【摘要】 目的 探讨肌电生物反馈治疗对脑卒中偏瘫患肢上肢腕背伸功能的影响。方法 将36例脑卒中偏瘫患者随机分为治疗组和对照组,每组18例。两组药物治疗相同,对照组进行常规康复治疗,治疗组在常规康复治疗基础上加肌电生物反馈技术进行治疗。观察两组治疗前后腕背伸时主动关节活动范围(AROM),腕背伸时肌肉最大收缩时肌电(EMG)阈值。 结果 3个疗程后治疗组患者腕关节的AROM、EMG阈值均优于对照组(P＜0.001)。 结论 肌电生物反馈治疗有助于明显改善偏瘫患者腕背伸功能。【Abstract】 Objective To explore the effect of the electromyographic biofeedback therapy on the extension of wrist joint of the hemiplegic patients after stroke. Methods Thirtysix hemiplegic patients were included and were divided into two groups randomly, including a treatment group and a control group. They were treated with the same drugs and the routine rehabilitation therapy while the patients in the treatment group still received the electromyographic biofeedback therapy additionally. Results After three courses of treatment, the patients in the treatment group had better active range of movement (AROM) of extension of wrist joint and also higher electromyographic (EMG) threshold of maximum contraction of muscle than the patients in the control group (Plt;0.001). Conclusion The electromyographic biofeedback therapy has good effect on improving the function of the wrist of hemiplegic patients after stroke.
Objective To explore the awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke. Methods From January to August 2012, using self-designed questionnaire, trained neurologists conducted the face to face investigation in 500 inpatients with a high risk of stroke, including those with a history of stroke in Department of Neurology in the Second Affiliated Hospital of Chongqing Medical University. Results A total of 467 valid questionnaires were recovered. Only 16.1% (75/467) patients were aware of thrombolytic therapy for acute stroke, of whom 50.7% (38/75) knew the time window of thrombolytic therapy. Awareness of thrombolytic therapy was higher in patients aged 56-70 years, with a higher level of education and income, and in those who knew at least 3 stroke warning signs and those with a history of stroke. While awareness of the time window of thrombolytic therapy was higher in those unmarried or widowed and with a history of stroke. Multiple logistic regression analysis showed that awareness of thrombolytic therapy was independently associated with age, education level, knowledge of stroke warning signs and a history of stroke; awareness of the time window was associated with marital status and a history of stroke (P<0.05). Conclusions Inpatients with a history of stroke and with a high risk of stroke in the Department of Neurology have poor awareness of thrombolytic therapy for acute ischemic stroke. It is necessary to improve the level of patients’ knowledge about thrombolytic therapy for acute stroke by health education.
ObjectiveTo explore the risk factors of stroke-associated pneumonia (SAP) in the patients with acute ischemic stroke, in order to provide effective guidance for clinical prevention and treatment.MethodsFrom November 2016 to November 2019, 330 patients with acute ischemic stroke admitted to the Department of Neurology of West China Hospital of Sichuan University and the Department of Neurology of the Sixth People’s Hospital of Chengdu were selected as the research object. The clinical data of the patients were analyzed retrospectively. According to whether SAP occurred, they were divided into infected group and non-infected group. Multivariate logistic regression model was used to analyze the risk factors of SAP.ResultsA total of 71 cases of SAP occurred in patients with acute ischemic stroke, accounting for 21.52%. Logistic regression analysis showed that age≥70 years old [odds ratio (OR)=3.677, 95% confidence interval (CI) (1.452, 9.311), P=0.006], chronic lung disease [OR=4.985, 95%CI (1.558, 15.952), P=0.007], disturbance of consciousness [OR=7.147, 95%CI (1.617, 31.587), P=0.009], bulbar palsy [OR=5.909, 95%CI (2.668, 13.089), P<0.001], the use of nasal feeding tube [OR=7.427, 95%CI (1.681, 32.812), P=0.008] were independent risk factors for SAP in patients with acute ischemic stroke.ConclusionsAge≥70 years old, chronic lung disease, disturbance of consciousness, bulbar paralysis and use of nasal feeding tube are independent risk factors for SAP. It is necessary to strengthen the management of these risk factors in order to identify high-risk patients with SAP early, and develop intervention strategies for risk factors, so as to improve the prognosis.
Objective To investigate the current situation of clinical studies on puerarin for ischemic stroke and the reliability of these evidence. Methods By electronic searching and handsearching, we collected all the published clinical study reports on puerarin for ischemic stroke and assessed all the included reports according to clinical epidemiologic standard. Results 35 RCTs, 22 non-randomized controlled trials and 17 case serials studies were included and analysed. Conclusions Current quality of clinical studies of puerarin for ischemic stroke is not good enough to provide reliable evidence.
High mobility group box 1 (HMGB1) is widely expressed in mammalian tissues and cells which is involved in various pathophysiological processes such as inflammation, autophagy, and apoptosis, and plays an important role in maintaining cell survival and normal function. HMGB1 plays an important part in the development of stroke, which can affect the prognosis by inducing neuroinflammation and autophagy. HMGB1 may have a bidirectional effect in acute and chronic phases. Exploring the specific role and mechanism of HMGB1 in each stage of stroke may make it a new target for prevention and treatment in the future.
Objective To systematically review the rehabilitation effect of isokinetic muscle training on knee muscle strength, functional walking ability and dynamic balance in post-stroke patients. Methods PubMed, Ovid Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang databases were searched online for randomized controlled trials on isokinetic muscle training of lower limbs in post-stroke patients. The retrieval time was from inception to October, 2022. Endnote X9 software was used to manage the literature. Cochrane Manual 5.1.0 was used for quality assessment, and RevMan 5.4 software was used for meta-analysis. Results A total of 20 randomized controlled trials were included in the study, with the intervention group using isokinetic muscle training of the lower extremities or combined with conventional rehabilitation training and the control group using conventional rehabilitation training and/or other intervention, with a total of 1448 study subjects. Meta-analysis results showed that the differences in knee flexion peak torque [mean difference (MD)=5.85 N·m, 95% confidence interval (CI) (4.84, 6.85) N·m, P<0.00001], knee extension peak torque [MD=9.09 N·m, 95%CI (4.83, 13.36) N·m, P<0.0001], Time Up Go test [MD=–4.70 s, 95%CI (–6.68, –2.72) s, P<0.00001], 10-meter walking test [MD=–4.71 s, 95%CI (–9.12, –0.31) s, P=0.04], Fugl-Meyer Lower Extremity Motor Function Assessment score [MD=6.61, 95%CI (3.52, 9.70), P<0.0001], and Berg Balance Scale score [MD=5.61, 95%CI (0.91, 10.31), P=0.02] were statistically significant. Conclusion Isokinetic training may improve knee strength and functional walking ability in post-stroke patients, but there is still no strong evidence of improvement in motor function and balance.
Objective To investigate the assessment and treatment methods for unilateral spatial agnosia as well as its influence on the functional recovery of patients after stroke, so as to comprehensively understand unilateral spatial agnosia and formulate an effective treatment plan to improve the effect of rehabilitation for stroke patients. Methods A total of 86 patients with unilateral spatial agnosia were analyzed and a pre-treatment and post-treatment comparison was done. Results Of the 86 patients, 21% suffered from unilateral spatial agnosia. The occurrence of unilateral spatial agnosia was related to the location of the stroke lesion. The treatment group witnessed significant improvement after rehabilitation training of correcting unilateral spatial agnosia (Plt;0.05). Conclusion The correct rehabilitation method is beneficial for an early improvement in a patient’s cognitive ability. This also lays a foundation for the recovery of function in their limbs.
目的:探讨康复治疗脑卒中患者临床神经功能和日常生活活动能力(ADL)的影响。方法:将60例脑卒中偏瘫患者随机分为康复组(30例)和对照组(30例)进行临床对照研究,两组均常规进行神经内科治疗,康复组加以运动疗法,对每例患者入院时、出院时分别进行临床神经功能缺损评分、Bathel指数(MBI)评分。结果:康复组与对照组在入院时临床神经缺损评分及ADL评分比较差异无统计学意义(Pgt;0.05),而出院时两组上述评分比较差异有统计学意义(Plt;0.01)。结论:配合康复的临床疗效优于单独药物治疗。
Objective To investigate the application effect of ndividualized dietary care based on a multidisciplinary collaboration model on glycemic control, neurological recovery, dietary self-management, and satisfaction in stroke patients with abnormal blood glucose. Methods Patients with stroke and abnormal blood glucose admitted to the Department of Neurology, Shangjin Hospital, West China Hospital, Sichuan University between March and October 2024 were enrolled. Using SPSS 26.0 software, a random allocation sequence was generated to divide participants into an observation group and a control group. The control group received comprehensive nursing interventions, while the observation group received additional multidisciplinary collaboration model based individualized dietary care. Both groups were intervened until discharge. Glycemic indicators [glycated albumin (GA), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG)], neurological recovery, dietary adherence, and patient satisfaction were compared pre-intervention and post-intervention (at discharge). Results A total of 112 patients were included, with 56 patients in each group. At the post-intervention stage, GA, FBG and 2hPG in the observation group were lower than those in the control group (P<0.05), and the scores of the Dietary Compliance Scale for Type 2 Diabetes were higher than those in the control group (P<0.05). Except for admission (3.27±0.86 vs. 3.25±0.90, P＞0.05), the modified Rankin Scale scores of the observation group were lower than those of the control group at discharge (3.14±0.86 vs. 3.17±0.86), 30-days follow-up (2.93±0.76 vs. 3.02±0.84), and 90-days follow-up (1.05±0.80 vs.1.43±1.01) (P<0.05). The comparison results within the group showed that, there were significant differences in GA, FBG, 2hPG, modified Rankin Scale scores and Dietary Compliance Scale for Type 2 Diabetes between admission and discharge (P<0.05). The satisfaction rate of the observation group was higher than that of the control group (97.78% vs. 86.76%; χ2=3.877, P=0.049). Conclusion Multidisciplinary collaboration model based individualized dietary care improves short-term glycemic control, promotes long-term neurological recovery, enhances dietary adherence, and increases patient satisfaction in stroke patients with abnormal blood glucose, demonstrating clinical value for widespread application.