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Objective:To test the reliability and validity of a multi-dimensional, quantitative video evaluation system (the Multi-dimensional system) for evaluating hand dysfunction among stroke survivors so as to provide an objective basis for its clinical application.Methods:Sixty stroke survivors with single dysfunctional hand were evaluated using the Multi-dimensional system and also using the Fugl-Meyer Upper Extremity Assessment (FMA-UE) and the Action Research Arm Test (ARAT) and in terms of their active range of hand motion (AROM-H). The Multi-dimensional system′s internal consistency, composite reliability, split-half reliability, parallel-forms reliability as well as intra- and inter-observer reliability were quantified. Its validity was tested in terms of content validity, structural validity, convergent validity and criterion validity.Results:The system′s Cronbach′s α was determined to be 0.86. Its one-dimension composite reliability was 0.939, its split-half reliability coefficient was 0.88 and its parallel-forms reliability was 0.922. The inter-evaluator reliability was between 0.965 and 0.998 [95%CI= (0.919, 0.999)], and the single evaluator ICC value was 0.973 to 0.998 [95%CI= (0.937, 0.999)]. The validity test produced a content validity index of 1, and the Pearson correlation coefficients between each sub-item and the total score were all greater than 0.60. The KMO value for structural validity was 0.882, and there was a common factor in the component matrix which reflected 60.9% of the information in the original variables. The system′s convergent validity AVE was 0.609 with Pearson correlation coefficients between the multidimensional system and the FMA-UE and ARAT both > 0.70.Conclusion:The multi-dimensional quantitative video evaluation system has good reliability and validity in the evaluation of stroke survivors with hand dysfunction.
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Objective To observe the effect of ultrashortwave irradiation on the adhesion,proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (rMSCs) in rats.Methods The rMSCs were put under ultrashortwave radiation for 15 minutes every day.Early cell adhesion was detected after 1 day of the treatment.The cell morphology was observed under an inverted fluorescence microscope on the 3rd day,the cell proliferation was measured on the 1st,3rd and 7th day,while the expression of the osteogenic gene osteopontin was detected on the 8th day.Results Early cell adhesion increased 80％ (a significant increase) and more pseudo-feet with a larger range of spread were observed.After 7 days of irradiation the proliferation and the expression of osteogenic gene osteopontin had both increased significantly.Conclusion Ultrashortwave irradiation can affect the early adhesion and morphology of rMSCs and promote their proliferation and osteogenic differentiation.
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Objective To explore the effect of right median nerve stimulation ( RMNS) on brain function in healthy subjects . Methods Twenty-eight healthy volunteers were selected as the study′s subjects. RMNS was admin-istered as a task stimulation in a wake-up therapy mode. The subjects were given 30 seconds of stimulation followed by 30 seconds of rest, repeated for 6 times as the block experiment designed, and functional magnetic resonance imaging (fMRI) was performed simultaneously with the task stimulation . The brain activation was analyzed using SPM 12 soft-ware. Results The fMRI showed that RMNS activated primarily the left M1, the premotor cortex (PMC), the bilater-al primary and secondary somatosensory cortexes (S1 and S2), and the left insular lobe. Compared with the resting state, the intensity of BOLD signal in the above activated brain areas changed significantly in RMNS wake-up stimula-tion mode. Conclusion Stimulation of the right median nerve can stimulate the local cerebral cortex and produce a certain wake-up effect by activating the right brain areas related to the motor and sensory functioning of the hand.
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Rehabilitation physician training is an important part of the development of rehabilitation medicine.Rehabilitation physician education in Taiwan has a complete and standardized training system,and rehabilitation physician training in mainland China is mainly achieved through standardized residency training.This article compares the differences in training processes for rehabilitation physicians in education in medical colleges and universities,residency training,and specialist training between Taiwan and mainland China.The results show that rehabilitation physician training in Taiwan is rigorous and orderly,with reasonable contents,clear objectives,strong specialty,and standardized assessment,while in mainland China,rehabilitation physicians in mainland China have insufficient training time,and there is a lack of detailed training plan and unified assessment standards.Rehabilitation physician training in mainland China needs to learn from advanced experience,further reform the training process,improve the operability of the overall education program,and perfect the training system of rehabilitation physicians.
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Objective To observe brain areas activated during verb generation in Uyghur and Chinese,and thus to explore the neural mechanism of speech formation and understanding and the language barriers after brain injury and during recovery.Methods The blood oxygen level dependent contrast functional magnetic resonance imaging (BOLD-fMRI) was used to scan activated brain areas of 31 cases of Uyghur and 28 cases of Chinese speakers as they completed a verb generation task.Results The mainareas activated in the brains of the Chinese group were the left caudate nucleus,the left inferior occipital gyrus,the left fusiformgyrus,bilateral supplementary motor areas (BA8/6),the left BA32 area,the left precuneus,the left superior parietal lobe (BA7),the left inferior parietal lobe,the left angular gyrus,the right precentral area (BA9),the pars triangularis of the left inferior frontal gyrus,the pars opercularis of the right inferior frontal gyrus and the bilateral cerebellum.The main activated areas of the Uyghur group were the left precentral area (BA9),the pars opercularis of the left inferior frontal gyrus,the pars triangularis of the left inferior frontal gyrus and the left cerebellum.Moreover,the Chinese group showed significantlygreater activation in left caudate body,the left orbital part of the middle frontal gyrus,the right caudate head and the bilateral anterior cingulate gyrus (BA32) compared to the Uyghur group.The Uyghur group,on the other hand,did not show activation significantly greater than that of the Chinese group in any area.Conclusions The brain areas activated when generating verbs in Uyghur and Chinese are not exactly the same-the processing of Uyghur mainly occursin the left hemisphere,while that of Chinese may need the participation of more brain areas in the right hemisphere.
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Objective To study the reliability and validity of an aphasia battery of Uighur (ABU).Methods The Chinese Aphasia Battery (ABC) was translated into Uighur.Appropriate adaptation was made according to the features of Uyghur language,but the overall structure was unchanged.Three rounds of comments and revisions were conducted by experts and the ABU was back-translated into Chinese after language adjustment and pretesting.The ABU was then applied to evaluating 104 cases of stroke aphasia among Uighur speakers,among which 30 cases were retested one week later.The construct validity,internal reliability,retest reliability and splithalf reliability of the scale were tested using factor analysis and Spearman rank correlation analysis.Results The discrepancy between the original and back-translated ABC was less than 10％.The Kaiser-Meyer-Olkin value was 0.917 and the p value of the Bartlett's test for sphericity was ≤0.005.Three common factors were extracted using principal component analysis with a varimax orthogonal rotation:a writing factor;and a listening comprehension factor.Together they explained a total of 81％ of the variance.The Cronbach's α of the components were 0.969 for oral expression,0.922 for listening comprehension,0.966 for reading and 0.924 for writing,giving a total α coefficient of 0.978.The test-retest correlation coefficients of 22 items were greater than 0.8,with only another two below 0.7.The split-half reliability of the scale was 0.906.Conclusions The aphasia battery in Uighur has good validity and reliability,and can quantitatively reflect the functional status and language changes among Uighur's with stroke aphasia.It may also be suitable for application in the clinical rehabilitation of other sorts of Uighurspeaking aphasics.
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Objective To investigate the effect of bone marrow stem cells (BMSCs) transplantation combined with body weight supported treadmill training on neural functional recovery of rats with spinal cord injury.Methods T11 complete spinal cord injury (SCI) was introduced into 40 Sprague-Dawley male rats using an improved simple device,imitating the Allen method.The rats were randomly divided into a stem cell transplantation group,a body weight support treadmill training group,a combined treatment group and a control group,each of 10 assigned according to a random number table.One week after the SCI operation,stem cell transplantation was performed on the rats in the stem cell transplantation group and the combined treatment group.One day before their transplantation,the third passage BMSCs were labeled with 5-ethynyl-2'-deoxyuridine (Edu).The rats in body weight support treadmill training group and combined treatment group were received body weight support treadmill training,while the other two groups were not given any training.At the 1 st,2nd,3rd,4th and 5th week after SCI modeling,Basso-Beattie-Bresnahan (BBB) movement function score was used to evaluate the motor function recovery of all rats.At the 5 th week after SCI,immunohistochemical staining and immunofluorescence staining was applied to detect neural specific markers including the neuron specific enolase (NSE),microtubule associated protein (MAP-1 β) and vimentin (VIM).The survival and differentiation of the transplanted cells,as well as the nerve fiber recovery in the lesion were also observed.Results The average BBB score of the combined treatment group was (6.60 ± 0.97) at the 2nd week after SCI operation,significantly higher than the other 3 groups,while that of the stem cell transplantation group and the body weight support treadmill training group was (5.00 ± 0.67) and (4.80 ± 0.63) respectively,both higher than that of the control group but without significant differences (P ＞ 0.05).In the third week after modeling,however,the value of the stem cell transplantation group rose to (8.00 ± 0.67),significantly higher than that of the body weight support treadmill training group (6.80 ± 0.79).The immuohistochemical staining showed that a variable degree of neural specific markers (NSE,MAP-1 β,VIM) positive cells were observed in the SCI tissues of all groups,with those in the combined treatment group significantly higher than the other 3 groups.The immunofluorescence also found significantly higher fluorescence expression of neural specific protein markers including NSE,MAP-1 βand VIM in the combined treatment group than the rest group,with obvious proliferation and differentiation of nerve fibers.Conclusions Stem cell transplantation combined with partial body weight supported treadmill training can effectively promote the recovery of neural function of rats with spinal cord injury,and the effect is better than solely stem cell transplantation or the weight loss training.
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Objective To observe the different needs of Uighur and Han stroke patients for oceupational activities using the Canadian occupational performance measure (COPM).Methods The COPM was employed to evaluate 51 stroke patients in hospital before and after treatment.Thirty were from the Han ethnic group and 21 were Uighur.The first evaluation was performed at admission to confirm their occupational activity problems.Interventions were then planned using a patient-centered occupational therapy model.At discharge the second evaluation was performed to assess and compare the effects of treatment.Results In the first evaluation,both the Uighur and Han stroke patients had problems with self-care activities which were more prominent than those with productive and leisure activities.Older Uighur patients had special occupational activity needs resulltng from their religious practices.Compared witb the first evaluation,the total performance and satisfaction scores had improved significantly by the second evaluation for both the Han and Uighur patients,but their satisfaction scores were lower than their occupational activities performance scores.Conclusion Different nationalities may have different occupational activities needs.The COPM is easy to use and helpful in confirming occupational activity problems.Its use can contribute to the plan ning of primary goals for rehabilitation and treatment programs and help assess the effect of rebabilitation.
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Objective To study the linguistic manifestations and locations of brain lesions of Uyghur aphasia patients,and the differences between Uyghurs and other Chinese aphasics.Methods Forty-five aphasic Uyghurs and forty-five other Chinese aphasies were studied.All had suffered a stroke.Aphasia examinations were performed using a Chinese aphasia battery(ABC).CT and MRI images were taken of all patients.Results There was no obvious difference in linguistic manifestations between the Uyghur and other aphasics.The brain lesions of 24 Uyghur cases(53.33％)and 36 of the others(80％)were located in the classic language centers,a highly significant difference.The incidence of crossed aphasia in the Uyghur group was higher than among the others.Conclusion Various types of aphasia have their own unique linguistic characteristics,but the same type of aphasia has the same linguistic characteristics among Uyghurs and other Chinese.Chinese aphasia is more coincident with the pattern of classic language centers than aphasia among Uyghurs.
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Objective To study the effect and mechanism of the neurological function recovery in rats with spinal cord injury (SCI) rats after the transplantation of neural stem cells which are directly differentiated from bone marrow mesenchymal stem cells (BMSC), and to investigate the suitable engraftment time.Methods The BMSC at 3rd passage were differentiated into neural stem cells (NSC), and immunofluorescence staining was used to identify the NSC. The oriented-induced cells were labeled with Brdu 3 days before they were transplanted, and they were slowly injected into the injured site of the SCI rats. The SCI rats were randomly divided into group Ⅰ (transplantation at first week postinjury), group Ⅱ (transplantation at 2nd week postinjury) and control group (the operation was the same as group Ⅰ, but the cell suspension was replaced by the equal volume of normal saline). The BBB scores after transplantation were recorded. The distribution and differentiation of transplanted cells were observed by using immunofluorescence staining with antibodies against Brdu combined with Nestion and Brdu combined with NF200. NF200 immunofluorescence staining was used to show the regeneration of nerve fibers. The pathological changes of the injured site were observed by HE staining.Results The nestin expression was positive after the BMSC were differentiated for 3 days, and if the induced spherical cells were cultured continuously, the different levels of NF200 and GFAP were found. BBB scores in group Ⅰ and group Ⅱ were significantly higher than in control group (P<0.05), especially in group Ⅰ. The immunofluorescence showed that a large number of Brdu and Nestin double-positive cells and some Brdu and NF200 double-positive cells filled the injured site and linked the two sides of the injured area in group Ⅰ and group Ⅱ, and the lesion area of the spinal cord was reduced as compared with control group (P<0.05). More importantly, further reduction in lesion area and improvement in neurological function were observed in group Ⅰ.Conclusion The BMSC can be differentiated into NSC. The transplantation of the NSC could effectively promote the nerve function recovery after SCI, and the effect of transplantation at first week postinjury was better than at 2nd week postinjury.