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Functional electrical stimulation for improving motor function in elderly patients with cerebral apoplexy hemiplegia

Ting HUANG ; Qinghua FAN ; Tingyu WU ; Zhigang WANG ; Ling ZHU

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(5):370-372. doi:10.3760/cma.j.issn.0254-1424.2010.05.013

Objective Electric stimulation functional observation statistics (FES) were collected for elderly patients with cerebral apoplexy in search of any curative effect. Methods A total of 40 patients with cerebral apoplexy were divided randomly into a FES group of 20 cases and a control group of 20 cases. Both groups received the same routine rehabilitation training and basic drugs. The FES group was also treated using FES therapeutic apparatus for 30 min daily over 3 weeks (15 sessions). The control group received no electrical stimulation. Upper limb motor function, lower limb motor function, balanceand Barthel's index were evaluated. Results In the FES group, upper limb motor function was significantly improved after treatment, and significantly better compared with the control group. Lower limb motor function showed the same significant differences. Balance was also significantly better after treatment and significantly better than in the control group. Similar significant improvements were seen in terms of Barthel's index. Conclusions FES can improve the functional capacity of elderly patients with cerebral apoplexy hemiplegia and improve their ability in daily activities.

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Surface electromyography signals from neck muscles during different craniocervical postures in a lateral recumbent position

Fang ZHANG ; Huaixia LIU ; Junyan LU ; Taotao TAO ; Bo CHENG ; Songhe JIANG

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(5):363-365. doi:10.3760/cma.j.issn.0254-1424.2010.05.011

Objective To survey cervical myoelectric signals during craniocervical flexion, neutral and extension postures, and to explore the evidence that proper head position can alleviate cervical muscle fatigue in a lateral recumbent position. Methods Surface electromyography (sEMG) signals were detected from the sternocleidomastoid, upper trapezius and erector spinae muscles of 30 young subjects bilaterally during craniocervical flexion,neutral and extension postures in the left lateral recumbent position. The integrated trace area (IEMG) and median frequency (MF) were estimated. Results The average IEMG of the sternocleidomastoid muscles was significantly lower in flexion than in extension bilaterally. The average IEMG of the erector spinae muscles was lower in extension than in flexion bilaterally, and the difference was again significant. The IEMGs of the upper trapezius muscle showed no significant difference on average in the three postures bilaterally. There was no significant MF difference in any of the muscles. Conclusions The muscles in the cervical back were less activated during craniocervical extension in a lateral recumbent position. A little cranicocervical extension is optimal while resting in a lateral recumbent position.

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Rehabilitation outcomes for 51 earthquake victims with spinal cord injury

Yongqiang LI ; Ying LIU ; Mingpu DING ; Jianan LI ; Xia ZHANG ; Sijing CHEN ; Wenchao YI

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(5):359-362. doi:10.3760/cma.j.issn.0254-1424.2010.05.010

Objective To analyze the outcomes of clinical management and rehabilitation interventions for earthquake victims with spinal cord injury. Methods Comprehensive rehabilitation intervention was conducted for 3 to 4 months with 51 earthquake victims with spinal cord injuries. The study involved their physical examination and on site interviews during hospitalization, and follow-up by telephone. Etiology, severity, complications and outcomes of rehabilitation and clinical management were analyzed. Results In 9.8% of the patients the spinal cord injury was at C7 or above, 5.9% at C8 to T6 , 68.6% at T7 to L2 , 13.7% at L3 to S2 and 2.0% at S2 or below. There were 22 complete injuries and 29 incomplete. After 4 months of training, 76.5% of the wounded reached wheelchair independence, 78.4% ambulated with an orthosis and 88.2% were partially independent in the activities of daily living.Conclusions The comprehensive rehabilitation intervention allowed most of the victims to resume an independent life. Their long-term care remains a challenge.

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Effects of treadmill training on the expression of HSP70 and C-MYC in the brains of rats with focal cerebral ischemia

Deshan LIU ; Nan LIU ; Yixian ZHANG ; Houwei DU ; Ronghua CHEN

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(5):333-337. doi:10.3760/cma.j.issn.0254-1424.2010.05.004

Objective To observe the effects of treadmill training on the recovery of neurological function and the expression of HSP70 and C-MYC in the brains of rats with focal cerebral ischemia. Methods Forty-two male adult Sprague-Dawley rats were randomly divided into a sham group ( n =6), a model group (n =18) and a treadmill exercise group (n=18). Focal cerebral ischemia was induced by right middle cerebral artery occlusion (MCAO) in the model group and exercise group using a modified version of Longa's method. The rats in the treadmill exercise group were given treadmill training 6 d per week for 2 weeks after 24 h of MCAO. By contrast, the rats in the sham group and the model group were reared in standard cages. Before the rats were sacrificed at the 3rd, 7th and 14th d after MCAO, their neurological functions were tested using modified neurological severity scores ( mNSS) , and the mRNA and protein levels of HSP70 and C-MYC were detected using a reverse transcriptase-polymerase chain reaction (RT-PCR) , immunohistochemistry and Western blotting. Results Neurological function in the exercise group at the 7th and 14th days after MCAO had improved significantly compared with the control and model groups.The mRNA and protein levels of HSP70 and C-MYC were significantly upregulated at the 7th and 14th days. Conclusions Treadmill training can improve neurological function by upregulating the expression of HSP70 and C-MYC in the ischemic brain after MCAO.

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The effect of phonophoresis on transdermal delivery of sinomenine hydrochloride gel in vitro

Lian LI ; Jianle ZHAO ; Xinping LI ; Hong WANG ; Jianqing GAO

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(5):328-332. doi:10.3760/cma.j.issn.0254-1424.2010.05.003

Objective To study the effect of phonophoresis on transdermal delivery of sinomenine hydrochloride ( SH ) gel in vitro. Methods Ultrasound at one of two frequencies ( 800 kHz or 1 MHz) was applied with a sonicator with a transducer in this study. The skin of male Sprague-Dawley rats was used as the model and SH gel was used as the ultrasound couplant. The permeation rate of SH was detected using a modified Franz diffusion cell maintained at 32±0.5℃ and filled with 20% polyethylene glycol 400 physiological saline solution. The transdermal phonophoresis experiments were carried out in five groups: Group Ta, f=800 kHz, / = 0.75 W/cm2, t = 10 min:Group Tb,f=1 MHz,I=0.7 W/cm2, t=10 min; Group Tc,f=1 MHz,I=0.35 W/cm2, t=10 min; Group Td,f=800 kHz, I = 1.5 W/cm2, t = 10 min and Group Tc,f=800 kHz, I=1.5 W/cm2,t=5 min. There was also a control group (C) in which the SH was allowed to diffused passively. Samples were withdrawn at the indicated intervals and the concentration of SH was determined by high-performance liquid chromatography. The transdermal parameters such as average accumulated delivery quantity per unit area Q8h, average transdermal steady delivery rate J, and Tlag were calculated. Results The Q8h and Js of the control group were 20.65±10.23 μ/cm2 and 3.02±0.11μ/cm2/h respectively. The phonophoresis parameters in groups Ta and Tb were, on average, significantly higher than in the control group. The parameters in group Tb were significantly larger, on average, than in Te. In group Td the parameters were significantly larger than in groups Ta and Te. Conclusions The results show that phonophoresis can enhance the transdermal delivery of SH. Phonophoresis variables such as frequency and time influence its effects on drug permeation. Almost no change was observed in the structure of the skin after phonophoresis, though under a scanning electron microscope the surface of the corneum appeared rough and porous. Phonophoresis is there-fore an effective and safe method for SH transdermal delivery, and the effect is positively relation with the applied intensity and exposure time.

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Effects of low power laser irradiation on olfactory ensheathing cells in vitro

Xiangyu MENG ; Xinfeng ZHENG ; Qin WEI ; Weibin SHENG

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(5):324-327. doi:10.3760/cma.j.issn.0254-1424.2010.05.002

Objective To investigate the effects of 810 nm semi-conductor laser irradiation on the proliferation of olfactory ensheathing cells in vitro. Methods Olfactory ensheathing cells obtained from adult rat olfactory mucosa using the method based on different rates of attachment were irradiated with a semi-conductor laser ( wave length 810 nm; power density 10.3 mW/cm2) for 30, 60 or 120 seconds. Laser irradiation was performed 3 times with a 24 h interval. After the last irradiation, the cells were cultured. At the 3rd, 5th and 8th day of cell culture,cell proliferation was assessed with cell counts and a methylthiazoletetrazolium ( MTT) colorometric method. Results After 3 days of cell culture, the number of cells and average MTT values showed no statistically significant difference between the irradiated and control groups. At the Sth and 8th day, the differences among all the laser exposure groups and with the control group were significant, except for the average MTT values of the control group and the 30 s exposure group. Maximal effect was achieved with a 60 s exposure. Conclusions Low power laser irradiation can stimulate the proliferation of olfactory ensheathing cells in vitro, and the effect is time-dose dependent. The optimal irradiation time was found to be 60 s daily for 3 times, with a 24 h interval.

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The effect of the Chinese medical herb decoction qu yin tang combined with ultraviolet B phototherapy on psoriasis vulgaris, and the influence on osteopontin and vascular endothelial growth factor in serum

Chunhong ZHANG ; Chunmin ZHANG ; Xixian DU ; Guo WEI ; Yongjian SHI ; Ying CAI

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(4):289-292. doi:10.3760/cma.j.issn.0254-1424.2010.04.013

Objective To observe the therapeutic efficacy of the Chinese medical herb decoction qu yin tang combined with narrow-band ultraviolet B (NB-UVB) phototherapy on psoriasis vulgaris, and to investigate its influ-ence on osteopontin (OPN) and vascular endothelial growth factor (VEGF) in serum. Methods Sixty patients with psoriasis were randomly divided into a treatment group and a control group. The treatment group was treated with qu yin tang and NB-UVB; the control group was treated with qu yin tang only. The levels of OPN and VEGF in serum were detected in both groups before and after treatment using an enzyme-linked immunosorbent assay (ELISA). Twenty healthy persons' serum samples were taken as controls. At the same time, any changes in psoriasis area and severity index (PASI) scores in the two groups were recorded and compared. Results After 8 weeks of treatment, PASI scores and levels of OPN and VEGF had been reduced significantly in both groups, and there was a significant difference between the treatment group and the control group. Conclusions Chinese medical herbs combined with NB-UVB phototherapy is a safe and effective method for the treatment of psoriasis. The results suggested that OPN and VEGF may play an important role in the pathogenesis of psoirasis vulgaris.

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Brain-computer interface technology in the rehabilitation of central nerve system diseases

Rongrong LU ; Yi WU ; Liqing ZHANG ; Jie LI

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(4):277-281. doi:10.3760/cma.j.issn.0254-1424.2010.04.010

Objective To explore the prospects for applying a brain-computer interface system in the reha-bilitation of dyskinesia by testing the brain-electricity signals of spinal cord injury patients and stroke patients during motor imagery. Methods The brain-electricity signals of 5 healthy people, 4 spinal cord injury patients and 2 stroke patients were tested during motor imagery, and the results were analyzed with a computer. Results All of the 5 healthy people showed event-related synchronization and desynchronization (ERS/ERD) in the α and β bands in the motor related cortex. Three of the 4 spinal cord injury patents showed similar characteristics, and 1 showed ob-vious and stable characteristics, but the 2 stroke patients did not show meaningful characteristics. Conclusions Spinal cord injury patients have brain-electrlcity characteristics similar to those of healthy people when they are expe-riencing motor imagery, whilst in the affected hemisphere of stroke patients the brain-electricity characteristics are not similar to those of healthy people.

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Mental practice and upper extremity function after stroke

Yongxin HU ; Qiang WANG ; Pingping MENG ; Mingzhu QI

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(4):273-276. doi:10.3760/cma.j.issn.0254-1424.2010.04.009

Objective To explore the effects of mental practice on upper extremity function after stroke. Methods Thirty sub-acute stroke patients were randomly divided into a treatment group ( n=15 ) and a control group (n=15). The patients in the control group were treated with conventional therapy. The patients in the treat-ment group were treated with motor imagery therapy in addition. All patients were assessed using the Fugl-Meyer mo-tor assessment (FMA) and the motor assessment scale (bIAS) before treatment and after 2, 4 and 8 weeks of treat-ment. Results After 2 weeks of treatment, average MAS scores in the treatment group improved significantly com-pared with before treatment, but there was no significant difference between the two groups. After 4 weeks, FMA and MAS scores in the two groups had improved, and the FMA scores in the treatment group were significantly higher than those of the control group. After 8 weeks, the FMA and MAS scores of both groups had further improved significant-ly, but the average FMA and MAS scores in the treatment group were now significantly higher than those in the control group. Conclusions Mental practice can improve the functional performance of the upper extremities of stroke pa-tients.

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MOTOmed training patterns and somatosensory evoked potential in healthy youths

Minghui CAO ; Jun YAN ; Tiebin YAN ; Yuegui CHEN

Chinese Journal of Physical Medicine and Rehabilitation.2010;32(4):270-272. doi:10.3760/cma.j.issn.0254-1424.2010.04.008

Objective To compare the effects of three different training patterns of MOTOmed training on the somatosensory evoked potentials (SEPs) of healthy youths. Methods Ten healthy young volunteers received training in patterned sequences of passive movement, active movement with no resistance and active movement with resistance. Each pattern lasted for 30 minutes and SEPs were examined before and after 90 minutes of training. The amplitude and latency of N9 and P40 were recorded. Results All three training patterns heightened SEP amplitude and lengthened SEP latency, but active training had the most obvious effect on amplitude. The rates of change of am-plitude after each training pattern had significant differences, which was most obvious after training the resistance training pattern. Conclusions MOTOmed motor training can excite the cerebral cortex and up-regulate SEP ampli-tude. Active movement with resistance is the most effective among the three patterns tested.

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