Effects of proprioceptive training on gait and plantar pressure after anterior cruciate ligament reconstruction: study protocol for a randomized controlled trial.

BACKGROUND: People who have undergone anterior cruciate ligament reconstruction have an increased risk of osteoarthritis. Abnormality of lower limb kinematics will occur after the operation. This may be related to lower limb muscle strength, the co-excitation of hamstrings and quadriceps femoris, and the weakness of proprioception. Proprioceptive training can improve the proprioception of lower limbs and promote the recovery of lower limb kinematics. Our research objective is to observe whether proprioceptive training can improve the proprioception of lower limbs within 3 months after surgery and whether the recovery of proprioception can correct the abnormal lower limb kinematics. The secondary objective is to explore the underlying mechanism of postoperative lower limb gait abnormalities. METHODS/DESIGN: This study is a prospective single-center randomized clinical trial to be conducted in the Sports Medicine and Orthopedics of Zhongda Hospital Southeast University. Forty participants aged 18-50, preparing to undergo anterior cruciate ligament reconstruction, and initial anterior cruciate ligament reconstruction using hamstring tendons as grafts will be randomly assigned to the intervention or comparator group. People in the intervention group will add proprioceptive training three times a week, 20 min each time. The intervention will be conducted on the first day after surgery. The researcher mainly collects the data of joint of sense, gait, and plantar pressure. The assessment will be divided into three stages: after signing the informed consent form (within 2 weeks before surgery), 6 weeks after surgery, and 12 weeks after surgery. DISCUSSION: The main purpose of our study is to explore whether the proprioception of patients after anterior cruciate ligament reconstruction is weakened, whether the lower limb kinematics is abnormal and whether the lower limb kinematics can be corrected through proprioceptive training. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200065808. Registered on 15 November 2022; Version 1.

Transcranial direct current stimulation combined with bilateral training can improve upper limb motor function after a stroke / 中华物理医学与康复杂志

Objective:To explore the effect of combining transcranial direct current stimulation (tDCS) with bilateral isokinematic training (BIT) to improve upper limb motor function after stroke.Methods:Sixty stroke survivors were randomly divided into a tDCS group, a BIT group and a tDCS + BIT group, each of 20. In addition to conventional medical treatment and rehabilitation training, the three groups were given the additional treatment their group names indicate for four weeks. Before and after the intervention, everyone′s motor evoked potential cortical latency (CL) and central motor conduction time (CMCT) were measured. Upper limb motor function was assessed using the Fugl-Meyer upper extremity assessment (FMA-UE) and the Hongkong edition of a functional test for the hemiplegic upper extremity (FTHUE-HK).Results:After 4 weeks of treatment the average CL and CMCT had decreased significantly in all three groups, with those of the combined group significantly shorter than the other two groups′ averages. The average FMA-UE and FTHUE-HK scores had increased significantly in all three groups compared to those before treatment, but those of the combined group were significantly superior to the other groups′ averages.Conclusions:tDCS combined with BIT can further improve the excitability of the cerebral cortex and promote the recovery of upper limb motor function.

The clinical efficacy of the Mulligan technique for treating cervical vertigo in an environment containing hy-perbaric oxygen / 中华物理医学与康复杂志

Objective To observe the clinical efficacy of the Mulligan technique in treating cervical vertigo ( CV) in a hyperbaric oxygen ( HPO) environment. Methods Sixty-eight CV patients were randomly divided into a control group and an observation group, each of 34. Both groups were given routine treatment with ultrashortwave irra-diation, but the observation group was additionally provided with 15 minutes of treatment based on the Mulligan tech-nique in an environment with oxygen at 0.2 MPa, five days a week for two weeks. Both groups were assessed using the cervical vertigo symptoms and functional assessment scale ( ESCV) and the daily frequency of vertigo was recorded before the treatment and 2, 4, 7, 14 and 60 days after treatment began. Moreover, the mean blood flow velocity in the patients' vertebral ( VA) and basilar arteries ( BA) was detected using transcranial Doppler sonography before the treatment and after two weeks and two months. Results There were no significant differences between the two groups in any of the measurements before the intervention. Afterward, however, significant improvement in all of the measurements was observed compared with before the treatment. After two weeks and two months the average ESCV score, daily occurrence of CV and mean VA and BA blood flows in the observation group were all significantly superi-or to those of the control group at the same time points. Conclusion Treatment based on the Mulligan technique in an environment with 0.2 MPa partial pressure of oxygen is a more effective way to relieve the symptoms of cervical vertigo and reduce the frequency of its occurrence. Such treatment is worthy of application in the clinic.

The clinical efficacy of the Mulligan technique for treating cervical vertigo in an environment containing hyperbaric oxygen / 中华物理医学与康复杂志

Objective@#To observe the clinical efficacy of the Mulligan technique in treating cervical vertigo (CV) in a hyperbaric oxygen (HPO) environment.@*Methods@#Sixty-eight CV patients were randomly divided into a control group and an observation group, each of 34. Both groups were given routine treatment with ultrashortwave irradiation, but the observation group was additionally provided with 15 minutes of treatment based on the Mulligan technique in an environment with oxygen at 0.2 MPa, five days a week for two weeks. Both groups were assessed using the cervical vertigo symptoms and functional assessment scale (ESCV) and the daily frequency of vertigo was recorded before the treatment and 2, 4, 7, 14 and 60 days after treatment began. Moreover, the mean blood flow velocity in the patients′ vertebral (VA) and basilar arteries (BA) was detected using transcranial Doppler sonography before the treatment and after two weeks and two months.@*Results@#There were no significant differences between the two groups in any of the measurements before the intervention. Afterward, however, significant improvement in all of the measurements was observed compared with before the treatment. After two weeks and two months the average ESCV score, daily occurrence of CV and mean VA and BA blood flows in the observation group were all significantly superior to those of the control group at the same time points.@*Conclusion@#Treatment based on the Mulligan technique in an environment with 0.2 MPa partial pressure of oxygen is a more effective way to relieve the symptoms of cervical vertigo and reduce the frequency of its occurrence. Such treatment is worthy of application in the clinic.

Transcranial direct current stimulation enhances the effect of task-oriented training in the rehabilitation of upper limb dysfunction after stroke / 中华物理医学与康复杂志

Objective To investigate the effect of transcranial direct current stimulation (tDCS) before or during task-oriented training on the upper limb dysfunction of stroke survivors.Methods Ninety stroke survivors were randomly divided into groups A,B and C,each of 30.Those in all the three groups received the same task-oriented training,but those in groups A and B received 20 minutes of tDCS of the M1 area of the cerebrum before and during the task-oriented training respectively.Group C was given placebo stimulation during the task-oriented training.The Fugl-Meyer functional upper limb assessment (FMA-UE),a Hong Kong hemiplegia upper limb function test (FTHUE-HK) and the modified Barthel index (MBI) were used to evaluate the outcomes before and after 4 weeks of treatment.Results After 4 weeks of treatment the average FMA-UE,FTHUE-HK and MBI scores of all three groups were significantly better than those before the treatment.Group B's average scores were significantly better than those of groups A and C.Conclusion tDCS significantly enhances the benefits of task-oriented training after stroke.

Effects of Multi-point Multi-axis Suspension Training on Nonspecific Low Back Pain: A Surface Electromyography Study / 中国康复理论与实践

@#Objective To study the effect of multi-point multi-axis suspension training on nonspecific low back pain (NLBP) through surface electromyography (sEMG). Methods From October, 2016 to November, 2017, 24 patients with unilateral NLBP (NLBP group) were randomly divided into dynamic group (n=12) and static group (n=12); other 12 healthy volunteers were selected as control group. NLBP group was trained on multi-point multi-axis suspension training system, the dynamic group accepted pelvic-up training in the supine position, while the static group accepted lumbar neutral keep training, for ten days. NLBP group was measured with average electromyographic values (AEMG) of affected musculi multifidi before and after treatment, and assessed with Visual Analogue Scale (VAS) of pain; while the control group was measured AEMG of unilateral musculi multifidi. Results The AEMG in static and pelvic-up positions was more in NLBP group than in the control group before treatment (t>3.209, P<0.01), and it was less when keeping neutral position (t=-2.364, P<0.05). The AEMG improved in NLBP groups after treatment (t>2.982, P<0.01). The AEMG in static position and in keeping neutral position was not significantly different among the three groups after treatment (F<2.921, P>0.05), and it was the most in the dynamic group as pelvic-up (P<0.001). The score of VAS decreased in both NLBP groups after treatment (t>10.416, P<0.001), and it was less in the static group than in the dynamic group (t=-4.389, P<0.001).Conclusion sEMG changes take place in patients with NLBP. Multi-point multi-axis suspension training is effective through improving the core muscle group, and it is more effective in static maintenance training.