Acupuncture in stroke rehabilitation Literature retrieval based on international databases

OBJECTIVE: To identify global research trends of acupuncture in stroke rehabilitation using a bibliometric analysis of the Web of Science and the Clinical Trials registry database (ClinicalTrials.gov). DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for acupuncture in stroke rehabilitation from 1992 to 2011 using the Web of Science and ClinicalTrials.gov. SELECTION CRITERIA: Inclusion criteria: (1) Web of Science: (a) Peer-reviewed articles on acupuncture in stroke rehabilitation that were published and indexed in the Web of Science. (b) Type of articles: original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material and news items. (c) Year of publication: 1992-2011. (2) ClinicalTrials.gov: All clinical trials relating to acupuncture in stroke rehabilitation were searched in this database. Exclusion criteria: (1) Web of Science: (a) Articles that required manual searching or telephone access. (b) We excluded documents that were not published in the public domain. (c) We excluded a number of corrected papers from the total number of articles. (2) ClinicalTrials.gov: (a) We excluded clinical trials that were not in the ClinicalTrials.gov database. (b) We excluded clinical trials that dealt with magnetic stimulation other than acupuncture in stroke rehabilitation in the ClinicalTrials.gov database. MAIN OUTCOME MEASURES: (1) Type of literature; (2) annual publication output; (3) distribution according to journals; (4) distribution according to country; (5) distribution according to institution; (6) top cited articles over the last 20 years; and (7) clinical trials registered. RESULTS: (1) In all, 92 studies on acupuncture in stroke rehabilitation appeared in the Web of Science from 1992 to 2011, almost half of which derived from Chinese and American authors and institutes. The number of studies addressing acupuncture in stroke rehabilitation has gradually increased over the past 20 years. Most papers on acupuncture in stroke rehabilitation appeared in journals with a particular focus on rehabilitation research, such as Stroke, Archives of Physical Medicine, Cochrane Database of Systematic Reviews and Journal of Alternative and Complementary Medicine. (2) In the ClinicalTrials.gov, three studies can be searched on acupuncture and stroke, all of which were registered and sponsored by Chinese institutions since February 2009. CONCLUSION: From our analysis of the literature and research trends, we found that acupuncture in stroke rehabilitation may offer further benefits in regenerative medicine.     

Research progress in muscle-derived stem cells Literature retrieval results based on international database

OBJECTIVE: To identify global research trends of muscle-derived stem cells (MDSCs) using a bibliometric analysis of the Web of Science, Research Portfolio Online Reporting Tools of the National Institutes of Health (NIH), and the Clinical Trials registry database (ClinicalTrials.gov). DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for MDSCs from 2002 to 2011 using the Web of Science, NIH, and ClinicalTrials.gov. SELECTION CRITERIA: Inclusion criteria: (1) Web of Science: (a) peer-reviewed articles on MDSCs that were published and indexed in the Web of Science. (b) Type of articles: original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material and news items. (c) Year of publication: 2002-2011. (d) Citation databases: Science Citation Index-Expanded (SCI-E), 1899-present; Conference Proceedings Citation Index-Science (CPCI-S), 1991-present; Book Citation Index-Science (BKCI-S), 2005-present. (2) NIH: (a) Projects on MDSCs supported by the NIH. (b) Fiscal year: 1988-present. (3) ClinicalTrials.gov: All clinical trials relating to MDSCs were searched in this database. Exclusion criteria: (1) Web of Science: (a) Articles that required manual searching or telephone access. (b) We excluded documents that were not published in the public domain. (c) We excluded a number of corrected papers from the total number of articles. (d) We excluded articles from the following databases: Social Sciences Citation Index (SSCI), 1898-present; Arts & Humanities Citation Index (A&HCI), 1975-present; Conference Proceedings Citation Index - Social Science & Humanities (CPCI-SSH), 1991-present; Book Citation Index - Social Sciences & Humanities (BKCI-SSH), 2005-present; Current Chemical Reactions (CCR-EXPANDED), 1985-present; Index Chemicus (IC), 1993-present. (2) NIH: (a) We excluded publications related to MDSCs that were supported by the NIH. (b) We limited the keyword search to studies that included MDSCs within the title or abstract. (3) ClinicalTrials.gov: (a) We excluded clinical trials that were not in the ClinicalTrials.gov database. (b) We excluded clinical trials that dealt with stem cells other than MDSCs in the ClinicalTrials.gov database. MAIN OUTCOME MEASURES: (1) Type of literature; (2) annual publication output; (3) distribution according to journals; (4) distribution according to country; (5) distribution according to institution; (6) top cited authors over the last 10 years; (7) projects financially supported by the NIH; and (8) clinical trials registered. RESULTS: (1) In all, 802 studies on MDSCs appeared in the Web of Science from 2002 to 2011, almost half of which derived from American authors and institutes. The number of studies on MDSCs has gradually increased over the past 10 years. Most papers on MDSCs appeared in journals with a particular focus on cell biology research, such as Experimental Cell Research, Journal of Cell Science, and PLoS One. (2) Eight MDSC research projects have received over US$6 billion in funding from the NIH. The current project led by Dr. Johnny Huard of the University of Pittsburgh-"Muscle-Based Tissue Engineering to Improve Bone Healing"-is supported by the NIH. Dr. Huard has been the most productive and top-cited author in the field of gene therapy and adult stem cell research in the Web of Science over last 10 years. (3) On ClinicalTrials.gov, "Muscle Derived Cell Therapy for Bladder Exstrophy Epispadias Induced Incontinence" Phase 1 is registered and sponsored by Johns Hopkins University and has been led by Dr. John P. Gearhart since November 2009. CONCLUSION: From our analysis of the literature and research trends, we found that MDSCs may offer further benefits in regenerative medicine.     

A simple risk score for early ischemic stroke mortality derived from National Institutes of Health Stroke Scale: A discriminant analysis

Objectives

The aim of the current study was to design a new simpler form of National Institutes of Health Stroke Scale (NIHSS) for use in emergency settings, and compare its predictive ability with original NIHSS score for mortality.

Methods

A total of 152 consecutive patients with first ever ischemic stroke admitted to a university affiliated hospital were recruited. NIHSS score on admission was estimated and the predictive ability of NIHSS items for mortality at 28 days was evaluated by logistic regression. Stepwise discriminant analysis was performed on NIHSS items to obtain a discriminant function with the best discriminative ability for mortality. Further, receiver operating characteristics (ROC) curves were depicted to compare the new determined discriminant function with the original NIHSS score.

Results

Cumulative rate of mortality was 11.8% for 28-day follow-up period. Among NIHSS items, scores of visual field, limb ataxia and extinction neglect were not associated with mortality (P > 0.05). On the contrary, level of consciousness-commands, language and gaze were determined as independent indicators of mortality (P < 0.05), and their coefficients on discriminant function were equal to 0.65, 0.44 and 0.30, respectively. In addition, area under the ROC curve of the calculated discriminant function was not statistically different from NIHSS score (P > 0.05).

Conclusions

The suggested discriminant function, comprising NIHSS items of level of consciousness-commands, language and gaze, can predict 28-day mortality after ischemic stroke in a similar way to the original NIHSS score and can provide a baseline for stroke severity in emergency settings.     

Trends in NLRP3 inflammasome research in ischemic stroke from 2011 to 2022: A bibliometric analysis

Background

Ischemic stroke is a leading cause of permanent disability and death globally. The nucleotide-biding oligomaerization domain (NOD)-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome is a multi-protein complex that plays a role in ischemic stroke. Recently, research on the role of NLRP3 in ischemic stroke has developed rapidly worldwide. However, there is no bibliometric analysis of NLRP3 in ischemic stroke to date.

Aim

Through bibliometric analysis, the aim of this study was to assess the current state of research on NLRP3 in the field of ischemic stroke research worldwide over the past 12 years and to identify important results, major research areas, and emerging trends.

Methods

Publications related to NLRP3 in ischemic stroke from January 1, 2011 to December 31, 2022 were obtained from the Web of Science Core Collection (WoSCC). We used HistCite, VOSviewer, CiteSpace, and Bibliometrix for bibliometric analysis and visualization. The Total Global Citation Score (TGCS) was employed to assess the impact of publications.

Results

We found that research of NLRP3 in ischemic stroke developed rapidly starting in 2011. 601 relevant studies have been published in 245 journals over the past 12 years. Journal of Neuroinflammation and International Immunopharmacology were the most productive journals and Journal of Neuroinflammation was the most cited journal. Additionally, Stroke and Journal of Cerebral Blood Flow & Metabolism were the most co-cited journal. The most productive country was China (records = 430) and the most productive university was the Zhejiang University (records = 24). Arumugam TV (TGCS = 949) was the most cited author in this field. NLRP3 inflammasome activation, nf–κb, oxidative stress, and inflammation were the knowledge bases for the research in this field.

Conclusion

This study is a scientometric study utilizing quantitative and qualitative methods to comprehensively review the publications on NLRP3 in ischemic stroke. This information provides a reference for scholars to further study NLRP3 in ischemic stroke.     

基于运动想象的脑-机接口技术在脑卒中患者神经康复中的应用

实验采用脑-机接口技术,通过让20位脑卒中患者实时操作一种基于运动想象的电脑游戏并和康复训练相结合,发现治疗后4周,患者Berg平衡量表评分和Holden步行能力评分均明显高于治疗前(P < 0.01)。表明基于运动想象的脑-机接口训练可改善脑卒中患者的平衡能力和步行能力。     

The 100 most-cited articles about the role of neurovascular unit in stroke 2001–2020: A bibliometric analysis

BackgroundThe neurovascular unit (NVU) is emerging as a potential therapeutic target in neurological conditions, such as stroke, brain injury, Alzheimer''s disease, and Parkinson''s disease; meanwhile, stroke is the second leading cause of death globally. The purpose of the study is to analyze the most influential articles, authors, countries, and topics in the role of NVU in stroke.MethodsThe Web of Science (WoS) database was used for bibliometric analysis using the search terms “Stroke” and “Neurovascular unit” on January 1st, 2021. Data were extracted from the WoS database to identify collaborations between authors, countries, organizations, and keywords using VOSviewer (1.6.16 mac). Two bibliometric indicators, the activity index (AI) and category normalized citation impact (CNCI), were computed. The keywords of bursts were also identified by CiteSpace.ResultsA total of 770 articles were analyzed by VOSviewer. AIs and CNCIs were computed of the eighteen countries according to VOSviewer co‐authorship analysis results. The majority of authors mainly came from the United States and Japan. Romania, Hungary, and Poland have emerged as rising‐star countries. In the 100 most‐cited articles, the number of citations ranged from 1873 to 69, with a total of 15,758 citations. Most articles were published in 2011 and 2012 (n = 13 each), followed by 2009 (n = 11) and 2013, 2014, and 2015 (n = 8 each). Stroke and Journal of Cerebral Blood Flow and Metabolism were the two top journals. EH Lo from Harvard University/ Massachusetts General Hospital was the top first author and corresponding author. Harvard University/Massachusetts General Hospital was the most productive affiliated institution with 15 publications.ConclusionThere has been growing attention and efforts made in the field of stroke and NVU. The merit of the above findings may help to shape the research policy in ischemic stroke both at the country and institutional level.     

Scientific progress regarding neural regeneration in the Web of Science A 10-year bibliometric analysis

BACKGROUND： Neural regeneration following nerve injury is an emerging field that attracts ex- tending interests all over the world. OBJECTIVE： To use bibliometric indexes to track studies focusing on neural regeneration, and to investigate the relationships among geographic origin, countries and institutes, keywords in the published articles, and especially focus on the region distribution, institution distribution, as well as collaborations in Chinese papers indexed in the Web of Science. METHODS： A list of neural regeneration studies was generated by searching the database of the Web of Science-Expanded using the term ＂Neural Regenera＊＂. Inclusive criteria： （1） articles in the field of neural regeneration; （2） fundamental research on animals, clinical trials and case reports; （3） article types： article, review, proceedings paper, note, letter, editorial material, discussion, book chapter; （4） year of publication： 2003-2012; and （5） citation database： Science Citation Index-Expanded. Exclusive criteria： （1） articles requiring manual searching or with access only by telephone; （2） unpublished articles; and （3） corrections. RESULTS： A total of 4 893 papers were retrieved from the Web of Science published between 2003 and 2012. The papers covered 65 countries or regions, of which the United States ranked first with 1 691 papers. The most relevant papers were in the neurosciences and cell biology, and the key- word ＂stem cell＂ was the most frequent. In recent years, China showed a great increase in the number of papers. Over the entire 10 years, there were 922 Chinese papers, with Jilin University ranking first with 58 articles. Chinese papers were published in connection with many countries, in- cluding the United States, Japan, and the United Kingdom. Among the connections, the papers published by the Chinese and the American are 107, with the highest rate. With regard to funding, 689 articles were funded from various projects, occupying 74.72% of the total amount. In these projects, National Foundation and Science and Technology programs were the majority. CONCLUSION： Our bibliometric analysis provides a historical perspective on the progress of neural regeneration research. At present, the number of articles addressing neural regeneration is increasing rapidly; however, through analysis of citations it is clear that there is a long way to go to improve the academic quality.     

Olfactory ensheathing cell transplantation for spinal cord injury An 18-year bibliometric analysis based on the Web of Science

OBJECTIVE:Olfactory ensheathing cell (OEC) transplantation is a promising new approach for the treatment of spinal cord injury (SCI),and an increasing number of scientific publications are devoted to this treatment strategy.This bibliometric analysis was conducted to assess global research trends in OEC transplantation for SCI.DATA SOURCE:All of the data in this study originate from the Web of Science maintained by the Institute for Scientific Information,USA,and includes SCI-EXPANDED,SSCI,A&HCI,CPCI-S,CPCI-SSH,BKCI-S,BKCI-SSH,CCR-EXPANDED and IC.The Institute for Scientific Information’s Web of Science was searched using the keywords "olfactory ensheathing cells" or "OECs" or "olfactory ensheathing glia" or "OEG" or "olfactory ensheathing glial cells" or "OEGs" and "spinal cord injury" or "SCI" or "spinal injury" or "spinal transection" for literature published from January 1898 to May 2012.DATA SELECTION:Original articles,reviews,proceedings papers and meeting abstracts,book chapters and editorial materials on OEC transplantation for SCI were included.Simultaneously,unpublished literature and literature for which manual information retrieval was required were excluded.MAIN OUTCOME MEASURES:All selected literatures addressing OEC transplantation for SCI were evaluated in the following aspects:publication year,document type,language,author,institution,times cited,Web of Science category,core source title,countries/territories and funding agency.RESULTS:In the Web of Science published by the Institute for Scientific Information,the earliest literature record was in April,1995.Four hundred and fourteen publications addressing OEC transplantation for SCI were added to the data library in the past 18 years,with an annually increasing trend.Of 415 records,405 publications were in English.Two hundred and fifty-nine articles ranked first in the distribution of document type,followed by 141 reviews.Thirty articles and 20 reviews,cited more than 55 times by the date the publication data were downloaded by us,can be regarded as the most classical references.The journal Experimental Neurology published the most literature (32 records),followed by Glia.The United States had the most literature,followed by China.In addition,Yale University was the most productive institution in the world,while The Second Military Medical University contributed the most in China.The journal Experimental Neurology published the most OEC transplantation literature in the United States,while Neural Regeneration Research published the most in China.CONCLUSION:This analysis provides insight into the current state and trends in OEC transplantation for SCI research.Furthermore,we anticipate that this analysis will help encourage international cooperation and teamwork on OEC transplantation for SCI to facilitate the development of more effective treatments for SCI.     

Literature study on clinical treatment of facial paralysis in the last 20 years using Web of Science Comparison between rehabilitation, physiotherapy and acupuncture

BACKGROUND: Facial paralysis is defined as severe or complete loss of facial muscle motor function. OBJECTIVE: The study was undertaken to explore a bibliometric approach to quantitatively assess the research on clinical treatment of facial paralysis using key words rehabilitation, physiotherapy and acupuncture using Web of Science from 1992 to 2011. DESIGN: Bibliometric approach. DATA RETRIEVAL: A bibliometric analysis based on the publications on Web of Science was performed using such as "facial paralysis", "rehabilitation", "physiotherapy" and "acupuncture". INCLUSIVE CRITERIA: (1) Research articles on the clinical treatment of facial paralysis using acupuncture or physiotherapy (e.g. exercise, electro-stimulation) and other rehabilitation methods; (2) researches on human and animal fundamentals, clinical trials and case reports; (3) Article types: article, review, proceedings paper, note, letter, editorial material, discussion, book chapter. (4) Publication year: 1992-2011 inclusive. Exclusion criteria: (1) Articles on the causes and diagnosis on facial paralysis; (2) Type of articles: correction; (3) Articles from following databases: all databases related to social science and chemical databases in Web of Science. MAIN OUTCOME MEASURES: (1) Overall number of publications; (2) number of publications annually; (3) number of citations received annually; (4) top cited paper; (5) subject categories of publication; (6) the number of countries in which the article is published; (7) distribution of output in journals. RESULTS: Overall population stands at 3 543 research articles addressing the clinical treatment of facial paralysis in Web of Science during the study period. There is also a markedly increase in the number of publications on the subject "facial paralysis treatments using rehabilitation" during the first decade of the 21st century, except in 2004 and 2006 when there are perceptible drops in the number of articles published. The only other year during the study period saw such a drop is 1993. Specifically, there are 192 published articles on facial paralysis treated by rehabilitation in the past two decades, far more than the output of physiotherapy treatment. Physiotherapy treatment scored only 25 articles including acupuncture treatment, with over 80% of these written by Chinese researchers and clinicians. Ranked by regions, USA is by far the most productive country in terms of the number of publications on facial paralysis rehabilitation and physiotherapy research. Seeing from another angle, the journals that focus on otolaryngology published the most number of articles in rehabilitation and physiotherapy studies, whereas most acupuncture studies on facial paralysis were published in the alternative and complementary medicine journals. CONCLUSION: Study of facial paralysis remains an area of active investigation and innovation. Further clinical studies in humans addressing the use of growth factors or stem cells continue to successful facial nerve regeneration.     

早期康复治疗对急性脑卒中患者生活质量的影响

目的探索早期康复治疗对急性脑卒中患者生存质量的影响。方法入选2008年1月～2010年11月收治的急性脑卒中患者150例,其中康复组80例,对照组70名,对所有患者在入院24 h内及入院后21 d、35 d采用神经功能缺损评分(NIHSS)评定其肢体运动功能状态,于治疗后35 d采用Barthel指数(BI)评定其日常生活活动能力,采用脑卒中生存质量量表(QOF)评定其生活质量,同时统计住院费用。结果康复组患者的肢体功能缺损评分在治疗后明显低于对照组患者(P<0.05),BI评分及QOF评分明显高于对照组(P<0.05),而住院费用明显低于对照组(P<0.05)。结论早期康复治疗可以明显促进卒中患者肢体功能的恢复,增强患者的自理能力,减轻患者负担,提高患者的生活质量。     

Effects of neuroserpin on clinical outcomes and inflammatory markers in Chinese patients with acute ischemic stroke

Objective: Neuroserpin (NSP) is known for its neuroprotective effects. The aim of this study was to investigate the relationship between NSP level and clinical outcomes and inflammatory markers in Chinese patients with acute ischemic stroke.

Methods: A total of 133 patients with acute cerebral infarction (ischemia group) and 44 controls were recruited. The modified Rankin Scale (mRS) was used to determine the functional outcome three months after onset. We investigated the relationship between serum NSP levels [on admission and a decrease in NSP levels (10 days after admission versus on admission)] and serum levels of several inflammatory markers.

Results: We confirmed that NSP levels on admission in the ischemia group were significantly higher than those in the control group. NSP levels in patients with good outcomes were significantly higher than those in patients with poor outcomes. NSP levels on admission were associated with having a good outcome in these patients. We found that a larger decrease in NSP levels (on admission vs. 10 days after admission) was correlated with lower serum levels of IL-6, IL-1β, and ICAM-1 10 days after admission.

Conclusions: A larger decrease in NSP levels related to lower levels of inflammatory marker, while higher NSP levels were associated with lower inflammatory markers and better functional outcomes. Decreasing the infarct size may play a role in this process. These results provide more evidence of the neuroprotective effect of NSP in cerebral ischemic patients. Decrease in the Serum NSP level and NSP level at admission may be considered as potential predictive factors for outcome of acute ischemic stroke.     

电脑康复治疗仪联合超早期强化运动康复治疗脑卒中的疗效

目的 探讨电脑康复治疗仪联合超早期强化运动康复对脑卒中患者运动功能及生活质量的影响。方法 选取首都医科大学附属北京潞河医院2017年6月至2020年9月收治的150例脑卒中患者,分为观察组(67例)与对照组(74例)。对照组实施电脑康复治疗仪治疗,观察组患者在对照组基础上联合超早期强化运动康复治疗。比较2组患者治疗前后简化Fugl-Meyer量表评分、改良阿什沃思量表评分、Brunnstrom分级、生活质量综合评定问卷、凝血功能[凝血酶原时间(prothrombin time,PT)、凝血酶原活动度(prothrombin activity,PTA)]、血常规及同型半胱氨酸水平。结果 治疗后,观察组患者简化Fugl-Meyer量表评分(75.63±10.84)高于对照组(47.29±8.75)(P<0.05);改良阿什沃思量表评分(0.57±0.13)低于对照组(1.82±0.25)(P<0.05)。治疗3个月后,观察组患者Ⅰ级、Ⅱ级患者比例均显著低于对照组(P<0.05);Ⅲ级、Ⅳ级、Ⅴ级患者比例均显著高于对照组(P<0.05)。治疗3个月后,观察组患者生活质...     

A magnetic nanoparticles-based method for DNA extraction from the saliva of stroke patients

C677T polymorphism in the methylenetetrahydrofolate reductase （MTHFR） gene is a risk factor for stroke, suggesting that widespread detection could help to prevent stroke. DNA from 70 stroke pa- tients and 70 healthy controls was extracted from saliva using a magnetic nanoparticles-based method and from blood using conventional methods. Real-time PCR results revealed that the C677T polymorphism was genotyped by PCR using DNA extracted from both saliva and blood samples. The genotype results were confirmed by gene sequencing, and results for saliva and blood samples were consistent. The mutation TT genotype frequency was significantly higher in the stroke group than in controls. Homocysteine levels were significantly higher than controls in both TT genotype groups. Therefore, this noninvasive magnetic nanoparticles-based method using saliva samples could be used to screen for the MTHFR C677T polymorphism in target populations.     

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke (59.6%) was the primary stroke type found in the young group, while ischemic stroke (60.0%) was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyper-homocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modiifed Rankin Scale scores were increased at discharge. Six months atfer discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction (such as friendship) improved. The degree of disability and functional status improved signiifcantly in young stroke patients atfer professional rehabilitation, but the number of patients who returned to society within 6 months atfer stroke was still small.     

Constraint-induced movement therapy in treatment of acute and sub-acute stroke: a meta-analysis of 16 randomized controlled trials

OBJECTIVE: The aim of this meta-analysis was to evaluate the clinical efficacy of constraint-induced movement therapy in acute and sub-acute stroke.DATA SOURCES: The key words were stroke, cerebrovascular accident, constraint-induced therapy, forced use, and randomized controlled trial. The databases, including China National Knowledge Infrastructure, Wan Fang, Weipu Information Resources System, Chinese Biomedical Literature Database, Pub Med, Medline, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, were searched for studies on randomized controlled trials for treating acute or sub-acute stroke published before March 2016. DATA SELECTION: We retrieved relevant randomized controlled trials that compared constraint-induced movement therapy in treatment of acute or sub-acute stroke with traditional rehabilitation therapy(traditional occupational therapy). Patients were older than 18 years, had disease courses less than 6 months, and were evaluated with at least one upper extremity function scale. Study quality was evaluated, and data that met the criteria were extracted. Stata 11.0 software was used for the meta-analysis. OUTCOME MEASURES: Fugl-Meyer motor assessment of the arm, the action research-arm test, a motor activity log for amount of use and quality of movement, the Wolf motor function test, and a modified Barthel index.RESULTS: A total of 16 prospective randomized controlled trials(379 patients in the constraint-induced movement-therapy group and 359 in the control group) met inclusion criteria. Analysis showed significant mean differences in favor of constraint-induced movement therapy for the Fugl–Meyer motor assessment of the arm(weighted mean difference(WMD) = 10.822; 95% confidence intervals(95% CI): 7.419–14.226), the action research-arm test(WMD = 10.718; 95% CI: 5.704–15.733), the motor activity log for amount of use and quality of movement(WMD = 0.812; 95% CI: 0.331–1.293) and the modified Barthel index(WMD = 10.706; 95% CI: 4.417–16.966). CONCLUSION: Constraint-induced movement therapy may be more beneficial than traditional rehabilitation therapy for improving upper limb function after acute or sub-acute stroke.     

Neglect in elderly stroke patients: A comparison of five tests

Abstract  Neglect is a disabling state in stroke patients. Five tests for visuo-spatial neglect, star cancellation, line crossing, line bisection, draw a clock and copy a cross, were compared in 57 elderly patients. Sensitivity and intercorrelations between the tests were determined. Patients with neglect were studied as regards their activities of daily living, motor activity and cognition. Left-hemisphere neglect in patients with right-hemisphere lesions was more severe than right-sided neglect in patients with left-sided lesions in the star cancellation test. Sensitivity of the tests was moderate for star cancellation, line bisection and draw a clock, and low for line crossing and copy a cross. Significant correlations existed between the tests and cognitive and functional ability. Intercorrelations between the tests were moderate. Neglect patients showed a slower recovery after 6 and 12 months. Draw a clock and copy a cross displayed no sensitivity for neglect in patients with hemianopia, which may be due to the fact that these tests also evaluate constructional apraxia. The cancellation tests were influenced by hemianopia and there is evidence that hemianopia exacerbates neglect. This study shows that a battery of neglect tests is required to diagnose the neglect syndrome.     

增强型体外反搏治疗急性缺血性卒中的临床疗效及预后评估

目的探讨增强型体外反搏(enhanced external counterpulsation,EECP)对急性缺血性卒中患者临床治疗效果及预后的影响,为缺血性卒中患者的康复治疗提供进一步的临床证据。方法选取急性期缺血性卒中住院患者共171例,随机分为EECP治疗组87例,对照组84例,治疗组予常规治疗加上36 h的EECP治疗,对照组予常规治疗,分别比较两组在入院第1天、EECP治疗后、第3个月的美国国立卫生研究院卒中量表(NIHSS)及改良Rankin量表(mRS)的差别。结果与对照组比较,治疗组在36次EECP治疗后及第3个月的NIHSS评分下降更明显,有统计学差异,(治疗后:44.1%vs.31.5%;第3个月:55.6%vs.40.5%),P值均小于0.05;与对照组比较,发病第3个月,治疗组mRS的评分下降更明显(45.5%vs.30.5%),预后良好者的比率明显升高,差异有统计学意义,P值均小于0.05。结论 EECP治疗可以有效改善急性缺血性卒中患者神经功能缺损症状,促进康复,改善预后。