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Background@#and Purpose Intravenous tenecteplase (TNK) efficacy has not been well demonstrated in acute ischemic stroke (AIS) beyond 4.5 hours after onset. This study aimed to determine the effect of intravenous TNK for AIS within 4.5 to 24 hours of onset. @*Methods@#In this pilot trial, eligible AIS patients with diffusion-weighted imaging (DWI)-fluid attenuated inversion recovery (FLAIR) mismatch were randomly allocated to intravenous TNK (0.25 mg/kg) or standard care within 4.5–24 hours of onset. The primary endpoint was excellent functional outcome at 90 days (modified Rankin Scale [mRS] score of 0–1). The primary safety endpoint was symptomatic intracranial hemorrhage (sICH). @*Results@#Of the randomly assigned 80 patients, the primary endpoint occurred in 52.5% (21/40) of TNK group and 50.0% (20/40) of control group, with no significant difference (unadjusted odds ratio, 1.11; 95% confidence interval 0.46–2.66; P=0.82). More early neurological improvement occurred in TNK group than in control group (11 vs. 3, P=0.03), but no significant differences were found in other secondary endpoints, such as mRS 0–2 at 90 days, shift analysis of mRS at 90 days, and change in National Institutes of Health Stroke Scale score at 24 hours and 7 days. There were no cases of sICH in this trial; however, asymptomatic intracranial hemorrhage occurred in 3 of the 40 patients (7.5%) in the TNK group. @*Conclusion@#This phase 2, randomized, multicenter study suggests that intravenous TNK within 4.5–24 hours of onset may be safe and feasible in AIS patients with a DWI-FLAIR mismatch.
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Objective:To evaluate the effect of motor imagery training on motor and executive function in the older population. Methods:Articles about the impact of motor imagery training on the motor and cognitive functions of the elderly in the databases of Web of Sciences, PubMed, CNKI, Wanfang data and VIP were searched from 1980 to 2020. The training program, rehabilitation effect and relatec factors of motor image training in the elderly were analyzed and summarized. Results:Twelve articles were included finally. The motor image training that suited the elderly over 60 years old was usually combined with actual exercise training, mostly for four to twelve weeks, two to three times a week and 15 to 60 minutes a time. Motor imagery training was effective on standing balance, postural control, falls and muscle strength, to improve the ability to solve conflict problems, working memory and cognitive flexibility. Conclusion:Motor imagery training is an effective way to delay the decline of physical function and improve the executive function of the elderly. It is needed to construct a reasonable and standard motor imagery training program according to the characteristics of the elderly, to improve the effect.
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Objective To analyze the effect of physical activity intervention on the cognitive and neural functions of attention deficit hyperactivity disorder (ADHD) children. Methods Literatures related to physical activity intervention and functional rehabilitation of ADHD children in PubMed, EMBASE, Web of Science, CNKI and Wanfang data were searched from January, 1990 to July, 2021. The authors, countries, publication time, subjects and ages, research methods, intervention methods, measurement tools, results and conclusions of the included literatures were extracted. Based on the theory of the International Classification of Functioning, Disability and Health (Children and Adolescents Version) (ICF-CY), the terminology and research framework were established to systematically analyze physical activity intervention programs and intervention effects in the cognitive neural function of ADHD children. Results A total of 1995 literatures were returned, twelve of them were finally included. These studies came from six countries, mainly from clinical medicine, sports rehabilitation, psychotherapy and other related journals, published mainly after 2015. The study design included randomized controlled trial, pre- and post-test design, and quasi-experimental design. Subjects were ADHD children aged four to 16 years. The physical activities included sport games, sport activities, school physical education courses and rehabilitation training. The measurement methods mainly included cognitive task, scale, questionnaire and electroencephalogram, etc. Physical activity intervention can improve ADHD children's inhibitory control, working memory and cognitive flexibility, as well as improve their motor function, and activity and participation. Conclusion Physical activity intervention can improve the cognitive neural ability, motor ability and emotion-social ability of ADHD children. However, the dose-effect relationship, influencing factors and neural mechanism need further research.
ABSTRACT
Objective To analyze the effect of physical activity intervention on the cognitive and neural functions of attention deficit hyperactivity disorder (ADHD) children. Methods Literatures related to physical activity intervention and functional rehabilitation of ADHD children in PubMed, EMBASE, Web of Science, CNKI and Wanfang data were searched from January, 1990 to July, 2021. The authors, countries, publication time, subjects and ages, research methods, intervention methods, measurement tools, results and conclusions of the included literatures were extracted. Based on the theory of the International Classification of Functioning, Disability and Health (Children and Adolescents Version) (ICF-CY), the terminology and research framework were established to systematically analyze physical activity intervention programs and intervention effects in the cognitive neural function of ADHD children. Results A total of 1995 literatures were returned, twelve of them were finally included. These studies came from six countries, mainly from clinical medicine, sports rehabilitation, psychotherapy and other related journals, published mainly after 2015. The study design included randomized controlled trial, pre- and post-test design, and quasi-experimental design. Subjects were ADHD children aged four to 16 years. The physical activities included sport games, sport activities, school physical education courses and rehabilitation training. The measurement methods mainly included cognitive task, scale, questionnaire and electroencephalogram, etc. Physical activity intervention can improve ADHD children's inhibitory control, working memory and cognitive flexibility, as well as improve their motor function, and activity and participation. Conclusion Physical activity intervention can improve the cognitive neural ability, motor ability and emotion-social ability of ADHD children. However, the dose-effect relationship, influencing factors and neural mechanism need further research.