Effect of wrist-hand orthosis combined with modified constraint-induced movement therapy on upper limb and hand function in patients with stroke / 中国康复理论与实践

ObjectiveTo observe the effect of wrist-hand orthosis combined with modified constraint-induced movement therapy (mCIMT) on upper limb and hand function in patients with stroke. MethodsFrom February, 2022 to December, 2023, 32 patients after stroke in Huashan Hospital, Fudan University were randomly assigned to control group (n = 16) and experimental group (n = 16). Both groups underwent routine rehabilitation, and wore constraint glove almost four hours a day. The experimenal group wore dynamic wrist-hand orthosis four hours everyday, additionally; five days every week, for three weeks. They were evaluated with Wolf Motor Function Test (WMFT), Action Reach Arm Test (ARAT), the strength of gripping, Amount of Use (AOU) and Quality of Movement (QOM) of Motor Activity Log (MAL), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) before and after treatment, while root mean square ratio of affected/healthy extensor muscle of wrist was measured with surface electromyography ResultsAfter treatment, the scores of WMFT, ARAT, MAL-QOM, HAMA and the root mean square ratio of affected/healthy extensor muscle of wrist improved in both groups (|t| > 2.179, P < 0.05), and the improvement of WMFT score and the strength of gripping was greater in the experimental group than in the control group (|t| > 2.343, P < 0.05); the strength of gripping, the scores of MAL-AOU and HAMD improved in the experimental group (|t| > 2.819, P < 0.05). ConclusionmCIMT assisted with dynamic wrist-hand orthosis could improve upper limb and hand function in stroke patients.

Task Transfer Learning for EEG Classification in Motor Imagery-Based BCI System.

The motor-imagery brain-computer interface system (MI-BCI) has a board prospect for development. However, long calibration time and lack of enough MI commands limit its use in practice. In order to enlarge the command set, we add the combinations of traditional MI commands as new commands into the command set. We also design an algorithm based on transfer learning so as to decrease the calibration time for collecting EEG signal and training model. We create feature extractor based on data from traditional commands and transfer patterns through the data from new commands. Through the comparison of the average accuracy between our algorithm and traditional algorithms and the visualization of spatial patterns in our algorithm, we find that the accuracy of our algorithm is much higher than traditional algorithms, especially as for the low-quality datasets. Besides, the visualization of spatial patterns is meaningful. The algorithm based on transfer learning takes the advantage of the information from source data. We enlarge the command set while shortening the calibration time, which is of significant importance to the MI-BCI application.

Reliability of Posturographic Parameters Assessing Standing Ability in Different Positions and Walking Activity in Healthy Participants / 中国康复理论与实践

@#Objective In the recovery process of stroke patients, the ability of maintaining standing and sitting position might have a great effect on the improvement of activity of daily living. There are few the methods which evaluate quantitatively and effectively the ability of position control ability in clinical practice. The aim of the study is to quantitatively evaluate the reliability of posturographic parameters based on the center of pelvis in different standing positions and walking activity.Methods From May to June, 2018, Seventy-nine healthy participants were enrolled. They were evaluated with iReGo, a walking assisstant robot, in three conditions: normal standing position, left/right standing position and walking 10 meters at an appropriate speed. The computer calculated the posturographic parameters automatically. The participants completed their second test one day after the first one.Results During normal standing position, the intra-class correlation coefficients (ICC) of average sway in coronal plane, average sway in sagittal plane, path length, and covered area were more than 0.70. During left standing position, ICC of all the above parameters were more than 0.70. During right standing position, ICC of all the above parameters were more than 0.49. When walking 10 meters at an appropriate speed, ICC of path length and covered area were more than 0.75. Comparing different standing positions, the normal standing position was more stable than the left/right standing position, and there was no difference between the left and the right standing positions.Conclusion Posturographic parameters based on the center of pelvis might be a reliable way to assess the position control ability in different standing positions and walking process.

Investigation on the Cognition of Medical Staff on the Third-Party Mediation in a Tertiary General Hospital of Nanjing / 中国医学伦理学

Objective:To investigate and analyze the cognition onthe third-party mediation among medical staff in a tertiary general hospital of Nanjing,and thus to put forward rational suggestions.Method:A questionnaire survey was conducted among 200 doctors from a tertiary general hospital.Chi-square test and non-parametric test were used to analyze the data.Results:Totally 57.5％ of doctors thought the doctor-patient relationship was tense,78.5％ of doctors to some extent had understood the third-party mediation,91.5％ of doctors thoughtthe third-party mediation played a different role in dealing the medical disputes,71.0％ of doctors had heard of medical liability insurance,and 89.5％ of doctors thought it necessary to purchase the medical liability insurance.Conclusions:Doctors gradually accept the third-party mediation,but as a new thing,the main bodies at all levels should publicize the third-party mediation so as to give full play to the role of it.

Reliability of Posturographic Parameters Assessing Sit-to-stand Movements in Healthy Participants / 中国运动医学杂志

Objective Currently,the sit-to-stand process is not well evaluated.The aim of the study is to evaluate quantitatively the reliability of posturographic parameters in the sit-to-stand process.Methods Seventy-four healthy participants were enrolled and required to finish 20-second sitting,standing and the sit-to-stand process.The computer calculated the posturographic parameters automatically.The test was repeated twice to assess the reliability at an interval of six days.Results During sitting and standing position,the intraclass correlation coefficients (ICCs) of all the parameters were above 0.50,indicating a good or fair reliability.During the standing stance and sitting phase of the sit-to-stand process,the ICCs of all the parameters were above 0.40 and 0.60 respectively,showing a good or fair reliability.Conclusions Sit-to-stand posturographic parameters are a new way to assess the position control ability among the healthy participants with a good reliability.Further study should be conducted among patients to result in better functional and effectiveness evaluation.