell development test results in children with cerebral palsy

Junying YUAN ; Dengna ZHU ; Erliang SUN ; Xiaoming XIE ; Ping LI ; Chunna WEI

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(10):761-764. doi:10.3760/cma.j.issn.0254-1424.2014.010.006

Objective To observe the effects of conductive education on gross motor function and Gesell development test results in children with cerebral palsy.Methods One hundred and thirty-eight children with cerebral palsy were stratified randomly according to the gross motor function classification system (GMFCS) and sexes into two groups:the conductive education group received conductive education combined with general comprehensive rehabilitation,the control group received general comprehensive rehabilitation only.After 4 months of training,the results of both groups in terms of gross motor function and Gesell development test results were compared.Results The GMFCS evaluation results of the 2 groups were compared through covariance analysis (F =4.479,P =0.036 ＜0.05),the result of conductive education group was better than that of control group; in both groups the result after training was superior to that before training.For Gesell development test results comparison,the differences between conductive education group and control group were statistically significant (P ＜ 0.05) ; the result of conductive education group was better than before the training (t =24.93,P =0.00 ＜ 0.05) ; but in control group the difference between the results before and after training was not significant (t =13.34,P ＞ 0.05).Conclusions Conductive education could improve gross motor function and whole body development.

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Speech disorders and their relationships with abnormal cranial magnetic resonance imaging findings in children with cerebral palsy

Qingyun XIE ; Mei HOU ; Jun LI ; Dianrong SUN ; Aiyun YUAN

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(10):756-760. doi:10.3760/cma.j.issn.0254-1424.2014.010.005

Objective To investigate the clinical characteristics of speech disorders in children with cerebral palsy (CP) and any relationship between those characteristics and cranial magnetic resonance images.Methods A sample of 138 children with CP were given the ＜ s-s ＞ language development test,a Chinese-language articulation test and oral motor scores to quantify their functional speech and articulation.The characteristics of their speech disorders,articulation and oral motor dysfunction were then related with abnormalities in their cranial magnetic resonance images (MRIs).Results Of the 138 MRIs,only 9 were normal.Three showed non-specific abnormalities (delayed myelination and/or broadening of the space outside the brain) and 122 (91％) showed specific abnormalities.Among the children with specific abnormalities,51.6％ had speech reception delay and 74.6％ had speech expression delays.The dysarthria rate was 71.3％,including 8.7％ with no speech ability at all.The main MRI abnormalities were lesions of the basal ganglia (23％),lesions of the cerebellum (11.5％),periventricular leukomalacia (PVL) (47.5％),extensive cortical or subcortical lesions (6.6％) and focal cerebral injury (11.5 ％).The corresponding oral motor scores increased successively.The children with lesions of the basal ganglia or cerebellum were most likely to manifest speech expression delay and dysarthria.The children with cortical or subcortical lesions or PVL also showed speech expression delay and dysarthria.However,the children who had a focal cerebral injury generally performed well on the speech ability assessment.Twelve children had no speaking ability at all,and in 7 of them the lesions were of the basal ganglia.Conclusions The probability and severity of speech disorders in children with cerebral palsy relate with specific abnormalities detectable with cranial MRI.Those with lesions of the basal ganglia or cerebellum will be more likely to show more severe speech disorders.

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Effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery

Haitao CAO ; Wan ZHANG

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(10):774-777. doi:10.3760/cma.j.issn.0254-1424.2014.010.009

Objective To investigate the effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery.Methods Sixty elderly patients with fixed hip fracture by operation were randomly divided into a training group and a control group with 30 cases in each group.The training group received mindfulness behavior training in addition to routine rehabilitation training,while the control group only received routine rehabilitation training.The mindfulness behavior training was administered 90 min for once a week,lasting for 5 weeks.The emotional disorder was assessed with the profile of mood states (POMS),and the immune system function were evaluated by the number of CD3 + 、CD4 + 、CD8 + in T cell subgroup before and after 5 weeks of training.Results Before training,there was no significant difference in scores of POMS and the cells number of CD3 +,CD4 +,CD8 + (P ＞ 0.05) between the two groups.After treatment,scores of POMS including tension-anxiety (13.14 ± 3.36 vs 15.90 ± 4.28),depression-dejection (18.10 ± 6.24 vs 20.06 ± 5.42),fatigue-inertia (16.53 ± 3.50 vs 18.98 ± 4.88),vgor-activity (26.68 ± 5.22 vs 22.43 ± 5.20) (P ＜ 0.05),the level of mindfulness practice(58.00 ± 4.78 vs 54.00 ± 4.89) and the cells number of CD3 +,CD4 +,CD8 + (75.75 ± 5.40vs 69.91 ± 4.42 ;39.54 ± 3.29 vs 34.44 ± 4.21 ; 39.82 ± 3.55 vs 36.82 ± 3.55) in experimental group improved more than those in control group (P ＜ 0.05).Conclusion Mindfulness behavior training can improve the patients' mood state and have positive promotion on immunological function.

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Automatic measurement of range of motion of human lower limbs using Kinect technique

Xiaolong ZHU ; Junze WANG ; Chang QU ; Aibo DAI

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(10):778-783. doi:10.3760/cma.j.issn.0254-1424.2014.010.010

Objective In order to improve the accuracy and efficiency of the measurement of range of motion (ROM) of human lower limbs and simplify process of ROM measurement,an automatic measurement of ROM of human lower limbs based on Kinect technique was proposed and tested in this study.Methods Fifty examinee were randomly divided into 5 groups,namely groups a,b,c,d and e,respectively,each group had 10 members.Using the human skeleton tracking technology from Kinect,the positions of the examinee's lower limbs were captured and tracked by processing the depth data of lower limbs' key joints.Then the information of ROM of hip and knee was output on human-computer interaction interface in real-time.By comparison with traditional manual measurement results,the accuracy of automatic measuring method could be verified.Meanwhile,with the aid of speech recognition and output technology,the mode of warning information transfer and the way of subject switch were optimized.Results According to the method of Grubbs-test and t-test,the ROM values | t | from the subjects' hip abduction (t =0.57,P =0.597),hip adduction (t =0.52,P =0.621),hip anteflexion (t =1.01,P =0.371),hip postextension (t =0.12,P =0.902),hip external rotation (t =0.00,P =1.000),hip internal rotation (t =0.34,P =0.753),knee flexion and extension (t =1.12,P =0.280) all were under the threshold value t0.025 (4) =2.776 on the premise of a level of significance α =0.05,which indicated that there was no significant difference between measured results and expected values(P ＞ 0.05).Conclusion The automatic measurement of ROM of lower limbs can be realized which can improve the measurement accuracy,simplify the measurement process and enhance the practicability of ROM of lower limbs measurement.

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Effects of treadmill exercise on spatial learning, memory and expression of hippocampal brain-derived neurotrophic factor of rats after mild traumatic brain injury

Jiecheng FAN ; Xi ZENG ; Liugen WANG ; Heping LI

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(11):817-822. doi:10.3760/cma.j.issn.0254-1424.2014.011.001

Objective To investigate the effects of treadmill exercise on spatial learning,memory and the expression of hippocampal brain-derived neurotrophic factor(BDNF) in rats after mild traumatic brain injury (TBI).Methods Thirty Sprague-Dawley rats were randomly divided into group T (n =10,undergoing TBI modelling operation and 4 weeks' treadmill exercise training beginning at 48 h after the operation),group C (n =10,undergoing TBI modelling operation and no exercise training) and group N (n =10,undergoing sham operation and no exercise training).Morris water maze(MWM)was used to test rats' abilities of spatial learning and memory.The number of BDNF-positive cells in the hippocampus was measured with immunohistochemistry.Results In the orientational navigation test,the escape latency period was gradually shortened for rats in all groups.At the second training week,the average time of group T(88.54 ±5.73 s) became shorter than that in group C (91.45 ± 8.91 s).At the fourth week,however,the difference [(55.33 ± 6.77 s) vs (74.53 ± 6.85 s)] was significant(P ＜ 0.01).Group N (88.44 ±7.79 s,79.52 ± 8.02 s,69.54 ± 10.14 s and 62.49 ± 7.22 s respectively) also improved significantly more than group C (98.99 ± 6.84 s,91.45 ± 8.91 s,79.65 ± 12.47 s and 74.53 ± 6.85 s respectively) from week 1 to 4 (P ＜ 0.01).The average number of times of passing through the platform area of group N in four weeks (3.00 ± 0.54,3.38 ± 0.74,4.38 ± 1.06 and 6.00 ± 0.76 respectively) and group T from the second week on(3.25 ± 1.28,5.00 ± 0.93 and 5.88 ± 0.99 respectively) were significantly higher than that of group C (1.25 ± 0.71,1.50 ± 0.54,2.13 ± 1.25 and 3.00 ± 0.54 respectively) accordingly (P ＜ 0.01).At the week four,the average number of BDNF-positive cells in group T(128.56 ± 7.93) were significantly larger than that in group C and group N (P ＜ 0.05),with no significant difference was noted between group N and group C (P ＞0.05).Conclusions Treadmill exercise could improve the spatial learning and memory of rats after mild traumatic brain injury.This may be related with the up-regulation of expression of BDNF in the hippocampus.

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Effects of standardized three-stage rehabilitation program on upper extremity spasticity and motor function after cerebral hemorrhage

Bei ZHANG ; Qiang HE ; Yingying LI ; Yulong BAI ; Yongshan HU ; Yi WU ; Yulian ZHU

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(11):828-831. doi:10.3760/cma.j.issn.0254-1424.2014.011.003

Objective To evaluate the effectiveness of standardized three-stage rehabilitation program on spasticity and motor function in the upper extremities after cerebral hemorrhage.Methods A total of 364 patients were included and randomly assigned to a control group (n =181) and a rehabilitation group (n =183).The standardized three-stage rehabilitation program,which included early-stage bedside rehabilitation,specialized treatment in rehabilitation ward during recovery and rehabilitation follow-up at regular intervals was applied in the rehabilitation group,but only rehabilitation guidance and follow-up after discharge were provided for the control group.The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were performed at the time of recruitment,1 month (M1),3 months(M3) and 6 months(M6) later.Results There was no statistical difference between the groups at recruitment.The occurrence rate of spasticity was 22.7％ in the control and 23.5％ in the rehabilitation group.At M6 the occurrence rate of spasticity was about 59.7％ and 43.2％ in control group and rehabilitation group respectively,and the number of patients grade 1 + and grade 2 on the MAS was 50/181 in the control group,significantly more than in the rehabilitation group (25/183).At all time points,MAS grade 0 accounted for a large proportion of both groups.At M6,both MAS distributions and scores of the two groups were different statistically (P ＜ 0.01).FMA scores in both groups increased significantly (P ＜ 0.01) with time,with the score being (17.13 ± 16.46),(24.87±18.36),(30.68±19.41) at M1,M3 and M6 in the control group and (24.71 ±19.80),(39.83 ± 19.50),(48.87 ± 18.25) in the rehabilitation group,but the average scores of the latter were consistently significantly higher than the former (P ＜ 0.01).Conclusions Standardized three-stage rehabilitation can alleviate spasticity and improve motor function of the upper extremities in cerebral hemorrhage patients.

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The effects of constraint-induced movement therapy on early stage upper limb function recovery in patients with subacute stroke

Honghong HUANG ; Lingxing WANG ; Quanxiang ZHANG ; Lingfeng WU ; Ruoting LIN

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(11):838-841. doi:10.3760/cma.j.issn.0254-1424.2014.011.005

Objective To investigate the effects of constraint-induced movement therapy (CIMT) on the function of hemiplegic upper extremity in the early subacute stroke patients.Methods A prospective,single-blinded,randomized controlled study was conducted.Forty-seven stroke patients with hemiplegic upper limb dysfunction were randomly divided into 2 groups:a CIMT group and a control group.The CIMT group received constraintinduced movement therapy and the control group was treated with conventional rehabilitation therapy.Both groups were treated 3 h daily,5 d a week for 2 weeks.The Wolf motor function test (WMFT) and Fugl-Meyer Assessment (FMA) were used to evaluate upper extremity motor function,and motor activity log (MAL) was used to assess upper extremity ability in activities.WMFT,FMA and MAL were measured before and after 1 day and 6 months of treatment.Results After 1 day of treatment,FMA,WMFT,MAL-AU and MAL-HW were 53.81 ± 2.59,66.68 ± 3.54,1.89 ± 0.88 and 3.26 ± 0.65,respectively,in the CIMT group,and 48.61 ± 4.48,62.10 ± 7.97,1.25 ± 0.64 and 2.65 ± 0.93,respectively,in the control group.After 6 months of treatment,FMA,WMFT,MAL-AU and MAL-HW were 57.53 ±2.01,69.57 ± 3.00,3.00 ±0.82 and 3.84 ±0.69,respectively,in the CIMT group,and 53.30 ± 2.88,66.20 ±3.59,2.20 ± 1.06 and 3.25 ±0.64,respectively,in the control group.The scores of FMA,WMFT,MAL in the CIMT group were all higher than those in the control group at 1 day and 6 months post-treatment,and the differences were statistically significant (P ＜ 0.05).Conclusion Constraint-induced movement therapy can significantly improve the patients' hand function in the early stage of subacute stroke,which maintain up to 6 months of follow-up.

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Effectiveness of ultrasound-guided botulinum toxin injection combined with orthosis training in the treatment of lower limb spasticity

Huiying JIN ; Hui WANG ; Zhongmin FU ; Jiangping WANG ; Qing DONG ; Xuejuan ZHOU ; Haifeng LI

Chinese Journal of Physical Medicine and Rehabilitation.2014;36(11):855-858. doi:10.3760/cma.j.issn.0254-1424.2014.011.010

Objective To observe the effect of ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with orthosis training for the treatment of lower limb spasticity for children with cerebral palsy.Methods Fifty-four patients with spastic cerebral palsy were randomly divided into an observation group and a control group using a random number table.Patients in the control group were given conventional rehabilitation training,while those in the observation group were additionally given ultrasound-guided BTX-A injection,followed by daily knee-ankle-foot orthosis rehabilitation training 24 h after the injection.Before and 6 weeks after treatment the lower limb function of the 2 groups was evaluated using the modified Ashworth scale (MAS) and the gross motor function measure (GMFM).Adductor angles,popliteal angles and motor ranges of the ankle joint were also measured and compared.Results After 6 weeks the average MAS scores were lower than before treatment in both observation[(1.26±0.63) vs (3.07±0.68)] and control group [(2.56±0.71) vs (2.89±0.64).And in both groups the average GMFM scores,adductor angles and popliteal angles,as well as range of motion of the ankle were all much better than before treatment.The observation group,however,improved significantly more than the control group(P ＜ 0.05).Conclusion Ultrasound-guided injection of BTX-A can effectively alleviate spasticity of lower extremity for children with cerebral palsy with accurate positioning,obvious curative effect and less adverse reactions.Knee-ankle-foot orthosis rehabilitation training after the injection can further alleviate spasticity and improve the motor function of the limbs.

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