1.Animal models of acquired heterotopic ossification: a systematic review
Tongxin CAI ; Mincong LEI ; Yijun ZHOU ; Dianhuai MENG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(4):429-438
Objective To systematically summarize the animal models of acquired heterotopic ossification (AHO), and provide reliable modeling methods for the study of disease prevention and treatment programs.Methods Literatures about the animal models of AHO were researched from PubMed, Web of Science, CNKI and Wanfang Database till November, 2021. The important contents of the literatures were extracted, and the animal models of various types of AHO were evaluated and analyzed by literature induction.Results A total of 20 literatures related to animal experiments were included, which could be divided into two types: post-traumatic and neurogenic heterotopic ossification animal models, which were used to simulate the occurrence and development of AHO. Currently, seven different animal models were commonly used to study post-traumatic heterotopic ossification, such as muscle injury, achilles tenotomy, muscle injury combined with joint immobilization, hip injury, heterotopic implantation, blast injury and burn. The studies of neurogenic heterotopic ossification animal models mainly included spinal cord injury and traumatic brain injury. At present, the methods of achilles tenotomy and osteogenic factor implantation were commonly used in the laboratory, and with the advantages of reliability, feasibility and high success rate; however, they could not accurately explain the pathogenesis of heterotopic ossification under complicated clinical conditions. Therefore, the improvement of modeling methods based on explosion injury, burn, nerve injury and other conditions became the basis for clinical research of molecular biological mechanism, prevention and treatment of heterotopic ossification.Conclusion Current modeling methods have their own advantages and disadvantages, but none of them can completely replicate all the characteristics of human heterotopic ossification. Therefore, there is no unified standard in the selection of animal model in clinic. According to different etiology of the disease, the selection of appropriate animal models is crucial to study effective intervention for different types of AHO in the early stage.
2.Gaze stabilization exercises can improve balance after a stroke
Ruoxin ZHAO ; Jun LU ; Xinrong LIU ; Yu WANG ; Yue XIAO ; Dianhuai MENG ; Guangxu XU
Chinese Journal of Physical Medicine and Rehabilitation 2022;44(8):690-694
Objective:To observe the effect of gaze stabilization exercises on the balance of stroke patients.Methods:Forty stroke patients were randomly divided into an experimental group ( n=20) and a control group ( n=20). Both groups were given conventional rehabilitation therapy, while the experimental group was additionally provided with gaze stabilization exercises, once a day, five days a week, for a total of four weeks. Each session lasted 30 minutes. Before and after the four weeks, both groups were evaluated in terms of their envelope ellipse area and the plantar pressure distribution on the affected side in static standing and using the anterior-posterior center of pressure displacement velocity (AP-COPV). They were also assessed using the Berg Balance Scale (BBS), the timed up-and-go test (TUGT), and the Activities-specific Balance Confidence Scale (ABC). Results:After the gaze stabilization exercises, the average envelope ellipse area, the plantar pressure distribution of the affected side with the eyes open and closed, AP-COPV, BBS score, TUGT time and ABC score of the experimental group were significantly superior to the control group′s averages and to the results four weeks previously.Conclusions:Gaze stabilization exercises can improve balance, weight shifting and one-leg standing after a stroke. That should enhance balance confidence and reduce the risk of falling.
3.Advance in chin-down maneuver in aspiration for dysphagic patients (review)
Jinjin CHEN ; Rufeina AERKEN ; Silin WU ; Dianhuai MENG ; Yuntao ZHOU
Chinese Journal of Rehabilitation Theory and Practice 2022;28(7):816-821
ObjectiveTo identify the appropriate definition, scope of application, the mechanism and the efficacy of the chin-down maneuver in aspiration reduction or prevention. MethodsLiteratures about chin-down published before July, 2021 were reviewed. ResultsA total of 13 articles were included. Chin-down refered to the action of bending the neck and leaning the chin as far as possible toward the chest. Chin-down maneuver could change the position and pressure of the pharyngeal structure to guide the food safely into the esophagus, to prevent or reduce aspiration. Chin-down maneuver was effctive on dysphagia caused by insufficient laryngeal elevation, delayed pharyngeal reflex, epiglottal defect, lychee cartilage defect, and glottis closure defect. However, this action worked in patients with premature overflow of food clumps, weak pharyngeal contraction muscle strength, and poor oral preservation. ConclusionChin-down maneuver is beneficial to aspiration dysphagia after dysphagia.
4.High frequency transcranial magnetic stimulation combined with mirror therapy improves upper limb motor function post-stroke
Jian YANG ; Dianhuai MENG ; Zhongyang SHAO ; Qing CHENG ; Mengting WANG ; Zhifei YIN
Chinese Journal of Physical Medicine and Rehabilitation 2018;40(2):91-95
Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with the mirror therapy (MT) on the recovery of upper limb function recovery 3 to 6 months after a stroke.Methods Forty-five male patients were randomly assigned to an MT (A) group,an rTMS+MT (B) group or an MT +rTMS group (C),each of 15.All received conventional medical treatment and stroke rehabilitation.In addition,group A received 60 min of MT daily,5 days a week for 4 weeks.Group B received 10 min of rTMS over the M1 area of the affected hemisphere followed by 50 min of MT treatment,and group C received 50 min of MT treatment followed by 10 min of rTMS.rTMS was delivered at a frequency of 10 Hz and an intensity of 90% resting motor threshold.The latency of motor evoked potential (MEP) for the affected abductor pollicis brevis muscle and its central motor conduction time (CMCT) were observed before and after the treatment.The upper extremity portion of the Fugl-Meyer assessment (FMA) was performed along with a functional test for the hemiplegic upper extremity (FTHUE).The motricity index (MI) was also quantified.Results Average MEP latency and CMCT had decreased significantly in all three groups after the treatments.The average MEP latency of group B was significantly shorter than that of group A,and CMCT was also significantly shorter than for groups A and C.Moreover,after the intervention,all of the groups had significantly improved their average FMA,MI and FTHUE scores,with the average FMA score of group B significantly better than those of groups A and C.The average FTHUE score of group B was also significantly better than that of group A.Conclusions MT either alone or in combination with rTMS can improve cerebral motor cortex excitability and motor recovery after a stroke.Ten minute rTMS sessions followed by 50 min of MT have the best effect.
5.The influence of constrained arms swing on temporal and spatial gait parameters in healthy young adults
Yi JIN ; Wentong ZHANG ; Dianhuai MENG
Chinese Journal of Rehabilitation Medicine 2017;32(11):1227-1230
Objective:To explore the influence of constrained arms swing on temporal and spatial gait parameters in healthy young adults.Method:Thirty-six healthy young persons (18 male,18 female;age:22.72±3.54 years;height:167.35±9.15 cm;weight:63.62±16.29 kg) were recruited for this study.All subjects received gait analysis by the Gait Watch analyses system.All subjects walked combined with 10 walking conditions (the arms swinging naturally,the arms constrained in front of the abdomen,the arms constrained in back of the abdomen,the left arm constrained in body side,the left arm constrained in front of the abdomen,the left arm constrained in back of the abdomen,the right arm constrained in body side,the right arm constrained in front of the abdomen and the right arm constrained in back of the abdomen).Walking conditions were randomly set during the experiment.The differences of the temporal and spatial gait parameters were analyzed and compared.Result:There was not significant difference of the temporal and spatial gait parameters (gait cycle,stride frequency,stride length,step velocity,step length,left step,right step,double support phase) between arm constrained and the arms swinging naturally.The left support phase and left swing phase showed significantly difference with the left arm constrained in body side,the left arm constrained in front of the abdomen and the left arm constrained in back of the abdomen compared with arms swinging naturally.The right support phase and right swing phase showed significantly difference with the left arm constrained in back of the abdomen,the right arm constrained in body side,the right arm constrained in front of the abdomen and the right arm constrained in back of the abdomen compared with arms swinging naturally.Conclusion:The left support phase was shorten and left swing phase was prolonged with the left arm constrained,while the right support phase was prolonged and right swing phase was shorten with the right arm constrained.
6.The effects of stance width on static standing balance
Chinese Journal of Physical Medicine and Rehabilitation 2017;39(6):418-421
Objective To explore the effect of stance width on balance in static standing.Methods Thirty healthy young subjects were evaluated using the PRO-KIN balance training apparatus.They stood with their eyes open and closed in three stances:feet together,feet 50 cm apart,and feet a comfortable distance apart (measured as 18.63±3.67 cm between the heels and 29.60±4.93 cm between the toes).The excursions of the center of pressure (COP),the standard deviation of their longitudinal sway (SDLS),the standard deviation of their horizontal sway (SDHS),the mean longitudinal and horizontal sway velocities (MVLS and MVHS),sway length (SL) and sway area (SA) were recorded.Results With the eyes either open or closed,significant differences in all of the COP data were observed when standing in the different stances.The average SDHS,MVHS,SL and SA were all significantly better when standing comfortably than when standing with the feet 50cm apart whether the eyes were open or closed.Conclusion There is a proper distance between the feet where healthy youngsters best maintain static standing balance.
7.The timed up and go test and maximum walking speed test for evaluating the walking ability of stroke patients
Wentong ZHANG ; Dianhuai MENG ; Guangxu XU ; Lin LI ; Jianan LI
Chinese Journal of Physical Medicine and Rehabilitation 2016;38(4):246-249
Objective To explore the effectiveness of the timed up and go test (TUGT) and the maximum walking speed test (MWST) in evaluating stroke patients' motor function.Methods Twenty-two stroke patients were assessed using the TUGT and MWST,and the temporal-spatial parameters of their gait were also assessed.The correlations among the TUGT times,walking speed and the gait parameters were quantified using Pearson correlation coefficients.Results The TUGT time was (18.57±7.41) s,significantly correlated with step length and velocity (P<0.05).Walking speed showed a significant positive correlation with step length,velocity and step length (P< 0.05).The TUGT times were negatively correlated with walking speed (r=-0.712,P=0.000).Conclusion The MWST and TUGT both can assess stroke patients' motor function effectively.
8.Effects of ICB orthopedic sole on balance and walking function in stroke survivors with hemiplegia
Zhaohua GU ; Sheng WANG ; Dianhuai MENG ; Chen GONG ; Xiang WANG ; Yu LUO ; Tong WANG
Chinese Journal of Physical Medicine and Rehabilitation 2015;37(8):597-599
Objective To observe the effects of ICB orthopedic sole combined with rehabilitation training on balance and walking function in stroke survivors.Methods Thirty hemiplegic stroke patients were recruited and divided into a study group (n =15) and a control group (n =15) by using a random number table.Both groups took exercises based on the principles of a motor relearning program and conducted core stability control training,and the study group additionally undertook hemiplegic lower extremity weight-bearing exercises and walking with ICB orthopedic sole used in daily living.The program was administered 20 min twice per day for 4 weeks.All patients were evaluated with Rest Calcaneus Standing Position (RCSP),Malleolar Position (MP),Forefoot Position (FP),Berg Balance Scale (BBS),l0 m Maximum Walking Speed (MWS) and walking section of Motor Assessment Scale (MAS)before and after the program.Results After 4 weeks of intervention,all the measurements except the FP in both groups improved significantly,and significant differences were observed between the two groups.After 4 weeks of training,the average RCSP (1.78 ± 0.32) ° and MP (13.33 ± 2.51)° were improved significantly compared to those of the control group [(2.58 ± 0.59) ° and (12.45 ± 3.31) °,respectively].Moreover,the average BBS,MAS and MWS improved significantly compared to the control group.Conclusions ICB orthopedic sole combined with rehabilitation training can improve the weight-bearing,balance and ambulation abilities of stroke survivors.
9.The effectiveness of low-frequency transcranial magnetic stimulation for restoring upper limb function after cerebral infarction
Zhifei YIN ; Ying SHEN ; Dianhuai MENG ; Hong HOU ; Wenjun DAI ; Jianan LI
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(8):596-601
Objective To compare the effects of repetitive transcranial magnetic stimulation (rTMS) at various low frequencies on upper limb function after cerebral infarction.Methods Fifty patients were randomly assigned to a control group (10 cases),a sham rTMS group (10 cases) or an rTMS group which had three sub-groups treated at 0.25 Hz,0.5 Hz and 0.75 Hz with 10 cases in each.All of the patients were treated with conventional medical treatment and rehabilitation training.The sham and true rTMS groups received rTMS applied over the M1 area of the unaffected hemisphere,5 days per week for 4 weeks.Motor evoked potential (MEP) cortical latency,and central motor conduction time (CMCT) were measured and the Fugl-Meyer assessment (FMA),motricity index (MI) and a Hong Kong functional test for the hemiplegic upper extremity (FTHUE-HK) were evaluated beforehand and at Post 1 after 2 weeks of treatment and Post 2 after 4 weeks of treatment.Results The average CMCT and FMA scores of the control and sham rTMS groups both had improved significantly at Post 2.There was no significant difference in any of the indices between those 2 groups at any time point.At Post 1,the average MEP cortical latencies of the 0.25 Hz and 0.5 Hz subgroups had improved to be significantly better than those of the control and sham rTMS groups.The average CMCTs of the 0.25 Hz and 0.5 Hz rTMS subgroups were significantly shorter after treatment,and significantly better than those of the control and sham rTMS groups.At Post 2,the average MEP cortical latency of all groups except the control group showed significant improvement compared with pre-treatment.The 2 indices of the 0.25 Hz and 0.5 Hz subgroups were again significantly shorter than those of the control and sham rTMS groups,and the average CMCTs were significantly better than that of 0.75 Hz subgroup.At Post 1 the average FMA and MI scores of the rTMS subgroups had all improved significantly.In the 0.25 Hz and 0.5 Hz subgroups the average MI scores were significantly higher than those of the control and sham rTMS groups.The FTHUE-HK scores of those 2 subgroups had also improved significantly.At Post 2,the average FMA and MI scores of all groups and the FTHUE-HK scores of rTMS group had improved significantly.In the 0.25 Hz and 0.5 Hz subgroups,all of the indices were significantly better than in the control and sham rTMS groups.The average FTHUE-HK score of the 0.25 Hz subgroup was significantly superior to that of the 0.75 Hz subgroup.In the 0.75 Hz subgroup the average MI score was significantly higher than in the control and sham rTMS groups.Conclusions rTMS at either 0.25 Hz or 0.5 Hz applied to the unaffected hemisphere provides effective treatment for enhancing the excitability of the motor cortex and the motor function of a paretic upper limb after stroke.Compared with others,the total number of stimulus pulse in 0.25 Hz subgroup was the least,and priority consideration should be given to the frequency of 0.25 Hz when using rTMS in clinical treatment of cerebral infarction.
10.The reliability and validity of the sacral marker method when evaluating the balance of stroke patients using three dimensional motion analysis
Sheng WANG ; Xiaojun ZHU ; Yi ZHU ; Dianhuai MENG ; Tong WANG
Chinese Journal of Physical Medicine and Rehabilitation 2013;(4):273-277
Objective To study the reliability and validity of using sacral markers in evaluating the balance function in standing and walking of stroke patients with hemiplegia.Methods Twenty-one hemiplegic stroke patients were recruited and their baseline mean sway amplitude (MSA) and mean sway velocity (MSV) were measured using sacral markers and center of gravity analysis assuming a segmented body,thegold standard for such analysis.The data were analyzed using Bland-Altman plots to obtain the 95% limits of agreement (LOA).Results ①Test-retest reliability:The 95% LOA of the MSA in standing was (-4.42,5.14) on the X axis,(-6.04,4.52)on the Y axis,and (-1.75,1.31) on the Z axis.The MSV in standing was (-0.08,0.09) on the X axis,(-0.10,0.08) on the Y axis and (-0.03,0.02) on the Z axis.The 95% LOA of the MSA in walking was (-185.74,105.53) on the X axis,(-22.57,2.76) on the Y axis and (4.43,2.76) on the Z axis.The MSV in walking was (-3.10,1.76) on the X axis,(-0.38,0.54) on the Y axis and (-0.07,0.02) on the Z axis.②Validity:The 95% LOA of the MSA in standing was (-3.62,2.55) on the X axis,(-3.95,3.94) on the Y axis and (-7.35,19.43) on the Z axis.For the MSV in standing it was (-0.06,0.04) on the X axis,(-0.07,0.07) on the Y axis and (-0.12,0.32) on the Z axis.The 95% LOA of the MSA in walking was (-4.40,4.74) on the X axis,(-17.35,4.14) on the Y axis and (-17.35,4.14) on theZ axis.For the MSV in walking itwas (-0.07,0.08) on the X axis,(-0.29,0.07) on the Y axis and (-0.12,0.18) on the Z axis.The 95% LOAs of the variables representing their reliability and validity are small enough to be acceptable in clinical application.Conclusions The sacral marker method can be used in assessing the balance of stroke patients.

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