In order to improve the accuracy and reliability of the electrodes implant location when using spinal functional electrical stimulation to rebuild hindlimb motor function, we measured the distributions of function core regions in rat spinal cord associated with hindlimb movements. In this study, we utilized three-dimensional scanning intraspinal microstimulation technology to stimulate the rat spinal cord to generate hip, knee and ankle joint movements, and acquired the coordinates of the sites in spinal cord which evoked these movements. In this article, 12 SD rats were used to overcome the individual differences in the functional region of the spinal cord. After normalized and overlaid the messages, we obtained the function core regions in spinal cord associated with ankle dorsiflexion movement, hip flexion movement, hip extension movement and hip adduction movement. It provides a reference for rebuilding the hindlimb movement function with micro-electronic neural bridge.
Motor dysfunction is the main clinical symptom and diagnosis basis of patients with Parkinson’s disease (PD). A total of 30 subjects were recruited in this study, including 15 PD patients (PD group) and 15 healthy subjects (control group). Then 5 wearable inertial sensor nodes were worn on the bilateral upper limbs, lower limbs and waist of subjects. When completing the 6 paradigm tasks, the acceleration and angular velocity signals from different parts of the body were acquired and analyzed to obtain 20 quantitative parameters which contain information about the amplitude, frequency, and fatigue degree of movements to assess the motor function. The clinical data of the two groups were statistically analyzed and compared, and then Back Propagation (BP) Neural Network was used to classify the two groups and predict the clinical score. The final results showed that most of the parameters had significant difference between the two groups, ten times of 5-fold cross validation showed that the classification accuracy of the BP Neural Network for the two groups was 90%, and the predictive accuracy of Hoehn-Yahr (H-Y) staging and unified PD rating scale (UPDRS) Ⅲ score of the patients were 72.80% and 68.64%, respectively. This study shows the feasibility of quantitative assessment of motor function in PD patients using wearable sensors, and the quantitative parameters obtained in this paper may have reference value for future related research.
ObjectiveTo evaluate the effect of the combination of collagen scaffold and brain-derived neurotrophic factor (BDNF) on the repair of transected spinal cord injury in rats.MethodsThirty-two Sprague-Dawley rats were randomly divided into 4 groups: group A (sham operation group), T9, T10 segments of the spinal cord was only exposed; group B, 4-mm T9, T10 segments of the spinal cord were resected; group C, 4-mm T9, T10 segments of the spinal cord were resected and linear ordered collagen scaffolds (LOCS) with corresponding length was transplanted into lesion site; group D, 4-mm T9, T10 segments of the spinal cord were resected and LOCS with collagen binding domain (CBD)-BDNF was transplanted into lesion site. During 3 months after operation, Basso-Beattie-Bresnahan (BBB) locomotor score assessment was performed for each rat once a week. At 3 months after operation, electrophysiological test of motor evoked potential (MEP) was performed for rats in each group. Subsequently, retrograde tracing was performed for each rat by injection of fluorogold (FG) at the L2 spinal cord below the injury level. One week later, brains and spinal cord tissues of rats were collected. Morphological observation was performed to spinal cord tissues after dehydration. The thoracic spinal cords including lesion area were collected and sliced horizontally. Thoracic spinal cords 1 cm above lesion area and lumbar spinal cords 1 cm below lesion area were collected and sliced coronally. Coronal spinal cord tissue sections were observed by the laser confocal scanning microscope and calculated the integral absorbance (IA) value of FG-positive cells. Horizontal tissue sections of thoracic spinal cord underwent immunofluorescence staining to observe the building of transected spinal cord injury model, axonal regeneration in damaged area, and synapse formation of regenerated axons.ResultsDuring 3 months after operation, the BBB scores of groups B, C, and D were significantly lower than those of group A (P<0.05). The BBB scores of group D at 2-12 weeks after operation were significantly higher than those of groups B and C (P<0.05). Electrophysiological tests revealed that there was no MEP in group B; the latencies of MEP in groups C and D were significantly longer than that in group A (P<0.05), and in group C than in group D (P<0.05). Morphological observation of spinal cord tissues showed that the injured area of the spinal cord in group B extended to both two ends, and the lesion site was severely damaged. The morphologies of spinal cord tissues in groups C and D recovered well, and the morphology in group D was closer to normal tissue. Results of retrograde tracing showed that the gray matters of lumbar spinal cords below the lesion area in each group were filled with FG-positive cells; in thoracic spinal cords above lesion sites, theIA value of FG-positive cells in coronal section of spinal cord in group A was significantly larger than those in groups B, C, and D (P<0.05), and in groups C and D than in group B (P<0.05), but no significant difference was found between groups C and D (P>0.05). Immunofluorescence staining results of spinal cord tissue sections selected from dorsal to ventral spinal cord showed transected injured areas of spinal cords which were significantly different from normal tissues. The numbers of NF-positive axons in lesion center of group A were significantly larger than those of groups B, C, and D (P<0.05), and in groups C and D than in group B (P<0.05), and in group D than in group C (P<0.05).ConclusionThe combined therapeutic approach containing LOCS and CBD-BDNF can promote axonal regeneration and recovery of hind limb motor function after transected spinal cord injury in rats.
Neurological damage caused by stroke is one of the main causes of motor dysfunction in patients, which brings great spiritual and economic burdens for society and families. Motor imagery is an important assisting method for the rehabilitation of patients after stroke, which is easy to learn with low cost and has great significance in improving the motor function and the quality of patient's life. This paper mainly summarizes the positive effects of motor imagery on post-stroke rehabilitation, outlines the physiological performance and theoretical model of motor imagery, the influencing factors of motor imagery, the scoring criteria of motor imagery and analyzes the shortcomings such as the few kinds of experimental subject, the subjective evaluation method and the low resolution of the experimental equipment in the process of rehabilitation of motor function in post-stroke patients. It is hopeful that patients with stroke will be more scientifically and effectively using motor imagery therapy.
Objective To investigate the effects of children’s crawling-promotion-training-robot on gross motor function and cognitive function in children with global developmental delay (GDD). Methods A total of 40 children with GDD admitted to the Department of Rehabilitation Medicine, Children’s Hospital of Nanjing Medical University were selected as the research subjects. By envelope method, the children were randomly and equally divided into experimental group and control group, with 20 cases in each group. The experimental group received children’s crawling-promotion-training-robot combined with conventional rehabilitation therapy, while the control group received manual crawling training combined with conventional rehabilitation therapy. Before and after treatment, the scores of Gross Motor Function Measure Scale-88 (GMFM-88) and Gesell Developmental Scale (GDS) were respectively used to evaluate gross motor function and cognitive function. Results There was no significant difference in gender (χ2=0.100, P=0.752) and age (t=0.053, P=0.962) between the two groups. Before treatment, there was no significant difference in GMFM-88 and GDS scores between the two groups (P>0.05). After treatment, there were statistically significant differences in GMFM-88 and GDS scores between the two groups (P<0.05). The comparison within the group showed that there were statistically significant differences in GMFM-88 and GDS scores between the two groups before and after treatment. Conclusion Children’s crawling-promotion-training-robot is more effective than manual crawling training in improving gross motor function and cognitive function in children with GDD.
Objective To explore whether the effect of cloud rehabilitation system on motor dysfunction and activities of daily living (ADL) of stroke patients is not inferior to hemiplegia manual treatment. Methods This study adopted a multicenter randomized controlled trial design. A total of 118 stroke patients were enrolled from 5 hospitals in China between April 2018 and April 2019, and they were randomly divided into a trial group and a control group, with 59 patients in each group. The trial group adopted hemiplegia manual treatment (≥30 min per time, once a day) and cloud rehabilitation training (30 min per time, once a day), and the control group adopted hemiplegia manual treatment alone (≥30 min per time, twice a day). All patients received continuous treatment for 2 weeks, and followed up for 2 weeks after that. The Brunnstrom stage (BRS), IK exercise stage, and Modified Barthel Index (MBI) were used to evaluate the motor function and ADL before and 4 weeks after treatment. Results There was no significant difference in gender, age, course, hemiplegia side, source (inpatient/outpatient) or hospital grade between the two groups (P>0.05), which were comparable. Compared with those before treatment, there were significant improvements in the BRS (upper and lower extremities), IK exercise stages (upper and lower extremities), and MBI scores in both groups 4 weeks after treatment (P<0.05). The four-week improvements in motor function indicators (BRS and IK) of the trial group were not inferior to those of the control group (P<0.05), and there was no significant difference in MBI score between the two groups 4 weeks after treatment (F=1.498, P>0.05). Conclusion The cloud rehabilitation system is not inferior to hemiplegia manual treatment in improving the limb motor function or ADL of patients .
Objective To analyze the correlation between frailty syndrome and lower limb motor function in hospitalized elderly patients. Methods Convenience sampling method was used to select inpatients aged 65 and above from the Center of Gerontology and Geriatrics of West China Hospital, Sichuan University between December 2022 and May 2023. The FRAIL Scale, Short Physical Performance Battery (SPPB), and Timed Up and Go Test (TUGT) were used to evaluate the degree of frailty and lower limb motor function, and to explore the correlation between frailty and lower limb motor function. Results A total of 501 elderly patients were included, including 325 males (64.9%) and 176 females (35.1%); 256 cases of frailty (51.1%), 161 cases of pre-frailty (32.1%), and 84 cases of non-frailty (16.8%). The incidence of frailty in hospitalized elderly male patients was higher than that in female patients (P<0.05); The incidence of frailty in patients aged 80-99 was higher than that in patients aged 65-79 (P<0.05). The Spearman correlation analysis results showed that all dimensions of SPPB were negatively correlated with frailty (P<0.001), while TUGT was positively correlated with frailty (r=0.776, P<0.001). The results of multiple linear regression analysis showed that the worse the motor function of the lower limbs, the higher the debilitation score. Conclusions Frailty syndrome in hospitalized elderly patients is closely related to lower limb motor function. Lower limb motor function assessment can be used to predict the onset of frailty in clinical practice, and interventions to improve lower limb motor function can be used to improve the frailty of elderly patients.