The Effect Of Constraint-induced Movement Therapy On Motor Function And ERK Protein In Cerebral Ischemic Rats

Part Ⅰ:The Effect of Constraint-induced Movement Therapy on Motor Function and ERK protein in Cerebral Ischemic RatsObjective:To investigated recovery of the affected forelimbs and protein level of ERK after constraint-induced movement therapy (CIMT) in cerebral ischemic rats.Methods:Sprague-Dawley rats were randomly divided into a CIMT group, a control group and a sham group (n= 15 for each group). Middle cerebral artery occlusion (MCAO) was performed in the CIMT group and control group. CIMT was conducted in the CIMT group and sham group. Functional evaluations were performed before surgery (d0), seven days (d7) and twenty-two days after surgery (d22). Infarct proportions, the expression of ERK and BrdU labeled new neurons were measured at d22.Results:Joint stiffness and local swelling were observed in some rats. The body weight growth could be affected by using plaster cast. Compared with the control group, CIMT significantly reduced foot fault rate and enhanced balance and walking ability on the beam. Infarct proportions in the CIMT group, control group and sham group were 18.22%±8.29%,17.68%±6.45% and -1.32%±4.12%, respectively (p< 0.01; post hoc p< 0.01 when CIMT vs. sham group and control vs. sham group). Total-ERK maintained similar among the three groups at d22, while p-ERK increased significantly in bilateral cortex and hippocampus in the control group. At d22, p-ERK expression in the CIMT group decreased significantly, as the level in the sham group. More immunological fluorescence signals were observed in the CIMT group than the control group. However, the outcome required further research.Conclusion:CIMT promoted functional recovery possibly through down-regulating p-ERK in bilateral cortex and hippocampus.Part Ⅱ:Three-Stage Rehabilitation Alleviates Spasticity and Promotes Motor Function of the Upper Extremities in Cerebral Hemorrhagic PatientsObjectives:To evaluate the effectiveness of Three-stage Rehabilitation on spasticity and motor function of the upper extremities in cerebral hemorrhagic patients.Methods:364 patients were included and randomly assigned to a control group (n=181) and a rehabilitation group (n=183). Standard Three-stage Rehabilitation was adopted in the rehabilitation group, but not in the control group. Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA) were performed at the time of recruitment (M0),1-month (M1),3-month (M3) and 6-month (M6) after recruitment.Results:No statistical differences were found in the baseline between groups. The occurrences of spasticity at the enrollment were similar, about 23%, in both groups. At M6, the occurrence of spasticity was about 43% and 60% in the rehabilitation group and the control groul, respectively. At M6, both distributions of MAS and MAS scores were different statistically (p<0.05). FMA scores in both groups increased through each time point. The scores at M1, M3 and M6 were significantly higher in the rehabilitation group than in the control group.Conclusion:Three-Stage Rehabilitation alleviates spasticity and promotes motor function of the upper extremities in cerebral hemorrhagic patients.