Traumatic brain injury （TBI） is usually caused by severe impact or vibration on the head， which can lead to mild concussion， severe injury， and even death. Survivors of TBI often have functional impairments such as motor， cognitive， and speech impairments. With the establishment of professional trauma centers and neurological intensive care units， the mortality rate of TBI has gradually decreased， but the disability rate has continued to increase， bringing huge burdens to patients， families，and society. Accurate assessment and timely intervention in rehabilitation therapy can effectively improve and restore the neurological and motor function of patients with TBI. This article provides an overview of the development process， rehabilitation assessment， rehabilitation treatment， and handling of special clinical problems in TBI rehabilitation， as well as the application of the latest technologies. It also looks forward to future development directions， aiming to provide valuable insights for professionals and patients in this field， and provide guidance and inspiration for research and practice in related fields.
The typical characteristics of dystonia are slow involuntary movements， abnormal postures， and muscle tone fluctuations， which are common in children with cerebral palsy and have a significant impact on motor function， pain， sleep， and home care. Due to its complex etiology， there is currently no specific treatment method available. Drug and neurosurgical interventions are important treatment methods for improving muscle tone disorders， but their evidence-based basis is limited and lacks clinical application standards. In March 2024， an international expert group consisting of 10 research centers from 6 countries released the “Pharmacological and neurosurgical management of cerebral palsy and dystonia： Clinical practice guideline update”， which updated and supplemented the intervention recommendations published in 2018. It proposed 10 evidence-based recommendations for drug treatment and neurosurgical intervention in patients with cerebral palsy and Muscular Dysfunction to guide clinical application decision-making. This article interprets the key content of this guideline in conjunction with the consensus of Chinese experts in the diagnosis and treatment of muscle tone disorders， in order to provide guidance and reference for the treatment of cerebral palsy and muscle tone disorders in China.
To construct a predictive model of cardiorespiratory fitness （CRF） - peak oxygen uptake （VO2peak） in stroke patients in the subacute phase based on influencing factors and to validate its effectiveness.
Methods
Mild and moderate severity stroke patients who underwent rehabilitation in the Neurorehabilitation Department of Beijing Boai Hospital from October 2023 to June 2024 were selected for prospective study. Based on the results of cardiopulmonary exercise test （CPET），VO2peak≥15 mL/（kg·min） was defined as the good CRF group， and ＜15 mL/（kg·min） was defined as the poor CRF group. The clinical data of 2 groups were compared， and multifactorial Logistic regression analysis was used to screen the influencing factors of VO2peak in stroke patients. The patients were randomly divided into a training set and an internal test set according to the ratio of 7∶3. The training set was used to construct a prediction model based on Logistic regression， and the prediction effect of the model was verified by the internal test set.
Results
A total of 80 patients were included， including 41 patients in the good CRF group and 39 patients in the poor CRF group， 56 patients in the training set and 24 patients in the internal test set. The lower limb Brunnstrom staging， Fugl-Meyer assessment scale（FMA）， modified Barthel index， functional walking ability scale， and 6-min walk test distance comparison，the differences were statistically significant （P＜0.05）. The results of multifactorial Logistic regression analysis showed that FMA score was an independent influence on VO2peak （P=0.038）. The constructed prediction model showed good predictive effect in the internal test set， with an area under the receiver operating characteristic curve of 0.745 （95%CI： 0.536-0.954）， a sensitivity of 54.5%， and a specificity of 92.3%.
Conclusion
Constructing a prediction model for predicting CRF-VO2peak in stroke patients in the subacute stage based on FMA scores helps to identify patients with low VO2peak early in the clinic and formulate personalized rehabilitation plans.
To explore the correlation between the co-contraction rate （CCR） of lower limb muscles during the stance phase in stroke hemiplegic patients and the limb function.
Methods
From September 2017 to October 2024， a total of 55 stroke hemiplegic patients admitted to the Rehabilitation Medicine Department of Hefei Second People's Hospital were iretrospectively analyzed. The CCR of rectus femoris （RF） and biceps femoris （BF） of the lower limb was computed in 55 stroke hemiplegic patients using surface electromyography between the initial foot strike and the peak of knee extension during the stance phase based on three-dimensional kinematic analysis. The Fugl-Meyer lower limb motor assessment （FMA）and Brunnstrom staging （BRS） were used to evaluate the lower limb function， and the modified Ashworth scale （MAS） was used to evaluate the muscle tone of hemiplegic lower limb； The correlation between CCR and FMA， BRS， MAS were analyzed.
Results
Among the patients in this group， there were 10 cases in stage BRS Ⅲ， 24 cases in stage Ⅳ， 19 cases in stage Ⅴ， and 2 cases in stage Ⅵ. The CCR of the involved extremity （1.077±0.369） was significantly higher than that of the uninvolved extremities （0.760±0.334） （P＜0.05）. A positive correlation between CCR and MAS （r=0.347， P＜0.05）， and negative correlation between CCR and BRS （r=-0.913， P＜0.05） or FMA （r=-0.916， P＜0.05） were observed during the stance phase of gait in hemiplegic stroke patients.
Conclusion
CCR can quantitatively evaluate the lower limb function status and spasm degree of patients with stroke hemiplegia， and can be used in clinical evaluation of the limb function of patients with stroke hemiplegia.
To investigate the effects of minimally invasive neuroendoscopic surgery on hypertensive intracerebral hemorrhage （HICH）.
Methods
Sixty patients with HICH who underwent surgical treatment in the Neurosurgery Department of Sanya Central Hospital from January 2022 to December 2023 were selected for retrospective analysis and divided into control group and observation group according to different operation methods， with 30 cases in each group. The control group received small bone window craniotomy for hematoma removal， and the observation group received neuroendoscopic hematoma removal. The perioperative indexes， the degree of neurological impairment［National Institute of Health stroke scale （NIHSS）］， self-care ability ［modified Barthel index （MBI）］，prognosis （GOS score） and the incidence of complications were compared between the two groups.
Results
The hematomas clearance rate of the observation group was higher， and perioperative indexes were better than those of the control group， with statistical significance （P＜0.05）. At 2 months after surgery， the good prognosis rate and MBI score of the observation group were higher than those of the control group， and the NIHSS score and complication rate were lower than those of the control group， with statistical significance （P＜0.05）.
Conclusion
Minimally invasive neuroendoscopic surgery can improve the hematoma clearance rate of HICH， strengthen the repair effect of nerve function defect， improve the prognosis of patients， and is safer than traditional craniotomy.
To investigate influencing factors of early deterioration in patients with mild traumatic brain injury （mTBI）.
Methods
Clinical data of 264 mTBI patients admitted to Department of Neurosurgery， Linquan County People's Hospital from January 2021 to August 2024 were retrospectively analyzed. The mTBI patients were divided into the deterioration group （26 cases） and the non- deterioration group （238 cases） deponding on whether the patients suffered from deterioration of the condition within 3 d after injury. Independent influencing factors of early deterioration in mTBI patients were revealed by univariate and multivariate Logistic regression analysis. Logistic regression prediction model was constructed based on the above independent influencing factors. Receiver operating characteristic （ROC） curve and area under curve （AUC） were used to evaluate the ability of different influencing factors to predict early deterioration. Internal validation of the prediction model was used by bootstrap analysis.
Results
Among 264 mTBI patients， 26 cases showed deterioration within 3 d after injury （the deterioration group）， and the incidence of deterioration was 9.8%， the remaining 238 patients were in the non-deterioration group. There was statistically significant difference in recurrent vomiting，first CT scan time， GCS score on admission， skull fracture， neutrophil-to-lymphocyte ratio （NLR）， level of fibrinogen （FIB）， and level of D-dimer between the two groups （P＜0.05）. Multivariate Logistic regression analysis showed that recurrent vomiting， first CT scan time， GCS score on admission， NLR， D-dimer were independent influencing factors for early deterioration. ROC curves showed that areas under the curve（AUC） of those independent influencing factors were 0.677， 0.803 （2.2 h as the threshold for first CT scan time）， 0.764 （14 scores as the threshold for GCS score on admission）， 0.753 （6.9 as the threshold for NLR），0.812 （8.6 mg/L as the threshold for D-dimer）. The AUC of the influencing factors combined to predict early deterioration was 0.928 （95%CI： 0.890-0.956， P＜0.001）.
Conclusion
Recurrent vomiting， first CT scan time， GCS score on admission， NLR and D-dimer are independent influencing factors for early deterioration in mTBI patients. These indexes could be jointly used to improve the predictive value for early deterioration.
To explore the effect of proprioceptive neuromuscular facilitation （PNF）technology combined with functional electrical stimulation （FES） rehabilitation treadmill on walking function in stroke patients.
Methods
A total of 100 stroke patients admitted to the Rehabilitation Medicine Department of Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University from December 2021 to October 2022 prospectively were selected and divided into 4 groups， each with 25 cases， according to different treatment methods. The conventional group received routine rehabilitation treatment， the FES group received FES rehabilitation cycling treatment in addition to the conventional group， the PNF group received PNF technique treatment in addition to the conventional group， and the combined group received PNF combined with FES rehabilitation cycling treatment， with a total treatment duration of 8 weeks. The functional ambulation category （FAC）， timed up-and-go test （TUG）， gait parameters （weight-bearing symmetry score， affected side contact time）， and changes in ［modified Ashworth scale （MAS） score］ were compared before treatment and at 4 and 8 weeks after treatment in the 4 groups of patients.
Results
Before treatment， there were no statistically significant differences in FAC scores， TUG time， weight-bearing symmetry scores， affected side contact time， and MAS scores among the four groups of patients （P＞0.05）. After 4 and 8 weeks of treatment， the FAC score， TUG time， weightbearing symmetry score， affected side ground contact time， and MAS score of the four groups improved significantly compared to before treatment， and the differences were statistically significant （P＜0.05）. The FAC score and affected side ground contact time of the combined group increased with time， while the TUG time， weight-bearing symmetry score， and MAS score decreased with time， those of the combined group were superior to those of the other three groups， and the differences were statistically significant （P＜0.05）.
Conclusion
The combination of PNF technology and FES rehabilitation treadmill can improve the walking function and muscle tone of stroke patients to a certain extent， and enhance the stability of walking.
To investigate the impact of virtual reality-based multimodal neurorehabilitation technology combined with mirror therapy and low-frequency pulsed electrical stimulation on the hand function recovery of patients with hemiplegia due to stroke.
Methods
A total of 248 patients with hemiplegia due to stroke who received rehabilitation treatment in the Rehabilitation Medicine Department of Jiangsu Provincial （Suqian） Hospital from January 2021 to December 2023 were prospectively selected and randomly divided into a study group and a control group using a random number table method， with 124 cases in each group. The control group received treatment with mirror therapy combined with lowfrequency pulsed electrical stimulation， while the study group added virtual reality technology on this basis. The hand function and activities of daily living were assessed using the Fugl-Meyer assessmentupper extremity scale （FMA-UE）， grip strength test， and the modified Barthel index （MBI）. Follow up for 6 months， the incidence of complications in 2 groups of patients were recorded.
Results
The study group showed significantly greater improvements in FMA-UE scores， grip strength， and MBI scores compared to the control group （P＜0.05）. After 6 months of follow-up， the incidence of complications in the study group was lower than that in the control group， and the difference was statistically significant （P＜0.05）.
Conclusion
Virtual reality-based multimodal neurorehabilitation technology combined with mirror therapy and low-frequency pulsed electrical stimulation can effectively promote the recovery of hand function and daily living abilities in stroke patients.
To investigate the effects of different modes of transcranial direct current stimulation （tDCS） on the lateral right cerebellum combined with language training on the language function of patients with post-stroke aphasia （PSA）.
Methods
The study was designed with before-after study in the same individuals. A total of 18 patients with PSA who were hospitalized in the Rehabilitation Medicine Department of Longgang District People's Hospital of Shenzhen from February 2022 to July 2024 were selected， they had to complete three stages of treatment， namely 1 week of tDCS pseudostimulation+language training， 1 week of tDCS anodic stimulation of the right lateral cerebellum+language training， and 1 week of tDCS cathodic stimulation of the right lateral cerebellum+language training. The sequence of the 3 phases varies， with each phase spaced 1 d apart. Patients are given a diagram naming test and an auditory word diagram matching test before and after each stage. The changes in test accuracy before and after treatment at each stage， as well as the difference in the degree of improvement of accuracy after stimulation by different tDCS modes were analyzed.
Results
When tDCS anodic stimulates the right lateral cerebellum， the improvement of image naming and auditory comprehension accuracy before and after treatment was significantly higher than that of pseudo-stimulation （P＜0.05），while cathodal tDCS applied to the right lateral cerebellum showed no significant difference in improvement compared with sham stimulation （P＞0.05）.
Conclusion
Anodal tDCS stimulation of the right lateral cerebellum can enhance the improvement degree of picture naming and auditory comprehension abilities in PSA patients.
Meningiomas occluding the superior sagittal sinus （SSS） present a significant surgical challenge. Given the intricate relationship between tumor tissue and venous structures， there is no consensus on the optimal surgical approach. Depending on the origin of the tumor， meningiomas associated with the SSS can be classified into two types： type Ⅰ （parasagittal meningiomas） and type Ⅱ（sagittal sinus meningiomas）. Both types exhibit distinct imaging characteristics and require different surgical strategies. Preoperative evaluation of the venous collateral circulation surrounding the tumor is essential to assess venous compensatory capacity and guide intraoperative decision-making. This video focuses on maximizing tumor resection while preserving venous integrity.
