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Objective:To compare the effects of repetitive transcranial magnetic stimulation (TMS) at three different relatively high frequencies on neuropathic pain so as to find the best frequency.Methods:One hundred Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a TMS group and a control stimulation group. The TMS group was further divided into a 5Hz group, a 10Hz group, and a 20Hz group. The rats in the model, control stimulation and TMS groups received constriction injury of the sciatic nerve, while the rats in the sham group were given a sham version of the operation. On the third day after the operation the rats in the TMS group and the control stimulation group began to receive TMS treatment. Neuropatic pain was evaluated on the day before the operation, and on the 3rd, 5th, 7th, 10th and 12th days after the operation. The evaluations included the paw withdrawal thermal latency (PWTL) and the paw withdrawal mechanical threshold (PWMT).Results:The average PWTLs and PWMTs in all of the TMS groups increased with the TMS treatment. Those of the 10Hz and 20Hz groups were significantly higher than the 5Hz group′s average, while there were no significant differences between the 10Hz group and 20Hz group.Conclusions:High-frequency TMS at different frequencies has different effects on neuropathic pain, at least in rats. The treatment efficacy at 10 and 20Hz is superior to that at 5Hz.
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Objective:To investigate the effect of combining repeated high-frequency transcranial magnetic stimulation (rTMS) with escitalopram in treating the neurological functioning and post-stroke depression of stroke survivors.Methods:Eighty persons with post-stroke depression were randomly divided into an observation group and a control group, each of 40. The control group was treated with oral escitalopram, while the observation group also received transcranial magnetic stimulation at 5Hz. The magnetic stimulation intensity was 80% of each person′s resting motion threshold. The rTMS was administered once a day, 5 days a week for 8 weeks. Neurological functioning and depression were evaluated using National Institutes of Health stroke scoring (NIHSS) and the Hamilton depression scale before and after the 8 weeks of treatment. The levels of tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2) and interleukin-6 (IL-6) in serum samples from the two groups were detected using enzyme-linked immunosorbent assays.Results:After treatment, the NIHSS and Hamilton scores and TNF-α, IL-2 and IL-6 levels in both groups had improved significantly, but in each case they were significantly better in the treated group, on average.Conclusion:Supplementing escitalopram with high-frequency transcranial magnetic stimulation more effectively improves depression and neurological functioning after a stroke.
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Objective:To investigate the effect of paired associative stimulation (PAS) on the recovery of neurological function after cerebral infarction, and to explore whether any such effect is associated with autophagy in the ischemic penumbra.Methods:Sixty adult male Sprague-Dawley rats were randomly divided into a sham operation group ( n=20) and an experimental group ( n=40). The rats of the experimental group underwent 90 minutes of right middle cerebral artery occlusion (MCAO), while the sham group received a sham operation. The experimental group was subsequently divided into a model group ( n=20) and a PAS group ( n=20). The PAS group received 14 days of paired associative stimulation (PAS) beginning 24 hours after the operation. Neurological dysfunction was evaluated with a modified neurological severity scale (mNSS) and the elevated body swing test (EBST) on the 1st, 7th and 14th day after the MCAO. The rats were then euthanized and the expression of LC3Ⅰ, LC3Ⅱ, Beclin1, and Cathepsin B in the ischemic penumbra were detected using Western blotting, while the distribution of LC3 in neurons was detected using double immunofluorescent staining. Results:Compared with the sham group, the average mNSS scores and EBST values of the model and PAS groups were both higher on the 7th and 14th day after the MCAO, with those of the PAS group significantly lower than those of the model group on those days. The average mNSS score on the 14th day was significantly lower than on the 7th day. Compared with the sham group, the average LC3Ⅱ/Ⅰ values, Beclin 1 and Cathepsin B levels of both the model group and the PAS group were significantly higher on the 7th and 14th day after the MCAO, with the LC3Ⅱ/Ⅰ values of the PAS group significantly lower than those of the model group at both time points. The PAS group also had significantly lower Beclin1 and Cathepsin B levels on day 14. On the 7th and 14th days after the MCAO, the average number of LC3-positive cells and the ratio of LC3-positive neurons to total neurons in the model and PAS groups were significantly greater than the those of sham group, with the PAS group′s values significantly lower than those of the model group at each time point.Conclusion:PAS can significantly promote neurological recovery after stroke. The beneficial effects may involve inhibition of neuronal autophagy in the ischemic penumbra.
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Objective@#To observe the effects of paired associative stimulation (PAS) on synaptic ultrastructure, neuron apoptosis and BDNF in rats with cerebral infarct, and explore the possible underlying mechanisms.@*Methods@#Forty-five male Sprague-Dawley rats were randomly divided into three groups: a sham operation group, a model group and a PAS group, with 15 rats in each. All the rats underwent a surgical operation for transient middle cerebral artery occlusion (MCAO) on the right side to model focal cerebral ischemia, with those in the sham operation group left without real occlusion. PAS treatment was given to rats in the PAS group 24h after MCAO model was successfully established, while no special intervention was given to those in the sham operation group and model group. After 28 days of treatment, transmission electron microscopy was used to investigate the ultrastructure of the ischemic penumbra, TUNEL was used to observe the apoptosis of cortex neurons, and real time-PCR to investigate BDNF mRNA expression.@*Results@#It was found that after 28 days treatment: ①The synaptic curvature, the synapse length and the post-synaptic density (PSD) decreased significantly in the rats of model group in contrast to those of the sham control group (P<0.05). And compare to model group, the synaptic curvature, the synapse length and the PSD increased significantly in the rats of PAS group (P<0.05). ②Compare to sham control group, the apoptosis rate of model group and PAS group increased significantly (P<0.05). And the apoptosis rate of PAS group decreased significantly in contrast to those of model group (P<0.05). ③Compare to sham control group, BDNF mRNA expression of the PAS group increased significantly(P<0.05), while BDNF mRNA expression of the model group decreased significantly(P<0.05). BDNF mRNA expression of the PAS group increased significantly in contrast to those of model group (P<0.05).@*Conclusion@#PAS promotes neural plasticity and inhibits apoptosis of cortex neurons of the ischemic penumbra in rats with ischemic cerebral infarction. One of the underlying mechanisms might be related to the up-regulation of BDNF mRNA expression.
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Objective To observe the effect of paired associative stimulation ( PAS) on the recovery of sensorimotor function and to explore the mechanism in terms of neural plasticity. Methods Ninety male adult Sprague-Dawley rats were randomly divided into a sham operation group (Sham group), a model group (Model group) and a paired associative stimulation group ( PAS group) , each of 30. Each group was then subdivided into 7-, 14-and 28-day subgroups with 10 rats in each. A model of focal cerebral ischemia and reperfusion was estab-lished using the Longa suture method in the Model and PAS groups. The rats in the Sham group underwent the same surgical procedure except for the occlusion of the middle cerebral artery. The rats received 30 minutes of paired pe-ripheral nerve stimulation and transcranial magnetic stimulation comprising 90 pairs at 0.05 Hz beginning 24 h after the occlusion. The impulse wave width of the peripheral nerve stimulation was 200 μs and the intensity was 6 mA. The intensity of the transcranial magnetic stimulation was 120％ of the resting motor threshold. The other two groups weren't given any intervention. Neurological function was tested using Garcia scores on the 1st, 7th, 14th and 28th day after surgery. The rats were then sacrificed and the expression of MAP-2 and GAP-43 in the ischemic penumbra were detected using western blotting and immunohistochemistry. Results No neurological dysfunction was ob-served in the Sham group at any time. Compared with the Sham group at the same time points, the average Garcia scores of the Model and PAS groups were significantly lower (P≤0.05). However, the average Garcia scores on the 7th, 14th and 28th day were significantly higher in the PAS group compared with the Model group at the same time points ( P≤0.05) . The average Garcia scores of the Model and PAS groups on the 28th day after surgery were significantly higher than those on the 1st day (P≤0.05), but only the PAS group's average Garcia score on the 28th day was significantly higher than that on the 7th day. Compared with the Sham group at the same time points, the expression of MAP-2 and GAP-43 protein in the Model and PAS groups was significantly higher, but with that of the Model group significantly lower than that of the PAS group ( all P≤0.05) . The protein expression of MAP-2 and GAP-43 protein in the PAS group on the 14th day was significantly higher than on the 7th and 28th day ( P≤0.05 for both) . Conclusions PAS can promote the recovery of sensorimotor function after cerebral thrombosis, at least in rats. That may be due to its promoting the expression of the neuroplasticity-associated proteins MAP-2 and GAP-43 in the ischemic penumbra.
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Objective To explore the effects and the underlying mechanisms by which paired associative stimulation ( PAS) of tibial nerve electrostimulation and M1 cortex transcranial magnetic stimulation ( TMS) in pro-moting the recovery of forelimb dysfunction in rats with cerebral ischemic stroke. Methods Resting motor thresholds of left extensor carpi radialis muscle ( ECR) were determined 5 min before and 5 min, 30 min, 60 min after PAS,respectively, in 8 male Sprague-Dawley ( SD) rats. Then 48 male SD rats were divided into a sham group ( n=16) subject to sham surgery, an experimental group (n=32) which was further divided into a MCAO group (n=16) and a PAS group (n=16) after cerebral ischemic stroke model was established successfully by occluding the right middle cerebral artery. 24 hours after surgery, PAS consisting of left tibial nerve stimulation and right M1 cortex area TMS was applied to PAS group once daily for 7 consecutive days. The corner tests and grip strength tests were per-formed before and after 7 days of PAS treatment in each group. The RMTs of left ECR were determined, metabolites of the left area tissue of cervical spinal cord were measured by nuclear magnetic resonance spectrum, and expressions of Bcl-2 and Bax of left and right area tissue of cervical spinal cord enlargement were detected by Western Blot tech-nique after 7 days of intervention. Results The average RMTs of left ECR at 5 min, 30 min, 60 min after PAS were significantly lower than those at 5 min before PAS ( P<0.05) . All rats in experimental group showed significant higher turning scores and lower grip strength when compared with sham group (P<0.001 or P<0.01). After PAS interven-tion, PAS group demonstrated lower turning scores, higher grip strength and lower RMT of left ECR as compared with MCAO group ( P<0.05 or P<0.01) . The expression of GABA of left cervical enlargment was significantly decreased in MCAO group when compared with the sham group ( P<0.05) , and there was no significant difference between MCAO group and PAS group. Meanwhile, other metabolites showed no significant difference among the three groups. The av-erage expression level of Bcl-2 and Bax proteins in both sides of cervical spinal cord enlargment showed no significant difference among three groups either. Conclusions Tibial nerve-M1 cortex area PAS may increase the excitability of motor cortical representation of forelimbs in rats, by which PAS promotes the recovery of forelimb dysfunction in rats with cerebral ischemic stroke.
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Objective To investigate the effect of a pulsed electromagnetic field ( PEMFS) on bone mineral density and bone metabolism in males with osteoporosis after a stroke. Methods Fifty male stroke survivors with os-teoporosis were randomly divided into a control group and a treatment group, both of 25. Both groups were treated with routine rehabilitation, oral calcium carbonate and vitamin D3 tablets, while the treatment group was additionally pro-vided with PEMFS treatment. The subjects′bone mineral density ( BMD) and their blood levels of bone-specific alka-line phosphatase (B-ALP), type I procollagen amino-terminal peptide (PINP) and type β-I collagen cross-linked carboxy-terminal peptide (β-CTx) were measured before and after the 12 weeks of treatment. Results After the treatment the BMD values of the lumbar spine, femoral neck, trochanter and Ward′s triangle had increased signifi-cantly in both groups, but the average BMD values of the lumbar spine and femoral neck in the treatment group were significantly higher than those of the control group. After the treatment, the average B-ALP, PINP andβ-CTx levels of both groups had also improved significantly compared with before the treatment, but the average improvement in all three among the treatment group was significantly greater than among the controls. Conclusion PEMFS treatment supplementing routine rehabilitation, oral calcium carbonate and vitamin D3 tablets can improve bone formation, re-duce bone resorption and increase bone mineral density in men after a stroke.
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Objective To observe the effects of repeated low and high-frequency transcranial magnetic stimulation (rTMS) on neuropathic pain and the expression of specific activation markers of astrocytes and glial fibrillary acidic protein (GFAP) in the lumbar spinal cord.Methods Twenty-eight male Sprague-Dawley rats were randomly divided into a sham-operated group,a sham-rTMS group,a 1 Hz group and a 20 Hz group,with 7 in each group.The rats in the sham-operated group had their sciatic nerve exposed without ligation,while the other groups underwent sciatic nerve ligation to induce neuropathic pain.Three days after the operation,rTMS was applied to the primary motor cortex (M1) contralateral to the pain once a day for 10 consecutive days.Pain-related behavior and thermal pain response were tested before the operation and before and after the course of rTMS therapy.The expression of GFAP in the lumbar spinal cord was examined.Results All of the rats which underwent sciatic nerve ligation showed pain-related behavior and significantly decreasing thermal pain latency compared with the sham-operated group.After the rTMS therapy the thermal hyperalgia was significantly attenuated in the 20 Hz group but not in the 1 Hz group compared with the sham-rTMS group.The expression of GFAP in the dorsal horn of the lumbar spinal cord ipsilateral to the neuropathic pain was significantly increased in the sham-rTMS group and the 1 Hz group compared with the sham-operated group.Compared with the sham-rTMS group,GFAP levels were significantly lower in the 20 Hz group but not in the 1 Hz group.The pain relief in the 20 Hz group was negatively related to the expression of GFAP.Conclusions Neuropathic pain induced by peripheral nerve injury is associated with increased activity and proliferation of astrocytes in the dorsal horns of the spinal cord.High-frequency rTMS can relieve neuropathic pain through inhibiting the activity and proliferation of astrocytes in the dorsal horns,but low-frequency rTMS has no clinically significant effect.
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Objective To generate data on the current medical rehabilitation resources in Hubei province so as to improve the management of rehabilitation quality.Methods Medical institutions on the second level and above were investigated using a questionnaire which covered installations,personnel,equipment and field of operations.Results A total of 176 questionnaires were recovered.Among them,166 (94.3％) of the hospitals had established a department of rehabilitation medicine,and 122 (69.3％) had set up an independent rehabilitation ward,accounting for a total of 3,359 beds.Altogether,there were 1,260 rehabilitation physicians (36.7％ of the assigned personnel),904 therapists (26.3％) and 1,272 nurses (37％).Senior physicians,therapists and nurses were 26％,3.1％ and 28.3％ of the respective totals.Conclusion Rehabilitation medicine in Hubei Province remains relatively poorly developed.It is weak in terms of building the discipline,management and devices,especially in a serious lack of professionals and rehabilitation therapists.
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Objective To investigate the diabetic foot occurrence and influence factors of the type 2 diabetes patients in order to provide the reference for the prevention and treatment of diabetic foot. Methods Three hundred and fifty-seven type 2 diabetes patients treated in the endocrinology department of our hospital from June 2012 to June 2014 were chosen as the research objects, the clinical data of them were collected by self-made questionnaire after consult-ing a large number of references. The clinical data was analyzed by descriptive statistics and binary classification logis-tic regression analysis of SPSS19.0 statistical package to find out the occurrence and influence factors of diabetic foot in type 2 diabetes patients. Results The diabetic foot incidence of type 2 diabetes patients was 6.44%(23/357). Multi-ariable Logistic regression analysis revealed that high degree of culture (β=-1.26, P=0.000), the degree of the related knowledge of diabetic foot (β=-1.44, P=0.000) and PDCA cycle management of diabetic foot (β=-1.68, P=0.000) were the postoperative factors of type 2 diabetes patients complicated with diabetic foot, abnormal glycosylated hemoglobin (β=1.16, P=0.000) was a risk factor for type 2 diabetes patients complicated with diabetic foot. Conclusion The diabetic foot incidence of the type 2 diabetes patients is high, it is affected by many factors. In clinical medical process, we should strengthen health education and blood glucose monitoring,and then optimize the prevention countermeasures for diabetes in order to effectively control the patients' blood sugar, reduce the occurrence of diabetic foot and improve the prognosis of patients.
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Objective In order to explore the mechanism of repetitive transcranial magnetic stimulation rTMS) on neuropathic pain,we observed the effect of different frequencies of rTMS on neuropathic pain and the expression of neuronal nitric oxide synthase (nNOS) in the dorsal root ganglion (DRG).Methods A total of 28 male Sprague-Dawley rats were used and divided into a control group,in which sham-operation was performed,and an experimental group which was further divided into a sham-rTMS group,a 1 Hz group and a 20 Hz group after successful neuropathic pain model was established by operation to ligate the left sciatic nerves,with 7 rats in each group.Three days after the operation,rTMS was applied to the primary motor cortex (M1) contralateral to the pain once dai ly for 10 consecutive days.The pain behavior and nNOS expression in the DRG were measured before and after 10 days of rTMS intervention.Results All the neuropathic pain model rats demonstrated pain-related behaviors 3 days postoperation,the mechanical pain thresholds were significantly lower than those in the control group (P ＜ 0.05).After rTMS treatment,the mechanical hyperalgsia was significantly relieved in 20 Hz group but not 1 Hz group as demonstrated by a comparison with the sham-rTMS group (P ＜ 0.05).The expression of nNOS in DRG ipsilateral to the neuropathic pain was significantly increased in sham-rTMS group and 1 Hz group (P ＜ 0.05) when compared with the control group.Meanwhile,it was shown that expression of nNOS was down-regulated in 20 Hz group but not 1 Hz group (P ＜ 0.05).The degree of pain relief in 20 Hz group was negatively correlated with the expression of nNOS in DRG (P ＜0.05).Conclusions Neuropathic pain induced by peripheral nerve injury is associated with elevated expression of nNOS in the DRG.High-frequency rTMS can relieve neuropathic pain through down-regulating the overexpression of nNOS in the DRG,but the low-frequency rTMS has no such effect.
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Objective To observe the therapeutic efficacy of focal vibration on shoulder-hand syndrome (SHS) in stroke patients.Methods Two stroke patients with SHS were observed.Both patients were treated with routine interventions including exercises,manipulation,intermittent sequential pneumatic compression,medications etc at the beginning,but got no significant improvement after 4 weeks of treatment.Focal vibration was then added on by applying it on the affected side for 10-12 minutes,once daily for 2 weeks.The SHS scoring system developed by Braus and colleagues was used to evaluate the outcome.Results It was found that after 2 weeks of treatment with focal vibration,both patients were improved significantly,in terms of pain,edema and shoulder range of movement,as reflected by the changes of SHS scores.The SHS scores of both patients were 12 before treatment with focal vibration and reduced to 5 after the treatment.Conclusions Focal vibration could be an effective option for the management of SHS in stroke patients.
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Objective To compare the effects of paired associative stimulation (PAS) and repetitive transcranial magnetic stimulation (rTMS) on motor cortex excitability.Methods The baseline corticospinal excitability of the left hemispheres of 10 healthy subjects was measured in terms of resting motor threshold (RMT) and other indicators of motor evoked potentials (MEP).On the following day they received PAS composed of trascranial magnetic stimulation (TMS) to the motor cortex of the left hemisphere and electric stimulation (ES) of the median nerve contralateral to the motor cortex,with an interval of 10ms between the TMS and ES (termed PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ of the RMT,for a total of 90 pulses.The MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.After the PAS intervention,an interval of one week was allowed to eliminate any effect of PAS on motor cortex excitability.Then rTMS was delivered to the subjects' left motor cortex at the same time of day at a frequency of 1 Hz and an intensity of 120％ of the RMT,for a total of 1000 pulses.MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.The two interventions were compared in terms of MEP amplitude,MEP latency and RMT.Results The average MEP amplitude,MEP latency and RMT at baseline were (2.93 ± 0.99) mV,(20.97 ± 1.67) ms,and (46.06 ±5.32) ％,respectively.One minute after PAS10,the MEP amplitude,MEP latency and RMT were (1.14 ± 0.76) mV,(21.87 ± 1.09) ms and (52.06 ±4.20) ％,respectively.One minute after rTMS,the MEP amplitude and latency and the RMT were (2.24 ± 0.79) mV,(20.88 ± 1.94) ms,and (49.00 ± 4.54) ％,respectively.The differences in MEP amplitude,MEP latency and RMT pre-and post-intervention were (0.69 ± 0.10) mV,(0.09 ±0.05) ms and (3.94 ± 0.93) ％,respectively for rTMS.For PAS10 they were (1.83 ± 0.14) mV,(0.90 ± 0.26)ms and (6.00 ± 1.13)％,respectively.The differences in MEP amplitude decrease and MEP latency lengthening between the two stimulation protocols were significant,but the difference in RMT elevation was not.Conclusion Both PAS10 and low frequency rTMS suppressed motor cortex excitability,but the suppressive effect of PAS10 is more significant.
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Objective To investigate the effects of paired associative stimulation (PAS) on the recovery of upper limb motor function in stroke patients,and to analyze the relationship between the change of motor cortex excitability in the contralesional hemisphere and the recovery of motor function in the affected upper limb.Methods Thirty hemiplegic stroke patients were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation therapy,but the treatment group also received PAS consisting of transcranial magnetic stimulation (TMS) of the intact motor cortex and electrical stimulation (ES) of the median nerve at the wrist of the intact arm with an interval of 10 ms between the TMS and ES (PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ the resting motor threshold (RMT),once daily for 30 minutes,five times a week for 4 weeks.Corticospinal excitability was measured using motor evoked potentials (MEP) and the RMT.The FuglMeyer upper limb assessment (FMA),Brunnstrom staging and the modified Barthel index (MBI) were also applied before and at the end of the 4 weeks of treatment.Correlation was sought between any changes in MEP amplitude,the RMT of the contralesional hemisphere and changes in the FMA results.Results Before the intervention there were no significant differences between the two groups in terms of any of the assessments.After 4 weeks of treatment,all the assessments had changed significantly compared to those before the treatment,but there were still no significant differences between the two groups in terms of any the assessments.After 4 weeks of treatment,the differences in MEP amplitude from the contra-lesional hemisphere and the differences in FMA scores were positively and significantly correlated with a correlation coefficient of r =0.431.The lesioned hemisphere was also positively correlated with the differences in FMA scores with a significant correlation coefficient of r =0.608.Conclusion PAS10 can facilitate the recovery of upper limb motor function.The change in motor cortex excitability of the contra-lesional hemisphere significantly correlates with functional recovery in the upper limb.
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Objective To compare the functional profiles of organ transplant patients using the International Classification of Functioning,Disability,and Health (ICF) core set.Methods The patients were enrolled 5 to 10 days after discharge following an organ transplant.The Functional Independence Measure (FIM),Barthel Index (BI) and the ICF core set were used to assess them.Analysis was conducted by grouping the kidney transplant patients (group A) separately from the heart,lung and liver transplant patients (group B).The prevalence of sevcre impairment in each group was calculated and compared.Results Average FIM and BI secores were both significantly higher in group A than in group B.No severe or total impairment was observed in group A,but in group B,the prevalence of 5 categories (ie.b455,b730,s430,d415 and d450) was significantly greater than in group A.The most prevalent were poor exercise tolerance (b455,56.8％),low muscle power (b730,54.5％),difficulty in maintaining a body position (d415,54.5％),and impaired walking (d450,45％) With regard to the environment factors,the prevalence of e110 (products or substances for personal consumption) and e120 (products and technology for personal use in daily living) were both significantly different in the two groups.Conclusion Heart,lung and liver transplant patients transplant demonstrated more impairments than the kidney transplant patients.All the organ transplant patients deserve early evaluation for detecting any possible impairment.
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Objective To explore a new electrodiagnostic approach using the H reflex elicited by magnetic stimulation of the S1 nerve root and F waves to evaluate sensory nerve root function in patients with S1 radiculopathy.Methods Thirty normal subjects and 30 patients with unilateral S1 radiculopathy were recruited in this study.H reflex and M response were recorded from the bilateral soleus of all the subjects by magnetic stimulation of S1 nerve roots.F and M wave responses elicited by electrical stimulation of bilateral tibial nerves at the popliteal fossa were also recorded.The sensory root conduction time (SRCT) was calculated.Correlations of age and body height with SRCT in the healthy subjects,and between SRCT and pain in the patients with S1 radiculopathy were analyzed.Results The mean values of normal subjects were 3.10 ± 0.44 ms for SRCT,and 0.13 ± 0.19 ms for inter-side SRCT differences.In the 30 patients with S1 radiculopathy,H reflex could not be elicited from 4 patients.Among the remaining patients,the SRCT of the affected side was prolonged significantly (3.90 ±0.65 ms),and the mean value of the inter-side difference increased significantly (0.90 ±0.50 ms).A regression equation correlating SRCT with height was developed,but no significant correlation between SRCT and age in the normal subjects was revealed.There was positive correlation between SRCT and the severity of pain among the patients.Conclusion SRCT can be used as a new electrodiagnostic index in estimating sensory nerve root function in patients with S1 radiculopathy.
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Objective To test the reliability and validity of the brief International Classification of Functioning, Disability and Health (ICF) core sets for Chinese stroke patients using Rasch model analysis. Methods The body functions of 38 Chinese stroke patients were measured using the brief ICF core sets. The qualifiers of the 20items were measured by two raters and analyzed using FACETS statistical software. The intra-rater reliability and validity were tested by using the separation index and separation reliability and fit analysis. Results The brief ICF core sets had good internal consistency and reliability (person separation index = 6.02, person separation reliability = 0.94 ) with these Chinese patients. The raters showed significantly different strictness in rating, but their ratings had good internal self-consistency. The construct validity was good for the body functions of the ICF component ( separation index = 10.50, separation reliability = 0.80) , but misfitting and overfitting were found in items b117, b152and b755. Conclusion The body function of the brief ICF core sets has good reliability and validity for Chinese stroke patients. A many-facet Rasch measurement model can provide comprehensive information and has good application prospects for testing the reliability and validity of ICF core sets.
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Objective To investigate the effects of magnetic stimulation (MS) on the proliferation and differentiation of endogenous neural stem cells (NSCs)/progenitor cells after spinal cord injury (SCI) in rats. Methods Forty-six Wistar rats were used, of which 40 were used to make an animal model of spinal cord injury (SCI) by administering a 10 g x 12.5 cm impact at the T8 level. The other 6 served as the normal controls. The SCI model rats were evenly divided into a magnetic stimulation (MS) group ( n = 20) and a control group ( n = 20). The rats in the MS group received 0.5 Hz and 1.44 T magnetic stimulation 24 h post injury, then 30 pulses per day for 7 days. The rats in the other groups were not exposed to MS. The scale of Basso, Beatti and Bresnahan (BBB) was used to assess hindlimb neurological function. Rats were sacrificed at the 24th hour, and at the 1st, 4th and 8th weeks after SCI. The ratio of nestin to microtubule associated protein 2 (MAP2)/nestin in the cells of the spinal cord was determined by immunofluorescence. Results The BBB scores in the MS group were signifi-cantly higher than those of the control group at 1, 4 and 8 weeks post SCI. Nestin and the MAP2/nestin ratios were mild in the normal spinal cords, but increased after SCI. They were higher in the MS group than that in the control groups at all time points. Conclusions MS can promote nestin expression in the spinal cord after SCI and facili-tate neural differentiation.
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Objective To evaluate the test-retest and inter-rater reliability of the hand-held pressure algometer as a measuring instrument of pressure pain threshold(PPT).Method A total of 37 healthy subjects were recruited for reliability test.Three raters measured the PPT at 12 body sites of the subjects.Each rater conducted three trials on each site.In the validity test,10 patients with active trigger points in the upper trapezius were recruited and measured by one rater using the pressure algometer for PPT,the visual analogue scale(VAS)was also used to evaluate the pain intensity induced by the trigger point.The intraclass correlation coefficient and Spearman correlation coefficient were calculated to reflect the reliability and validity.Results The test-retest and inter-rater reliabilities were both high(ICC＞0.95),with the measurements by one rater were more reliable than measurements by multiple raters.The inter-rater reliability of PPT measurement obtained by using the mean value of 3 trials was higher than any of the 3 trials alone.The PPT values of the trigger points were higher than those of the normal points,and there was a significantly negative correlation between the PPT values of the trigger points and the VAS scores.Conclusion The intra-and inter-rater PPT measurements in healthy subjects obtained with the hand-held pressure algometer were highly reliable.The algometer was valid for quantifying myofascial trigger point sensitivity.
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Objective To explore the value of a new electrodiagnostic approach for evaluating motor nerve root function in patients with S1 radiculopathy. Methods Thirty healthy subjects and 30 patients with clinical mani-festations of unilateral S1 radiculopathy were recruited. Bilateral compound muscle action potentials evoked by magnetic stimulation of the first sacral nerve root were recorded from the soleus of all the subjects. F wave and M responses to electrical stimulation of the bilateral tibial nerves at the popliteal fossa were also recorded. The peripheral motor conduction time (PMCT) and the motor root conduction time (MRCT) were calculated and compared between the two groups. In addition, needle electromyographic examination (NEE) was performed on the affected side to detect any possible EMG abnormalities. Results The norm established with the normal subjects was 3.45±0.39 ms for the MRCT, and 0.28±0.15 ms for the inter-side difference in the MRCT. In the 30 patients, the mean MRCT and PMCT values on the affected side were prolonged. Of the 23 patients who received NEE, 6 had EMG abnormalities. The agreement between the NEE and MRCT diagnoses was 82.6%. Conclusion MRCT can be used reliably for non-invasive estimation of motor nerve root function and to help diagnose the S1 radiculopathy.