Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group (group A, 58 cases) and swallowing n...Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group (group A, 58 cases) and swallowing neuromuscular electrical stimulation combined with acupuncture group (group B, 62 cases). Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points: Junjin (金津 EX-HN 12), Yuye(玉液 EX-HN 23), Fengchi (风池 GB 20), Yifeng (翳风 TE 17), Lianquan (廉泉 CV 23), Wangu (完骨 GB 12). Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture: GB 20, Fengfu (风夜 GV 16), TE 17, Yiming (翳明 EX-HN 14), Yamen (哑门 GV 15), Tianrong(天容 SI 17), Tianchuang (天窗 SI 16), CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method (1-2 mL blood) was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current (50-100 Hz). Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups (P〈0.05). Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.展开更多
Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 pat...Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.展开更多
Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease involving both upper and lower neurons with no effective cure. Electrophysiological studies have found decremental responses d...Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease involving both upper and lower neurons with no effective cure. Electrophysiological studies have found decremental responses during low-frequency repetitive nerve stimulation (RNS) except for diffused neurogenic activities. However, the difference between ALS and generalized myasthenia gravis (GMG) in terms of waveform features is unclear. In the current study, we explored the variation trend of the amplitudes curve between ALS and GMG with low-frequency, positive RNS, and the possible mechanism is discussed preliminarily. Methods: A total of 85 ALS patients and 41 GMG patients were recruited. All patients were from Peking Union Medical College Hospital (PUMCH) between July 1,2012 and February 28,2015. RNS study included ulnar nerve, accessory nerve and facial nerve at 3 Hz and 5 Hz stimulation. The percentage reduction in the amplitude of the fourth or fifth wave from the first wave was calculated and compared with the normal values of our hospital. A 15% decrease in amplitude is defined as a decrease in amplitude. Results: The decremental response at low-frequency RNS showed the abnormal rate of RNS decline was 54.1%(46/85) in the ALS group, and the results of different nerves were 54.1 %(46/85) of the accessory nerve, 8.2%(7/85) of the ulnar nerve and 0%(0/85) of the facial nerve stimulation, respectively. In the GMG group, the abnormal rate of RNS decline was 100%(41/41) at low-frequency RNS of accessory nerves. However, there was a significant difference between the 2 groups in the amplitude after the sixth wave. Conclusions: Both groups of patients are able to show a decreasing amplitude of low-frequency stimulation RNS, but the recovery trend after the sixth wave has significant variation. It implies the different pathogenesis of NMJ dysfunction of these 2 diseases.展开更多
BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction an...BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength 展开更多
文摘Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group (group A, 58 cases) and swallowing neuromuscular electrical stimulation combined with acupuncture group (group B, 62 cases). Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points: Junjin (金津 EX-HN 12), Yuye(玉液 EX-HN 23), Fengchi (风池 GB 20), Yifeng (翳风 TE 17), Lianquan (廉泉 CV 23), Wangu (完骨 GB 12). Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture: GB 20, Fengfu (风夜 GV 16), TE 17, Yiming (翳明 EX-HN 14), Yamen (哑门 GV 15), Tianrong(天容 SI 17), Tianchuang (天窗 SI 16), CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method (1-2 mL blood) was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current (50-100 Hz). Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups (P〈0.05). Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.
文摘Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.
文摘Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease involving both upper and lower neurons with no effective cure. Electrophysiological studies have found decremental responses during low-frequency repetitive nerve stimulation (RNS) except for diffused neurogenic activities. However, the difference between ALS and generalized myasthenia gravis (GMG) in terms of waveform features is unclear. In the current study, we explored the variation trend of the amplitudes curve between ALS and GMG with low-frequency, positive RNS, and the possible mechanism is discussed preliminarily. Methods: A total of 85 ALS patients and 41 GMG patients were recruited. All patients were from Peking Union Medical College Hospital (PUMCH) between July 1,2012 and February 28,2015. RNS study included ulnar nerve, accessory nerve and facial nerve at 3 Hz and 5 Hz stimulation. The percentage reduction in the amplitude of the fourth or fifth wave from the first wave was calculated and compared with the normal values of our hospital. A 15% decrease in amplitude is defined as a decrease in amplitude. Results: The decremental response at low-frequency RNS showed the abnormal rate of RNS decline was 54.1%(46/85) in the ALS group, and the results of different nerves were 54.1 %(46/85) of the accessory nerve, 8.2%(7/85) of the ulnar nerve and 0%(0/85) of the facial nerve stimulation, respectively. In the GMG group, the abnormal rate of RNS decline was 100%(41/41) at low-frequency RNS of accessory nerves. However, there was a significant difference between the 2 groups in the amplitude after the sixth wave. Conclusions: Both groups of patients are able to show a decreasing amplitude of low-frequency stimulation RNS, but the recovery trend after the sixth wave has significant variation. It implies the different pathogenesis of NMJ dysfunction of these 2 diseases.
文摘BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength