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Objectives of Study：
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Post-stroke depression (PSD) is a physical and mental illness caused by post-stroke physical disorder combined with mood disorder, which seriously affects the recovery of stroke. Based on the holistic view of TCM, the "mind and body" method of regulating body, breath and spirit is the symptomatic therapy of "body and mind together with health". Electroencephalogram (EEG) can reflect the comprehensive electrophysiological activities of neurons and provide abundant physiological or psychological information. In this study, eeg signals were used to observe the effect of exercise of "mind and breath" in healthy people, and clinical scales of NIHSS, SS-QOL and HAMD-24 were used to evaluate the clinical efficacy of exercise therapy in PSD patients. Furthermore, the effects of EEG on THE EEG of PSD patients before and after the treatment were observed with objective indicators, and the characteristic changes in the four frequency domain EEG signals, brain network functional connections, and local and global information processing efficiency were analyzed, so as to provide safe and reliable supplementary therapy for clinical PSD patients and to seek objective basis for the traditional performance method.
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Description for medicine or protocol of treatment in detail：
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Patients in the two groups were given basic neurological treatment, such as the use of neurotrophic drugs, control of blood pressure, blood glucose and blood lipids, improve circulation, symptomatic support treatment and traditional Chinese medicine to promote blood circulation. The use of all drugs did not produce antidepressant effect. On the basis of routine diagnosis and treatment, the two groups were given the following treatment:
Routine group: routine rehabilitation treatment and psychological support intervention.
1. Manipulation techniques after hemiplegia
1. Upper limbs: supine position with the dominant functional disorder side; a. Dab the extensor of the upper limb and rub with the palm
The degree of warmth sensation is from the inferior side of spasm (extension side) to the skin of this side. B. The surgeon will slowly extend the elbow, wrist, and knuckle of the affected limb and flex the elbow, wrist, and flexor joints more quickly.
Do forearm pronation and pronation slowly and fully. C. The patient lies on the back. The doctor holds the affected hand with four fingers in one hand, controls the thumb of the affected hand with the other hand, and puts five fingers
And wrist joints were placed in the extension position to assist patients to lift, abduct, adduction and rotate the upper limb, with the amplitude increasing from small to large. D. In supine position, the shoulder joint of the patient was extended by 55° and flexed by 30°. The therapist squeezed the shoulder joint and increased it
Proprioception.
(2) Body cadre: A. The patient lies on his back, bends his knees and bends his hips, and holds his knees in both hands. The doctor gently shakes the patient's body to the left and right. B. In the patient's sitting position, the therapist placed one hand on the patient's sternum stalk and the other hand behind the thoracic vertebra for the postural control exercise with the figure of eight around.
(3) Lower limbs: Mainly functional impairment side. A. The rolling massage method is applied to the abdominal muscles on the dominant side of the thigh; Rub the palm onto the inferior side of the spasm (large
The degree of warmth to the skin. B. The patient was placed in supine position with the affected foot supported on the bed. The doctor fixed the affected ankle joint with one hand and assisted with the other
The patient does dorsiflexion and ankle-flap. C. The patient lies on the back and exercises hip flexion with the knee in the extended position. Start by the healthy side
Drive the affected side, or medical assistance. D. The patient lies on the back, bends the hips and bends the knees of both lower limbs, supports the whole sole of both feet on the bed surface, and performs the control training of hip joint adduction and abduction. E. The patient flexes the knee in prone or standing position with the hip joint extended
Psychological support intervention: a. Protect patient self-esteem and improve self-confidence under the premise of providing appropriate care and ensuring safety. treatment
In speech and action to avoid damage to the patient's self-esteem, patience to treat patients in daily life and in the time of rehabilitation treatment sentiment again and again. Give appropriate cover, articles for daily use put patients with convenient take put as far as possible, both to protect the safety of patients, making patients to understand that they still can do some things, so often in the successful experience in the state of mind. B. Explain the harmfulness and manifestations of depression, and strive for family members' cooperation. C. Improve patients' understanding of the disease and reduce their fear of dysfunction. On the basis of establishing a good doctor-patient relationship, patients can be informed in advance of the process and possible consequences of the recovery of limbs and other functions, so as to help patients correctly understand the dysfunction after stroke, eliminate the fear of disability, and calmly accept the change of role. D. Encourage patients to receive rehabilitation treatment in a positive manner. Through individual conversation, health education and other means. To understand the rehabilitation plan and specific procedures, it is emphasized that rehabilitation treatment is a repeated process of learning and exercise, which is different from the passively accepted clinical treatment and requires the cooperation of patients to achieve good results. E. Encourage the patient's progress in life and training. Arrange several patients with similar conditions into a group, encourage communication between patients, install interesting cognitive games, improve cognitive function at the same time, transfer depression and other negative emotions.
Treatment group: routine rehabilitation therapy and "mind and spirit" exercise program.
Conventional rehabilitation treatment is the same as above.
The techniques include: (1) Deep breathing techniques: lying on the back, bending the knees, keeping the abdominal wall loose, focusing on the present movement during the breathing process, keeping the breath deep and steady, and completing one breath and one breath within 10s. Focus on the feeling of the breath focus on the breath or the fluctuations of the chest and abdomen that the breath brings about. Listen to audio every day and exercise with exercise imagination activation. Practice for 10 minutes, once a day. Listen to the 30-minute version of nature relaxation guide, listen with eyes closed, and control the volume at the patient's self-comfortable level. (3) Watch the video of simplified body movements in the sitting position, listen to the audio command, and practice the first simplified weituo offering pestle, the second simplified Weituo offering pestle, and the third simplified Weituo offering pestle in the sitting position. Practice for 15 minutes, once a day.
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Exclusion criteria：
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(1) Severe encephalopathy, epilepsy, drug intoxication or drug withdrawal;
(2) Those who have obvious consciousness and intelligence disorder, can't understand and don't cooperate with scale evaluator;
(3) Patients who cannot sit for examination and treatment;
(4) Moderately or severely depressed patients undergoing antidepressant treatment;
(5) persons suffering from mental illness or having been screened for severe dementia;
(6) Patients with serious diseases such as heart failure, myocardial infarction, liver and kidney dysfunction, gastrointestinal bleeding, etc.;
(7) More than 40ml cerebral hemisphere hemorrhage, more than 15ml cerebellar hemorrhage, more than 5ml cerebral stem hemorrhage and subarachnoid hemorrhage;
(8) Have participated in or are participating in other clinical researchers in the first month before enrollment.
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