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Executive impairment is common after stroke, which causes in disabilities for controling thinking, emotion and behavior. The etiology is uncertain. There is no specific assessment tool for it. The psychological assessment is the main approach to screen and diagnose executive impairment, including screening and specific examination. There are still some advantages and disadvantages. The strategy for rehabilitation includes recovery, compulsory and adaptive treatment. Medication is the main treatment, but still unsatisfactory. Cognitive training, computer-assisted cognitive rehabilitation and transcranial direct current stimulation and so on are applied. Imaging and physiological electrical techniques are needed.
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Objective:To observe the effect of 3 Hz and 10 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function and activities of daily living in patients with ischemic stroke. Methods:From June, 2016 to September, 2017, 60 inpatients with ischemic stroke were randomly divided into sham rTMS group (n = 19), 3 Hz-rTMS group (n = 21) and 10 Hz-rTMS group (n = 20). All the patients received routine training and their own rTMS for two weeks. Their rest motor threshold (RMT) was measured, and they were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment, and at six weeks follow-up. Results:There were 48 patients completing the trial, while five in 3 Hz-rTMS group, five in 10 Hz-rTMS group and two in the sham rTMS group dropped. The RMT increased in 3 Hz and 10 Hz rTMS groups (t > 2.390, P < 0.05) after treatment, but there was no significantly difference among the three groups (F = 0.164, P > 0.05). The MAS scores of elbow and wrist decreased gradually over time in 3 Hz and 10 Hz rTMS groups (P < 0.05), and the MAS scores of elbow was less in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at follow-up (P < 0.05). The interaction of time and group was significant on the FMA-UE scores (F = 14.243, P < 0.001), and the FMA-UE scores improved more in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at different stages (P < 0.01). The interaction of time and group was not significant in MBI score (F = 1.481, P > 0.05), and there was no significant difference among the three groups at any time (F < 2.925, P > 0.05). Conclusion:Both 3 Hz and 10 Hz rTMS can promote the recovery of upper limb motor function in ischemic stroke patients safely and effectively, and 10 Hz rTMS is recommended as less time is needed.
ABSTRACT
Objective:To observe the effect of 3 Hz and 10 Hz repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function and activities of daily living in patients with ischemic stroke. Methods:From June, 2016 to September, 2017, 60 inpatients with ischemic stroke were randomly divided into sham rTMS group (n = 19), 3 Hz-rTMS group (n = 21) and 10 Hz-rTMS group (n = 20). All the patients received routine training and their own rTMS for two weeks. Their rest motor threshold (RMT) was measured, and they were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment, and at six weeks follow-up. Results:There were 48 patients completing the trial, while five in 3 Hz-rTMS group, five in 10 Hz-rTMS group and two in the sham rTMS group dropped. The RMT increased in 3 Hz and 10 Hz rTMS groups (t > 2.390, P < 0.05) after treatment, but there was no significantly difference among the three groups (F = 0.164, P > 0.05). The MAS scores of elbow and wrist decreased gradually over time in 3 Hz and 10 Hz rTMS groups (P < 0.05), and the MAS scores of elbow was less in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at follow-up (P < 0.05). The interaction of time and group was significant on the FMA-UE scores (F = 14.243, P < 0.001), and the FMA-UE scores improved more in 3 Hz and 10 Hz rTMS groups than in the sham rTMS group at different stages (P < 0.01). The interaction of time and group was not significant in MBI score (F = 1.481, P > 0.05), and there was no significant difference among the three groups at any time (F < 2.925, P > 0.05). Conclusion:Both 3 Hz and 10 Hz rTMS can promote the recovery of upper limb motor function in ischemic stroke patients safely and effectively, and 10 Hz rTMS is recommended as less time is needed.
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@#Objective To observe the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on hand function in patients after stroke. Methods From June,2016 to September,2017,30 stroke patients were randomly divided into control group(n=30)and experimental group(n=30).Both groups received routine training after sham rTMS or 3 Hz rTMS.Fugl-Meyer Assessment(FMA),modified Ashworth Scale(MAS)and modified Barthel Index(MBI)were used to evaluate the hand function and the activities of daily living before and after treatment. Results Finally 27 patients completed the experiment.After treatment, the FMA score increased in both groups (Z>2.070, P<0.05), and the difference value was higher in the experimental group than in the control group (Z=-2.296,P<0.05);the MAS score improved in the experimental group(Z=-2.456,P<0.05),no difference was found in the control group(Z=-0.816,P>0.05),and the difference value was higher in the experimental group than in the control group(Z=-2.792,P<0.01);the MBI score improved in both groups(t>3.085,P<0.01),howev-er,no difference was found in the MBI score and the difference value between two groups(t<0.246,P>0.05). Conclusion High-frequency rTMS could promote the hand function in patients after stroke.
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Objective To investigate the effect of partial body-weight supported treadmill training ( PBW- STT) on function of lower limbs, walk function, ADL performance and quality of life of hemiplegic patient induced by cerebral infarction. Methods A total of 132 cerebral infarction patients were divided into a control group (n = 69) and a training group( n = 63) randomly. Both groups accepted routine rehabilitation therapy, and the training group accepted PBWSTT at the same time in addition. Both groups were evaluated with regard to their walking ability, func- tion of lower limbs, ADL performance and their quality of life by using Functional Ambulation Category (FAC) , Fugl-Meyer assessment (FMA) , Barthel index (BI) and SF-36 before and after rehabilitation treatment. Results The function of lower limb, walking ability, ADL performance and the quality of life of both groups were improved significantly after treatment, and those in the training group were improved to a significantly greater extent than those in the control group ( P
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Objective To investigate the effects of partial body weight supported treadmill training (BW- STT) on post-stroke depression (PSD) and on patients' quality of life.Methods Sixty patients with PSD were re- cruited and divided into a training group (n=30,male 17,female 13) and a control group (n=30,male 16,fe- male 14).All patients were treated with routine internal medication and rehabilitation.The patients of the training group also received BWSTT in addition to their routine treatment.All patients' neurological impairment was evaluated using the Modified Edinburgh-Scandinavian Stroke Scale (MESSS).The Hamilton depression scale (HAMD) was used for evaluating the degree of depression.The Fugl-Meyer scale and the Barthel index were used to assess ambula- tion and balance,and facility in the activities of daily living.All patients were assessed before and after the treat- ment.Results After four weeks of treatment,depression in the training group had improved significantly more than in the control group.Conclusion BWSTT intervention is very important for patients with PSD:it can reduce the degree of depression and improve the quality of life.