ObjectiveTo explore the effects of walking pattern based intelligent electrical stimulation on lower limb function in out-patients with stroke.MethodsA total of 60 outpatients with stroke who met the inclusion criteria were randomly divided into real stimulation group, sham stimulation group and control group. Finally, 52 patients completed the evaluation, including 20 patients in the control group, 15 patients in the sham stimulation group and 17 patients in the real stimulation group. All patients in the three groups received routine outpatient rehabilitation treatment and home rehabilitation guidance. The control group was not given electrical stimulation. The real stimulation group received walking pattern-based intelligent electrical stimulation once a day for 10 minutes, once a day, five days a week, with a duration of 8 weeks. The stimulation electrodes were placed on the active points of lower limb muscles (quadriceps femoris, hamstring muscle, tibialis anterior and gastrocnemius) on the hemiplegic side. The stimulation frequency was 30 Hz, the wavelength was 200 μs, and the intensity was the minimum intensity of muscle contraction. The stimu- lation electrodes placed in the sham stimulation group were the same with the real stimulation group, and the intensities could only cause weak sensory stimulation but no real muscle contraction. Lower limb function was assessed by Fugl-Meyer assessment (FMA), and balance function was assessed by postural assessment scale for stroke (PASS) and Berg balance scale (BBS). In addition, the walking ability was assessed by time up and go test (TUGT). The differences were compared among the three groups before the treatment and 2, 4 and 8 weeks posttreatment.ResultsThere was no significant difference in the baseline data and the evaluation results of the three groups before treatment. After 2 weeks treatment, the scores of FMA were significantly better than those before treatment in three groups (P<0.05). After 4 and 8 weeks treatment, the scores of FMA, PASS and BBS were significantly higher than those before treatment in the real stimulation group (P<0.05). After 2, 4 and 8 weeks treatment, the scores and improvement ratios of FMA, PASS and BBS were significantly different between the real stimulation group and the sham stimulation group or the control group (P<0.05). Besides, TUGT decreased more significantly in the real stimulation group than that of the sham stimulation group and the control group (P<0.05). That meaned that the stimulation group showed significant improvement in lower limb motor function, balance function, and walking ability compared to the control group and the sham stimulation group.ConclusionAfter discharge, hemiplegic outpatients after stroke receiving intelligent walking therapy could significantly improve the lower limb function, balance and walking ability.

ObjectiveTo observe the effect of transcranial direct current stimulation (tDCS) synchronized with normal walking pattern based on multi-channel functional electrical stimulation (FES) on lower limb motor and balance function in patients with traumatic brain injury hemiplegia.MethodsA total of 56 patients with TBI and hemiplegia were divided into synchronous group (n=21), FES group (n=20), and tDCS group (n=15) by using sealed-envelope randomization. The tDCS group was given head tDCS treatment and lower extremity sham FES treatment, the FES group was given head sham tDCS treatment and lower extremity FES treatment, and the synchronous group was given head tDCS treatment and lower extremity FES treatment. The treatment was 20 min/time, 1 time/d, for 12 days. Before treatment, after 6 days treatment and after 12 days treatment, the following scales were used to evaluate: Fugl-Meyer assessment of lower extremity (FMA-LE), Berg balance scale (BBS), and Neurocom Balance Manager System.ResultsThere was no significant differences among the evaluation results of the three groups before treatment. After treatment, compared with those before treatment, the FMA-LE scores of three groups were significantly different (P<0.05), but there was no significant differences in FMA-LE among the three groups (P>0.05). Compared with the three groups before and after treatment, BBS scores of the three groups were significantly different respectively (P<0.05). Compared the tDCS group with the FES group, the differences in BBS scores of the synchronization group were significant (P<0.05). In balance assessment, compared with those before treatment, visual cues (VIS), vestibular cues (VEST), sensory organization test composite (SOTC) and motion control test composite (MCTC) were significantly different in the synchronous group after treatment (P<0.05); MCTC was significantly different in the FES group (P<0.05); VIS and SOTC was significantly difference in the tDCS group (P<0.05). Compared among the three groups, the change rate of MCTC was significantly difference (P<0.05); there were no significant differences in other indicators (P>0.05).ConclusionThe three methods can effectively improve the lower limb motor and balance function of patients with traumatic brain injury in chronic period. The treatment of tDCS with FES is better than the treatment of tDCS or FES alone in terms of some evaluation indicators.

目的:观察康复训练对脑缺血再灌注大鼠神经功能的影响,探讨康复训练调节血管再生的机制.方法:将SD大鼠适应性喂养1周后,进行脑缺血再灌注手术造模,24h后挑选神经功能评分2～3分的大鼠和假手术大鼠分为假手术组(8只),康复组(16只)和脑缺血组(24只),康复组每天按计划进行跑步训练,分别于康复训练的第7天、第14天对大鼠进行神经行为学评分并随机挑选部分大鼠进行取材进行TTC染色、免疫组化及免疫印迹实验.结果:脑缺血再灌注造成大鼠神经功能损伤,7d和14d的康复训练有效提高了大鼠神经行为学评分(P＜0.05).此外,脑缺血再灌注诱导了大鼠脑中血管内皮生长因子(VEGF)与神经生长因子(NGF)蛋白表达增加,促进脑中血管微循环的建立;与脑缺血组相比,7d和14d康复训练显著增加了大鼠脑中VEGF与NGF表达(P＜0.05),加速了缺血区血管微循环的建立(P＜0.05).结论:康复训练对于脑缺血再灌注有良好的治疗效果,其机制可能是增加了 VEGF与NGF表达,加速了缺血区血管微循环的建立.

《国际功能、残疾和健康分类》(International Classification of Functioning,Disability and Health,ICF),自2001年由世界卫生组织(WHO)颁布至今已近二十年,但我国大多数康复专业人员对ICF临床应用仍较为模糊.因此,探索ICF中国应用模式并加以推广应用具有重要意义.本ICF专家共识通过广泛征求专家意见并经反复讨论,分别从ICD到ICF的变革、ICF到ICF康复组合的演变、ICF类目在临床评估过程中的量化、ICF的临床应用模式、ICF数据平台的构建、ICF权重体系的构建等角度提出了ICF临床应用的专家共识,为ICF在国内临床康复中更好地应用提供了借鉴.

目的:探讨高压氧联合虚拟现实(VR)技术对脑损伤患儿功能重建的效果.方法:选取2017年1月至2019年1月本院收治的90例脑损伤综合征患儿,随机分成高压氧组、VR组及高压氧联合VR组,各30例,在常规康复治疗基础上予以相应的治疗方法,观察三组治疗前后智力发育与运动功能、血清指标变化.结果:治疗后三组患儿Gesell四方面评分、FMA评分较治疗前均明显升高(P<0.05);治疗后联合组各量表评分均显著高于高压氧组、VR组(P<0.05);三组血清NES、S-100β蛋白、IL-6较治疗前显著降低(P<0.05)且联合组低于高压氧组、VR组(P<0.05);三组并发症及随访脑瘫发生率无统计学差异(P>0.05).结论:高压氧联合VR技术能促进脑损伤患儿神经功能与运动功能重建,减轻脑组织损伤,抑制脑损伤炎性反应,值得临床借鉴.

Objective:To observe the effect of motor imagery therapy combined with electro -acupuncture on upper limb function re-covery of patients with hemiplegia .Methods:60 cases of patients with hemiplegia were randomly divided into control group , 4 weeks for a course of treatment .Before and after the two courses of treatment , all patients were assisted with Fugl Meyer assessment ( FMA) ,modi-fied Barthel Index ( MBI) and activities of daily living scale .Results:After 8 weeks of treatment , the scores of assessment in all patients were significantly improved compared with before treatment with FMA and MBI ( P<0.05);and it is obvious improved in the comprehen-sive group compared with the control group and the electro -acupuncture group (P<0.05).Conclusion: It is effectively improved the function of upper limb in patients with hemiplegia after stroke by motor imagery therapy combined with electro -acupuncture .

Objective:To observe the effect of swallowing function training combined with transcutanclus electrical acu-point stimulation(TEAS)on patients with swallowing dysfunction of stroke. Methods:All 60 patients were randomly divided in-to 3 groups,swallowing function training group(training group),TEAS group and comprehensive group. Each patient were ex-aminated by video fluoroscopic swallowing study(VFSS). Before and after the treatment on basis of the score of which evalua-ting assess the curative effect of swallowing function. Results:After 4 courses of treatment,3 groups of patients with swallowing function were improved. The efficacy of the combined treatment group was the most significant,the effect of which was more sig-nificantly than that of the training group and the TEAS group(P < 0. 05). Conclusion:Swallowing function training and treat-ment with TEAS can better improve the swallowing function in patients with swallowing dysfunction of stroke.