Reliability and validity of the Turkish version of Fullerton Advanced Balance Scale in cerebral palsy

BackgroundThe Fullerton Advanced Balance Scale (FAB) is a multi-item balance assessment test designed to measure balance in relatively higher functioning individuals. The aim of this study was to examine the reliability and validity of the Turkish version of the FAB (FAB-T) in children with cerebral palsy (CP).Research questionIs the Turkish version of the Fullerton Advance Balance Scale valid and reliable in determining balance problems in children with cerebral palsy and determining the underlying cause of this condition?MethodsForty-six children with CP participated in this study. Rasch analysis was used to investigate item adherence. Internal consistency of the FAB-T was established using Cronbach's alpha coefficient. Test-retest reliability was also evaluated. In addition, to assess concurrent validity, FAB-T scores were compared with the Pediatric Balance Scale (PBS) using the Spearman correlation coefficient.ResultsThe FAB-T showed satisfactory internal consistency (Cronbach's alpha value=0.94) and excellent test-retest reliability (ICC=0.99). The FAB and the PBS exhibited concurrent positive validity (r = 0.913; p < 0.001). All items of the FAB-T were found to fit the Rasch Model (Chi-square 16.01(df=20), p = 0.716).SignificanceThe FAB-T is a reliable and valid tool that can be used to measure balance skills and to identify the source of the problem in children with CP.     

针刺结合康复训练治疗中风偏瘫不同分期患者的临床疗效研究进展

现代康复学者Bobath通过临床经验的总结指出,中风后患者肢体的运动能力的恢复一般需要经历固定的三个阶段:迟缓期;痉挛时期;相对恢复时期。根据针灸经络理论及Signe Brunnstrom提出的中风偏瘫后机体运动功能恢复的六个阶段的特殊病理过程,灵活采用针刺、放血、点穴推拿以及火针等治疗方法对不同分期的中风偏瘫患者进行治疗,疗效显著。在中风偏瘫的康复治疗过程中常常把传统的中医针刺与现代康复技术积极的结合在一起,对偏瘫患者的功能康复起到了至关重要的作用,本文将对近五年此类文章进行总结。     

Hip Displacement in Cerebral Palsy: The Role of Surveillance

IntroductionHip displacement is common in cerebral palsy (CP) and is related to the severity of neurological and functional impairment. It is a silent, but progressive disease, and can result in significant morbidity and decreased quality of life, if left untreated. The pathophysiology of hip displacement in CP is a combination of hip flexor-adductor muscle spasticity, abductor muscle weakness, and delayed weight-bearing, resulting in proximal femoral deformities and progressive acetabular dysplasia. Due to a lack of symptoms in the early stages of hip displacement, the diagnosis is easily missed. Awareness of this condition and regular surveillance by clinical examination and serial radiographs of the hips are the key to early diagnosis and treatment.Hip surveillance programmesSeveral population-based studies from around the world have demonstrated that universal hip surveillance in children with CP allows early detection of hip displacement and appropriate early intervention, with a resultant decrease in painful dislocations. Global hip surveillance models are based upon the patients’ age, functional level determined by the Gross Motor Function Classification system (GMFCS), gait classification, standardized clinical exam, and radiographic indices such as the migration percentage (MP), as critical indicators of progressive hip displacement.ConclusionDespite 25 years of evidence showing the efficacy of established hip surveillance programmes, there is poor awareness among healthcare professionals in India about the importance of regular hip surveillance in children with CP. There is a need for professional organizations to develop evidence-based guidelines for hip surveillance which are relevant to the Indian context.     

穴位埋线配合针刺及康复训练治疗中风后肢体偏瘫的临床观察

目的观察穴位埋线配合针刺及康复训练治疗对中风后恢复期肢体偏瘫患者的临床治疗效。 方法选择2018年6月至2019年8月贵州省铜仁市碧江区中医院康复科收治住院的98例中风恢复期肢体偏瘫患者，按随机数值表法随机分为对照组48例(针刺联合康复训练治疗)和治疗组50例(穴位埋线配合针刺联合康复训练治疗)，连续治疗4周，治疗前和治疗后神经功能缺损程度评定量表(NDS)、Berg平衡功能进行评定量表(BBS)、巴氏(Barthe)指数组间比较采用两独立样本t检验，治疗前后比较采用自身配对t检验；2组总有效率比较采用χ²检验。 结果(1)总有效率：治疗组有效50例，无效0例，治疗总有效率100.0%(50/50)；对照组有效43例，无效5例，总有效率89.6%(43/48)，治疗组总有效率高于对照组(χ²＝12.163，P<0.05)。(2)2组治疗前后自身比较：治疗4周后，治疗组与对照组患者NDS评分均较治疗前降低(t＝18.39、16.22，均P<0.05)，治疗组治疗后Barthel指数、BBS评分均较治疗前评分增高(t＝145.00、54.25，均P<0.05)，对照组治疗后Barthel指数、BBS评分均较治疗前评分增高(t＝126.00、27.13，均P<0.05)，差异均有统计学意义。(3)治疗组与对照组比较：治疗4周后，治疗组患者NDS评分均较照组降低(t＝-5.299，P<0.05)，治疗组Barthel指数、BBS评分均较照组评分增高(t＝2.805、13.203，均P<0.05)。 结论埋线疗法结合针刺、康复训练对中风恢复期肢体偏瘫患者有良好治疗作用，能更好、更快地提高患者的运动功能和日常生活能力及生存的质量，此法值得临床推广。     

Dry eye in chronic stroke patients with hemiplegia: A cross-sectional study

ABSTRACT

Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group.

Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared.

Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group.

Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients.     

经颅直流电刺激结合局部振动对脑卒中后偏瘫 53例肢体运动功能康复的影响

目的 探讨经颅直流电刺激（tDCS）结合局部振动对脑卒中后偏瘫（HAS）病人53例肢体运动功能康复的影响。方法选择2019年2月至2021年9月三亚市人民医院收治的106例HAS病人,将其按随机数字表法划分为tDCS组（n=53,tDCS治疗）和联合组（n=53,tDCS+局部振动治疗）。于治疗前、治疗8周后采用中国卒中量表（CSS）对两组神经功能进行评定,采用FuglMeyer评估表（FMA）、Wolf运动功能测试量表（WMFT）对两组肢体运动功能进行评定,采用改良Barthel指数量表（MBI）对两组日常生活能力进行评定,同时检测两组血清神经生长因子（NGF）、神经营养素-3(NT-3)、S100-β蛋白（S100-β）水平。结果 治疗后,两组CSS评分、血清S-100β水平均较治疗前明显降低（P<0.05）,且联合组CSS评分[（7.21±1.76）分比（9.47±2.13）分]、血清S-100β水平[（0.67±0.22）μg/L比（0.93±0.28）μg/L]均明显较tDCS组低（P<0.05）;两组FMA、WMFT、MBI评分及血清NGF、NT-3水平均较治疗...     

早期康复护理干预在预防脑卒中偏瘫病人肩痛的作用

目的 探讨早期康复护理干预对预防脑卒中偏瘫病人肩痛的作用。方法 将101例急性脑卒中偏瘫患者随机分成两组,对照组50例,接受常规治疗与护理;干预组51例,接受常规治疗的同时,给予早期康复护理干预。结果 干预组肩痛的发生程度明显低于对照组。结论 早期康复护理干预能有效减轻脑卒中偏瘫病人肩痛程度的发生(P<0.05)。     

新 Bobath 技术治疗脑卒中偏瘫患者的应用价值

〔摘 要〕 目的：分析在脑卒中偏瘫患者运动治疗基础上结合新 Bobath 技术治疗促进上肢功能康复的作用。方法：选取 东莞市第八人民医院 2019 年 5 月至 2020 年 5 月收治的 48 例脑卒中偏瘫患者,根据康复治疗方法分为对照组与观察组,各 24 例。对照组接受常规康复治疗,观察组行新 Bobath 技术治疗。比较分析两组患者治疗前后运动功能评分与日常生活自理 能力,统计上肢功能康复效果。结果：经治疗后,两组患者的 Fugl–Meyer 上肢运动功能评定量表（FMA–UE）评分与改良 barthel 指数（MBI）评分均较治疗前升高,且观察组高于对照组,差异均具有统计学意义（P ＜ 0.05）。观察组患者的康 复有效率为 95.83 %,明显高于对照组的 83.33 %,差异具有统计学意义（P ＜ 0.05）。结论：新 Bobath 技术治疗用于脑卒 中偏瘫的效果理想,可有效改善患者的肢体功能。     

针灸联合运动想象疗法治疗脑卒中偏瘫临床研究

目的:观察针灸联合运动想象疗法治疗脑卒中偏瘫患者的临床疗效。方法:选择105例脑卒中偏瘫患者,按随机数字表法分为对照组与治疗组。对照组45例给予常规内科治疗,治疗组60例在对照组基础上给予针灸联合运动想象疗法治疗。比较2组康复效果、运动功能(Fugl-Meyer)评分、下肢平衡能力(BBS)评分、四肢瘫功能指数(QIF)评分。结果:治疗组总有效率为95.0%,对照组为71.1%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组上肢功能、下肢功能等Fugl-Meye评分及总分均较疗前升高(P<0.05),且治疗组各项评分高于对照组(P<0.05)。治疗后,2组BBS、QIF评分均较疗前升高(P<0.05),且治疗组BBS、QIF评分高于对照组(P<0.05)。结论:针灸联合运动想象疗法在脑卒中偏瘫患者康复治疗中效果显著,可明显提高患者的运动功能、下肢平衡能力。