Objective:To compare the efficacy of peripheral and central transcranial magnetic stimulation (rTMS) in the treatment of functional constipation.Methods:Sixty patients with functional constipation were randomly divided into a control group, a peripheral group and a central group, each of 20. All were given oral lactulose medication, while the peripheral groups was additionally provided with high-frequency repetitive magnetic stimulation (rMS) treatment in the sacral region (S2-4) and the central group received low-frequency rTMS treatment in the right dorsal prefrontal cortex. Before and after 3 weeks of treatment, all were evaluated in terms of the average weekly frequency of spontaneous complete bowel movements (SCBM), major constipation symptom scoring, and using the Constipation Patient Symptom Self Rating Scale (PAC-SYM).Results:After the treatment, all of the indicators had improved significantly in all three groups, but all were better in the peripheral and central groups than in the control group, on average. The peripheral group and the central group averages were not significantly different after the treatment. The total effectiveness rates in the peripheral and central groups both exceeded 90%, significantly better than among the control group.Conclusions:Both peripheral high-frequency rTMS and central low-frequency rTMS can effectively supplement lactulose drug treatment in relieving the symptoms of constipation.

Objective:To explore any effect of combining Liuzijue training with pulmonary rehabilitation training on functional recovery after pulmonary nodule resection.Methods:Sixty patients after pulmonary nodule resection were randomly divided into an observation group and a control group, each of 30.Both groups were given pulmonary rehabilitation training, but the observation group also received Liuzijue training for 4 weeks. Before and after the treatment and at follow-up 3 months after the surgery, both groups′ forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were evaluated. Exercise endurance and somatic functioning were quantified using the 6-minute walk test (6MWT) and the short physical performance battery (SPPB), respectively. The 36-item short form survey (SF-36) was administered to assess their life quality.Results:After 4 weeks the pulmonary function index, 6-minute walking distance, SPPB scores and SF-36 scores of both groups were significantly improved. Both groups′ improvements had persisted 2 months later. The observation group′s average FVC and FEV1 values, as well as their average scores on some components of the SF-36 instrument were significantly better than the control group′s averages after 4 weeks. After 3 months their average 6MWT distance and SPPB score was also significantly better.Conclusions:Combining Liuzijue training with pulmonary rehabilitation training can significantly improve the pulmonary function of patients after pulmonary nodule resection. It can further improve their exercise endurance, somatic function and life quality. The combination is worthy of clinical promotion and application.

Objective:To explore the effects of different electrical stimulations on cerebral cortex excitability, upper limb motor function, left-right coordination and counterbalance mechanisms among stroke survivors.Methods:Thirty stroke survivors with hemiplegia were randomly divided into a neuromuscular electrical stimulation (NMES) group and a contralateral control functional electrical stimulation (CCFES) group, each of 15. In addition to conventional rehabilitation treatment, the NMES group was additionally given daily 20-minute NMES to promote elbow extension and wrist extension 5 days a week for 4 weeks, while the CCFES group was given CCFES, instead. Before and after the treatment, the bilateral resting motor thresholds (RMTs), motor evoked potential (MEPs) cortical latency, MEP amplitude and inter-hemisphere asymmetry (IHA) index were measured. The Fugl-Meyer upper extremity assessment (FMA-UE) and the Hong Kong version of the functional test for hemiplegic upper extremities (FTHUE-HK) were employed to evaluate the subjects′ motor functioning. Pearson correlation coefficients relating cortical excitability with upper extremity function were computed.Results:After the treatments, significant improvement was observed in both groups in the latency and amplitude of the RMT and MEP of the affected hemisphere, the IHA value, as well as the FMA-UE and FTHUE-HK scores. The CCFES group then had scores significantly superior to those in the NMES group, on average. The improvements in the FMA-UE and FTHUE-HK scores were significantly positively correlated with the gap in IHA values and the MEP amplitude of the affected hemisphere.Conclusions:Both NMES and CCFES can improve the excitability of the affected motor cortex after a stroke. They help to restore the dynamic balance between the brain hemispheres for better motor functioning of the upper limbs. CCFES has a better therapeutic effect than NMES. The improvement in upper limb motor function is positively correlated with the increase in cortical excitability of the affected hemisphere and the normalization of inter-hemisphere asymmetry.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition and ability in the activities of daily living (ADL) of persons with cerebral small vessel disease.Methods:A total of 71 patients with cognitive impairment due to cerebral small vessel disease were randomly divided into a control group ( n=35) and a treatment group ( n=36). The treatment group was further divided into a group with mild cognitive impairment (a score of 21 to 26 on the mini-mental state exam, n=23) and a moderate cognitive impairment group (scoring 10 to 20, n=13). The treatment groups received 10Hz rTMS, while the control group received sham rTMS. Before and after 90 days of treatment, all were assessed using the mini-mental state examination (MMSE) and the cognitive subscale of the vascular dementia assessment scale (VaDAS-cog). Ability in the activities of daily living was quantified using the Barthel Index (BI). Results:After treatment, significantly increased MMSE and BI scores, but significantly decreased VaDAS-cog scores were observed in both groups. At that point the treatment group showed a significantly higher average post-treatment MMSE score (25.61±2.94) and BI score (80.00±7.85), but a significantly lower average VaDAS-cog score (44.06±3.41) than the control group. The average MMSE scores were not significantly different between the mild and moderate cognitive impairment subgroups. No severe adverse reactions were observed during the rTMS treatment.Conclusions:The 10Hz rTMS can effectively improve the cognition and daily living ability of persons with cerebral small vessel disease.

Objective:To explore the effect of combining ultrasound stimulation with continuous passive movement (CPM) on triceps crus spasms and the motor functioning of children with spastic cerebral palsy.Methods:Sixty children with spastic cerebral palsy were randomly divided into a control group, a CPM group, and a combined treatment group, each of 20. All received routine rehabilitation treatment (including exercise therapy, electrical stimulation and massage), while the CPM and combined groups were additionally provided with CPM and CPM + ultrasound stimulation, respectively. All of the children were treated once a day, 6 times a week, for 4 consecutive weeks. Before and after the treatment, the Tardieu scale (MTS) was used to assess the degree of triceps spasm, and the Berg Balance Scale (BBS), the Gross Motor Function Test (GMFM-88), and 10m walking speed (10MWT) were employed to assess motor function.Results:After the treatment, the average MTS scores, BBS scores and GMFM-88 scale scores in the D and E areas of all 3 groups had improved significantly compared with before the treatment, with those of the observation and CPM groups significantly better than among the control group. With the knee flexed and extended, the Tardiu scale R1, R2 and X values of the combined treatment group were significantly better than those of the CPM group, on average. The combined group′s average BBS score and its average score in the D-zone of the GMFM-88 were also significantly better than the CPM group′s averages.Conclusions:Ultrasound combined with continuous passive movement can effectively relieve triceps spasm in children with cerebral palsy, and improve their static posture control during squatting, sitting and standing.

Objective:To observe any therapeutic effect of kinesio taping the orbicularis oris and cervical swallowing muscle groups on drooling among children with cerebral palsy (CP).Methods:Fifty-two children with CP salivating excessively were divided at random into a control group and an experimental group, each of 26. Both groups received routine oral and facial exercise training and sensory stimulation, but the experimental group was additionally provided with kinesio taping of the orbicularis oris muscle and related neck muscle groups. The taping was applied twice a week for 12 hours each time, continuing for 6 months. Before and after the treatment, both groups′ drooling and language use were evaluated using the teacher drooling grading method (TDS) and a language developmental delay assessment (S-S), respectively. Kendall rank correlation coefficients were computed to compare the treatment efficacy for children with the same TDS grading, cerebral palsy classification, and S-S segmentation.Results:After the treatment the average TDS scores of both groups had decreased significantly. The average TDS score of the experimental group was then significantly lower than that of the control group. The total effectiveness rate for those in the experimental group with TDS grades II or V was significantly higher than those controls with the same TDS grades, the effectiveness rate for those with spastic and mixed type or language function in stage 4-2 and stage 5-2 in the experiment group was also significantly higher than for those of the control group. According to the correlation analysis, the language function of both groups was significantly correlated with the therapeutic effect.Conclusions:Supplementing routine rehabilitation training with kinesio taping of the orbicularis oris muscle and the cervical swallowing muscle group can significantly relieve CP children′s excessive salivation. Their language use is significantly positively correlated with the effectiveness of such combined treatment.

Objective:To assess any effect of combining kinesio taping with Baduanjin in the management of upper cross syndrome (UCS).Methods:Thirty-nine college students with UCS were randomly divided into a kinesio taping group ( n=14), a Baduanjin group ( n=12) and a combined treatment group ( n=13). The kinesio taping and Baduanjin groups received taping and underwent Baduanjin training, respectively, while the combined treatment group received both interventions for 6 weeks. Before, as well as 3 and 6 weeks after the intervention, all were evaluated using a visual analogue scale (VAS), a neck disability index (NDI), and for forward head extension (FHA), round shoulder angle (FSA) and vital capacity (VC). Results:A significant decrease in the average VAS ratings and NDI scores, and better average FHA and FSA was observed in both groups after the experiment. There was also a significant increase in VC. At 6 weeks, all of the indicators were significantly better than three weeks earlier. The kinesio taping and Baduanjin groups showed significantly smaller average improvements than the combined group.Conclusions:Kinesio taping combined with Baduanjin can effectively alleviate pain associated with UCS, relieve cervical dysfunction, correct abnormal posture and increase lung capacity. Its efficacy is superior to that achieved through single interventions.

Objective:To investigate the distribution of pathogens and the risk of urinary tract infection for hospitalized spinal cord injury (SCI) patients.Methods:A total of 152 hospitalized SCI patients with a urinary tract infection were randomly divided into a complicated infection group (77 cases) and an uncomplicated infection group (75 cases) according to the diagnostic criteria for urinary tract infection. Univariate analysis quantified any correlation of urinary tract infection with gender, age, etiology, course of disease, injury level, injury degree, indwelling catheter use, diabetes history, hypoproteinemia, pressure ulcers, bladder compliance, maximum bladder manometric volume, maximum detrusor pressure during urine storage and detrusor overactivity during urine storage. Multivariate logistic regressions were evaluated to determine the independent risk factors.Results:A total of 124 pathogens were found in the subjects′ urine cultures. They included 83 gram-negative (G-) bacteria (66.94%), 31 gram-positive (G+ ) bacteria (25.00%), 9 fungi (7.26%) and 1 mycoplasm. The most common G- pathogen was Escherichia coli (42, 50.60%) with Enterococcus faecium (6, 19.35%) the most common G+. Overall, the five most common pathogens were Escherichia coli (42 strains, 33.87%), Klebsiella pneumoniae (10 strains, 8.06%), Proteus mirabilis (8 strains, 6.45%), Acinetobacter baumannii (7 strains, 5.65%), and Enterococcus faecium (6 strains, 4.84%). The univariate analysis showed that the etiology, injury level, injury degree, an indwelling catheter, pressure ulcers, maximum cystometric capacity, maximum detrusor pressure and detrusor overactivity in the storage phase were predictors of infection. The multivariate logistic regression analysis revealed that complete injury, an indwelling catheter, and increased maximum detrusor pressure in the storage phase were the independent risk factors.Conclusions:Escherichia coli is the most common pathogen causing urinary tract infection among SCI patients undergoing rehabilitation during hospitalization. Complete injury, an indwelling catheter, and increased maximum detrusor pressure in storage phase may be independent risk factors for urinary tract infection among such patients.

Objective:To observe the effectiveness of using cases in seminars to teach neuroelectrophysiology in rehabilitation medicine.Methods:Sixty participants in the " Hubei Province Rehabilitation Shortage Talent Training Program" were divided into an experimental group ( n=30) and a control group ( n=30). During a ninety-minute " Neuroelectrophysiological Technology" training course, the experimental group was taught in a seminar using the case study method (SCL training) while the control group was taught using traditional lecture-based learning (LBL). All then took a theory test and a case analysis test and completed a survey of teaching satisfaction. Results:The average score of the SCL group on the theory and case analysis tests were significantly higher than those of the LBL group. The teaching satisfaction survey showed that the SCL group exhibited greater interest and motivation, better communication, teamwork and clinical thinking. They were generally more satisfied with their teaching method compared to the LBL group.Conclusions:The SCL method can effectively improve the learning and satisfaction of neuroelectrophysiology students. It helps to mobilize learning enthusiasm, cultivate clinical thinking ability, and deepen the memory of knowledge points. It is an effective method in teaching rehabilitation medicine.