scholarly journals A Chinese Herbal Medicine, Tokishakuyakusan, Reduces the Worsening of Impairments and Independence after Stroke: A 1-Year Randomized, Controlled Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hirozo Goto ◽  
Nobuhiko Satoh ◽  
Yoshinori Hayashi ◽  
Hiroaki Hikiami ◽  
Yutaka Nagata ◽  
...  

In post-stroke patients, the recurrence of stroke and progression of impairments lead to a bedridden state and dementia. As for their treatments, only anti-hypertension and anti-coagulation therapies to prevent the recurrence of stroke are available. In Asia, post-stroke patients with impairments are often treated with herbal medicine. The present study evaluated the effectiveness of tokishakuyakusan (TS) in improving the impairment and independence in post-stroke patients. Thirty-one post-stroke patients (mean age = 81.4 years) were recruited and enrolled. Participants were randomly assigned to the TS group (n= 16) or non-treatment (control) group (n= 15) and treated for 12 months. Impairments were assessed using the Stroke Impairment Assessment Set (SIAS). Independence was evaluated using the functional independence measure (FIM). For each outcome measure, mean change was calculated every 3 months. The results were that impairments according to SIAS did not significantly change in the TS group. In contrast, SIAS significantly worsened in the control group. There was a significant difference between the two groups. In each term of SIAS, affected lower extremity scores, abdominal muscle strength, function of visuospatial perception, and so forth. in the TS group were better than those in the control group. Independence according to FIM did not change significantly in the TS group. In contrast, FIM significantly worsened in the control group. There was also a significant difference between the two groups. In conclusion, TS was considered to suppress the impairments of lower limbs and to exert a favorable effect on cerebral function for post-stroke patients.

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lena Rafsten ◽  
Anna Danielsson ◽  
Asa Nordin ◽  
Ann Björkdahl ◽  
Asa Lundgren-Nilsson ◽  
...  

Abstract Background and purpose Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine. Methods A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients’ degree of overall disability, measured by the modified Rankin Scale (mRS). Results No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke. Conclusions The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit. Trial registration Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).


2013 ◽  
Vol 41 (05) ◽  
pp. 971-981 ◽  
Author(s):  
Yong Zhang ◽  
He Jin ◽  
Dayong Ma ◽  
Yuanbo Fu ◽  
Yanming Xie ◽  
...  

This study aimed to determine the efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine (IRT-TCM) on patients with ischemic stroke as an alternative therapy to conventional rehabilitation techniques. Sixty-nine patients with ischemic stroke were randomly assigned to receive either IRT-TCM (intervention group, n = 46) or conventional rehabilitation techniques (control group, n = 23). The IRT-TCM consisted of a sequential combination of acupuncture and massage techniques. The Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI) and modified Rankin Scale (mRS) were measured on day 0 (baseline, before treatment), day 21, and day 90. We observed that the scores in FMA and BI were increased, and NIHSS were decreased in both groups on day 21 and 90, compared with the baseline (day 0). Furthermore, significantly better scores in FMA of lower limbs and NIHSS were found in patients treated with IRT-TCM on day 21 and 90. For mRS, the percentage of patients ranking 0 and 1 in the intervention group presented a striking contrast to the control group on day 90 but with no significant difference. The results indicated that, as a feasible alternative therapy, IRT-TCM is beneficial for patients with ischemic stroke. Further research with larger sample size, long-term observation, and strict blinding are still in need to confirm the efficacy of IRT-TCM.


2019 ◽  
Vol 33 (5) ◽  
pp. 885-893 ◽  
Author(s):  
Paola Antoniotti ◽  
Laura Veronelli ◽  
Antonio Caronni ◽  
Alessia Monti ◽  
Evdoxia Aristidou ◽  
...  

Objective: The aim of this study was to investigate the efficacy of mirror therapy on upper-limb recovery in early post-stroke patients. Design: Assessor-blinded randomized controlled trial. Setting: Inpatient rehabilitation clinic. Subjects: A total of 40 patients with upper-limb impairment due to a first-ever ischaemic or haemorrhagic stroke, within four weeks from the cerebrovascular accident. Intervention: The intervention group received mirror therapy, while the control group received sham therapy. During mirror therapy, patients’ sound hand was reflected by a mirror. During sham therapy, an opaque surface replaced the mirror-reflecting surface. Both the mirror therapy and sham therapy groups practised their sound hand with exercises, ranging from the simple elbow flexion–extension to complex tasks (e.g. reaching and grasping). Mirror therapy and sham therapy were added to conventional rehabilitation. Main measures: Primary outcome includes Fugl–Meyer upper extremity scale. Secondary outcomes include action research arm test (ARAT) and functional independence measure (FIM) scale. Outcomes were measured at the beginning (T0) and end (T1) of the treatment. Results: At baseline, both groups (sham therapy vs. mirror therapy; mean (SD)) were comparable for Fugl–Meyer (30.9 (23.9) vs. 28.5 (21.8)), ARAT (25.1 (25.5) vs. 23.5 (24)) and FIM (71.0 (20.6) vs. 72.9 (17.8)) scores. At the end of the treatment, both groups significantly improved in the Fugl–Meyer (40.6 (21.3) vs. 38.3 (23.4)), ARAT (31.9 (23.0) vs. 30 (24.1)) and FIM (100.3 (21.9) vs. 99.4 (22.6)) scores. However, at T1, no significant difference was observed between the sham therapy and mirror therapy groups, neither for the Fugl–Meyer, nor for ARAT and FIM scores. Conclusion: Compared with sham therapy, mirror therapy did not add additional benefit to upper-limb recovery early after stroke.


2016 ◽  
Vol 31 (2) ◽  
pp. 197-206 ◽  
Author(s):  
Silvina Santana ◽  
José Rente ◽  
Conceição Neves ◽  
Patrícia Redondo ◽  
Nina Szczygiel ◽  
...  

Objective: To evaluate an early home-supported discharge service for stroke patients. Design: We carried out a prospective, randomised, open-label, blinded-endpoint trial (allocation ratio of 1:1) with patients assigned to either an early home-supported discharge service or usual care. Setting: The study was undertaken in Aveiro, Portugal, between April 2009 and April 2013. Subjects: We included stroke patients aged 25–85 years admitted to the stroke unit with an initial Functional Independence Measure of up to 100, who gave informed consent. Interventions: Patients in the early home-supported discharge group began their rehabilitation intervention in the stroke unit and the early home-supported discharge team worked with them at home for a maximum of one month. Patients in the control group received usual services. Main measures: The primary outcome measure was the Functional Independence Measure at six months after stroke. Results: We randomised 190 patients of whom 34 were lost to follow-up. There were no significant differences (p > 0.5) in the average scores of Functional Independence Measure between the early home-supported discharge (69 ±22; mean ±SD) and the control groups (71 ±17) measured at baseline; and between the early home-supported discharge (107 ±20) and the control groups (107 ±25) measured at six months. The number of individuals with a low Functional Independence Measure score (<60) in the early home-supported discharge group compared with the control group was higher at admission (34/95 vs. 26/95) and lower at follow-up (2/74 vs. 5/78). Conclusions: It was feasible to implement early home-supported discharge procedures in a Southern European setting, but we have not shown convincing differences in disability at six months.


2021 ◽  
Vol 13 ◽  
Author(s):  
Yongqiang Li ◽  
Tao Fan ◽  
Qi Qi ◽  
Jun Wang ◽  
Huaide Qiu ◽  
...  

Objective: To investigate the efficacy and safety of a novel lower-limb exoskeletal robot, BEAR-H1 (Shenzhen Milebot Robot Technology), in the locomotor function of subacute stroke patients.Methods: The present study was approved by the ethical committee of the First Affiliated Hospital of Nanjing Medical University (No. 2019-MD-43), and registration was recorded on the Chinese Clinical Trial Registry with a unique identifier: ChiCTR2100044475. A total of 130 patients within 6 months of stroke were randomly divided into two groups: the robot group and the control group. The control group received routine training for walking, while in the robot group, BEAR-H1 lower-limb exoskeletal robot was used for locomotor training. Both groups received two sessions daily, 5 days a week for 4 weeks consecutively. Each session lasted 30 min. Before treatment, after treatment for 2 weeks, and 4 weeks, the patients were assessed based on the 6-minute walking test (6MWT), functional ambulation scale (FAC), Fugl-Meyer assessment lower-limb subscale (FMA-LE), and Vicon gait analysis.Results: After a 4-week intervention, the results of 6MWT, FMA-LE, FAC, cadence, and gait cycle in the two groups significantly improved (P &lt; 0.05), but there was no significant difference between the two groups (P &gt; 0.05). The ratio of stance phase to that of swing phase, swing phase symmetry ratio (SPSR), and step length symmetry ratio (SLSR) was not significantly improved after 4 weeks of training in both the groups. Further analyses revealed that the robot group exhibited potential benefits, as the point estimates of 6MWT and Δ6MWT (post-pre) at 4 weeks were higher than those in the control group. Additionally, within-group comparison showed that patients in the robot group had a significant improvement in 6MWT earlier than their counterparts in the control group.Conclusions: The rehabilitation robot in this study could improve the locomotor function of stroke patients; however, its effect was no better than conventional locomotor training.


2021 ◽  
Author(s):  
Xin Xue ◽  
Xue-Xing Jin ◽  
Kai-Liang Luo ◽  
Xin-Hao Liu ◽  
Li Zhang ◽  
...  

Abstract Background: Statistics show that every year, 5.4 million people in the world suffer a stroke. Post-stroke cognitive impairment (PSCI) is one of the most common complications after stroke with a rate of 75%, which leads to decreased functions for independent living and reduced quality of life (QOL). Exercise training has been reported to be useful to improve the cognitive functions of post-stroke patients. Yijinjing, a traditional Chinese Qigong exercise characterized by an integration of mind and body in moderate exercise intensity, can improve cognitive functions of PSCI patients. This study aims to explore the feasibility and effectiveness of the Yijinjing exercise in this regard.Methods: A single-blind, randomized controlled trial will be employed with evaluations at three and six months. 72 PSCI patients will be recruited and randomly assigned to the Yijinjing exercise intervention group or the control group (1:1). Participants in the control group will receive routine rehabilitation therapies, including occupational therapy, physical therapy, acupuncture therapy, and health education 5 times a week for 3 months. The intervention group will receive a 12-week routine rehabilitation therapy combined with the Yijinjing exercise intervention for 40 minutes each session and 3 sessions a week. The primary outcome of cognition will be measured by the Montreal Cognitive Assessment scale (MoCA). Secondary outcomes include executive function, memory function, visuospatial function, sleep quality, gait and motor function, activity of daily living (ADL), and quality of life (QOL).Discussion: Current evidence has reported the effectiveness of traditional Chinese exercise in improving the post-stroke population’s motor functions. This research is a randomized controlled trial that evaluates traditional Chinese exercise’s effectiveness for PSCI patients. It is expected to expand the traditional Chinese exercise scope and provide a new treatment approach for stroke populations with cognitive impairments.Trail registration: Chinese Clinical Trial Registry, ChiCTR1900026532. Registered on 13 October 2019.


MedPharmRes ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 17-21
Author(s):  
Man Bui ◽  
Dan Nguyen ◽  
Nam Thai ◽  
Thuong Trinh

Background and Objectives: Combining modern medicine and traditional medicine in the rehabilitation of post-stroke motor deficit has shown interesting results. Many studies on modified acupuncture, a combination of modern and traditional techniques, have proven its effectiveness in motor rehabilitation in post-stroke patients. Furthermore, the effectiveness of the motor relearning method in the treatment of post-stroke paralysis has been elucidated. Therefore, our study aims to determine whether the combination between modified acupuncture and motor relearning method can improve treatment outcomes. Method: Multicenter randomized controlled trial (Traditional Medicine Hospital of Ho Chi Minh City, General Hospital of Soc Trang Province, and People Military Hospital of Soc Trang Province) from July 2014 to July 2015. 66 post-stroke patients were divided into two groups: The control group received modified acupuncture combined with Bobath method and the trial group received modified acupuncture combined with motor relearning method. After six weeks, patients were evaluated according to the Barthel score, the 10-hole test, and the ability to walk. Results: The trial group showed better results than the control group. There was a significant difference between the two groups in the Barthel score and the ability to walk, excluding the 10-hole test. After treatment, 77.42% of patients in the trial group showed improvement compared to only 51.61% in the control group (P < 0.05). Conclusion: The combination of modified acupuncture and motor relearning method is more effective than the combination of modified acupuncture and Bobath method in the rehabilitation of motor deficit after stroke.


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 83-83
Author(s):  
Akira Tangoku ◽  
Takeshi Nishino ◽  
Seiya Inoue ◽  
Takahiro Yoshida

Abstract Background Daikenchuto (TJ-100), a traditional Japanese herbal medicine, is widely used in Japan. Its effects on gastrointestinal motility, microcirculation and its anti-inflammatory effect are known. The purpose of this prospective randomized controlled trial was to investigate the effect of TJ-100 after esophagectomy in esophageal cancer patients. Methods Forty patients to whom subtotal esophagectomy for esophageal cancer was planned at our institute from March 2011 to August 2013 were enrolled and divided into two groups at the point of determination of the operation schedule after informed consent: TJ-100 treated group (n = 20) and Control group (n = 20). The primary end-points were maintenance of the nutrition condition and the recovery of gastrointestinal function. The secondary end-points were the serum C-reactive protein (CRP) level and adrenomedullin level during the postoperative course, the incidence of postoperative complications, and the length of hospital stay after surgery. Results We examined 39 patients because one patient in TJ-100 group couldn’t perform a curative surgery. The mean age of the TJ-100 group patients was significantly older than that of the control group. The rate of body weight decrease at postoperative day 21 was significantly suppressed in the TJ-100 group (3.6% vs. 7.0%, P = 0.014), but the serum albumin levels were not significantly different between the groups. The recovery of gastrointestinal function regarding flatus, defecation, and oral intake showed no significant between the groups, but postoperative bowel ill symptoms tended to be rare in the TJ-100 group. There was no significant difference in hospital stay after surgery. The serum CRP levels at postoperative day 3 tended to be suppressed in the TJ-100 group (P = 0.126). The rate of increase in adrenomedullin levels tended to be high postoperatively in the TJ-100 group, but there was no significant difference. Conclusion TJ-100 treatment after esophagectomy prompts the recovery of gastrointestinal motility and minimizes body weight loss. Those effects might suppress the excess inflammatory reaction related to surgery Disclosure All authors have declared no conflicts of interest.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xin Xue ◽  
Xue-Ming Jin ◽  
Kai-Liang Luo ◽  
Xin-Hao Liu ◽  
Li Zhang ◽  
...  

Abstract Background Statistics show that every year, 5.4 million people in the world suffer a stroke. Post-stroke cognitive impairment (PSCI) is one of the most common complications after stroke with a rate of 75%, which leads to decreased functions for independent living and reduced quality of life (QOL). Exercise training has been reported to be useful to improve the cognitive functions of post-stroke patients. Yijinjing, a traditional Chinese Qigong exercise characterized by an integration of mind and body in moderate exercise intensity, can improve cognitive functions of PSCI patients. This study aims to explore the feasibility and effectiveness of the Yijinjing exercise in this regard. Methods A single-blind, superiority, randomized controlled trial will be employed with evaluations at 3 and 6 months. Seventy-two PSCI patients will be recruited and randomly assigned to the Yijinjing exercise intervention group or the control group (1:1). Participants in the control group will receive routine rehabilitation therapies, including occupational therapy, physical therapy, acupuncture therapy, and health education 5 times a week for 3 months. The intervention group will receive a 12-week routine rehabilitation therapy combined with the Yijinjing exercise intervention for 40 min each session and 3 sessions a week. The primary outcome of cognition will be measured by the Montreal Cognitive Assessment scale (MoCA). Secondary outcomes include executive function, memory function, visuospatial function, sleep quality, gait and motor function, activity of daily living (ADL), and quality of life (QOL). Discussion Current evidence has reported the effectiveness of traditional Chinese exercise in improving the post-stroke population’s motor functions. This research is a randomized controlled trial that evaluates traditional Chinese exercise’s effectiveness for PSCI patients. It is expected to expand the traditional Chinese exercise scope and provide a new treatment approach for stroke populations with cognitive impairments. Trial registration Chinese Clinical Trial Registry ChiCTR1900026532. Registered on 13 October 2019.


2017 ◽  
Vol 4 (S) ◽  
pp. 94
Author(s):  
Bui Pham Minh Man ◽  
Thuong Trinh Thi Dieu

Background and Objectives: The combination of modern medicine and traditional medicine in the rehabilitation of motor deficit after stroke has shown interesting results. Many studies on modified acupuncture, a combination of modern and traditional techniques, have proven its effectiveness in motor rehabilitation in post-stroke patients. Furthermore, many studies have elucidated the effectiveness of the motor relearning method in the treatment of post-stroke paralysis. Therefore, this study aims to determine whether the combination of modified acupuncture and motor relearning method can improve the treatment results.  Method: Multi-centered randomized controlled trial (Traditional Medicine Hospital of Ho Chi Minh City, General Hospital of Soc Trang Province, and People Military Hospital of Soc Trang Province) from July 2014 to July 2015. 66 post-stroke patients were divided into two groups: a control group received modified acupuncture combined with Bobath method and a trial group received modified acupuncture combined with motor relearning method. After six weeks, patients were evaluated according to the Barthel score, 10-hole test, and 10-meter-walk test.  Results: The trial group showed better results than the control group did. There was a significant difference between two groups in Barthel score and 10-meter-walk test, but not in the 10-hole test. After treatment, 77.42% patients of the trial group showed improvement while only there are 51.61% in the other group (P < 0.05).  Conclusion: The combination of modified acupuncture and motor relearning method is more effective than the combination of modified acupuncture and Bobath method in the rehabilitation of motor deficit after stroke.


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