1.Enlightenment of Taiwan occupational therapy postgraduate education on higher education in mainland China
Rongrong JIANG ; Yan CHEN ; Maohua FAN ; Lijuan LUO ; Cuihuan PAN
Chinese Journal of Medical Education Research 2020;19(3):263-267
Occupational therapy, as one of the important subdisciplines of rehabilitation therapy, takes occupational activities as the medium or purpose of treatment and life participation as the goal of treatment to meet the growing demand for rehabilitation. According to the Minimum Standards for the Education of Occupational Therapists developed by the World Federation of Occupational Therapists, many countries and regions have formulated educational standards that meet their own national or regional characteristics. Comparatively, the number of occupational therapists is seriously insufficient, the talents cultivation is relatively lagging behind, and the education level is uneven in mainland China; while in Hongkong and Taiwan, occupational therapy has an independent education system and a relatively mature talent training model. This study summarized the practical experience and reviewed the relevant literature. Based on the summary and review, we made a comparative analysis of postgraduate education in mainland China and Taiwan from the aspects of educational system and accreditation, enrollment objects, curriculum setting and teaching methods, which would provide a reference for the improvement of occupational therapy personnel training system in mainland China.
2.A comparison of curriculum design for undergraduate education of rehabilitation therapy in mainland China and Taiwan area
Yuanwen LIU ; Cuihuan PAN ; Rui YU ; Ping MIAO ; Nan HU ; Maohua FAN ; Zhen FU ; Changlin XIAO
Chinese Journal of Medical Education Research 2018;17(3):310-315
Undergraduate education started late in rehabilitation medicine in mainland China.At present,there are some shortcomings in current undergraduate education for rehabilitation medicine in mainland China,mainly due to the shortage of teachers,the poor pertinence of professional subjects,the broad and superficial knowledge,and the lack of close connection with the necessary professional knowledge of rehabilitation technologies.The Department of Rehabilitation in Taiwan starts its undergraduate education earlier.The curriculum has been sub-professionally oriented.Its subjects are highly targeted and detailed in content.At the same time,it emphasizes forward-looking education such as "statistics".In view of this,the mainland colleges and universities should standardize the undergraduate education of rehabilitation therapies,strengthen the training of professional teachers,pay attention to the cross-mutualism of theory and practice in the teaching plan,enrich the number of professional courses,the appropriate introduction of teaching methods of scientific research,standardize the teaching management system.
3.A robot exoskeleton can improve hand function early after stroke
Changlin XIAO ; Cuihuan PAN ; Yan CHEN ; Zhengmao YE ; Liting FANG ; Lijuan LUO ; Yanjuan GENG ; Yongsheng LUO
Chinese Journal of Physical Medicine and Rehabilitation 2018;40(2):100-105
Objective To explore the effectiveness of a myoelectricity-driven hand robot on the recovery of hand motor function early after a stroke.Methods Thirty stroke survivors were randomly assigned to either a control group (n=15) or an experimental group (n =15).Both groups received routine rehabilitation exercises,while the experimental group additionally received hand training using a robotic hand exoskeleton.Before and after 4 weeks of treatment,the motor function of the wrist and fingers in both groups were measured using the Fugl-Meyer assessment.Spasticity in the index,middle,ring and little fingers was quantified using the modified Ashworth scale.The muscle force of the fourth finger,thumb and all of the fingers during maximum voluntary extension and flexion were recorded using the robot's surface electromyography system.Results Significant increases in the average Fugl-Meyer scores in both groups were observed after 4 weeks of treatment,but the experimental group's average score was by then significantly higher than that of the control group.The experimental group's average Ashworth score and the average sEMG amplitudes were also significantly better than those of the control group.Conclusion Supplementing routine rehabilitation exercises with a hand robot can improve hand motor function and muscle force significantly,as well as relieving hand spasticity early after a stroke.
4.Effects of high frequency repetitive transcranial magnetic stimulation on executive function in patients after stroke
Yuanwen LIU ; Jie FANG ; Rongrong JIANG ; Nan HU ; Cuihuan PAN ; Zhengmao YE ; Lijuan LUO
Chinese Journal of Neurology 2017;50(10):745-750
Objective To observe the effect of high frequency repetitive transcranial magnetic stimulation ( rTMS) on executive function in patients after stroke .Methods Thirty-six stroke patients with executive dysfunction in the Second Affiliated Hospital of Guangzhou Medical University from March 2016 to April 2017 were randomly divided into experimental group ( n=18 ) and control group ( n=18 ) .The experimental group received 10 Hz rTMS of the left dorsolateral prefrontal cortex ( DLPFC ) and cognitive functional training , while the control group received sham rTMS and cognitive functional training , for four weeks.Mini-Mental State Examination(MMSE), Wisconsin Card Classification Test(WCST), Digit Symbol Test( DST) and Digital Span ( DS) were used for cognitive assessment at baseline and therapy completed . Results After a four weeks therapy , the total number of responses showed no significant difference in WCST between two groups.But the control group after treatment showed that MMSE score (17.44 ±4.73) and DST score (4.50 (2.75, 8.25)) were improved compared with that before treatment (MMSE score 15.28 ±4.61, t=-8.371, P=0.000;DST score 4.00 (2.75, 7.25), Z=-2.122, P=0.049), and the DS score and the numbers of correction , classification and continuous errors of WCST showed no significant difference compared with that before treatment .The experimental group after treatment showed that MMSE score (20.67 ±4.59), DST score (7.50(4.75, 12.50)), DS score (recite in order 7.00 (7.00, 8.00), recite in reverse order 3.00 (2.00, 4.00)), the numbers of correction of WCST (24.61 ± 8.30), the numbers of continuous errors (12.17 ±5.08), the numbers of classification (2.00 (2.00, 3.00) were improved compared with that before treatment ( MMSE score 15.50 ±5.24, t=-21.013, P=0.000;DST score 3.00(1.00, 7.00), Z=-3.757, P=0.000; DS score recited in order 6.00(5.00, 6.00), Z=-3.703, P=0.000;DS score recited in reverse order 2.00(1.00, 3.00), Z=-3.494, P=0.000;The numbers of correction of WCST (16.50 ±9.34), t=-6.544, P=0.000); The numbers of continuous errors (18.06 ±5.63, t=9.744, P=0.000); The numbers of classification (1.00 (1.00, 2.00), Z=-3.900, P=0.000 ).And the curative effect was better than that of control group . Conclusion High frequency rTMS combined with cognitive function training can improve the executive dysfunction of stroke patients , and the improvement is better than cognitive functional training alone .
5.Native Hakka speakers' identification of Cantonese tones: A comparative analysis
Hanxiong GAO ; Yan CHEN ; Cuihuan PAN ; Nan HU ; Xuan WANG ; Yongmei ZENG
Chinese Journal of Physical Medicine and Rehabilitation 2017;39(11):851-855
Objective To investigate the features of native Hakka speakers' ability to identify Cantonese tones.Methods Twenty native Cantonese speakers and 12 native Hakka speakers were given the Hongkong Cantonese tone identification test.Results Neither group was troubled by similar vowel and consonant sounds.The Cantonese group could identify all tones well except distinguishing tones 5 and 2 (89%) and tones 4 and 6 (89%).The Hakkas had the most difficulty distinguishing tones 3 and 6 (70.0%),but significant differences were observed between the two groups in the identification of tones 2 and 5 and 2 and 4.Conclusion A native Hakka speaker's ability to identify Cantonese tones may be closely related to the tone's pitch,tonal patterns as well as the Hakka tone system.
6.Effect of Virtual Reality Robotic Hand on Hand Motor Function and Activities of Daily Living of Patients after Stroke
Yuanwen LIU ; Cuihuan PAN ; Zhengmao YE ; Nan HU ; Lijuan LUO ; Yan CHEN
Chinese Journal of Rehabilitation Theory and Practice 2017;23(1):19-22
Objective To observe the effect of virtual reality robotic hand on hand motor function and activities of daily living of pa-tients after stroke. Methods From June, 2015 to June, 2016, 32 patients with hand motor dysfunction were assigned into experimental group (n=16) and control group (n=16). The experimental group received training with virtual reality robotic hand and hand based rehabilitation, while the control group received hand based rehabilitation only, for four weeks. They were evaluated with Fugl-Meyer Assessment (FMA) of fingers and wrists and modified Barthel index (MBI) before and after treatment. Results The total score and the scores of items of FMA and MBI improved after treatment in the experimental group (Z>3.45 or t>3.45, P<0.01). The total score and the scores of the finger, wrist of FMA, and the scores of the eating, dressing and grooming of MBI improved in the control group (Z>2.07 or t>4.18, P<0.05). The total scores and scores of the items of FMA and MBI improved more in the experimental group than in the control group (Z>2.14 or t>3.20, P<0.05). Conclusion Virtual reality robotic hand training can promote the recovery of hand function and activities of daily living in patients af-ter stroke.
7.Effects of Robot-assisted Task-oriented Training on Hand Function after Stroke
Zhen FU ; Rongrong JIANG ; Cuihuan PAN ; Yan CHEN ; Zhengmao YE ; Nan HU ; Lijuan LUO ; Changlin XIAO ; Yuanwen LIU
Chinese Journal of Rehabilitation Theory and Practice 2017;23(3):338-344
Objective To study the effects of the rehabilitation robot-assisted task-oriented training on the hand function in patients after stroke. Methods From June, 2015 to September, 2016, 35 inpatients suffering from stroke were randomly allocated to control group (n=17) and trial group (n=18). Based on the routine rehabilitation, the trial group accepted robot-assisted task-oriented training, while the control group accepted therapist-assisted task-oriented training, for two weeks. They were measured the active range of motion (AROM) of fingers, assessed with fingers motor of Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) invovled with hands before and after train-ing. Results The inpatients dropped three in the control group, two in the trial group. AROM of extension and flexion of all the fingers, the AROM of extension and total of three fingers of thumb, index and middle, and the total AROM of each finger improved in the trial group af-ter training (t>2.937, P<0.05), while the AROM of extension and flexion of all the fingers, AROM of extension, flexion and total of the fin-gers of thumb, index and middle, total AROM of the fingers of thumb, index and little improved in the control group after training (t>2.528, P<0.05);the AROM of extension and total of the fingers of thumb, index and middle, and the total AROM of fingers of thumb and index im-proved more in the trial group than in the control group (t>2.535, P<0.05). The scores of mass flexion, mass extension, opposition, cylinder grip, spherical grip and total score of FMA improved in the trial group after training (Z>2.000, P<0.05), while the scores of mass extension, opposition and the total score of FMA improved in the control group after training (Z>2.000, P<0.05). There was no significant difference between the two groups on the items and total scores after training (P>0.05). The scores of feeding, dressing, toilet transfers, bathing, groom-ing of MBI and the total score of them improved in the trial group after training (Z>2.041, P<0.05), while the total score of MBI improved in the control group after training (Z=-2.527, P<0.05). There was no significant difference between the two groups in the items and total scores after training (P>0.05). Conclusion The rehabilitation robot-assisted task-oriented training can improve AROM of hemiplegic fingers and grip function.
8.Advance in Repetitive Transcranial Magnetic Stimulation for Post-stroke Executive Impairment (review)
Yuanwen LIU ; Cuihuan PAN ; Nan HU ; Yan CHEN ; Jie FANG
Chinese Journal of Rehabilitation Theory and Practice 2016;22(10):1132-1136
Executive impairment is one of the common sequelae of stroke, which seriously affects the quality of life of patients. Repeti-tive transcranial magnetic stimulation (rTMS), as a new type of electrophysiological technique, has been used in the clinical treatment of Post-Stroke Executive Impairment (PSEI). This paper summarized the survey of PSEI, the basic principle and mechanism of rTMS, clinical application of rTMS for PSEI and its safety. Clinical studies showed that high frequency stimulation, low frequency stimulation, and combi-nation with other therapeutic methods were effective in PSEI. However, there was no unified theory about the mechanism and the best treat-ment plan of rTMS for PSEI.
9.Effect of Resistance Breathing Training on Breast Cancer Related Lymphedema
Jiulong SU ; Cuihuan PAN ; Tengfei CAO ; Ping LIAO
Chinese Journal of Rehabilitation Theory and Practice 2016;22(11):1318-1321
Objective To observe the effect of resistance breathing training on breast cancer related lymphedema. Methods Sixty breast cancer patients with lymphedema after operation from October, 2013 to April, 2015 were randomly divided into control group (n=30) and experiment group (n=30). The control group received routine rehabilitation and manual lymphatic drainage, while the experiment group received resistance breathing training in addition, for four weeks. Their flow of lymph was measured with emission computer tomography (ECT), and their upper arm circumferences were measured, their upper limb volumes were measured with water displacement before and after treatment. Results The flow of lymph increased in both groups after treatment (t>3.446, P<0.05), while the difference of bilateral upper arm circumferences (t>2.143, P<0.05) and upper limb volumes (t>1.562, P<0.05) reduced, and all the indices improved more in the experiment group than in the control group (t>1.982, P<0.05). Conclusion Resistance breathing training may increase the back flow of lymph, to relieve the lymphedema of injured extremity.
10.Influence of NGF-PEG-PLGA-NPs on neuronal differentiation of neural stem cells and PI3K/Akt signaling pathway
Yan CHEN ; Guoqing BAO ; Feifei LIU ; Jundu ZHANG ; Cuihuan PAN ; Dahong LONG
Chinese Journal of Tissue Engineering Research 2015;(28):4576-4581
BACKGROUND:Our previous studies confirmed that NGF-PEG-PLGA-NPs has good sustained release effect and biological activity in vitro, and can induce the differentiation of PC12 cel s into neuron-like cel s.
OBJECTIVE:To investigate the feasibility of neuronal differentiation of neural stem cel s from septal area of fetal brain induced by NGF-PEG-PLGA-NPs and its influence on PI3K/Akt signaling pathway.
METHODS:According to optimization prescription, NGF-PEG-PLGA-NPs were prepared by multiple emulsion solvent diffusion method. Neural stem cel s were induced to neuronal differentiation in six groups, including control group, NGF group, NGF-PEG-PLGA-NPs group, LY294002 group, LY294002+NGF group and LY294002+NGF-PEG-PLGA-NPs group. Neurons were identified by immunofluorescence, while phosphorylation levels of Akt in PI3K/Akt signaling pathway were detected by western blotting.
RESULTS AND CONCLUSION:The proportions ofβ-Tubulin III-positive neurons in control group, NGF group, NGF-PEG-PLGA-NPs group, LY294002 group, LY294002+NGF group and LY294002+NGF-PEG-PLGA-NPs group were (22.80±2.58)%, (35.80±3.98)%, (35.40±5.77)%, (26.60±3.87)%, (21.20±2.59)%and (25.80±7.22)%, respectively. There were no statistical differences in neuronal differentiation between NGF group and NGF-PEG-PLGA-NPs group (P>0.05), but the ratios of neural differentiation in the two groups were both higher than that in the other four groups (P<0.05). Western blotting results revealed that there were no statistical differences in Akt phosphorylation levels between NGF group and NGF-PEG-PLGA-NPs group (P>0.05), but the phosphorylation levels of Akt were both higher than other four groups (P<0.05). There were also no significant differences between LY294002+NGF and LY294002+NGF-PEG-PLGA-NPs groups and control group (P>0.05), but the phosphorylation levels of Akt were higher than LY294002 group (P<0.05). Results suggest that NGF-PEG-PLGA-NPs promoted neural differentiation of neural stem cel s. The role might be related to increasing phosphorylation levels of Akt in PI3K/Akt signaling pathway.

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