Mechanism Of Constraint-induced Movement Therapy To Promote Functional Recovery In Rats After Stroke

Part â… :Constraint-induced movement therapy enhances expression of BNDF but not Synapsin I in the cerebral cortex and improves neurological recovery in rats with middle cerebral artery occlusionBackground:Our study aimed to study effects of constraint-induced movement therapy (CIMT) on the brain-derived neurotrophic factor (BNDF) and synapsin I of stroke rats.Method:The unimpaired limb of adult rats after ischemic were restricted for14days. The behavioral testing was recorded and the cortex of the brain was collected for western blot analysis and immunofluorescence staining. The level of BDNF and Synapsin I in CIMT group was compare with the sham group and control group. And the infarct area and the penumbra area were observed by electronic microscopy.Results:Our data suggest that the expression of BDNF in left cortex of CIMT group was higher than other groups at day21after cerebral ischemia (P<0.05). But there was no difference in the expression of Synapsin I between three groups(P>0.05). At the same time, the CIMT group have a more significant improvement in the foot-fault test (P<0.05).Conclusion:Our present study suggest that CIMT convincingly enhance functional recovery after stroke in the long run. The expression of BDNF in the ipsilateral cortex was higher than natural recovery and CIMT could decrease the edema of the neurons. There should be more improvement for the model of CIMT in the future. Part II:The cost-effectiveness analysis of different rehabilitation programs of patients with ischemic strokeObjective:To analyze the effect of rehabilitation training, acupuncture and the group combine these two therapies on the motor function and health economic evaluation in patients with ischemic stroke.Methods:Two hundred and five cases with ischemic stroke were randomly divided into rehabilitation, acupuncture and combined groups. Rehabilitation group received rehabilitation training for28days while the acupuncture group received scalp needling combined with body acupuncture.The combined group received the treament of rehabilitation training and acupuncture.The clinical nerve deficiency scale(NDS) and functional comprehensive assessment(FCA) were evaluated at baseline, the28th and56th days after treatment. The total cost including the direct medical costs, direct non-medical costs and indirect costs were calculated and analyzed.Results:The NDS and FCA score showed no significant difference between the three groups at baseline. At the28th and56th after treatment, the NDS and FCA scores improved significantly comparing with the baseline of each group(P<0.05).However, there was no significant difference between groups.At the28th after treatment, there was a significant difference in the NDS of combined group compared to the other two groups(P<0.05).The significant difference of NDS was appeared between three groups at the56th (P<0.05), while there was no significant difference on the score of FCA.At the28th after treatment no significant difference was observed on the costs between three groups.But the combined group spend less on the total cost, direct medical costs, direct non-medical costs and indirect costs for one point decrement of NDS(P<0.05).However, no significant difference of costs for the one point increment of FCA was observed between three groups.Conclusion:Therapy combined the rehabilitation training and acupuncture was more economical and effective than the treatment of rehabilitation training and acupuncture used alone.