早期介入运动想象疗法对急性脑卒中偏瘫患者下肢运动功能及日常生活活动能力的影响

目的探讨早期介入运动想象疗法对急性脑卒中偏瘫患者下肢运动功能和日常生活活动能力的影响。方法将67例急性脑卒中偏瘫患者随机分为运动疗法组(34例)、对照组(33例)。对照组采用常规西药和基础康复治疗,运动疗法组在此基础上采用运动想象疗法进行早期干预。分别于入组时,治疗后2、4、8周以及90 d,采用简化的Fugl-Meyer运动量表(FMA)和改良Barthel指数量表(MBI)评定患者的下肢运动功能和日常生活活动能力。结果两组治疗前下肢FMA及MBI评分差异无统计学意义(P0.05)。至第8周,两组患者下肢FMA及MBI评分呈增高趋势,各时间点差异有统计学意义(均P0.05),两组患者第90 d与第8周差异无统计学意义(均P0.05)。运动疗法组第2、4、8周及第90 d的下肢FMA及MBI评分均高于对照组(均P0.05)。结论在常规康复治疗基础上,早期介入运动想象训练可显著促进急性脑卒中偏瘫患者下肢运动功能和日常生活活动能力的恢复。     

运动想象结合运动再学习对偏瘫患者上肢运动功能恢复的作用

目的 探讨运动想象结合运动再学习对偏瘫患者上肢运动功能恢复的影响.方法 将120例脑卒中偏瘫患者随机分成运动想象组(治疗组)和一般治疗组(对照组),其中治疗组60例,对照组60例,2组均进行常规神经内科药物治疗和运动再学习训练,其中运动想象组在训练前进行 "运动想象".2组均接受1次/d,40min/次,治疗6周.采用Fugl-Meyer上肢运动功能评分法(FMA)、改良Barthel指数法(MBI)对2组患者治疗前、后上肢功能和日常生活活动能力进行评定.结果 2组患者上肢功能和日常生活活动能力积分较治疗前均有明显提高(P<0.01),但治疗组的改善明显优对照组(P<0.01).结论 运动再学习结合运动想象疗法可提高偏瘫患者上肢运动功能.     

重复经颅磁刺激联合生物反馈对脑卒中上肢运动功能的康复评价

目的探讨重复经颅磁刺激(rTMS)联合生物反馈对脑卒中患者上肢运动功能的康复效果。方法选取脑卒中患者120例,随机分为观察组和对照组各60例,2组患者均给予常规药物及康复治疗,观察组在常规康复的基础上给予rTMS和生物反馈治疗。颅磁刺激联合生物治疗前应用加拿大功能神经功能量表(CNS)、Fugl-Meyer运动功能量表(FMA)和改良Barthel指数(MBI)对2组患者的上肢运动功能以及日常生活活动能力进行评定;经4周治疗后再进行效果评价。结果治疗后4周观察组CNS、MBI、FMA评分均高于对照组,差异具有统计学意义(P0.05)。结论 rTMS联合生物反馈康复训练可改善脑卒中患者的上肢运动功能,有效地提高患者的生活质量。     

早期康复治疗对脑卒中患者肢体功能恢复的影响

目的探讨早期康复治疗对脑卒中患者肢体功能恢复的影响。方法选择2015-05—2016-05在驻马店市中心医院治疗的脑卒中患者100例,随机分为观察组和对照组各50例,对照组给予常规治疗和护理,观察组在常规治疗和护理的基础上给予早期康复治疗,比较2组患者肢体功能恢复情况和日常生活活动能力。结果干预前,2组患者的CCS评分、MBI评分及FMA评分无明显差异(P0.05);干预后2组患者的CCS评分、MBI评分及FMA评分均有所改善(P0.05),干预后2组CCS评分、MBI评分及FMA评分比较差异有统计学意义(P0.05)。结论脑卒中患者采用早期康复治疗有助于改善肢体运动功能和神经功能,促进患者肢体康复,提高日常生活活动能力和自理能力。     

超早期康复护理在脑卒中患者功能恢复中的作用

目的探讨超早期康复护理对脑卒中患者日常生活能力恢复的影响。方法将120例脑卒中患者随机分为对照组和观察组,对照组给予常规护理,观察组在一般药物治疗护理基础上进行超早期综合康复治疗护理。采用自行设计的调查表评价患者对护理质量满意度,采用国际通用量表改良Barthel指数(MBI)、简化Fugl-Meyer运动功能评分量表(FMA)评价患者的运动功能及日常生活能力。结果护理干预后观察组患者对护理满意度为95.00%,明显高于对照组的81.67%,差异有统计学意义(P<0.05);随访4周后,观察组患者的FMA评分及MBI均显著高于对照组,差异有统计学意义(P<0.05)。结论超早期综合康复护理可减少脑卒中患者的残疾发生,能明显改善脑卒中患者偏瘫肢体功能和日常生活活动能力,改善脑卒中后抑郁等不良情绪,值得在临床推广。     

镜像疗法联合康复训练对缺血性脑卒中偏瘫患者上肢功能的影响

目的探讨镜像疗法联合康复训练对缺血性脑卒中偏瘫患者上肢功能的影响。方法选取60例缺血性脑卒中上肢功能障碍的偏瘫患者,随机分为对照组29例行常规综合康复治疗,实验组31例为镜像疗法联合常规康复训练。采用Fugl-Meyer运动功能评价量表(Fugl-Meyer assessment,FMA)、Wolf运动功能评价量表(Wolf motor function test,WMFT)和改良Barthel指数(modified Barthel indext,MBI)评分对上肢和手的运动功能及日常生活能力进行评价。结果与对照组同期相比,治疗1个月和治疗2个月实验组FMA评分较对照组提高(P0.05),治疗2个月实验组WMFT评分较对照组提高(P0.05)。与治疗前相比,治疗1个月和2个月时实验组上肢MBI评分提高(P0.05);与同期对照组比较,治疗2个月时实验组MBI评分显著提高(P0.05)。结论镜像疗法联合康复训练有助于缺血性脑卒中偏瘫患者上肢运动功能的恢复,改善患者的日常生活能力,可作为缺血性脑卒中后上肢功能康复的一种治疗手段。     

早期综合康复治疗对急性脑卒中患者运动功能的影响

目的:探讨早期康复治疗对急性脑卒中患者运动功能的影响。方法:将219例急性脑卒中患者随机分为康复治疗组和对照组。康复治疗组116例,对照组103例。两组患者均采用常规药物治疗,而康复治疗组在患者生命体征稳定24-48小时内采用神经肌肉促进技术、功能性电刺激、心理治疗等综合康复治疗措施,于治疗前及治疗3个月时采用Fugl-Meyer(Fugl-Meyer Assessment,FMA)评分评定患者的运动功能;用Barthel指数(Modified Barthel Index,MBI)评定患者的日常生活活动功能(ADL)。结果:康复治疗组患者的FMA评分及MBI评分均较对照组明显提高,其差异具有非常显著性意义(P<0.01)。结论:早期康复治疗可明显改善急性脑卒中患者的运动功能及日常生活活动能力。     

综合性康复训练联合心理干预对脑梗塞偏瘫患者负性情绪及日常生活能力和运动功能的影响

目的探讨综合性康复训练结合心理干预对脑梗塞后偏瘫患者的负性情绪,日常生活活动能力及运动功能的影响。方法选取2015年12月～2016年12月期间在我院接受治疗的78例脑梗塞后肢体偏瘫患者作为研究对象,随机分为观察组和对照组,各39例。对照组予以常规的药物治疗及康复训练;观察组在对照组基础上予以综合性康复训练及心理干预。分别对两组患者的治疗前、治疗3周和治疗8周后的汉密尔抑郁量表(HAMD-17)、Fugl-Meyer运动功能量表评分(FMA)、改良Barthel指数评分(MBI)进行比较。结果治疗前,两组患者的HAMD-17、FMA和MBI评分差异无统计学意义(P0.05),治疗后两组患者上述指标均较治疗前改善,且经治疗3周和8周后观察组的HAMD-17评分、MBI评分和FMA显著优于对照组(P0.05)。结论在常规治疗及康复训练的基础上,实施综合性康复训练结合心理干预可以更有效改善脑梗塞后偏瘫患者的抑郁情绪,促进患者的肢体运动功能和日常生活活动能力的恢复。     

早期康复治疗对急性脑卒中患者运动功能和生活能力的影响

目的探讨早期康复治疗对脑卒中患者运动功能和日常生活活动能力(ADL)的影响。方法将50例脑卒中偏瘫患者随机分成康复组(25例)和对照组(25例)进行临床对照研究,两组均进行常规神经内科药物治疗,康复组加以运动疗法,每例患者入组时、治疗第30d分别用Fugl-Meyer运动功能(FMA)量表测试运动功能和改良Barthel指数量表(MBI)测试ADL。结果MBI值:康复组治疗前、后分别为:20.68±8.98、72.36±17.39,对照组治疗前后分别为:21.24±12.59、51.29±18.52。FMA值:康复组治疗前、后分别为33.84±12.63、68.46±20.45,对照组治疗前、后分别为32.13±11.26、44.25±18.86。康复组和治疗组组间及组内比较差异具有显著统计学意义。结论康复治疗对偏瘫患者运动功能和日常生活活动能力具有良好的促进作用。可明显降低患者的依赖程度,提高其生活质量。     

早期康复治疗对急性脑卒中偏瘫患者运动功能的影响

目的分析急性脑卒中偏瘫患者行早期康复治疗对其运动功能的影响。方法选取我院于2013-06—2014-06收治的急性脑卒中偏瘫患者72例为研究对象,随机分成观察组和对照组,每组36例。2组患者在入院后均常规药物治疗,观察组在此基础上行规范化的运动功能康复训练,对照组在此基础上未经系统指导的自我运动功能锻炼。在治疗前1d和治疗后8周对患者的运动功能和日常生活活动能力进行系统评分。运动功能评分使用FMA运动功能积分法评定,日常生活活动能力使用巴塞尔指数评定。结果 2组康复治疗前FMA评分和巴塞尔指数差异无统计学意义(P0.05),康复治疗8周后,FMA评分及巴塞尔指数均有不同程度的好转,观察组改善幅度方面显著优于对照组,差异有统计学意义(P0.05)。结论急性脑卒中偏瘫患者若不进行有效的康复治疗会严重影响患者预后的生活质量,早期康复治疗能够有效改善患者的上下载运动功能和日常生活能力,利于患者预后,值得临床应用。     

Evaluation of the results of the treatment of patients with subacute sclerosing panencephalitis with TFX-Polfa

The authors report the results of a trial of treatment of patients with SSPE with the preparation TFX-POLFA given together with isoprinosine and amantadine to 13 children for 12 weeks, and to 7 for 6 weeks. The results of clinical and immunological treatment were compared with those in a group of 10 patients with SSPE receiving only isoprinosine and amantadine. In both groups a steady deterioration of the neurological status was observed in about half the cases. No significant effect of TFX was observed on the immune reactivity. During the treatment with TFX the per cent of lymphocytes forming early E rosettes rose.     

Use of the BAT with a Cantonese-Putonghua speaker with aphasia

The aim of this article is to illustrate the use of the Bilingual Aphasia Test (BAT) with a Cantonese-Putonghua speaker. We describe G, who is a relatively young Chinese bilingual speaker with aphasia. G's communication abilities in his L2, Putonghua, were impaired following brain damage. This impairment caused specific difficulties in communication with his wife, a native Putonghua speaker, and was thus a priority for investigation. Given a paucity of standardised tests of aphasia in Putonghua, our goal was to use the BAT to assess G's impairments in his L2. Results showed that G's performance on the BAT subtests measuring word and sentence comprehension and production was impaired. His pattern of performance on the BAT allowed us to generate hypotheses about his higher-level language impairments in Putonghua, which were subsequently found to be impaired. We argue that the BAT is able to capture the primary language impairments in Chinese-speaking patients with aphasia when Putonghua is the second language. We also suggest some modifications to the BAT for testing Chinese-speaking patients with bilingual aphasia.     

Understanding the experience of driving with a passenger with aphasia

Background: Drivers and passengers often spend a great deal of time conversing when riding in a personal automobile. Under most circumstances, drivers are easily able to maintain a conversation with their passengers while safely operating their vehicle. However, this task may be challenging when the passenger riding in the car has aphasia since many people with aphasia supplement their limited verbal output with other communication modalities, such as writing, gesturing, and using body language.

Aims: The aim of this paper is to describe the experience of driving a personal automobile when a passenger with aphasia is riding in the car.

Methods & Procedures: A phenomenological approach was used to gain an understanding of the lived experience of driving a car with a passenger with aphasia. Nine people who regularly serve as the primary drivers of a person with aphasia were interviewed twice using a semi-structured interview guide. Data were analysed using thematic analysis.

Outcomes & Results: Three main themes characterised the drivers’ experiences of riding with an aphasic passenger: (1) communicating, (2) helping, and (3) adapting. The theme of communicating was specified in terms of time constraints, topic avoidance, and communication strategies. The theme of helping was constructed from two subthemes: avoiding accidents and navigating. Drivers reported that passengers needed to adapt to the car environment due to stroke-induced cognitive and physical deficits.

Conclusions: The findings describe various problems that people who drive an automobile with a passenger with aphasia experience and the ways in which they seek to overcome these problems. Clinicians should collaborate with drivers and passengers with aphasia to enhance the safety and quality of their in-vehicle experience.     

Interaction of pathogens with the endothelium

The endothelium lines the inner surface of the vessel wall establishing a multifunctional, semi-permeable cellular barrier at blood-tissue interface. The large total surface of the endothelium is exposed to pathogens, pathogen-derived products as well as to agents of the activated host defense during an inflammatory reaction. The endothelium is not only specifically targeted by important infective agents like Rickettsiae (1) or Bartonella (2), it is involved in virtually most, if not all, acute inflammatory responses. Pathogens attack the endothelium by a wide variety of strategies, as different as activation of preformed receptor-mediated pathways in the endothelium, release of pore-forming exotoxins or intracellular replication and chronic parasitism. These pathophysiological forces affect the endothelial phenotype, resulting in endothelial barrier dysfunction, increased leukocyte-endothelial interaction, mediator release, and procoagulant activity. Moreover, endothelial responses retroact on the invading pathogen as well as on the host defense resulting in a complex and dynamic interaction. Endothelial activation contributes considerably to inflammation and resulting clinical characteristics. In this context the endothelium is not just a passive victim, it rather aggravates the ongoing struggle with the pathogen. In this review we focus on some important mechanisms of the cellular microbiology of endothelial infection by bacteria and viruses.