Modified constraint-induced movement therapy is an effective treatment for neurological and motor impairments in patients with stroke by increasing the use of their affected limb and limiting the contralateral limb.Ho...Modified constraint-induced movement therapy is an effective treatment for neurological and motor impairments in patients with stroke by increasing the use of their affected limb and limiting the contralateral limb.However,the molecular mechanism underlying its efficacy remains unclear.In this study,a middle cerebral artery occlusion(MCAO)rat model was produced by the suture method.Rats received modified constraint-induced movement therapy 1 hour a day for 14 consecutive days,starting from the 7^th day after middle cerebral artery occlusion.Day 1 of treatment lasted for 10 minutes at 2r/min,day 2 for 20 minutes at 2 r/min,and from day 3 onward for 20 minutes at 4 r/min.CatWalk gait analysis,adhesive removal test,and Y-maze test were used to investigate motor function,sensory function as well as cognitive function in rodent animals from the 1st day before MCAO to the 21^st day after MCAO.On the 21^st day after MCAO,the neurotransmitter receptor-related genes from both contralateral and ipsilateral hippocampi were tested by micro-array and then verified by western blot assay.The glutamate related receptor was shown by transmission electron microscopy and the glutamate content was determined by high-performance liquid chromatography.The results of behavior tests showed that modified constraint-induced movement therapy promoted motor and sensory functional recovery in the middle cerebral artery-occluded rats,but had no effect on cognitive function.The modified constraint-induced movement therapy upregulated the expression of glutamate ionotropic receptor AMPA type subunit 3(Gria3)in the hippocampus and downregulated the expression of the beta3-adrenergic receptor gene Adrb3 and arginine vasopressin receptor 1 A,Avprla in the middle cerebral artery-occluded rats.In the ipsilateral hippocampus,only Adra2 a was downregulated,and there was no significant change in Gria3.Transmission electron microscopy revealed a denser distribution the more distribution of postsynaptic glutamate receptor 2/3,which is an a-amino-3-hydrox展开更多
目的系统评价强制性运动疗法联合其他康复技术对脑卒中患者运动能力及日常生活活动能力的干预效果。方法计算机检索Web of Science、PubMed等8个数据库,检索有关(改良)强制性运动疗法(CIMT)干预脑卒中患者的临床随机对照试验。由2名研...目的系统评价强制性运动疗法联合其他康复技术对脑卒中患者运动能力及日常生活活动能力的干预效果。方法计算机检索Web of Science、PubMed等8个数据库,检索有关(改良)强制性运动疗法(CIMT)干预脑卒中患者的临床随机对照试验。由2名研究者独立筛选文献、提取资料并评价偏倚风险后,采用软件Stata与ADDIS进行分析。结果共纳入26项研究,涉及9种联合干预方案:CIMT+延续性护理(am)、CIMT+生物反馈(bm)、CIMT+推拿(dm)、CIMT+针刺(em)、CIMT+经颅磁刺激(fm)、CIMT+功能性电刺激(gm)、CIMT+音乐疗法(hm)、CIMT+双侧康复(im)、CIMT+运动想象(jm)。结果显示,在FMA评分方面Rank1为最优概率排序为dm>em>gm>am>c;在提高上肢运动功能上,仅bm优于c,其余相互比较差异均无统计学意义(MD=8.31,95%CI:1.73~14.24,P<0.05);各联合干预方案间比较,im和jm的最优概率排序位列前二;在改善ADL上,jm>em>am>c,BI评分在干预4、8个月时,em疗效均位列第一。结论bm在提高上肢运动功能上较常规方案有明显的改善。CIMT的不同联合疗法对改善脑卒中患者运动能力及日常生活活动能力有不同的优势,dm、em显著提高运动功能,bm、im、em有益于提高上肢运动功能,em提高日常生活自理能力最佳。展开更多
基金supported by the National Natural Science Foundation of China,No.81871841(to YLB) and No.81772453(to DSX)
文摘Modified constraint-induced movement therapy is an effective treatment for neurological and motor impairments in patients with stroke by increasing the use of their affected limb and limiting the contralateral limb.However,the molecular mechanism underlying its efficacy remains unclear.In this study,a middle cerebral artery occlusion(MCAO)rat model was produced by the suture method.Rats received modified constraint-induced movement therapy 1 hour a day for 14 consecutive days,starting from the 7^th day after middle cerebral artery occlusion.Day 1 of treatment lasted for 10 minutes at 2r/min,day 2 for 20 minutes at 2 r/min,and from day 3 onward for 20 minutes at 4 r/min.CatWalk gait analysis,adhesive removal test,and Y-maze test were used to investigate motor function,sensory function as well as cognitive function in rodent animals from the 1st day before MCAO to the 21^st day after MCAO.On the 21^st day after MCAO,the neurotransmitter receptor-related genes from both contralateral and ipsilateral hippocampi were tested by micro-array and then verified by western blot assay.The glutamate related receptor was shown by transmission electron microscopy and the glutamate content was determined by high-performance liquid chromatography.The results of behavior tests showed that modified constraint-induced movement therapy promoted motor and sensory functional recovery in the middle cerebral artery-occluded rats,but had no effect on cognitive function.The modified constraint-induced movement therapy upregulated the expression of glutamate ionotropic receptor AMPA type subunit 3(Gria3)in the hippocampus and downregulated the expression of the beta3-adrenergic receptor gene Adrb3 and arginine vasopressin receptor 1 A,Avprla in the middle cerebral artery-occluded rats.In the ipsilateral hippocampus,only Adra2 a was downregulated,and there was no significant change in Gria3.Transmission electron microscopy revealed a denser distribution the more distribution of postsynaptic glutamate receptor 2/3,which is an a-amino-3-hydrox
文摘目的系统评价强制性运动疗法联合其他康复技术对脑卒中患者运动能力及日常生活活动能力的干预效果。方法计算机检索Web of Science、PubMed等8个数据库,检索有关(改良)强制性运动疗法(CIMT)干预脑卒中患者的临床随机对照试验。由2名研究者独立筛选文献、提取资料并评价偏倚风险后,采用软件Stata与ADDIS进行分析。结果共纳入26项研究,涉及9种联合干预方案:CIMT+延续性护理(am)、CIMT+生物反馈(bm)、CIMT+推拿(dm)、CIMT+针刺(em)、CIMT+经颅磁刺激(fm)、CIMT+功能性电刺激(gm)、CIMT+音乐疗法(hm)、CIMT+双侧康复(im)、CIMT+运动想象(jm)。结果显示,在FMA评分方面Rank1为最优概率排序为dm>em>gm>am>c;在提高上肢运动功能上,仅bm优于c,其余相互比较差异均无统计学意义(MD=8.31,95%CI:1.73~14.24,P<0.05);各联合干预方案间比较,im和jm的最优概率排序位列前二;在改善ADL上,jm>em>am>c,BI评分在干预4、8个月时,em疗效均位列第一。结论bm在提高上肢运动功能上较常规方案有明显的改善。CIMT的不同联合疗法对改善脑卒中患者运动能力及日常生活活动能力有不同的优势,dm、em显著提高运动功能,bm、im、em有益于提高上肢运动功能,em提高日常生活自理能力最佳。
