[Correlation between swallowing function and pulmonary ventilation function and respiratory muscles strength in patients with dysphagia after stroke].

Objective: To observe the difference of pulmonary function among patients with dysphagia after stroke, patients without dysphagia and normal people, and to explore the correlation between swallowing function and pulmonary function. Methods: From September 2018 to April 2019, 310 stroke patients were enrolled from the rehabilitation department and neurology department of sun yat-sen memorial hospital, sun yat-sen university, of which 60 were selected as standard stroke patients. Pulmonary function of the three groups was assessed by pulmonary function detector and further compared. The swallowing function of the dysphagia group after stroke was examined by using videofluroscopic swallowing study (VFSS). The swallowing function was quantitatively assessed by Rosenbek penetration-aspiration scale (PAS), dysphagia outcome and severity scale (DOSS) and videofluoroscopy dysphagia scale (VDS), and the correlation between swallowing function and respiratory function was analyzed. Results: There were significant differences in pulmonary function among three groups (P<0.05). Besides the FEF25,FVC, FIVC between patients with dysphagia after stroke and patients without dysphagia, the FEF75 between patients without dysphagia and normal people (all P>0.05), there were significant differences in the pairwise comparison of other indicators (all P<0.05). There were correlations between PAS and MIP (r=-0.618, P=0.001),PAS and MEP (r=-0.410, P=0.038), PAS and PEF (r=-0.443, P=0.024), DOSS and MIP (r=0.602, P=0.000),DOSS and MEP (r=0.496, P=0.005), DOSS and PEF (r=0.553, P=0.002), VDS and MEP (r=-0.483, P=0.012),VDS and PEF (r=-0.494, P=0.010), respectively. Conclusion: The pulmonary function of dysphagia patients after stroke decrease significantly, and the severity of dysphagia is correlated with the decrease of pulmonary function.

[Effects of functional electrical stimulation based on normal gait pattern on walking function in subjects with recovery of stroke].

OBJECTIVE: To observe the effects of functional electrical stimulation(FES) based on normal gait pattern on walking function in subjects with recovery of stroke. METHODS: From December 2010 to January 2013, 58 patients with recovery of stroke were recruited from the Rehabilitation Medicine Departments of Sun Yat-sen Memorial Hospital and the Guangdong Provincial Traditional Chinese Medicine Hospital. And the Minimize software was used to divide them randomly into 1 of the 3 groups: four-channel FES group (n=29), single-channel FES group (n=15) and placebo electrical group (n=14) at the rate of 2∶1∶1. All received standardized rehabilitation program. The four-channel FES group received four-channel FES treatment based on normal gait pattern, the single-channel FES group received single-channel FES treatment, the placebo electrical group received the same electrical stimulation as the four-channel FES group, but without current output when stimulating. Stimulation lasted for 30 min/d, 1 session / d, 5 d/w for 3 weeks. All subjects in the three groups received Fugl-Meyer Assessment scale (FMA), Berg Balance scale (BBS), gait speed during a 10-meter walking test, muscle co-activation index (CI) of the lower extremity during walking and the Modified Barthel index (MBI) assessments before and after 3 weeks treatment. RESULTS: Before treatment, the FMA, BBS and gait speed during a 10-meter walking test of the four-channel FES group were (23.0±2.2), (31±71) and (0.23±0.10), respectively. After 3 weeks treatment, the scores were improved to (28.4±1.5), (42±6)and(0.43±0.09), respectively. And the FMA, BBS and gait speed during a 10-meter walking test of the ingle-channel FES group increased from (21.9±3.4), (31±6) and (0.24±0.09) to (26.6±1.8), (38±5) and (0.34±0.08), respectively. The placebo electrical group increased from (23.6±3.0), (33±5) and (0.25±0.09) respectively to (26.0±2.4), (36±4) and (0.29±0.08). And the FMA, BBS and gait speed during a 10-meter walking test of the three groups were significantly higher than those in pre-treatment (P<0.05), and the scores in four-channel FES group were significantly higher than the single-channel group and the placebo electrical group's (P<0.05). The MBI score of the three groups were all improved, but it didn't show difference among the three groups (P>0.05). The results of surface electromyography showed significant decrease in CI of quadriceps / hamstring of the 3 groups, and the four-channel FES group had more significant decrease than the other two groups (P<0.05). CONCLUSION: Functional electrical stimulation based on normal gait pattern could improve walking function in subjects with recovery of stroke.

Birth prevalence of Down syndrome in Singapore from 1993 to 1998.

OBJECTIVE: To examine the livebirth prevalence rate of Down Syndrome in Singapore from 1993 to 1998. DESIGN: Index cases for the National Birth Defects Register were obtained from all neonatal nurseries in Singapore, all hospital discharge summaries, cytogenetic and pathology reports from all pathology laboratories in Singapore and from the compulsory reporting of all termination of pregnancy cases and stillbirths delivered. SETTING: Information for the Register was obtained from case notes retrieved from the medical record offices, antenatal clinics, cytogenetic laboratories, pathology departments and the Registry of Births and Deaths. SUBJECTS: All foetuses with Trisomy 21 diagnosed prenatally together with livebirths and stillbirths with Down Syndrome diagnosed at or after birth were identified from the Registry database. MAIN OUTCOME MEASURES: Prevalence of Down Syndrome RESULTS: From 1993 to 1998, there were 295 Down Syndrome livebirths, four stillbirths and 197 Down Syndrome foetuses aborted. There has been an increasing number of Down Syndrome foetuses diagnosed antenatally ending in termination and this is accompanied by a falling trend in the Down Syndrome livebirth rate in the same years from 1.17 to 0.89 per 1000 total live births. This is despite an expected increase in Down Syndrome livebirth rate obtained by modelling maternal Down Syndrome age-related risks on the maternal age distribution over the years. CONCLUSIONS: The livebirth prevalence of Down Syndrome in Singapore has fallen over the years from 1.17/1000 livebirths in 1993 to 0.89/1000 livebirths in 1998 due to antenatal diagnosis and selective termination.