The prevalence of developmental delay (DD) in children worldwide is still on the rise, and its causes are complex and diverse, causing varying degrees of impact on the development of the sensory nervous system in the brain of children. Sensory integration training is a treatment method that applies sensory stimulation and comprehensive activities. It is currently widely used in children with DD. This therapy can effectively improve the development and integration of the sensory system in children with DD. It also enhances the individual’s ability to adapt to external stimuli, promoting their development in language, motor, and cognitive functions. This article explores the relevant mechanisms of sensory integration training and DD, as well as the current status and effects of its application in DD children, in order to promote the development and progress of related research fields.
Objective To evaluate the survival condition and quantitative variation of mechanoreceptors in the tibial remnant of ruptured anterior cruciate l igament (ACL) in human knees. Methods Between April 2009 and May 2010, 60 patients who underwent arthroscopic ACL reconstruction were included and divided into 4 groups according to the time of injury, with 15 patients in each group. In group A, there were 14 males and 1 female aged 20-37 years (mean, 27 years); the injury was caused by traffic accident in 5 cases and by sports in 10 cases, and the time between injury and surgery was not more than 3 months. In group B, there were 14 males and 1 female aged 17-43 years (mean, 24 years); the injury was caused by traffic accident in 2 cases and by sports in 13 cases; and the time between injury and surgery was 3 to 6 months. In group C, there were 11 males and 4 females aged 16-53 years (mean, 28 years); the injury was caused by traffic accident in 2 cases and by sports in 13 cases; and the time between injury and surgery was 6 to 12 months. In group D, there were 12 males and 3 females aged 18-41 years (mean, 26 years); the injury was caused by sports in 11 cases, and the other 4 cases had no defined etiology; and the time between injury and surgery was more than 12 months. Specimens were donated by the volunteers from the anteromedial side of the ACL tibial remnant (40 sl ices per specimen) and stained via immunohistochemical method. The type, size, and quantity of mechanoreceptors were observed under l ight microscope. Results Totally 80 Ruffini-l ike corpuscles, 8 Pacini-l ike corpuscles, 5 atypical neural endings and no distinct Golgi organ-l ike corpuscles were observed under l ight microscope in 60 specimens (2 400 sl ices) of 4 groups. There was no obvious difference in size and type of mechanoreceptors among 4 groups. However,some degenerative and atrophic changes could be observed in the specimens of group D. The total number of echanoreceptors was 31 (35.2%) in group A, 22 (25.0%) in group B, 23 (26.1%) in group C, and 12 (13.7%) in group D. There was no significant difference (P gt; 0.05) in Ruffini-l ike corpuscles and Pacini-l ike corpuscles among 4 groups. Mechanoreceptors were found in 9,8, 9, and 6 patients in groups A, B, C, and D, respectively; the detection rates were 60.0%, 53.3%, 60.0%, and 40.0%, respectively; showing no significant difference (P gt; 0.05). Conclusion The mechanoreceptors in tibial residual of ruptured ACL have a long survival without obvious degeneration and atrophy within 12 months. So it may contribute to restoration of proprioceptive function after operation if the remnant is preserved during ACL reconstruction.
【摘要】 目的 探讨感觉统合训练及神经发育疗法对脑性瘫痪患儿智能发育的影响。方法 对2006年7月—2008年6月脑性瘫痪患儿100例,随机分成治疗组和对照组,治疗组50例,男26例,女24例,年龄8个月～5.8岁,平均2.7岁。对照组50例,男27例,女23例,年龄9个月～5.8岁,平均年龄2.7岁。两组均采用神经发育疗法,治疗组加用感觉统合训练,1次/d,30 min/次,每周5次,3个月1疗程,连续治疗2个疗程；治疗前后进行Gesell量表测试,观察患儿智能发育改善情况。结果 治疗组显效24例,有效25例,无效1例；对照组显效8例,有效39例,无效3例,两组比较有统计学意义(Plt;0.05),Gesell测试5项评分,两组治疗前无差异(Pgt;0.05),治疗后差异有统计学意义(Plt;0.05)。结论 感觉统合训练可提高脑性瘫痪患儿的智能发育,是减少小儿残疾的一个重要途径。
Objective To evaluate the clinical effect of sural nerve bridging transplantation for the restoration of penis disturbance of sensation after selective dorsal nerve neurotomy. Methods Between May 2014 and May 2016, 23 patients underwent sural nerve bridging transplantation for the restoration of penis disturbance of sensation after selective dorsal nerve neurotomy. The age ranged from 19 to 38 years (mean, 27 years). The course of disease was 1-28 months (mean, 14 months). The defect length was 1.0-1.5 cm. Preoperative main neurological sign was sensory disturbance. The chief complaint of 21 patients was a erectile dysfunction; all had normal hormone levels, and there was no other organic diseases or surgical contraindication. According to the self-assessment lists of symptom-SCL90 evaluation, 19 cases had depression, 16 cases had anxiety, and 15 cases had both anxiety and depression; 3 cases had psychological abnormalities (social barriers, etc.). According to the functional neurological evaluation standard of British Medical Research Institute, the static two-point discrimination and sensation recovery standard rating were evaluated before and after operation; sexual pleasure obstacle sensitivity, temperature sense, and other subjective improvement were recorded. The International Index of Erectile Function 5 (IIEF-5) was used to evaluate questionnaire of the patient with erectile dysfunction before and after operation. The psychological state was accessed with the self-assessment lists of symptom-SCL90 evaluation after operation. Results All incisions healed by first intention. The mean follow-up time was 8 months (range, 6-12 months). Sexual pleasure obstacle was obviously improved in 11 cases, partially improved in 5 cases; the improvements in temperature and tactile sensitivity were achieved in 21 cases; no obvious improvement was observed in 1 case. The sensation recovery standard rating, static two-point discrimination and grade of IIEF-5 were significantly improved at 3 and 6 months after operation when compared with preoperative ones (P<0.05). At 6 months after operation, symptom was improved in 14 of 19 patients with depression (73.68%), in 12 of 16 patients with anxiety (75.00%), and in 12 of 15 patients with anxiety and depression(80.00%). Conclusion Sural nerve bridging transplantation is an effective method for the restoration of penis disturbance of sensation after selective dorsal nerve neurotomy.
ObjectiveTo investigate the mechanism of Semaphorin 3A (Sema3A) in fracture healing after nerve injury by observing the expression of Sema3A in the tibia fracture healing after traumatic brain injury (TBI). MethodsA total of 192 Wistar female rats, 8-10 weeks old and weighing 220-250 g, were randomly divided into tibia fracture group (group A, n=48), TBI group (group B, n=48), TBI with tibia fracture group (group C, n=48), and control group (group D, n=48). The tibia fracture model was established at the right side of group A; TBI model was made in group B by the improved Feeney method; the TBI and tibia fracture model was made in group C; no treatment was given in group D. The tissue samples were respectively collected at 3, 5, 7, 14, 21, and 28 days after operation; HE staining, immunohistochemistry staining, and Western blot method were used for the location and quantitative detection of Sema3A in callus tissue. ResultsHE staining showed that no obvious changes were observed at each time point in groups B and D. At 3 and 5 days, there was no obvious callus growth at fracture site with inflammatory cells and fibrous tissue filling in groups A and C. At 7 and 14 days, fibrous tissue grew from periosteum to fracture site in groups A and C; the proliferation of chondrocytes in exterior periosteum gradually formed osteoid callus at fracture site in groups A and C. The chondrocyte had bigger size, looser arrangement, and more osteoid in group C than group A. Group B had disorder periosteum, slight subperiosteal bone hyperplasia, and no obvious change of bone trabecula in group B when compared with group D. At 21 and 28 days, cartilage callus was gradually replaced by new bone trabecula in groups A and C. Group C had loose arrange, disorder structure, and low density of bone trabecula, big callus area and few chondrocyte and osteoid when compared with group A; group B was similar to Group D. Immunohistochemistry staining showed that Sema3A expression in chondrocytes in group C was higher than that in group A, particularly at 7, 14, and 21 day. Sema3A was significantly higher in osteoblasts of new bone trabecula in group A than group C, especially at 14 and 21 days (P<0.05). Western blot results showed that the Sema3A had the same expression trend during fracture healing in groups A and C. However, the expression of Sema3A protein was significantly higher in group C than group A (P<0.05) and in group B than group D (P<0.05) at 7, 14, 21, and 28 days. ConclusionAbnormal expression of Sema3A may play a role in fracture healing after nerve injury by promoting the chondrocytes proliferation and reducing the distribution of sensory nerve fibers and osteoblast differentiation.
ObjectiveTo study the effect of arthroscopic intercondylar fossa angioplasty on the ability of neuromuscular control of the knee joint in elderly patients with knee osteoarthritis (KOA). MethodsBetween June 2012 and March 2013, 20 elderly patients with KOA and in accordance with inclusion and exclusion criteria underwent arthroscopic intercondylar fossa angioplasty (operation group), and 20 healthy elderly people served as control group. There was no significant difference in age, height, weight, and body mass index between 2 groups (P>0.05). The proprioception capability (using passive regeneration test at measurement angles of 15, 30, and 60°) and quadriceps mobilization [including maximum voluntary contraction (MVC), central activation ratio (CAR), and activation deficit (AD)] were measured to avaluate the neuromuscular control of the knee;the Lysholm score was used to evaluate knee function. The above indexes were measured to assess the knee neuromuscular control and recovery of joint function in patients of operation group at 3, 6, and 9 months after operation. ResultsCompared with the control group, MVC, CAR, and Lysholm scores were significantly decreased, and the AD and passive knee angle difference were significantly increased in operation group (P<0.05) before operation. With the time after operation, the Lysholm score, CAR, and MVC increased gradually, and the AD and the passive knee angle difference decreased gradually. There was no significant difference in the indexes between 2 groups at 9 months after operation (P>0.05). ConclusionArthroscopic intercondylar fossa angioplasty can relieve ACL pressure, abrasion, and impact, which will recover the ability of neuromuscular control, increase proprioception and quadriceps mobilization capacity, and improve the joint function.
ObjectiveTo investigate the effectiveness of using a sensory prefabricated flap to repair the heel avulsion injury. MethodsBetween August 2012 and August 2013, 6 cases of heel avulsion injury were treated. There were 4 males and 2 females, aged 16-54 years (mean, 29 years). The causes were crush injury in 4 cases and wheel twist injury in 2 cases. The injury to admission time was 2-6 hours (mean, 4 hours). The size of skin avulsion ranged from 5 cm×3 cm to 15 cm×8 cm. Avulsion skin had no replanted condition. At one stage operation, the avulsed heel skin soft tissue was made the full thickness skin graft which was fostered on the anterolateral thigh with lateral circumflex femoral artery perforator, and the lateral femoral cutaneous nerve was put beneath the skin to prefabricate the prefabricated flap; at two stage operation, the prefabricated skin flap pedicled with lateral circumflex femoral artery was used to repair the wound, and the lateral femoral nerve was anastomosed with the calcaneal nerve to reconstruct the feeling. ResultsSix prefabricated flaps all survived, and re-plantation flaps survived after operation. The wounds healed by first intention at donor site and recipient site. The patients were followed up 1-2 years (mean, 1.5 years). The flaps had satisfactory appearance and soft texture. At 1 year after operation, the sensation of the flaps was S3, with two-point discrimination of 22-27 mm (mean, 24.3 mm). According to ZHANG Ming's evaluation standards, the results were excellent in 5 cases, and good in 1 case. The patients could walk normally or with weight-bearing; only linear scar formed at the donor site. ConclusionFor patients with heel soft tissue avulsion injury without replantation qualification, a sensory prefabricated flap by the avulsed heel skin soft tissue can transplanted to repair the heel defect. Satisfactory effectiveness can be obtained in heel appearance and function recovery.
Objective To investigate the sensation of the fingers innervated by the brachial plexus roots and provide the theoretic basis for diagnosis of a brachial plexus injury. Methods From June 2003 to January 2005，10 patients (8 males, 2 females; age,18-47 years) with complete brachial plexus avulsion were involved in this study, who underwent thecontralateral C7 nerve root transfer. The latency and amplitude of the sensory nerve actiopotential(SNAP) were record at the C5 T1 nerve roots when stimulation was given at the fingers.Results When the thumb and the index finger were stimulated and SNAP was recorded at all the roots of the brachial plexus in all the patients, we found that there was a higher amplitude and a shorter latency at the C5-7 roots than at the C8 and T1 roots(P＜0.05). When the middle finger was stimulated and SNAP was recorded at the C7,8 and T1 roots, we found that there was the highest amplitude and the shortest laency at the C7 root(P＜0.01). When the ring finger was stimulated and SNAP was recorded at the C7,8and T1 roots, we found that there was a higher amplitude and a shorter latency at the C8 and T1 roots than at the C7 root(P＜0.01). When the little finger was stimulated and SNAP was recorded at the C7,8and T1 roots, we found that there was the highest amplitude and the shortest latency at the T1 root(P＜0.01). ConclusionThe sense of the thumband the index finger is mainly nnervated by the C5-7 roots, the middle finger sense is mainly innervated by the C7 root, the ring finger sense is mainly innervated by the C8 and T1 roots, and the little finger sense is mainly innervated by the T1 root.