Swallowing apraxia (SA) represents a distinct subtype of swallowing dysfunction, with its pathogenesis remaining unclear and no unified or standardized treatment protocols currently available. Both domestically and internationally, understanding of SA remains insufficient, and clinical research reports related to SA are scarce. This article describes the clinical course of a 43-year-old SA patient post-stroke who exhibited observed clinical improvement over the course of a multimodal rehabilitation program, aiming to enhance understanding of SA and propose a promising comprehensive treatment approach.

Background:Post-stroke muscle hyper-resistance is produced by both neurogenic (spasticity) and non-neurogenic (contracture) factors. BoNT-A is the most effective intervention for post-stroke spasticity, yet whether concomitant contracture alters its therapeutic benefit remains unclear. Aims:To compare BoNT-A effectiveness in plantar-flexor hyper-resistance stratified by contracture. Methods:We retrospectively reviewed stroke survivors with spastic hemiplegia and ankle plantar-flexor hyper-resistance who received BoNT-A injections. Patients were stratified into two groups according to the presence of restricted passive ankle dorsiflexion: the spasticity group (PROM limitation <7°) and the spasticity-with-contracture group (PROM limitation ≥7°). Outcomes were assessed at baseline and at 2, 4 and 12 weeks post-injection, including the Modified Ashworth Scale (MAS) for plantar-flexors, Brunnstrom Recovery Stage (BRS), Fugl-Meyer Assessment (FMA) lower-extremity subscore and Barthel Index (BI). Results:A total of 107 patients were enrolled-54 in the spasticity group and 53 in the spasticity-with-contracture group. Baseline comparison revealed a significantly longer disease duration in the spasticity-with-contracture group; other characteristics were comparable. Both groups achieved improvements in MAS and BRS at all three follow-up visits. FMA and BI improved in the spasticity group at 4 and 12 weeks, whereas the spasticity-with-contracture group showed improvement only at 12 weeks. Between-group analyses indicated that MAS and BRS scores were consistently better in the spasticity group at each time point; although median FMA and BI were numerically higher in this group, the differences did not reach statistical significance. Conclusion:BoNT-A markedly reduces post-stroke hyper-resistance and enhances motor function and activities of daily living; by contrast, concomitant contracture is associated with delayed and attenuated improvement in MAS and BRS.

Background:Stroke remains the leading cause of long-term disability worldwide. Approximately 60% of individuals with chronic ischemic stroke experience persistent upper limb impairment that limits daily activities. The Repair Study aims to evaluate the safety and efficacy of vagus nerve stimulation (VNS) paired with rehabilitation in patients with chronic ischemic stroke in developing countries, including those with severe upper limb dysfunction, thereby generating evidence to support broader global application. Methods:It is a multicenter, triple-blinded, randomized controlled trial conducted across 13 centers in China. Up to 99 participants with upper limb motor impairment, 9 months to 10 years post-stroke, will be enrolled. All participants will undergo VNS implantation (Model G115R/G115, PINS Medical, Beijing, China) and be randomized 2:1 by a central randomization system to active stimulation (0.8 mA) or sham stimulation (0 mA) paired with standardized upper limb rehabilitation. The blinded phase includes 6 weeks of clinical therapy (three sessions/week, 90-120 min/session, ≥300 stimulation-movement repetitions) followed by 6 weeks of home-based therapy (30 min/day). Post-unblinding, the active VNS group continues home-based therapy, while the sham group receives 6 weeks of clinic-based therapy. Discussion:The primary outcome is the between-group difference in Fugl-Meyer Assessment for Upper Extremity scores at the end of 6 weeks of clinical therapy. Secondary outcomes include additional motor, functional, and quality-of-life measures. Safety will be assessed through adverse event monitoring. The Repair Study is a multicenter randomized controlled trial targeting chronic ischemic stroke populations in developing countries. It supplements the existing clinical evidence by enrolling patients with more servere motor dysfunction and being conducted in a developing country. Trial Registration:ClinicalTrials.gov: NCT06722677.

Depressive disorders and coronary heart disease (CHD) are significant and pervasive global public health challenges, influenced by various factors such as diet, physical activity, social circumstances, and lifestyle habits. This study aim to investigate the relationship among regular walking, the systemic immune-inflammation index (SII), and depression in CHD patients. Additionally, it seeks to explore the mediating role of SII in the effect of regular walking on depression among these patients. This cross-sectional study involved 464 patients aged ≥ 65 years with CHD, admitted to the cadre ward of the First Hospital of Jilin University from September 2021 to December 2022. A comprehensive geriatric assessment (CGA) inventory was prepared by compiling and screening regular walking, calculated SII, and the Geriatric Depression Scale (GDS). Binary logistic regression was employed to examine the relationship among walking, ln(SII) and depression. After adjusting for confounding factors, linear regression analysis was used to assess the correlation among exercise-related factors, ln(SII) and depression. Sensitivity analyses were performed through stratified analysis, investigating the relationship between walking and depression within the strata of each variable, as well as the P-interaction among stratified variables. Additionally, the Process package in SPSS was used to explore the mediating role of ln(SII) in the association between regular walking and depression. Model 2: Elderly individuals who walk regularly are 72.2

Aphasia is a language network disorder caused by organic brain lesions, which severely affects patients' daily communication and interaction. The therapeutic effect of conventional rehabilitation training alone is limited. Currently, Theta Burst Stimulation (TBS) is a novel therapeutic modality of repetitive Transcranial Magnetic Stimulation (rTMS) and is a commonly used patterned rTMS. It appears in the form of burst waves and mimics the natural firing pattern of hippocampal neurons under Theta rhythm. Based on rTMS, TBS embeds a pattern in which three 50 Hz pulse bursts are inserted into a 5 Hz pulse train. This stimulation pattern can induce cortical plasticity in a shorter period of time and is gradually being applied in the treatment of aphasia. Auditory comprehension, as the initial component of language input, involves the reception and storage of linguistic signals, as well as the analysis and integration of lexical semantics. The recovery of this ability plays a prerequisite role in the functional improvement of patients with post-stroke aphasia (PSA). In recent years, research on aphasia has mainly focused on speaking, reading, and writing abilities, with relatively less attention paid to auditory comprehension. Therefore, this article reviews the research progress related to the use of TBS in treating auditory comprehension in aphasia, aiming to provide new ideas and references for the clinical selection of TBS stimulation protocols.

Background Over 80% of patients with stroke experience finger grasping dysfunction, affecting independence in activities of daily living and quality of life. In routine training, task-oriented training is usually used for functional hand training, which may improve finger grasping performance after stroke, while augmented therapy may lead to a better treatment outcome. As a new technology-supported training, the hand rehabilitation robot provides opportunities to improve the therapeutic effect by increasing the training intensity. However, most hand rehabilitation robots commonly applied in clinics are based on a passive training mode and lack the sensory feedback function of fingers, which is not conducive to patients completing more accurate grasping movements. A force feedback hand rehabilitation robot can compensate for these defects. However, its clinical efficacy in patients with stroke remains unknown. This study aimed to investigate the effectiveness and added value of a force feedback hand rehabilitation robot combined with task-oriented training in stroke patients with hemiplegia. Methods In this single-blinded randomised controlled trial, 44 stroke patients with hemiplegia were randomly divided into experimental (n = 22) and control (n = 22) groups. Both groups received 40 min/day of conventional upper limb rehabilitation training. The experimental group received 20 min/day of task-oriented training assisted by a force feedback rehabilitation robot, and the control group received 20 min/day of task-oriented training assisted by therapists. Training was provided for 4 weeks, 5 times/week. The Fugl-Meyer motor function assessment of the hand part (FMA-Hand), Action Research Arm Test (ARAT), grip strength, Modified Ashworth scale (MAS), range of motion (ROM), Brunnstrom recovery stages of the hand (BRS-H), and Barthel index (BI) were used to evaluate the effect of two groups before and after treatment. Results Intra-group comparison: In both groups, the FMA-Hand, ARAT, grip strength, AROM, BRS-H, and BI scores after 4 weeks of treatment were significantly higher than those before treatment (p < 0.05), whereas there was no significant difference in finger flexor MAS scores before and after treatment (p > 0.05). Inter-group comparison: After 4 weeks of treatment, the experimental group's FMA-Hand total score, ARAT, grip strength, and AROM were significantly better than those of the control group (p < 0.05). However, there were no statistically significant differences in the scores of each sub-item of the FMA-Hand after Bonferroni correction (p > 0.007). In addition, there were no statistically significant differences in MAS, BRS-H, and BI scores (p > 0.05). Conclusion Hand performance improved in patients with stroke after 4 weeks of task-oriented training. The use of a force feedback hand rehabilitation robot to support task-oriented training showed additional value over conventional task-oriented training in stroke patients with hand dysfunction. Clinical trial registration information NCT05841108

This study aimed to investigate the impact of a visual feedback task-oriented training system on post-stroke pusher syndrome. Eighty-four patients diagnosed with post-stroke pusher syndrome were carefully selected and randomly assigned to either a treatment group or a control group, with an equal distribution of 24 patients per group, using a random number table method. Both cohorts underwent a standardized rehabilitation regimen, which consisted of daily sessions lasting two hours, conducted six days a week over a period of eight weeks. The treatment group was introduced to a task-oriented training modality, complemented by visual feedback, with each session lasting twenty minutes and occurring once daily. To systematically assess and compare the efficacy of the rehabilitation protocols, the following assessments were administered: the Trunk Control Test (TCT), Berg Balance Function Scale (BBS), Modified Barthel Index (MBI), and Scales for Contraversive Pushing (SCP). These evaluations were conducted at three distinct time points: prior to treatment initiation, at the four-week mark post-treatment, and upon completion of the eight-week treatment period. The primary outcomes of interest were the comparative evaluations of trunk control, balance capabilities, activities of daily living (ADL), and the degree of contraversive pushing between the two groups.Following the 4-week and 8-week treatment milestones, both groups exhibited a statistically significant enhancement in their TCT, BBS, MBI, and SCP scores when compared to baseline measures (P< 0.05). Specifically, at the 4-week juncture, the treatment group demonstrated a notably superior performance in TCT scores, with the difference being statistically significant (P< 0.05).Upon reaching the 8-week mark, the treatment group not only sustained this advantage but also achieved significantly higher scores across all evaluated metrics-TCT, BBS, MBI, and SCP-when juxtaposed with the control group, reinforcing the efficacy of the treatment. These disparities were again statistically significant (P< 0.05), underscoring the robust impact of the intervention. The visual feedback task-oriented training instrument has been demonstrated to markedly enhance the trunk control capabilities, balance functionality, and activities of daily living for patients afflicted with post-stroke pusher syndrome. Furthermore, it significantly mitigates the degree of tilt, an essential factor in the rehabilitation process.

Whisker sensors play a significant role in the navigation of robots in dark environments. However, contemporary whisker sensors suffer from impractical sizes, underdeveloped space detection capabilities and robustness, hindering their integration into robotic systems. To overcome these issues, we propose a compact optical bionic whisker (OWH) capable of perceiving external stimuli in both contact and noncontact modes. The whisker sensor achieves deflection and direction solely by calculating the variation in light intensity collected from symmetrically distributed photodiodes. Additionally, fine element analysis (FEA) is employed to optimize the sensitivity of the whisker sensor. Experimental validation involving contact and noncontact multidirectional wind test results demonstrated the promising performance of the OWH sensor, affirming its potential for integration into robot perception systems and providing improved adaptability and sensing capabilities across diverse environments.

Post-stroke depression is closely related to the poor prognosis of stroke, resulting in prolonged hospital stay, neurological dysfunction, and increased mortality. Post-stroke depression has a complex pathogenesis, and cannot be explained by a single pathophysiological mechanism; therefore, no treatment is definitely effective. Currently, the commonly used treatment methods include drug therapy, psychotherapy and noninvasive neuromodulation therapy, such as repetitive transcranial magnetic stimulation, and transcranial direct current stimulation. However, simple drugs have poor efficacy and are often accompanied by side effects. Although repetitive transcranial magnetic stimulation and transcranial direct current stimulation combined with drug therapy enhance drug efficacy, their application is limited in some cases. Light therapy can regulate the central nervous system through the light-sensitive retinal nerve pathway, which has been proven to have therapeutic effects in patients with depression. Light therapy has the advantages of no obvious side effects and a wider range of adaptation. This review summarizes the current research status of noninvasive neuromodulation and light therapy in post-stroke depression and explores the possibility of widespread application of physical factors modulation for post-stroke depression.

Backgroud: The impaired hand function after stroke severely affected the patients' activities of daily living. Robot-assisted training is a supplementary method to promote the recovery of hand motor function, but few studies have reported the effect of haptic perception rehabilitation robots on hand grasping function after stroke. Objective: To investigate the effect of haptic perception rehabilitation robot training on the recovery of hand grasping function after stroke. Methods: This study was a single-blind randomized controlled trial. 44 stroke patients were randomly divided into experimental group (n = 22) and control group (n = 22). On the basis of conventional rehabilitation training, the experimental group received the grasp training session assisted by the haptic perception rehabilitation robot for 20 min, and the control group received the conventional hand grasp training session for 20 min. Grasp and grip part in action research arm test (ARAT), grip strength, modified Ashworth scale (MAS), total active movement (TAM) and Barthel index (BI) were used to evaluate the recovery of hand grasping function and activities of daily living before and 20 training sessions. Results: Compared with the therapist-assisted hand function training, the haptic perception rehabilitation robot training improved the grasping function and TAM of stroke patients (P < 0.05). However, there were no significant changes in other clinical outcome indicators (P > 0.05). Conclusion: The haptic perception rehabilitation robot training can help to restore the hand grasp function after stroke.

Pusher syndrome, characterized by a postural bias and resistance to correction after stroke, significantly hinders functional recovery. This study evaluates the clinical efficacy of a dynamic balance training instrument in 58 elderly patients with post-stroke Pusher syndrome from September 2023 to June 2024. Patients were randomly divided into treatment group and control group. All 29 patients in each group received routine rehabilitation training. On this basis, the treatment group increased the dynamic balance training with Tecnobody S.r.l's system. The Trunk Control Test (TCT), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and SCP scale assessed trunk control, balance, ADL ability, and tilt degree, respectively. Results: After 3 weeks and 6 weeks of treatment, all of the scores of TCT, BBS and MBI were significantly improved compared with those before treatment in both groups (P < 0.05); After 3 weeks of treatment, the score of TCT in the treatment group was significantly higher than that of the control group (P < 0.05); After 6 weeks of treatment all of the scores in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion: Dynamic balance training instrument combined with routine rehabilitation training can significantly improve the trunk control ability, balance function and the ability of activity of daily living of patients with Pusher syndrome after stroke.

Convolutional neural network (CNN)-based models are widely used in human movement decoding based on surface electromyography. However, they capture only the spatial information of the surface electromyography and lack prior knowledge of the system, resulting in unsatisfactory decoding accuracy. To address these issues, we propose an attention-based Kalman filter scheme (AKFS), which uses an attention-based CNN model to better extract temporal information and a KF to add prior knowledge of the system. We further solve the problem of insufficient data due to the short training time of new subjects by using a transfer learning method based on a fine-tuning strategy. The proposed scheme was tested in four scenarios: intra-session, intra-session long-time use, inter-subject, and inter-subject with a fine-tuning strategy. The proposed attention-based CNN model outperformed the vanilla CNN model and a hybrid CNN-long short-term memory (LSTM) model in intra-session and intra-session long-time use. After fine-tuning with a small amount of data on a new subject, the attention-based CNN model achieved higher decoding accuracy than the vanilla CNN model and lower response time than CNN-LSTM model. Furthermore, the schemes with KF outperformed the schemes without KF in all scenarios. Our proposed scheme improves the decoding accuracy of the traditional CNN model for a single subject by better capturing the temporal information of the surface electromyography signal and increasing the prior knowledge of the system. Additionally, the proposed scheme can be easily transferred to a new subject using only a small amount of data.

BACKGROUND Angiosarcoma is a rare malignant tumor. Owing to the lack of specific clinical manifestations of this disease, it is difficult to achieve early diagnosis and start early treatment. CASE SUMMARY A 78-year-old male patient was admitted to the hospital because of a bump on his head that did not heal for 4 mo. The patient was diagnosed with a refractory head wound. The patient underwent neoplasm resection and skin grafting surgery in the Plastic Surgery. The neoplasm was sent for pathological examination during the operation. The final pathological results were confirmed scalp angiosarcoma. CONCLUSION Our research suggests that pathological examination should be performed for refractory ulcers of the scalp, and physical factor therapy should be used with caution before the diagnosis is clear.

The clinical efficacy of ESWT in treating bone non union has been widely recognized, but the biological mechanism of ESWT promoting bone non union healing is still unclear. ESWT can make old callus micro fracture through mechanical conduction, form subperiosteal hematoma, promote the release of bioactive factors, reactivate the fracture healing mechanism, rebalance the activities of osteoblasts and osteoclast, promote the angiogenesis of fracture site, and accelerate the healing of bone nonunion.Over recent years, great efforts have been made by both scientists and clinicians to explore the underlying mechanism behind the healing effect of ESWT on bone fractures. In this review, we introduced the growth factors during osteogenesis induced by ESWT hoping to provide new insights in the clinical use of ESWT.

Multiple sclerosis is a slowly progressive disease, immunosuppressants and other drugs can delay the progression and progression of the disease, but the most patients will be left with varying degrees of neurological deficit symptoms, such as muscle weakness, muscle spasm, ataxia, sensory impairment, dysphagia, cognitive dysfunction, psychological disorders, etc. From the early stage of the disease to the stage of disease progression, professional rehabilitation treatment can reduce the functional dysfunction of multiple sclerosis patients, improve neurological function, and reduce family and social burdens. With the development of various new rehabilitation technologies such as transcranial magnetic stimulation, virtual reality technology, robot-assisted gait, telerehabilitation and transcranial direct current stimulation, the advantages of rehabilitation therapy in multiple sclerosis treatment have been further established, and more treatment means have also been provided for patients.

针对密度非均匀点云重建时难以控制网格生长范围的问题,研究了一种基于自适应邻域的非均匀点云数据封装方法.首先根据点云密度自适应地调整空间搜索球半径,然后利用投影法将邻域投影到二维平面,再根据约束准则寻找最优扩展点,逐步构建出网格曲面,最后利用孔洞修补方法修补网格中的孔洞.实验结果表明,该算法能够有效控制网格生长范围,构建出表达细节特征的网格曲面.

Spasticity is one of the most common complications after stroke. With the gradual intensification of spasticity, stroke patients will have a series of problems such as joint ankylosis and movement restriction, which affect the daily activities and increase the burden on patients' families, medical staff and society. There are many ways to treat post-stroke spasticity before, including physical therapy and exercise therapy, drug therapy, surgery and so on, but not satisfied because of a few shortcomings. In recent years, many researchers have applied extracorporeal shock wave therapy (ESWT) for the treatment of post-stroke spasm and achieved good clinical effect, because it is non-invasive, safe, easy to operate, low cost and other advantages compared with other treatment methods. This article reviews the research progress and existing problems of ESWT in the treatment of post-stroke spasticity.

Stroke and spinal cord injury are common neurological disorders that can cause various dysfunctions. Motor dysfunction is a common dysfunction that easily leads to complications such as joint stiffness and muscle contracture and markedly impairs the daily living activities and long-term prognosis of patients. Orthotic devices can prevent or compensate for motor dysfunctions. Using orthotic devices early can help prevent and correct deformities and treat muscle and joint problems. An orthotic device is also an effective rehabilitation tool for improving motor function and compensatory abilities. In this study, we reviewed the epidemiological characteristics of stroke and spinal cord injury, provided the therapeutic effect and recent advances in the application of conventional and new types of orthotic devices used in stroke and spinal cord injury in different joints of the upper and lower limbs, identified the shortcomings with these orthotics, and suggested directions for future research.

首先对预处理后图像进行像素级和亚像素级边缘曲线特征提取,然后进行边缘曲线解码以及码值匹配,最后依据三角测距原理获取三维点云.实验结果表明,该方法对平面的重建偏差为0.1905 m m.