Objective: The aim of this study was to evaluate the effectiveness of Cognitive Sensory Motor Training Therapy (Perfetti’s method) vis-à-vis conventional occupational therapy in the recovery of arm function after acute stroke. Design: Prospective randomized controlled trial. Setting: Two rehabilitation centers in Bangkok, Thailand. Subjects: Forty first-time acute stroke patients without severe cognitive or language impairment. Intervention: All subjects were randomly divided into two groups; one was treated using Perfetti’s method and the other using conventional occupational therapy. Each group underwent therapy for 30 minutes, five times a week for four weeks. Main measures: The primary variable was arm function as assessed by the Action Research Arm Test; secondary variables were the extended Barthel Index and the box and block test score. Results: The intention-to-treat analysis revealed no statistically significant differences between the two groups at the end of treatment for any variable. Conclusions: There was no evidence of a difference between Cognitive Sensory Motor Training Therapy of Perfetti’s method and conventional occupational therapy with respect to the restoration of hand and arm function after a stroke.

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Patient: Male, 71-year-old Final Diagnosis: Stroke Symptoms: Hemiplegia Medication: — Clinical Procedure: — Specialty: Rehabilitation Objective: Unusual or unexpected effect of treatment Background: The criterion standard treatments for ischemic stroke patients, starting from systemic thrombolysis and/or undergoing endovascular recanalization therapy to intensive rehabilitation, are the best options available nowadays, but still cannot achieve total recovery. Neuroprotective and neurotrophic agents seem to be promising therapeutic targets in stroke, even in ischemic and/or hemorrhagic stroke, either in the acute stage or to support neuro-recovery in subacute to chronic stages. Therefore, new therapies are needed as adjuvants in the rehabilitation phase for promoting the recovery and monitoring adverse effects of treatment. Case Report: We describe a patient with an acute occlusion of the right middle cerebral artery who was treated with recombinant tissue-plasminogen activator (rtPA), underwent mechanical thrombectomy, and was then enrolled in a 1-month rehabilitation program. After the post-stroke recovery plateau, the patient received 10 days of 30 mL intravenous Cerebrolysin ® to support further neuro-recovery, together with long-term rehabilitation. We utilized clinical standard assessment tools, including National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), modified Barthel Index (MBI), and function of ambulation, to evaluate the outcome of the patient, together with the adverse events monitoring. After Cerebrolysin ® administration, the patient demonstrated improvement in all assessment scores at 1, 3, and 6 months. Conclusions: Postoperative treatment with Cerebrolysin ® in our patient with subacute ischemic stroke, after plateau recovery in the rehabilitation phase, together with the standard acute stroke regimen, improved the patient’s recovery outcomes. No serious adverse effects were observed.

【摘要】目的：采用光纤维内镜观察针刺新穴位组方治疗中风后吞咽障碍的疗效。方法：选取 5 个新穴 位治疗 1 例中风后吞咽障碍患者，治疗 4 星期后采用光纤维内镜观察疗效。结果：针刺治疗后患者的吞 咽功能以及语言功能均有改善。结论：针刺新穴位对中风后吞咽困难有确切疗效。 【关键词】针刺疗法；吞咽障碍；脑卒中；中风后遗症 【中图分类号】R246.6 【文献标志码】B 【Abstract】Objective: To describe the effect of acupuncture with a new acupoint prescription in treating dysphagia from a chronic stroke patient by fiberoptic endoscopic evaluation of swallowing (FEES). Methods: A case of chronic dysphagic stroke patient was treated by acupuncture with 5 established acupoints, and assessed by FEES before and after 4-week treatments. Results: There is improvement in swallowing and speech function after acupuncture treatment. Conclusion: There is evidence showing that new acupuncture points maybe beneficial for dysphagic stroke patients.