Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and i...Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and improving post-stroke gait impairment.However,a large inter-individual variability in the response to noninvasive brain stimulation interventions has been increasingly recognized.We first review the neurophysiology of human gait and post-stroke neuroplasticity for gait recovery,and then discuss how noninvasive brain stimulation techniques could be utilized to enhance gait recovery.While post-stroke neuroplasticity for gait recovery is characterized by use-dependent plasticity,it evolves over time,is idiosyncratic,and may develop maladaptive elements.Furthermore,noninvasive brain stimulation has limited reach capability and is facilitative-only in nature.Therefore,we recommend that noninvasive brain stimulation be used adjunctively with rehabilitation training and other concurrent neuroplasticity facilitation techniques.Additionally,when noninvasive brain stimulation is applied for the rehabilitation of gait impairment in stroke survivors,stimulation montages should be customized according to the specific types of neuroplasticity found in each individual.This could be done using multiple mapping techniques.展开更多
目的:了解电刺激疗法治疗脊髓损伤后神经源性肠道功能障碍的临床研究现状.方法:计算机检索PubMed、MEDLINE、EMbase、Cochrane Central Register of Controlled Trials(CENTRAL)、ISI Web of Knowledge、OVID、中国知网、万方和维普数...目的:了解电刺激疗法治疗脊髓损伤后神经源性肠道功能障碍的临床研究现状.方法:计算机检索PubMed、MEDLINE、EMbase、Cochrane Central Register of Controlled Trials(CENTRAL)、ISI Web of Knowledge、OVID、中国知网、万方和维普数据库中关于电刺激疗法治疗脊髓损伤后神经源性肠道功能障碍的临床研究报道,同时检索已纳入文献的参考文献.检索时间从建库至2012-10.研究人员对纳入文献进行深入阅读及资料提取.结果:共纳入11篇文献,通过分析发现:电刺激疗法主要包括经皮电刺激疗法、经直肠电刺激疗法、经膀胱电刺激疗法、骶神经调节疗法,通过调节脊髓损伤患者包括脊柱裂患儿、脊髓脊膜膨出患者、腰椎间盘突出症患者的肠道内、外的神经支配,改善胃肠道的局部血流,促进蛋白质合成,提高患者的肠道控制能力,改善患者的大便失禁或便秘的症状.结论:电刺激疗法在一定程度上能改善脊髓损伤患者的神经源性肠道功能障碍,但目前关于这方向的临床研究报道数量较少,且其中的随机对照试验数量尤为稀少,同时纳入研究中样本量小,干预强度、结局指标、随访周期不一致,故仍需开展大样本量、实验设计更完善的临床研究,来进一步验证电刺激疗法对脊髓损伤后神经源性肠道功能障碍的治疗效果.展开更多
目的：探讨生物反馈联合电刺激疗法在医护合作治疗产妇产后重度乳房疼痛中的效果观察方法将进入研究的112例产妇按照随机数字表分为干预组和对照组。干预组接受生物反馈联合电刺激治疗，并按摩挤奶；对照组接受常规按摩挤奶。评估医护...目的：探讨生物反馈联合电刺激疗法在医护合作治疗产妇产后重度乳房疼痛中的效果观察方法将进入研究的112例产妇按照随机数字表分为干预组和对照组。干预组接受生物反馈联合电刺激治疗，并按摩挤奶；对照组接受常规按摩挤奶。评估医护合作状况、疼痛治疗满意度，比较治疗后3、7 d 及产后42 d 乳房疼痛程度、肿胀程度、母乳喂养状态。结果干预组与对照组治疗后3 d 乳房肿胀程度比较，Z=-5.91，P＜0.05（其中Ⅰ度肿胀19例比1例）；母乳喂养状态比较， Z=-4.18，P＜0.01（其中纯母乳喂养6例比1例）。干预组与对照组治疗后7 d 乳房疼痛评分比较[（2.34±0.78）分比（4.79±0.92）分]，t=16.84，P＜0.01；乳房肿胀程度比较，Z=-3.97，P＜0.01（其中Ⅰ度肿胀37例比18例）；母乳喂养状态比较，Z=-6.23，P＜0.01（其中纯母乳喂养23例比0例）。产后42 d 回访，干预组与对照组乳房疼痛评分比较[（1.22±0.47）分比（2.12±0.81）分]，t=6.82，P＜0.01；乳房肿胀程度比较，Z=-4.74，P＜0.01（其中Ⅰ度肿胀43例比21例）；母乳喂养状态比较， Z=-4.05，P＜0.01（其中纯母乳喂养39例比20例）。医护合作状况评分（98.66±2.96）分，产妇对乳房疼痛治疗的总体满意度为94%（47/50）。结论标准化医护合作关系下，生物反馈联合电刺激治疗能显著改善重度乳房疼痛产妇乳房疼痛程度及乳房肿胀度，提高母乳喂养状态，提高疼痛治疗满意度。展开更多
基金supported by the National Natural Science Foundation of China,No.30973165,81372108a grant from Clinical Research 5010 Program Mission Statement of Sun Yat-Sen University,China,No.2014001
文摘Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and improving post-stroke gait impairment.However,a large inter-individual variability in the response to noninvasive brain stimulation interventions has been increasingly recognized.We first review the neurophysiology of human gait and post-stroke neuroplasticity for gait recovery,and then discuss how noninvasive brain stimulation techniques could be utilized to enhance gait recovery.While post-stroke neuroplasticity for gait recovery is characterized by use-dependent plasticity,it evolves over time,is idiosyncratic,and may develop maladaptive elements.Furthermore,noninvasive brain stimulation has limited reach capability and is facilitative-only in nature.Therefore,we recommend that noninvasive brain stimulation be used adjunctively with rehabilitation training and other concurrent neuroplasticity facilitation techniques.Additionally,when noninvasive brain stimulation is applied for the rehabilitation of gait impairment in stroke survivors,stimulation montages should be customized according to the specific types of neuroplasticity found in each individual.This could be done using multiple mapping techniques.
文摘目的:了解电刺激疗法治疗脊髓损伤后神经源性肠道功能障碍的临床研究现状.方法:计算机检索PubMed、MEDLINE、EMbase、Cochrane Central Register of Controlled Trials(CENTRAL)、ISI Web of Knowledge、OVID、中国知网、万方和维普数据库中关于电刺激疗法治疗脊髓损伤后神经源性肠道功能障碍的临床研究报道,同时检索已纳入文献的参考文献.检索时间从建库至2012-10.研究人员对纳入文献进行深入阅读及资料提取.结果:共纳入11篇文献,通过分析发现:电刺激疗法主要包括经皮电刺激疗法、经直肠电刺激疗法、经膀胱电刺激疗法、骶神经调节疗法,通过调节脊髓损伤患者包括脊柱裂患儿、脊髓脊膜膨出患者、腰椎间盘突出症患者的肠道内、外的神经支配,改善胃肠道的局部血流,促进蛋白质合成,提高患者的肠道控制能力,改善患者的大便失禁或便秘的症状.结论:电刺激疗法在一定程度上能改善脊髓损伤患者的神经源性肠道功能障碍,但目前关于这方向的临床研究报道数量较少,且其中的随机对照试验数量尤为稀少,同时纳入研究中样本量小,干预强度、结局指标、随访周期不一致,故仍需开展大样本量、实验设计更完善的临床研究,来进一步验证电刺激疗法对脊髓损伤后神经源性肠道功能障碍的治疗效果.
文摘目的：探讨生物反馈联合电刺激疗法在医护合作治疗产妇产后重度乳房疼痛中的效果观察方法将进入研究的112例产妇按照随机数字表分为干预组和对照组。干预组接受生物反馈联合电刺激治疗，并按摩挤奶；对照组接受常规按摩挤奶。评估医护合作状况、疼痛治疗满意度，比较治疗后3、7 d 及产后42 d 乳房疼痛程度、肿胀程度、母乳喂养状态。结果干预组与对照组治疗后3 d 乳房肿胀程度比较，Z=-5.91，P＜0.05（其中Ⅰ度肿胀19例比1例）；母乳喂养状态比较， Z=-4.18，P＜0.01（其中纯母乳喂养6例比1例）。干预组与对照组治疗后7 d 乳房疼痛评分比较[（2.34±0.78）分比（4.79±0.92）分]，t=16.84，P＜0.01；乳房肿胀程度比较，Z=-3.97，P＜0.01（其中Ⅰ度肿胀37例比18例）；母乳喂养状态比较，Z=-6.23，P＜0.01（其中纯母乳喂养23例比0例）。产后42 d 回访，干预组与对照组乳房疼痛评分比较[（1.22±0.47）分比（2.12±0.81）分]，t=6.82，P＜0.01；乳房肿胀程度比较，Z=-4.74，P＜0.01（其中Ⅰ度肿胀43例比21例）；母乳喂养状态比较， Z=-4.05，P＜0.01（其中纯母乳喂养39例比20例）。医护合作状况评分（98.66±2.96）分，产妇对乳房疼痛治疗的总体满意度为94%（47/50）。结论标准化医护合作关系下，生物反馈联合电刺激治疗能显著改善重度乳房疼痛产妇乳房疼痛程度及乳房肿胀度，提高母乳喂养状态，提高疼痛治疗满意度。
