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1.
Article in Chinese | WPRIM | ID: wpr-928212

ABSTRACT

The body weight support rehabilitation training system has now become an important treatment method for the rehabilitation of lower limb motor dysfunction. In this paper, a pelvic brace body weight support rehabilitation system is proposed, which follows the center of mass height (CoMH) of the human body. It aims to address the problems that the existing pelvic brace body weight support rehabilitation system with constant impedance provides a fixed motion trajectory for the pelvic mechanism during the rehabilitation training and that the patients have low participation in rehabilitation training. The system collectes human lower limb motion information through inertial measurement unit and predicts CoMH through artificial neural network to realize the tracking control of pelvic brace height. The proposed CoMH model was tested through rehabilitation training of hemiplegic patients. The results showed that the range of motion of the hip and knee joints on the affected side of the patient was improved by 25.0% and 31.4%, respectively, and the ratio of swing phase to support phase on the affected side was closer to that of the gait phase on the healthy side, as opposed to the traditional body weight support rehabilitation training model with fixed motion trajectory of pelvic brace. The motion trajectory of the pelvic brace in CoMH mode depends on the current state of the trainer so as to realize the walking training guided by active movement on the healthy side of hemiplegia patients. The strategy of dynamically adjustment of body weight support is more helpful to improve the efficiency of walking rehabilitation training.


Subject(s)
Biomechanical Phenomena , Gait , Hemiplegia , Humans , Pelvis , Range of Motion, Articular , Stroke Rehabilitation , Walking
2.
Article in Portuguese | LILACS | ID: biblio-1353095

ABSTRACT

A Hemiplegia Alternante da Infância é um distúrbio neurológico grave e uma doença rara (1 em cada 100.000 recém-nascidos), caracterizado por ataques repetidos transitórios de hemiplegia episódica ou tetraplegia que podem durar minutos a horas, acompanhados por outros sintomas paroxísticos como anormalidades oculomotoras e autonômicas, distúrbios do movimento como ataxia, comprometimento cognitivo progressivo, convulsões, distonia e coreia. Os tratamentos atuais são amplamente sintomáticos. Neste relato de caso, apresentamos paciente do sexo feminino, 18 anos, na qual aos 10 meses apresentou o primeiro episódio aparente de crise convulsiva com versão ocular. O eletroencefalograma e tomografia computadorizada não revelaram anormalidades e foram administradas diversas medicações como fenobarbital, carbamazepina, valproato de sódio, topiramato, dicloridrato de flunarizina, clonazepam, cipro-heptadina e pizotifeno, todos sem resultado. Devidos aos sintomas extrapiramidais, paciente passou a utilizar biperideno, apresentando não só melhora da distonia, mas também no número de crises hemiplégicas. Aos 13 anos, ela foi diagnosticada com Hemiplegia Alternante da Infância na mutação patogênica missense de novo c.2415C G (p.Asp805Glu) no gene ATP1A3 apresentando boa resposta ao tratamento com cloridrato de biperideno. (AU)


Alternating hemiplegia of childhood is a severe neurological disorder and a rare disease (1 in 100,000 newborns), characterized by repeated transient attacks of episodic hemiplegia or tetraplegia that can last minutes to hours, accompanied by other paroxysmal symptoms such as oculomotor and autonomic abnormalities, movement disorders such as ataxia, progressive cognitive impairment, seizures, dystonia, and chorea. Current treatments are largely symptomatic. In this case report, we present a female patient, 18 years old, who presented the first apparent episode of seizure with ocular version at ten months of age. The electroencephalogram and CT scan revealed no abnormalities, and several medications such as phenobarbital, carbamazepine, sodium valproate, topiramate, flunarizine dihydrochloride, clonazepam, cyproheptadine and pizotifen were administered, all without result. Due to the extrapyramidal symptoms, the patient started using biperidene, showing improvement in dystonia and the number of hemiplegic seizures. At age 13, she was diagnosed with Alternating hemiplegia of Childhood in the pathogenic missense de novo mutation c.2415C>G (p.Asp805Glu) in the ATP1A3 gene showing a good response to treatment with biperidene hydrochloride. (AU)


Subject(s)
Humans , Female , Adult , Ataxia , Seizures , Biperiden , Rare Diseases , Cognitive Dysfunction , Hemiplegia
3.
Rev. bras. med. esporte ; 27(3): 262-265, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1288590

ABSTRACT

ABSTRACT Introduction Patients with cerebrovascular accident and hemiplegia need to perform physical exercise and aerobic training, but physical dysfunction restricts the performance of these activities. Objective The article aims to develop physical strength sports for stroke patients with hemiplegia to explore the efficacy of sports to regain limb function in these patients. Methods We randomly selected 30 patients with stroke sequelae and divided them into control and exercise groups. While undergoing rehab, the exercise group performed a certain amount of aerobic exercise. During this period, we compared the relevant physiological indicators of the patients, and, at the same time, we used the Fugle-Meyer motor function scoring method to assess limb function. Results The two groups of patients are significantly different regarding the recovery of physical function and the capacity for daily life. Physiological indicators of patients are also different. Conclusion Low-intensity aerobic exercise can help stroke and hemiplegia patients regain their basic ability to live and exercise. Level of evidence II; Therapeutic studies: investigation of treatment results.


RESUMO Introdução É muito importante que pacientes com acidente vascular encefálico e hemiplegia realizem exercícios físicos e treinamento aeróbio, mas a disfunção física restringe a realização dessas atividades. Objetivo o artigo tem como objetivo desenvolver esportes de força física para pacientes com AVC com hemiplegia para explorar a eficácia dos esportes para recuperar a função dos membros nesses pacientes. Métodos Selecionamos aleatoriamente 30 pacientes com sequela de AVC e os dividimos em grupos controle e exercício. Durante a reabilitação, o grupo de exercícios realmente executou uma certa quantidade de exercícios aeróbicos. Durante esse período, comparamos os indicadores fisiológicos relevantes dos pacientes e, ao mesmo tempo, usamos o método de pontuação da função motora de Fugle-Meyer para avaliar a função dos membros. Resultados Os dois grupos de pacientes são significativamente diferentes em termos de recuperação da função física e capacidade para a vida diária. Os indicadores fisiológicos dos pacientes também são diferentes. Conclusão O exercício aeróbico de baixa intensidade pode ajudar os pacientes com derrame e hemiplegia a recuperar sua capacidade básica de viver e se exercitar. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.


RESUMEN Introducción Es muy importante para los pacientes con accidente cerebrovascular y hemiplejía realizar ejercicio físico y entrenamiento aeróbico, pero la disfunción física restringe la realización estas actividades.Objeto: El artículo tiene como objetivo desarrollar deportes de fuerza física para pacientes con accidente cerebrovascular con hemiplejía para explorar la eficacia de los deportes para recuperar la función de las extremidades de estos pacientes. Métodos Seleccionamos aleatoriamente a 30 pacientes con secuelas por accidente cerebrovascular y los dividimos en grupos de control y de ejercicio. Mientras se sometía a rehabilitación, el grupo de ejercicio llegó a realizar una cierta cantidad de ejercicio aeróbico. Durante este período, comparamos los indicadores fisiológicos relevantes de los pacientes y, al mismo tiempo, utilizamos el método de puntuación de la función motora de Fugle-Meyer para evaluar la función de las extremidades. Resultados Los dos grupos de pacientes son significativamente diferentes en cuanto a la recuperación de la función física y la capacidad para la vida diaria. Los indicadores fisiológicos de los pacientes también son diferentes. Conclusión El ejercicio aeróbico de baja intensidad puede ayudar a los pacientes con accidente cerebrovascular y hemiplejía a recuperar su capacidad básica de vida y ejercicio. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.


Subject(s)
Humans , Stroke/complications , Exercise Therapy , Stroke Rehabilitation/methods , Hemiplegia/rehabilitation , Treatment Outcome , Extremities
4.
Fisioter. Bras ; 22(1): 25-36, Mar 19, 2021.
Article in Portuguese | LILACS | ID: biblio-1284010

ABSTRACT

Introdução: Crianças com paralisia cerebral hemiplégica (PCH) exibem dificuldades funcionais na utilização do membro superior hemiparético, repercutindo negativamente no desempenho em realizar atividades de vida diária. Atualmente, os déficits motores nessa população são acompanhados por distúrbios sensoriais, dificuldades na aprendizagem, alterações de comportamento e comunicação e défices cognitivos gerais. Objetivo: Investigar a possível associação entre os déficits motores e cognitivos de crianças com PCH, verificando ainda a influência da lateralidade da hemiplegia. Métodos: Participaram do estudo 30 crianças com PCH (idade média = 10,48 ± 2,46 anos). Os participantes foram submetidos aos seguintes testes: Assisting Hand Assessment (AHA), Matrizes Progressivas Coloridas de Raven, o Subteste cubos do Wechsler Intelligence Scale for Children fourth Edition - WISC IV e a fluência verbal semântica de animais. Resultados: Os grupos foram homogêneos em relação ao sexo e idade (p > 0.05). Os grupos não diferiram em relação ao nível de desempenho motor, memória de trabalho, inteligência e fluência verbal (p > 0,05). O desempenho motor correlacionou com todas as variáveis cognitivas. Conclusão: Em crianças com PCH o desempenho motor correlacionou fortemente com funções cognitivas. Além disso, a lateralidade da lesão cerebral não influenciou o desempenho em tarefas motoras e cognitivas. (AU)


Introduction: Children with hemiplegic cerebral palsy (HCP) exhibit functional difficulties in using the hemiparetic upper limb, negatively impacting their performance in carrying out activities of daily living. Currently, motor deficits in this population are accompanied by sensory disorders, learning difficulties, changes in behavior and communication and general cognitive deficits. Objective: To investigate the possible association between motor and cognitive deficits in children with PCH, also verifying the influence of laterality in hemiplegia. Methods: Thirty children with PCH participated in the study (mean age = 10.48 ± 2.46 years). Participants were subjected to the following tests: Assisting Hand Assessment (AHA), Raven's Colorful Progressive Matrices, the Wechsler Intelligence Scale for Children fourth Edition - WISC IV Subtest and the semantic verbal fluency of animals. Results: The groups were homogeneous in relation to sex and age (p > 0.05). The groups did not differ in relation to the level of motor performance, working memory, intelligence and verbal fluency (p> 0.05). Motor performance correlated with all cognitive variables. Conclusion: In children with PCH, motor performance correlated strongly with cognitive functions. In addition, the laterality of the brain injury did not influence performance in motor and cognitive tasks. (AU)


Subject(s)
Humans , Male , Female , Child , Psychomotor Performance/physiology , Cerebral Palsy/physiopathology , Cognition/physiology , Hemiplegia/physiopathology , Functional Laterality/physiology , Cross-Sectional Studies
5.
Chinese Acupuncture & Moxibustion ; (12): 1308-1312, 2021.
Article in Chinese | WPRIM | ID: wpr-921050

ABSTRACT

OBJECTIVE@#To explore the effect of scalp acupuncture combined with suspension training on balance ability and motor function in stroke patients with balance dysfunction.@*METHODS@#A total of 105 stroke patients with balance dysfunction were randomly divided into a combined group (35 cases, 2 cases dropped off), a scalp acupuncture group (35 cases, 3 cases dropped off) and a suspension training group (35 cases, 2 cases dropped off). The scalp acupuncture group was treated with scalp acupuncture at bilateral suboccipital lateral line, parietal midline, upper 1/5 line of anterior oblique line of parietal and temporal and line 1 of the parietal lateral line on the opposite side of hemiplegia. The suspension training group was treated with suspension training. The combined group was treated with suspension training at the same time of scalp acupuncture. All the treatment was given once a day, 30 min each time, 5 days a week, for a total of 6 weeks. The Berg balance scale (BBS) score, balance tester and Fugl-Meyer assessment (FMA) score were used to evaluate the motor function and balance ability before treatment, 3 and 6 weeks into treatment. The clinical efficacy was evaluated in the 3 groups.@*RESULTS@#The scores of BBS and FMA in each group at 3 and 6 weeks into treatment were higher than those before treatment (@*CONCLUSION@#Scalp acupuncture combined with suspension training could improve the balance ability and motor function in stroke patients with balance dysfunction, and the curative effect is better than simple scalp acupuncture and simple suspension training.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Hemiplegia , Humans , Scalp , Stroke/therapy , Stroke Rehabilitation , Treatment Outcome
6.
Chinese Acupuncture & Moxibustion ; (12): 1069-1073, 2021.
Article in Chinese | WPRIM | ID: wpr-921011

ABSTRACT

OBJECTIVE@#To verify the superiority of motor imagery acupuncture in improving muscle tension for patients with upper limb hemiplegia in early stroke.@*METHODS@#A total of 64 patients of stroke hemiplegia with upper limb flaccid paralysis were randomly divided into an observation group (32 cases, 1 case dropped off ) and a control group (32 cases, 4 cases dropped off ). The observation group was treated with motor imagery acupuncture (both acupuncture and motor imagery therapy at affected upper limb were performed).The control group was treated with acupuncture plus motor imagery therapy at affected lower limb, 2 h later after acupuncture, motor imagery therapy was applied to upper limb. Baihui (GV 20) to Taiyang (EX-HN 5) of healthy side, Fengchi (GB 20) and Jianyu (LI 15), Jianjing (GB 21), Quchi (LI 11), Waiguan (TE 5) on the affected side, ect. were selected in both groups, once a day, 5 times a week for 4 weeks. Before and after treatment, 4, 8 weeks after treatment, the modified Ashworth scale (MAS) grade and Brunnstrom stage were compared in the two groups.@*RESULTS@#Compared before treatment, the muscle tension of shoulder, elbow and wrist each time point after treatment was increased in the two groups (@*CONCLUSION@#Motor imagery acupuncture could promote hemiplegia upper limb muscle tension recovery in patients of stroke hemiplegia with upper limb flaccid paralysis, make the patients gradually shift to the separate fine movement mode, inhibit and relieve the appearance and development of spasm.


Subject(s)
Acupuncture Therapy , Hemiplegia/therapy , Humans , Muscle Tonus , Stroke/therapy , Treatment Outcome , Upper Extremity
7.
Article in Chinese | WPRIM | ID: wpr-887470

ABSTRACT

OBJECTIVE@#To observe the effect of tapping at acupoints along meridian combined with thunder-fire moxibustion on upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke.@*METHODS@#A total of 140 patients with upper-limb hemiplegia after stroke were randomly divided into a combination group (35 cases, 2 cases dropped off), an acupoint-tapping group (35 cases), a moxibustion group (35 cases, 2 cases dropped off) and a routine group (35 cases). The patients in the routine group were only treated with routine treatment and nursing. On the basis of the treatment in the routine group, the patients in the acupoint-tapping group were treated with tapping along the large intestine meridian of hand @*RESULTS@#Compared before treatment, body mass indexs of shoulder abduction, elbow extension, wrist flexion as well as BI scores in the four groups were significantly increased after treatment (@*CONCLUSION@#Tapping at acupoints along meridian combined with thunder-fire moxibustion could effectively improve the upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke, and its effect is superior to simple tapping at acupoints along meridian or thunder-fire moxibustion.


Subject(s)
Activities of Daily Living , Acupuncture Points , Acupuncture Therapy , Hemiplegia/therapy , Humans , Meridians , Moxibustion , Stroke/therapy , Treatment Outcome , Wrist
8.
Medicentro (Villa Clara) ; 24(4): 735-752, oct.-dic. 2020. tab
Article in Spanish | LILACS | ID: biblio-1143242

ABSTRACT

RESUMEN Introducción: las enfermedades cerebrovasculares son afecciones por pérdida funcional transitoria o permanente de una parte del sistema nervioso central, generalmente son de instalación súbita, causadas por: oclusiones arteriales, trombos, émbolos o por rotura de una arteria encefálica. Objetivo: determinar los resultados terapéuticos de la aplicación de la craneopuntura y acupuntura somática en pacientes hemipléjicos con diagnóstico de accidente cerebrovascular isquémico. Métodos: se realizó una investigación cuasi-experimental y prospectiva en el Hospital Universitario Clínico Quirúrgico Cmdte. Manuel Fajardo Rivero, Santa Clara, en el período de octubre 2015 a septiembre 2018. La población estuvo constituida por los pacientes ingresados en los servicios de Medicina Interna y Medicina Tradicional. Se conformaron dos grupos: estudio y control (17 pacientes en cada uno). Se realizó una entrevista médica a los pacientes, se aplicó el índice de Barthel y se confeccionó la historia clínica tradicional. Ambos grupos recibieron tratamiento fisioterapéutico y al grupo estudio se le añadió la craneopuntura y la acupuntura somática. Resultados: predominaron los pacientes del sexo masculino y el grupo etario de 70 a 79 años. La deficiencia de yin del riñón prevaleció en la muestra estudiada; se evidenció un mayor número de pacientes autónomos frágiles en el grupo estudio, en el cual, un 52,9 % presentó una evolución de la capacidad funcional satisfactorio, acompañada de un tiempo terapéutico corto. Conclusiones: los pacientes hemipléjicos por accidente cerebrovascular isquémico tratados con craneopuntura y acupuntura somática, mostraron resultados terapéuticos favorables, en comparación con el grupo que no recibió este tratamiento.


ABSTRACT Introduction: cerebrovascular diseases are affections due to temporary or permanent functional loss of a part of the central nervous system, generally they are of sudden installation and are caused by arterial occlusions, thrombi, emboli or by rupture of an encephalic artery. Objective: to determine therapeutic results of the application of craniopuncture and somatic acupuncture in hemiplegic patients diagnosed with ischemic stroke. Methods: a quasi-experimental and prospective investigation was carried out at ‟Cmdte. Manuel Fajardo Rivero" Clinico-Surgical University Hospital in Santa Clara, from October 2015 to September 2018. The population consisted of patients admitted to the Internal Medicine and Traditional Medicine services. Two groups were formed: study and control (17 patients in each one). A medical interview to the patients was carried out, Barthel Index was applied and a traditional medical record was drawn up. Both groups received physiotherapeutic treatment and craniopuncture and somatic acupuncture were added to the study group. Results: male patients and the age group from 70 to 79 years predominated. Kidney -yin deficiency prevailed in the sample studied; a greater number of frail autonomous patients was evidenced in the study group, in which 52.9% had a satisfactory evolution of functional capacity, accompanied by a short therapeutic time. Conclusions: hemiplegic patients due to ischemic stroke treated with craniopuncture and somatic acupuncture, showed favorable therapeutic results, in comparison with the group that did not receive this treatment.


Subject(s)
Acupuncture Therapy , Stroke , Hemiplegia
9.
Rev. chil. neuro-psiquiatr ; 58(2): 150-160, jun. 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1115480

ABSTRACT

Resumen Introducción El accidente cerebrovascular constituye la principal causa de muerte y discapacidad en Chile. Más del 85% de los pacientes sufren hemiplejía y más del 69% discapacidad motora funcional de las extremidades superiores. Esta alteración genera impacto en el uso de la extremidad superior, afectando las diversas actividades de la vida diaria de las personas. No existen estudios que combinen terapia de biofeedback electromiográfico y activación bimanual con estimulación eléctrica funcional en sujetos secuelados de Accidente cerebrovascular (ACV). Por esto, surge el interés de determinar el efecto que tiene un protocolo de entrenamiento basado en Estimulación Eléctrica Funcional (EEF) con activación bimanual y terapia de biofeedback en la función de la extremidad superior. Metodología: 15 sujetos secuelados de ACV entre 40 y 85 años reclutados en el área de neurorrehabilitación ambulatoria de Clínica Dávila, aleatorizados en un grupo experimental y en dos grupos controles de 5 sujetos. En cada sesión el grupo experimental entrenará quince minutos de activación bimanual con electroestimulación funcional y luego un programa de entrenamiento de biofeedback de diez minutos, mientras que el grupo control 1 y control 2 entrenaron en las mismas condiciones pero con EEF placebo y BF-EMG placebo respectivamente Resultados Existieron cambios significativos en el grupo experimental luego de la intervención. Conclusión Este estudio sugiere la estimulación eléctrica funciona y biofeedback como una herramienta para la rehabilitación de la extremidad superior paréticas en sujetos secuelados de ACV.


Introduction: Stroke is the leading cause of death and disability in Chile. More than 85% of patients suffer from hemiplegia and more than 69% functional motor disability of the upper extremities. This alteration generates an impact on the use of the upper limb, affecting the various activities of people's daily lives. There are no studies that combine electromyographic biofeedback therapy and bimanual activation with functional electrical stimulation in subjects with stroke. Therefore, there is interest in determining the effect of a training protocol based on Functional Electrical Stimulation (FES) with bimanual activation and biofeedback therapy on the function of the upper limb. Methodology: 15 subjects with stroke between 40 and 85 years recruited in the outpatients neurorehabilitation program of Clínica Dávila, randomized in an experimental group and in two control groups of 5 subjects. In each session the experimental group will train fifteen minutes of bimanual activation with functional electrostimulation and then a ten-minute biofeedback training program, while the control 1 and control 2 group trained under the same conditions but with placebo FES and placebo BF-EMG respectively. Results There were significant changes in the experimental group after the intervention. Conclusion This study suggests the electrical stimulation works and biofeedback as a tool for the rehabilitation of the upper limb in subjects with stroke.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Therapeutics , Stroke , Upper Extremity , Electric Stimulation , Neurological Rehabilitation , Hemiplegia , Longitudinal Studies , Evaluation Studies as Topic
10.
Rev. bras. neurol ; 56(1): 30-35, jan.-mar. 2020. ilus
Article in English | LILACS | ID: biblio-1095940

ABSTRACT

Skilled movements certainly exist since the dawn of the humans, embedded in the actions of daily living, and also represented by tools and weapons making and use, as well as by artistic activities as drawing and engraving. A very long period of time elapsed until such actions were recognized as special, and the designation 'praxis' was attributed to such ability of produce refined movements. Another long time passed, and only recently disturbances of such actions caused by brain lesions were identified, leading to the concept of 'apraxia'. Studies on this subject progressed quickly, and in a few decades reached the state resembling to what is seen nowadays.


Movimentos hábeis certamente existem desde a aurora dos humanos, incluídos nas ações da vida diária e também representados na feitura e uso de ferramentas e de armas, assim como por atividades artísticas como desenhar e gravar. Decorreu um longo período de tempo até que tais ações fossem reconhecidas como especiais e a designação de 'praxia' foi atribuída para tais habilidades para produzir movimentos refinados. Outro tempo prolongado passou, e apenas recentemente desordens de tais ações causadas por lesões cerebrais fossem identificadas, levando ao conceito de 'apraxia'. Estudos sobre esse assunto progrediram rapidamente e em poucas décadas alcançaram o estado que se assemelha ao que é visto atualmente.


Subject(s)
Humans , Apraxias/classification , Apraxias/history , Apraxia, Ideomotor/diagnosis , Paresis , Art , Motor Skills Disorders , Hemiplegia
12.
Article in Chinese | WPRIM | ID: wpr-827252

ABSTRACT

OBJECTIVE@#To investigate the clinical effects of dual mobility total hip prosthesis in treating femoral neck fracture patients with hemiplegia.@*METHODS@#A retrospective analysis was performed on 18 patients with femoral neck fracture combined with hemiplegia who underwent dual mobility total hip prosthesis replacement from March 2014 to December 2016. The follow up data of these patients was complete. There were 5 males and 13 females, aged 65 to 70 years old with an average of (66.50±1.38) years. The left side was involved in 12 cases, while the right side in 6 cases. There were 4 cases with Garden Ⅲ type and 14 cases with type Ⅳ. Limb muscle strength of hemiplegia were in grade Ⅳ. The posterior-lateral approach of hip joint was used in surgery for all patients. The implant position, dislocation and loosening of the prosthesis were evaluated by X-ray examination. Harris hip score and the Merle D'aubigne score were used to assess the hip function in the follow up.@*RESULTS@#The operation duration was for 70-90 (81.56±7.48) min and the blood loss during the operation was for 160-200 (170.32± 12.56) ml. No blood was transfused during the operation. Postoperative incisions were healed at the first stage. The follow-up time was for 28-60(36.0±3.5) months. Harris hip score increased from 16.94±0.73 preoperatively to 96.19±1.27 at the final follow-up(<0.05). Merle D 'Aubigne score increased from 3.96±0.06 preoperatively to 16.81±0.63 at the final follow-up(< 0.05). No fracture or nerve or vascular injury were found during the operation. The postoperative X-ray showed that the prosthesis was in good position. No complications such as joint dislocation, dislocation of prosthesis, loosening of prosthesis, fracture around the prosthesis, pain in the front of thethigh, fracture of the self tapping screw in the ilium, and delayed infection occurred in the patients after operation.@*CONCLUSION@#Dual mobility total hip prosthesis has the advantages of both good initial stability and low dislocation rate of the prosthesis, and the clinical application of total hip replacement in hemiplegic femoral neck fracture is satisfactory.


Subject(s)
Aged , Arthroplasty, Replacement, Hip , Female , Femoral Neck Fractures , General Surgery , Follow-Up Studies , Hemiplegia , Hip Prosthesis , Humans , Male , Retrospective Studies , Treatment Outcome
13.
Article in Chinese | WPRIM | ID: wpr-826691

ABSTRACT

OBJECTIVE@#To evaluate the therapeutic effect of the combined treatment with balance acupuncture therapy and exercise re-learning rehabilitation therapy and the impact on serum cAMP and cGMP in the patients with hemiplegia of cerebral ischemic stroke.@*METHODS@#A total of 90 patients of hemiplegia of cerebral ischemic stroke were randomized into an observation group and a control group, 45 cases in each one. All of the patients in the two groups received health education, diet guidance, routine symptomatic treatment as well as exercise re-learning rehabilitation therapy. Additionally, in the observation group, balance acupuncture therapy was applied, in which, the acupoints on the aspect of the human body, on the governor vessel and bladder meridian were adopted in the morning and those on the aspect of the human body, on the conception vessel and kidney meridian were stimulated in the afternoon. In the control group, the regular acupuncture was given. In the two groups, both acupuncture and rehabilitation therapies were given 5 days a week, 2 week-treatment as one course and totally 2 courses were required. Separately, before and after treatment, the score of Fugl-Meyer assessment (FMA) and the score of Chinese stroke scale (CSS) were recorded, the levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) detected in serum and the clinical therapeutic effect were evaluated in the two groups.@*RESULTS@#After treatment, FMA score was increased in the patients of either of the groups as compared with that before treatment (<0.01) and CSS score decreased as compared with that before treatment (<0.01). After treatment, FMA score in the observation group was higher than that in the control group (<0.01) and CSS score was lower than the control group (<0.01). After treatment, the level of serum cAMP of the patients in either of the groups was increased as compared with that before treatment (<0.01) and that of cGMP decreased as compared with that before treatment (<0.01). After treatment, the level of cAMP in the observation group was higher than that in the control group (<0.01) and that of cGMP was lower than the control group (<0.01). The total effective rate was 93.3% (42/45) in the observation group, better than 73.3% (33/45) in the control group (<0.01).@*CONCLUSION@#The balance acupuncture therapy combined with exercise re-learning rehabilitation effectively improves the motor function of the affected limb, relieves injury and regulate the levels of serum cAMP and cGMP in the patients with hemiplegia of ischemic stroke.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Brain Ischemia , Therapeutics , Cyclic AMP , Blood , Cyclic GMP , Blood , Hemiplegia , Therapeutics , Humans , Stroke , Therapeutics , Stroke Rehabilitation , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-879377

ABSTRACT

With China's aging society, the number of patients with hemiplegia caused by cerebrovascular accident is increasing gradually. The risk of hip fracture in the first year after the onset of this kind of patients is 4 times higher than that of ordinary people, and most of them occur in the side of hemiplegia. For senile femoral neck fracture, artificial joint replacement is almost the first choice of treatment, with mature operation technology and good curative effect. At present, it is considered that if the muscle strength of hemiplegic side can reach grade III after cerebral vascular accident, hip arthroplasty can be the first choice for hemiplegic patients with hemiplegic femoral neck fracture. However, the situation of hemiplegic patients is different from that of ordinary people. The hemiplegic limbs may have muscle atrophy, muscle strength imbalance, osteoporosis and other problems, which brings difficulties to the formulation of surgical plan. This paper mainly discusses the choice of surgical approach, the use of total hip arthroplasty or hemiarthroplasty, the use of cemented prosthesis or cementless prosthesis, and how to reduce the incidence of postoperative dislocation The purpose is to provide more reference evidence for orthopedic doctors in clinical decision-making.


Subject(s)
Arthroplasty, Replacement, Hip , Femoral Neck Fractures/surgery , Hemiarthroplasty , Hemiplegia , Hip Prosthesis , Humans , Treatment Outcome
15.
Article in Chinese | WPRIM | ID: wpr-826670

ABSTRACT

OBJECTIVE@#To compare the therapeutic effect of - balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia.@*METHODS@#A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, - balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups.@*RESULTS@#①After treatment, the MAS classification reduced in both groups (<0.05), the cases of grade 0 to Ⅰ in the observation group were more than those in the control group (<0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups (<0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group (<0.05). ②After treatment, the scores of NIHSS were decreased (<0.05), the scores of FMA, MBI were increased in both groups (<0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group (<0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group (<0.05).@*CONCLUSION@#- balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.


Subject(s)
Acupuncture Therapy , Hemiplegia , Therapeutics , Humans , Stroke , Therapeutics , Stroke Rehabilitation , Treatment Outcome , Upper Extremity , Yin-Yang
16.
Article in English | WPRIM | ID: wpr-785552

ABSTRACT

We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.


Subject(s)
Hemiplegia , Humans , Lower Extremity , Postural Balance , Recovery of Function , Rehabilitation , Stroke , Upper Extremity , Weights and Measures
17.
Med. UIS ; 32(2): 53-58, mayo-ago. 2019. graf
Article in Spanish | LILACS | ID: biblio-1114968

ABSTRACT

Resumen El accidente cerebrovascular en adultos jóvenes es un evento raro presente en menos del 5% de los casos a nivel mundial, representando un reto diagnóstico debido a las múltiples etiologías posibles, entre ellas las infecciones. Del 15% al 40% de los pacientes con sífilis no tratada pueden desarrollar sífilis terciaria con manifestaciones principalmente neurodestructivas, descritas en la sífilis tardía pero con meningitis crónica y accidente cerebrovascular de tipo meningovascular en su fase temprana. Se presenta el caso de un paciente masculino de 40 años con antecedente de cambios de comportamiento, alucinaciones auditivas e insomnio, quien consulta a urgencias por presentar hemiplejia derecha, afasia motora, lesiones palmo-plantares y roseta en glande asociada a adenopatías inguinales. Dados los hallazgos imagenológicos y de líquido cefalorraquídeo se estableció diagnóstico de accidente cerebrovascular isquémico de circulación cerebral anterior izquierda secundario a neurosífilis meningovascular, con confirmación de inmunosupresión por virus de inmunodeficiencia humana. MÉD.UIS.2019;32(2):53-8


Abstract Stroke in young adults is a rare event present in less than 5% of cases worldwide, representing a diagnostic challenge due to the multiple possible etiologies, including infections. 15% to 40% of patients with untreated syphilis may develop tertiary syphilis; with mainly neurodestructive manifestations, described in late syphilis, but in its early stage with chronic meningitis and meningovascular stroke. The case of a 40-year-old male patient with a history of behavior changes, auditory hallucinations and insomnia is presented, who consults the emergency department for presenting right hemiplegia, motor aphasia, palmoplantar lesions and rosette in glans associated with inguinal adenopathies. Given the imaging and cerebrospinal fluid findings, a diagnosis of ischemic stroke of the left anterior cerebral circulation was established, secondary to meningovascular neurosyphilis, with confirmation of immunosuppression due to human immunodeficiency virus. MÉD.UIS.2019;32(2):53-8


Subject(s)
Humans , Male , Adult , Neurosyphilis , Aphasia, Broca , Patients , Penicillins , Treponema pallidum , Wounds and Injuries , Male , Syphilis , Cerebrospinal Fluid , Cerebrovascular Circulation , Adolescent , Acquired Immunodeficiency Syndrome , HIV , Immunosuppression Therapy , Stroke , Young Adult , Lymphadenopathy , Hallucinations , Hemiplegia , Infections , Sleep Initiation and Maintenance Disorders , Meningitis
18.
Rev. bras. ciênc. mov ; 27(3): 106-121, jan.-mar.2019. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1016028

ABSTRACT

O objetivo deste trabalho foi verificar a ativação dos músculos tibial anterior e sóleo em pacientes hemiparéticos e indivíduos hígidos, em bipedestação no ambiente aquático em comparação ao solo e verificar se há correlação entre ativação muscular e medidas funcionais. Trata-se de um estudo transversal, no qual foram incluídos 6 indivíduos hígidos no grupo controle (GC) e 6 hemiparéticos no grupo estudo (GE). Os participantes foram caracterizados por meio dos instrumentos Mini-Exame do Estado Mental (MEEM), Escala de Equilíbrio de Berg (EEB), Medida da Independência Funcional (MIF) e eletromiografia (EMG) de superfície dos músculos tibial anterior e sóleo em diferentes posturas de bipedestação, nos ambientes terrestre e aquático em dois níveis de imersão, sendo eles processo xifoide (PX) e crista ilíaca ântero superior (CIAS). Como resultados, o GE obteve pontuação média de 24±6,7 no MEEM, sem perdas cognitivas, 80,8±2,7 na MIF, com dependência modificada e independência completa e 48,5±7,1 na EEB, sem riscos de quedas. A EMG evidenciou maior ativação do músculo sóleo no GE quando comparado ao GC, bem como maior ativação no lado hemiparético quando comparado ao lado não afetado. Constatou-se uma correlação inversamente proporcional entre a EMG e a EEB no GE. Com esse estudo foi possível compreender o comportamento dos músculos tibial anterior e sóleo de indivíduos hemiparéticos no ambiente aquático quando comparado ao solo, em posturas comumente utilizadas na reabilitação aquática. Esse melhor entendimento pode possibilitar uma intervenção mais adequada, com repercussões na prática clínica e de atividade física realizadas no ambiente aquático com indivíduos hemiparéticos....(AU)


The purpose of this present trial was to evaluate the activation of the tibialis anterior and soleus muscles in hemiparetics and health individuals, in a standing position performed in aquatic environment and compared to activation of this muscles on the land and verify if there is correlation between muscular activation and functional measures. In this cross-sectional study were included six health individuals in the control group (CG) and six hemiparetics individuals in the experimental group (EG). Participants were characterized by Mini Mental State Exam (MMSE), Berg Balance Scale (BBS), Functional Independence Measure (FIM) and surface electromyography (EMG) of the tibialis anterior and soleus muscles in different stand positions in aquatic environment and on the land in a two-step immersion to the xiphoid process and anterior superior iliac spine. As a result, the EG obtained a mean score of 24 ± 6.7 in the MMSE, without cognitive losses, 80.8 ± 2.7 in the FIM, with modified dependence and complete independence, and 48.5 ± 7.1 in BBE, without risks of falls. The surface EMG showed greater activation of the soleus muscle in the EG when compared to the CG, as well as greater activation on the hemiparetic side when compared to the unaffected side. An inverse proportional relationship between surface EMG and BBE in the EG was found. With this study it was possible to understand the behavior of the tibialis anterior and soleus muscles in hemiparetic individuals in the aquatic environment when compared to land, in postures commonly used in aquatic rehabilitation. This better understanding may allow a more adequate intervention, with repercussions in clinical practice and physical activity performed in the aquatic environment with hemiparetic individuals....(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Physical Education and Training , Electromyography , Hemiplegia , Hydrotherapy
19.
Clinics ; 74: e905, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001819

ABSTRACT

OBJECTIVES: Poststroke shoulder pain occurs very frequently and compromises function and quality of life. Because treatment depends on a multidisciplinary approach, it is desirable to optimize effectiveness. Myofascial pain syndrome is defined by the presence of trigger points that can also be found in spastic stroke patients. The aim of this study was to evaluate the frequency of myofascial pain in the shoulder girdle muscles in patients with poststroke shoulder pain and to document the clinical and functional results obtained with specific treatment for this condition. METHODS: Spastic stroke hemiplegic patients undergoing rehabilitation at the Rehabilitation Center of the Hospital das Clínicas of the Ribeirão Preto Medical School of the University of São Paulo were evaluated regarding the intensity and characteristics of shoulder pain, previous therapeutic interventions, shoulder goniometry and the presence of trigger points. Patients underwent trigger point blockade by intramuscular infiltration of 1% lidocaine. The evaluation and treatment procedures were repeated in the subsequent 3 weeks as long as the pain intensity was greater than 5 on a visual analog scale (VAS). In the fourth week, the evaluation procedures were repeated. Patients who were in a multiprofessional rehabilitation program were instructed to continue the treatment, and the others received complementary therapeutic advice if necessary to initiate it. The evaluations were performed at 0, 1, and 3 weeks and after 4 months. RESULTS: Twenty-one patients (13 men; age=67.8±10.2 years; right hemiparesis: 11) participated in the study, and there was a reduction in pain assessed by VAS from baseline (7.6±2.7) to the first week (5.8±3.6; p<0.05) through the end of the third week (5.2±3.5; p<0.05), but not at the end of four months (6.6±2.9; p=0.11). Good responders had significantly lower pain levels after the third week and presented with a larger range of motion for passive abduction by the end of 4 months. These results demonstrate that the myofascial component of pain should be considered in poststroke shoulder pain and that its treatment may be a pathway for the rapid and long-lasting relief of symptoms. CONCLUSION: Trigger point blockade with lidocaine can reduce pain perception in spastic hemiplegic shoulder in as much as 50% of stroke survivors for four months.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Shoulder Pain/drug therapy , Anesthetics, Local/therapeutic use , Lidocaine/therapeutic use , Myofascial Pain Syndromes/drug therapy , Quality of Life , Pain Measurement , Treatment Outcome , Shoulder Pain/etiology , Stroke/complications , Trigger Points , Hemiplegia/etiology , Hemiplegia/drug therapy , Myofascial Pain Syndromes/etiology
20.
Article in English | WPRIM | ID: wpr-741769

ABSTRACT

OBJECTIVES: The purpose of this research was to study the influences of dual task training on upper extremity function and performance of daily activities of chronic stroke patients. METHODS: Dual task training was performed on 21 patients who had suffered a chronic stroke with hemiplegia. The dual task training was performed for 30 minutes per session, for 5 days a week, for 3 weeks. There were 5 evaluations carried out over 3 weeks before and after the intervention. Changes in upper extremity function were measured by using the Box and block test. Changes in the performance of daily activities were measured using the Korea-Modified Barthel Index. RESULTS: The mean upper limb function score of the chronic stroke patients increased significantly from 21.88 ± 19.99 before the intervention, to 26.22 ± 15.65 after the intervention (p < 0.05), and the mean daily activities score increased significantly from 65.82 ± 12.04, to 67.29 ± 12.90 (p < 0.05). CONCLUSION: Dual task training effectively improved upper extremity function, and the performance of daily activities in chronic stroke patients.


Subject(s)
Activities of Daily Living , Hemiplegia , Humans , Stroke , Upper Extremity
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