Five-Session Dual-Transcranial Direct Current Stimulation With Task-Specific Training Does Not Improve Gait and Lower Limb Performance Over Training Alone in Subacute Stroke: A Pilot Randomized Controlled Trial

ObjectiveTo determine the effect of five-session dual-transcranial direct current stimulation (dual-tDCS) combined with task-specific training on gait and lower limb motor performance in individuals with subacute stroke.Materials and MethodsTwenty-five participants who had a stroke in the subacute phase with mild motor impairment were recruited, randomized, and allocated into two groups. The active group (n = 13) received dual-tDCS with anodal over the lesioned hemisphere M1 and cathodal over the nonlesioned hemisphere, at 2 mA for 20 min before training for five consecutive days, while the sham group (n = 12) received sham mode before training. Gait speed as a primary outcome, temporospatial gait variables, lower-limb functional tasks (sit-to-stand and walking mobility), and muscle strength as secondary outcomes were collected at preintervention and postintervention (day 5), one-week follow-up, and one-month follow-up.ResultsThe primary outcome and most of the secondary outcomes were improved in both groups, with no significant difference between the two groups, and most of the results indicated small to moderate effect sizes of active tDCS compared to sham tDCS.ConclusionThe combined intervention showed no benefit over training alone in improving gait variables and lower-limb performance. However, some performances were saturated at some point, as moderate to high function participants were recruited in the present study. Future studies should consider recruiting participants with more varied motor impairment levels and may need to determine the optimal stimulation protocols and parameters to improve gait and lower-limb performance.     

输尿管软镜和经皮肾镜治疗嵌顿性输尿管上段结石的效果比较

目的探讨输尿管软镜和经皮肾镜治疗嵌顿性输尿管上段结石的临床效果。方法选取52例嵌顿性输尿管上段结石患者,随机分为两组各26例。A组予以经皮肾镜治疗,B组予以输尿管软镜治疗。比较两组的结石清除情况、住院时间、术后VAS评分,以及手术前后的IL-4、IL-6、IL-10水平。结果A组术后3 d、术后3个月的结石清除率均显著高于B组(P<0.05)。A组的住院时间显著长于B组,术后VAS评分显著高于B组(P<0.05)。两组术前的IL-4、IL-6、IL-10水平无显著性差异(P>0.05);术后1 d,两组的IL-4、IL-6、IL-10水平均较术前显著升高,且A组显著高于B组(P<0.05)。结论与经皮肾镜相比,输尿管软镜治疗嵌顿性输尿管上段结石的结石清除率较低,但对患者损伤小,术后疼痛轻,恢复快。     

Remind to move – A novel treatment on hemiplegic arm functions in children with unilateral cerebral palsy: A randomized cross-over study

Objective: To investigate the effects of ‘remind to move’ treatment on hemiplegic arm function in children with unilateral cerebral palsy (CP). Methodology: Twelve students with unilateral CP aged 6–18 were recruited from a special school and randomly assigned into two groups. Participants in the experimental group underwent a 3-week sensory cueing treatment followed by a 3-week sham treatment. Participants in the waitlist group completed the sham treatment first followed by the sensory-cueing treatment. There was a 4-week washout period between treatments. Results: Both functional hand use and arm impairment level significantxly improved after the 3-week sensory cueing treatment for the combined sample between groups. However, no significant carryover effects were found for either treatment. Conclusion: Three weeks of ‘remind to move’ treatment is useful in improving hemiplegic arm function and quantity of hand use in children with unilateral CP but the long-term carryover effect requires further investigation.     

Aminotransferases During Treatment Predict Long-Term Survival in Patients With Autoimmune Hepatitis Type 1: A Landmark Analysis

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