Stroke causes long-term disability, and rehabilitative training is commonly used to improve the consecutive functional recovery. Following brain damage, surviving neurons undergo morphological alterations to reconstru...Stroke causes long-term disability, and rehabilitative training is commonly used to improve the consecutive functional recovery. Following brain damage, surviving neurons undergo morphological alterations to reconstruct the remaining neural network. In the motor system, such neural network remodeling is observed as a motor map reorganization. Because of its significant correlation with functional recovery, motor map reorganization has been regarded as a key phenomenon for functional recovery after stroke. Although the mechanism underlying motor map reorganization remains unclear, increasing evidence has shown a critical role for axonal remodeling in the corticospinal tract. In this study, we review previous studies investigating axonal remodeling in the corticospinal tract after stroke and discuss which mechanisms may underlie the stimulatory effect of rehabilitative training. Axonal remodeling in the corticospinal tract can be classified into three types based on the location and the original targets of corticospinal neurons, and it seems that all the surviving corticospinal neurons in both ipsilesional and contralesional hemisphere can participate in axonal remodeling and motor map reorganization. Through axonal remodeling, corticospinal neurons alter their output selectivity from a single to multiple areas to compensate for the lost function. The remodeling of the corticospinal axon is influenced by the extent of tissue destruction and promoted by various therapeutic interventions, including rehabilitative training. Although the precise molecular mechanism underlying rehabilitation-promoted axonal remodeling remains elusive, previous data suggest that rehabilitative training promotes axonal remodeling by upregulating growth-promoting and downregulating growth-inhibiting signals.展开更多
OBJECTIVE: To evaluate the therapeutic effects of nape acupuncture combined with rehabilitative swallowing training for dysphagia caused by pseudobulbar palsy, and to compare it with rehabilitative swallowing training...OBJECTIVE: To evaluate the therapeutic effects of nape acupuncture combined with rehabilitative swallowing training for dysphagia caused by pseudobulbar palsy, and to compare it with rehabilitative swallowing training alone, and to observe the improvement in quality of life after the therapy.METHODS: One hundred patients were randomly divided into two groups: the rehabilitative swallowing training group(control group, n = 50) and the nape acupuncture combined with rehabilitative swallowing training group(experimental group,n = 50). Each group had 8 weeks' therapy, 5 times a week. Patients in the control group received rehabilitative swallowing training, while those in the experimental group received nape acupuncture therapy based on swallowing rehabilitation. The out-comes were assessed by the repetitive saliva-swallowing test(RSST), water swallow test(WST), standardized swallowing assessment(SSA), and a swallow quality-of-life questionnaire(SWAL-QOL). Correlations of onset age, onset frequency and lesion location with the efficacy of the acupuncture treatment were also observed.RESULTS: The scores for RSST, WST, and SSA in both groups were lower than before the therapy(P <0.001), although the changes were more marked in the experimental group than in the control group(RSST and WST, P < 0.005; SSA, P < 0.001). Both groups recorded changes in SWAL-QOL index after the therapy(P < 0.001); and the experimental group scored higher than the control group(P < 0.001). The efficacy of acupuncture was not correlated with location(P > 0.05), but was related to onset age(P < 0.05) and onset frequency(P < 0.01).CONCLUSION: Nape acupuncture combined with rehabilitative swallowing training has an effect on dysphagia caused by pseudobulbar palsy and improves quality of life.展开更多
Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often r...Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient 展开更多
In order to mitigate the effects of space adaptation syndrome(SAS) and improve the training efficiency of the astronauts, a novel astronaut rehabilitative training robot(ART) was proposed. ART can help the astronauts ...In order to mitigate the effects of space adaptation syndrome(SAS) and improve the training efficiency of the astronauts, a novel astronaut rehabilitative training robot(ART) was proposed. ART can help the astronauts to carry out the bench press training in the microgravity environment. Firstly, a dynamic model of cable driven unit(CDU) was established whose accuracy was verified through the model identification. Secondly, to improve the accuracy and the speed of the active loading, an active loading hybrid force controller was proposed on the basis of the dynamic model of the CDU. Finally, the actual effect of the hybrid force controller was tested by simulations and experiments. The results suggest that the hybrid force controller can significantly improve the precision and the dynamic performance of the active loading with the maximum phase lag of the active loading being 9° and the maximum amplitude error being 2% at the frequency range of 10 Hz. The controller can meet the design requirements.展开更多
Objective To compare the influences of acupuncture combined with rehabilitative training and simple rehabilitative training on neural functional recovery of stroke patients during recovery phase.Methods Sixty-seven st...Objective To compare the influences of acupuncture combined with rehabilitative training and simple rehabilitative training on neural functional recovery of stroke patients during recovery phase.Methods Sixty-seven stroke patients during recovery phase were randomly divided into an acupuncture combined with rehabilitative training group（group A） and a simple rehabilitative training group（group B） through random number table method,with 34 cases and 33 cases respectively;33 cases and 31 cases were respectively completed actually other than cases dropped out during the observation.Rehabilitation methods such as motion control and functional exercise training were primarily used for rehabilitative training,once daily for 45 min at a time,and 6 times a week;Baihui（百会 GV 20） and Fengchi（风池 GB 20） on the head and relevant acupoints on limbs were selected for acupuncture,once every other day,and 3 times a week.Both groups were treated for 8 weeks,National Institnte of Health Stroke Scale（NIHSS） was used to assess neurologic impairment,Fugl-Meyer scale was used to assess motor function,Barthel was used to assess activity of daily living,and comprehensive assessment was finally made to patients.Results NIH score,Fugl-Meyer scale scores of upper and lower limbs,Barthel score,and comprehensive assessment of group A after treatment were respectively：12.78±2.99,37.55±2.09 and25.67±3.93,63.76±4.65,11.33±1.98,superior to 16.06±4.57,28.71±4.07 and20.41±2.98,53.8214.35,15.18±1.72 of group B.Indices of both groups were significantly improved compared with those before treatment（P〈0.01,P〈0.05）,but improvement of indices of group A was more obvious that that of group B after treatment subject to comparison（all P〈0.05）.Conclusions Acupuncture combined with rehabilitative training has definite therapeutic effect on recovery of various functions such as neural functional recovery of stroke patients during recovery phase,obviously superior to simple rehabilitative training.展开更多
This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of soci...This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunit展开更多
BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore th...BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the 展开更多
The lumbar spinal stenosis (LSS) is a syndrome with a wide economic and social impact on the adult population. It is a particular form of narrowing of the lumbar vertebral canal or the intervertebral foramina which ca...The lumbar spinal stenosis (LSS) is a syndrome with a wide economic and social impact on the adult population. It is a particular form of narrowing of the lumbar vertebral canal or the intervertebral foramina which can compress the neural and vascular elements in the lumbar spine. It is a degenerative process which predominantly affects the geriatric population. The increase of the life expectancy has increased the health needs of this target of population. The (LSS) is a syndrome that can manifest itself with lower back pain and pain to the inferior limbs, and functional disabilities which affects mobility and motor skills. Given the complexity of the clinical presentation, an accurate clinical-functional evaluation is needed that includes: The combination of clinical signs from the patient’s history, a physical evaluation and diagnostic imaging, excluding possible red flags. In this respect, the use of Rehabilitative Ultrasound Imaging (RUSI) might be useful in the evaluation and treatment process, enhancing the effectiveness and documenting the benefits of it. The aim of this work is to propose an integrated evidence-based approach that may be useful for improving the quality of life of LSS patients.展开更多
BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe...BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate d展开更多
目的：探讨短肠综合征合并肠外瘘的临床特点与治疗方法。方法选择2008年1月至2015年12月普外科收治的剩余小肠＜105 cm 的肠外瘘患者36例，对其肠外瘘发生部位、原因、治疗方法和肠康复方法进行回顾性分析。结果36例中治愈23例，死亡4例...目的：探讨短肠综合征合并肠外瘘的临床特点与治疗方法。方法选择2008年1月至2015年12月普外科收治的剩余小肠＜105 cm 的肠外瘘患者36例，对其肠外瘘发生部位、原因、治疗方法和肠康复方法进行回顾性分析。结果36例中治愈23例，死亡4例，9例好转后中断治疗出院。患者肠管残存长度为（61.05±28.60）cm。31例接受肠内营养，其中10例未接受肠康复治疗，肠管长度为（53.30±31.60）cm，肠内营养恢复时间为（131.50±91.20）d；21例接受肠康复治疗，肠管长度为（63.60±20.50）cm，肠内营养恢复时间为（60.10±49.80）d。结论短肠综合征并肠外瘘的主要疾病为肠扭转、肠坏死，肠瘘部位多在吻合口，因肠坏死范围较广，手术切除界限不易判断。早期应用生长抑素能够减少消化液分泌的作用，同时能够减少短肠综合征急性期的腹泻及电解质紊乱症状。后期应用生长抑素能促进肠外瘘自愈和肠康复的双重作用。展开更多
OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language...OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the Keywords of 'stroke, basal ganglia aphasia, language rehabilitation' in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually. STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded. Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded. DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded. DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. O展开更多
基金supported by the JSPSKAKENHI Grant-in-Aid for Scientific Research(B),Grant Numbers24700572 and 30614276
文摘Stroke causes long-term disability, and rehabilitative training is commonly used to improve the consecutive functional recovery. Following brain damage, surviving neurons undergo morphological alterations to reconstruct the remaining neural network. In the motor system, such neural network remodeling is observed as a motor map reorganization. Because of its significant correlation with functional recovery, motor map reorganization has been regarded as a key phenomenon for functional recovery after stroke. Although the mechanism underlying motor map reorganization remains unclear, increasing evidence has shown a critical role for axonal remodeling in the corticospinal tract. In this study, we review previous studies investigating axonal remodeling in the corticospinal tract after stroke and discuss which mechanisms may underlie the stimulatory effect of rehabilitative training. Axonal remodeling in the corticospinal tract can be classified into three types based on the location and the original targets of corticospinal neurons, and it seems that all the surviving corticospinal neurons in both ipsilesional and contralesional hemisphere can participate in axonal remodeling and motor map reorganization. Through axonal remodeling, corticospinal neurons alter their output selectivity from a single to multiple areas to compensate for the lost function. The remodeling of the corticospinal axon is influenced by the extent of tissue destruction and promoted by various therapeutic interventions, including rehabilitative training. Although the precise molecular mechanism underlying rehabilitation-promoted axonal remodeling remains elusive, previous data suggest that rehabilitative training promotes axonal remodeling by upregulating growth-promoting and downregulating growth-inhibiting signals.
基金Supported by Zhejiang province administration of Traditional Chinese Medicine funded Project:Effects of nape acupuncture on dysphagia in pseudobulbar palsy in different stages(Project No:2014ZA094)
文摘OBJECTIVE: To evaluate the therapeutic effects of nape acupuncture combined with rehabilitative swallowing training for dysphagia caused by pseudobulbar palsy, and to compare it with rehabilitative swallowing training alone, and to observe the improvement in quality of life after the therapy.METHODS: One hundred patients were randomly divided into two groups: the rehabilitative swallowing training group(control group, n = 50) and the nape acupuncture combined with rehabilitative swallowing training group(experimental group,n = 50). Each group had 8 weeks' therapy, 5 times a week. Patients in the control group received rehabilitative swallowing training, while those in the experimental group received nape acupuncture therapy based on swallowing rehabilitation. The out-comes were assessed by the repetitive saliva-swallowing test(RSST), water swallow test(WST), standardized swallowing assessment(SSA), and a swallow quality-of-life questionnaire(SWAL-QOL). Correlations of onset age, onset frequency and lesion location with the efficacy of the acupuncture treatment were also observed.RESULTS: The scores for RSST, WST, and SSA in both groups were lower than before the therapy(P <0.001), although the changes were more marked in the experimental group than in the control group(RSST and WST, P < 0.005; SSA, P < 0.001). Both groups recorded changes in SWAL-QOL index after the therapy(P < 0.001); and the experimental group scored higher than the control group(P < 0.001). The efficacy of acupuncture was not correlated with location(P > 0.05), but was related to onset age(P < 0.05) and onset frequency(P < 0.01).CONCLUSION: Nape acupuncture combined with rehabilitative swallowing training has an effect on dysphagia caused by pseudobulbar palsy and improves quality of life.
文摘Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient
基金Project(61175128) supported by the National Natural Science Foundation of ChinaProject(2008AA040203) supported by the National High Technology Research and Development Program of ChinaProject(QC2010009) supported by the Natural Science Foundation of Heilongjiang Province,China
文摘In order to mitigate the effects of space adaptation syndrome(SAS) and improve the training efficiency of the astronauts, a novel astronaut rehabilitative training robot(ART) was proposed. ART can help the astronauts to carry out the bench press training in the microgravity environment. Firstly, a dynamic model of cable driven unit(CDU) was established whose accuracy was verified through the model identification. Secondly, to improve the accuracy and the speed of the active loading, an active loading hybrid force controller was proposed on the basis of the dynamic model of the CDU. Finally, the actual effect of the hybrid force controller was tested by simulations and experiments. The results suggest that the hybrid force controller can significantly improve the precision and the dynamic performance of the active loading with the maximum phase lag of the active loading being 9° and the maximum amplitude error being 2% at the frequency range of 10 Hz. The controller can meet the design requirements.
文摘Objective To compare the influences of acupuncture combined with rehabilitative training and simple rehabilitative training on neural functional recovery of stroke patients during recovery phase.Methods Sixty-seven stroke patients during recovery phase were randomly divided into an acupuncture combined with rehabilitative training group（group A） and a simple rehabilitative training group（group B） through random number table method,with 34 cases and 33 cases respectively;33 cases and 31 cases were respectively completed actually other than cases dropped out during the observation.Rehabilitation methods such as motion control and functional exercise training were primarily used for rehabilitative training,once daily for 45 min at a time,and 6 times a week;Baihui（百会 GV 20） and Fengchi（风池 GB 20） on the head and relevant acupoints on limbs were selected for acupuncture,once every other day,and 3 times a week.Both groups were treated for 8 weeks,National Institnte of Health Stroke Scale（NIHSS） was used to assess neurologic impairment,Fugl-Meyer scale was used to assess motor function,Barthel was used to assess activity of daily living,and comprehensive assessment was finally made to patients.Results NIH score,Fugl-Meyer scale scores of upper and lower limbs,Barthel score,and comprehensive assessment of group A after treatment were respectively：12.78±2.99,37.55±2.09 and25.67±3.93,63.76±4.65,11.33±1.98,superior to 16.06±4.57,28.71±4.07 and20.41±2.98,53.8214.35,15.18±1.72 of group B.Indices of both groups were significantly improved compared with those before treatment（P〈0.01,P〈0.05）,but improvement of indices of group A was more obvious that that of group B after treatment subject to comparison（all P〈0.05）.Conclusions Acupuncture combined with rehabilitative training has definite therapeutic effect on recovery of various functions such as neural functional recovery of stroke patients during recovery phase,obviously superior to simple rehabilitative training.
文摘This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunit
基金a grant from the State Science and Technology Department of "the Tenth Five-Year Plan" Tackle Key Problem,No.2001BA703B21
文摘BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the
文摘The lumbar spinal stenosis (LSS) is a syndrome with a wide economic and social impact on the adult population. It is a particular form of narrowing of the lumbar vertebral canal or the intervertebral foramina which can compress the neural and vascular elements in the lumbar spine. It is a degenerative process which predominantly affects the geriatric population. The increase of the life expectancy has increased the health needs of this target of population. The (LSS) is a syndrome that can manifest itself with lower back pain and pain to the inferior limbs, and functional disabilities which affects mobility and motor skills. Given the complexity of the clinical presentation, an accurate clinical-functional evaluation is needed that includes: The combination of clinical signs from the patient’s history, a physical evaluation and diagnostic imaging, excluding possible red flags. In this respect, the use of Rehabilitative Ultrasound Imaging (RUSI) might be useful in the evaluation and treatment process, enhancing the effectiveness and documenting the benefits of it. The aim of this work is to propose an integrated evidence-based approach that may be useful for improving the quality of life of LSS patients.
基金a grant from the Tackle Key Problem and Planning Projectin Science and Technology of Hebei Province,No.052761224
文摘BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate d
文摘目的：探讨短肠综合征合并肠外瘘的临床特点与治疗方法。方法选择2008年1月至2015年12月普外科收治的剩余小肠＜105 cm 的肠外瘘患者36例，对其肠外瘘发生部位、原因、治疗方法和肠康复方法进行回顾性分析。结果36例中治愈23例，死亡4例，9例好转后中断治疗出院。患者肠管残存长度为（61.05±28.60）cm。31例接受肠内营养，其中10例未接受肠康复治疗，肠管长度为（53.30±31.60）cm，肠内营养恢复时间为（131.50±91.20）d；21例接受肠康复治疗，肠管长度为（63.60±20.50）cm，肠内营养恢复时间为（60.10±49.80）d。结论短肠综合征并肠外瘘的主要疾病为肠扭转、肠坏死，肠瘘部位多在吻合口，因肠坏死范围较广，手术切除界限不易判断。早期应用生长抑素能够减少消化液分泌的作用，同时能够减少短肠综合征急性期的腹泻及电解质紊乱症状。后期应用生长抑素能促进肠外瘘自愈和肠康复的双重作用。
文摘OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the Keywords of 'stroke, basal ganglia aphasia, language rehabilitation' in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually. STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded. Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded. DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded. DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. O
