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Clinical, Electrophysiological and Radiological Features of Nitrous Oxide-Induced Neurological Disorders
To evaluate the effectiveness of constraint-induced movement therapy (CIMT) and combined mirror therapy for inpatient rehabilitation of the patients with subacute stroke.
Twenty-six patients with subacute stroke were enrolled and randomly divided into three groups: CIMT combined with mirror therapy group, CIMT only group, and control group. Two weeks of CIMT for 6 hours a day with or without mirror therapy for 30 minutes a day were performed under supervision. All groups received conventional occupational therapy for 40 minutes a day for the same period. The CIMT only group and control group also received additional self-exercise to substitute for mirror therapy. The box and block test, 9-hole Pegboard test, grip strength, Brunnstrom stage, Wolf motor function test, Fugl-Meyer assessment, and the Korean version of Modified Barthel Index were performed prior to and two weeks after the treatment.
After two weeks of treatment, the CIMT groups with and without mirror therapy showed higher improvement (p<0.05) than the control group, in most of functional assessments for hemiplegic upper extremity. The CIMT combined with mirror therapy group showed higher improvement than CIMT only group in box and block test, 9-hole Pegboard test, and grip strength, which represent fine motor functions of the upper extremity.
The short-term CIMT combined with mirror therapy group showed more improvement compared to CIMT only group and control group, in the fine motor functions of hemiplegic upper extremity for the patients with subacute stroke.
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To evaluate the effect of prolonged inpatient rehabilitation therapy in subacute stroke patients.
We enrolled 52 subacute stroke patients who had received 3 months of inpatient rehabilitation therapy. Thirty stroke patients received additional inpatient rehabilitation therapy for 3 months and 22 control patients received only home-based care. The evaluation was measured at 3 and at 6 months after stroke occurrence. Functional improvement was measured using the modified motor assessment scale (MMAS), the timed up and go test (TUG), the 10-meter walking time (10 mWT), the Berg balance scale (BBS) and the Korean-modified Barthel index (K-MBI). The health-related quality of life was evaluated using the medical outcome study, 36-item short form survey (SF-36).
In the experimental group, significant improvements were observed for all parameters at 6 months (p<0.05). However, significant improvements were observed only in MMAS, BBS, and K-MBI at 6 months in the Control group (p<0.05). In comparing the 2 groups, significant difference were observed in all parameters (p<0.05) except 10 meter walking time (p=0.73). The improvement in SF-36 was meaningfully higher in experimental group compared to control group.
This study demonstrates that subacute stroke patients can achieve functional improvements and an enhanced quality of life through prolonged inpatient rehabilitation therapy.
Citations
Subacute combined degeneration is the clinical syndrome associated with vitamin B12 deficiency and characterized by usually symmetrical weakness and progressively worsening of, and abnormal sensations of the legs, arms, trunk, or other area, mental abnormalities, and vision difficulties. Subacute combined degeneration primarily affects the spinal cord, but it also includes damage to the brain, the nerves of the eye, and the peripheral (body) nerves. In this study, we report two patients with subacute combined degeneration of the cord in association with folate deficiency. Subacute combined degeneration of the spinal cord and optic atrophy occurred only in the patients with vitamin B12 deficiency. However, diet-induced folic acid deficiency and subacute combined degeneration of the spinal cord which improved significantly after treatment with folic acid has been recorded.
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