目的研究手部陈旧性屈指肌腱断裂的重建修复方案的治疗效果。方法选择2014年1月—2016年1月青海大学附属医院创伤骨科收治的手部陈旧性屈指肌腱断裂患者63例,根据损伤肌腱部位按照解剖区域分为Ⅰ~Ⅴ五区。随机分为治疗组32例和对照组31...目的研究手部陈旧性屈指肌腱断裂的重建修复方案的治疗效果。方法选择2014年1月—2016年1月青海大学附属医院创伤骨科收治的手部陈旧性屈指肌腱断裂患者63例,根据损伤肌腱部位按照解剖区域分为Ⅰ~Ⅴ五区。随机分为治疗组32例和对照组31例。其中,治疗组采取分期改良手术即一期植入硅胶管、二期植入掌长肌(由可吸收生物膜即脑磷脂和卵磷脂材料包裹)重建其屈指肌腱结构并恢复其功能;对照组患者给予延迟活动治疗。两组患者术后通过总主动活动度(total active movement,TAM)测定以及功能独立性评定(functional independence measure,FIM)综合评估患者屈指肌腱功能重建情况,分析治疗效果。结果随访第12周,TAM评级治疗组为优者26例,对照组7例,治疗组明显优于对照组(χ~2=15.00,P<0.05);FIM评分治疗组(36.1±6.2),对照组(24.8±8.3),治疗组活动度范围显著优于对照组(t=5.97,P<0.05),治疗组其术后功能重建效果满意。结论改良手术能够明显提高手部陈旧性屈指肌腱断裂患者的重建修复效果,手术效果的提升得益于肌腱粘连的避免,值得临床深入研究和推广。展开更多
An accelerometry-based gait analysis approach via the platform of sensor network is reported in this paper. The hardware units of the sensor network are wearable accelerometers that are attached at the limbs of human ...An accelerometry-based gait analysis approach via the platform of sensor network is reported in this paper. The hardware units of the sensor network are wearable accelerometers that are attached at the limbs of human body. For the specific task of gait analysis, flexion angles of the thighs during gait cycles are computed. A Kalman filter is designed to estimate the flexion-extension angle, angular velocity of the thigh using the output of the wearable accelerometers. The proposed approach has been applied to four subjects and the performance is compared with video-based approach. Comparative results indicate that with the proposed Kalman filter, the sensor network is able to track the movement of the thighs during gait cycles with good accuracy and simultaneously detect major gait event of foot contact from the waveform of the angular velocity.展开更多
Background There are few effective methods for treating injuries to the lower trunk of brachial plexus, and the curative effect is usually poor. The purpose of this study was to provide anatomic references for transfe...Background There are few effective methods for treating injuries to the lower trunk of brachial plexus, and the curative effect is usually poor. The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve （BMBMCN） for selective neurotization of finger flexion in brachial plexus lower trunk injury, and to evaluate its clinical curative effects.Methods Microanatomy and measurement were done on 50 limbs from 25 adult human cadavers to observe the origin, branch, type of the BMBMCN and median nerve, as well as their adjacent structures. Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed. In addition, the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers. Acetylcholinesterase （AchE） staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers. This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury. These cases were followed up for 3, 6, 9 and 12 months postoperatively. Recovery of function, grip strength, nerve electrophysiology and muscle power of the affected limbs were observed and measured.Results The brachialis muscle was totally innervated by the musculocutaneous nerve （MCN）. Based on the Hunter＇s line, the level of the origin of the BMBMCN was （13.18±.2.77）cm. Ache histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers. At the level of the BMBMCN, the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with Ache stain. The posterior fascicular group was mainly composed of anterior interosseous nerves and branches to the palmaris Iongus. The technique was tested in six fresh cadavers successfully, except that stoma split occurred in one case. Five of the six cases recovere展开更多
Purpose： To determine the effect of the posterior condylar offset （PCO） on clinical results after total knee arthroplasty （TKA） using a high-flex posterior-stabilized （PS） fixed-bearing prosthesis. Methods： We...Purpose： To determine the effect of the posterior condylar offset （PCO） on clinical results after total knee arthroplasty （TKA） using a high-flex posterior-stabilized （PS） fixed-bearing prosthesis. Methods： We prospectively studied the clinical and radiographic materials of 89 consecutive female patients （89 knees）, who had undergone primary TKAs for end-stage osteoarthritis. All operations were performed by a single senior surgeon or under his supervision using the same operative technique. Based on the corrected PCO change, we divided all cases into two groups： group A （corrected PCO change _〉0 mm, 58 knees） and group B （corrected PCO change 〈0 ram, 31 knees）. One-year postoperatively, clinical and radiographic variables from the two groups were compared by independent t-test. The as- sociations between the corrected PCO changes and the improvements of clinical variables in all patients were analyzed by Pearson linear correlation. Results： One-year postoperatively, the Knee Society Scores, the Western Ontario and McMaster Uni- versities Osteoarthritis Index, non-weight-bearing active and passive range of knee flexion, flexion contracture, extensor lag, and their improvements had no statistical differences between the two groups （all p 〉 0.05）. The corrected PCO change was not significantly correlated with the improvement of any clinical variable （all p 〉 0.05）. Group A demonstrated greater flexion than group B during active weight bearing （p 〈 0.05）. Conclusions： Restoration of PCO plays an important role in the optimization of active knee flexion during weight-bearing conditions after posterior-stabilized TKA, while it has no benefit to non-weight-bearing knee flexion or any other clinical result.展开更多
BACKGROUND Considering the limited effectiveness of clinical interventions for knee osteoarthritis(KOA),it is necessary to continue to explore appropriate and effective treatment strategies to improve the condition of...BACKGROUND Considering the limited effectiveness of clinical interventions for knee osteoarthritis(KOA),it is necessary to continue to explore appropriate and effective treatment strategies to improve the condition of KOA patients.AIM To clarify the influence of ankle flexion and extension exercises combined with a psychological intervention on the psychological status and activities of daily living(ADLs)of patients with KOA.METHODS The research participants were 116 KOA patients admitted to The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine between May 2019 and May 2022,including 54 patients receiving routine treatment,care and psychological intervention(control group)and 62 patients additionally treated with ankle flexion and extension exercises(research group).The two groups were comparatively analyzed in terms of psychological status(Self-rating Anxiety/Depression Scale,SDS/SAS),ADLs,knee joint function(Lysholm Knee Scoring Scale),pain(Visual Analog Scale,VAS),fatigue(Multidimensional Fatigue Inventory,MFI),and quality of life(QoL;Short-Form 36 Item Health Survey,SF-36).RESULTS After evaluation,it was found that the postinterventional SDS,SAS,VAS,and MFI scores in the research group were significantly reduced compared with the baseline(before the intervention)values and those of the control group,while the postinterventional Lysholm,ADL and SF-36 scores were markedly elevated.CONCLUSION Therefore,ankle flexion and extension exercises are highly effective in easing negative psychological status,enhancing ADLs,daily living ability,knee joint function and QoL,and relieving pain and fatigue in KOA patients,thus warranting clinical promotion.展开更多
Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functio...Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.展开更多
Purpose The present study examined the effects of a reciprocal,slow velocity forearm flexion and extension task on fatigue-induced changes in isokinetic torque,agonist and antagonist muscle activation,and coactivation...Purpose The present study examined the effects of a reciprocal,slow velocity forearm flexion and extension task on fatigue-induced changes in isokinetic torque,agonist and antagonist muscle activation,and coactivation ratios at slow and moderate velocities.Methods Nine women(mean±SD:age=21.0±1.7 years;body mass=68.1±8.2 kg;height=167.4±7.2 cm)completed pre-testing for forearm flexion and extension isokinetic peak torque at 60 and 180°/s,a fatiguing task of 50 maximal,recip-rocal,isokinetic muscle actions at 60°/s,and post-testing.The amplitude(AMP)of the electromyographic(EMG)signals from the biceps and triceps were simultaneously recorded.Torque and EMG AMP were normalized to the corresponding values from the pre-testing peak torque movements.Repeated measures ANOVAs and pairwise comparisons were used to identify mean changes in torque,EMG AMP,and coactivation ratios.Results The torque analyses indicated significant decreases from pre-to post-testing for forearm flexion(14.1%±5.0%;P<0.001)and extension(25.4%±12.2%;P<0.001)at 60°.At 180°/s there was a significant decrease,collapsed across the forearm movements(24.7%±11.7%;P<0.001).For EMG AMP and coactivation ratios,there were no changes(P>0.05)from pre-to post-testing for either velocity or movement.Conclusions The torque responses were velocity-specific,with greater fatigability exhibited for forearm extension versus flexion at 60°/s,but no differences at 180°/s.The parallel EMG AMP responses between the agonist and antagonist muscles for both velocities supported the lack of fatigue-induced changes in coactivation ratios.Thus,our results demonstrated that fatigue-induced decreases in torque were not attributable to increases in antagonist activation or coactivation.展开更多
文摘目的研究手部陈旧性屈指肌腱断裂的重建修复方案的治疗效果。方法选择2014年1月—2016年1月青海大学附属医院创伤骨科收治的手部陈旧性屈指肌腱断裂患者63例,根据损伤肌腱部位按照解剖区域分为Ⅰ~Ⅴ五区。随机分为治疗组32例和对照组31例。其中,治疗组采取分期改良手术即一期植入硅胶管、二期植入掌长肌(由可吸收生物膜即脑磷脂和卵磷脂材料包裹)重建其屈指肌腱结构并恢复其功能;对照组患者给予延迟活动治疗。两组患者术后通过总主动活动度(total active movement,TAM)测定以及功能独立性评定(functional independence measure,FIM)综合评估患者屈指肌腱功能重建情况,分析治疗效果。结果随访第12周,TAM评级治疗组为优者26例,对照组7例,治疗组明显优于对照组(χ~2=15.00,P<0.05);FIM评分治疗组(36.1±6.2),对照组(24.8±8.3),治疗组活动度范围显著优于对照组(t=5.97,P<0.05),治疗组其术后功能重建效果满意。结论改良手术能够明显提高手部陈旧性屈指肌腱断裂患者的重建修复效果,手术效果的提升得益于肌腱粘连的避免,值得临床深入研究和推广。
基金Supported by Science & Engineering Research Council of Singapore (052 118 0052)
文摘An accelerometry-based gait analysis approach via the platform of sensor network is reported in this paper. The hardware units of the sensor network are wearable accelerometers that are attached at the limbs of human body. For the specific task of gait analysis, flexion angles of the thighs during gait cycles are computed. A Kalman filter is designed to estimate the flexion-extension angle, angular velocity of the thigh using the output of the wearable accelerometers. The proposed approach has been applied to four subjects and the performance is compared with video-based approach. Comparative results indicate that with the proposed Kalman filter, the sensor network is able to track the movement of the thighs during gait cycles with good accuracy and simultaneously detect major gait event of foot contact from the waveform of the angular velocity.
文摘Background There are few effective methods for treating injuries to the lower trunk of brachial plexus, and the curative effect is usually poor. The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve （BMBMCN） for selective neurotization of finger flexion in brachial plexus lower trunk injury, and to evaluate its clinical curative effects.Methods Microanatomy and measurement were done on 50 limbs from 25 adult human cadavers to observe the origin, branch, type of the BMBMCN and median nerve, as well as their adjacent structures. Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed. In addition, the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers. Acetylcholinesterase （AchE） staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers. This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury. These cases were followed up for 3, 6, 9 and 12 months postoperatively. Recovery of function, grip strength, nerve electrophysiology and muscle power of the affected limbs were observed and measured.Results The brachialis muscle was totally innervated by the musculocutaneous nerve （MCN）. Based on the Hunter＇s line, the level of the origin of the BMBMCN was （13.18±.2.77）cm. Ache histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers. At the level of the BMBMCN, the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with Ache stain. The posterior fascicular group was mainly composed of anterior interosseous nerves and branches to the palmaris Iongus. The technique was tested in six fresh cadavers successfully, except that stoma split occurred in one case. Five of the six cases recovere
文摘Purpose： To determine the effect of the posterior condylar offset （PCO） on clinical results after total knee arthroplasty （TKA） using a high-flex posterior-stabilized （PS） fixed-bearing prosthesis. Methods： We prospectively studied the clinical and radiographic materials of 89 consecutive female patients （89 knees）, who had undergone primary TKAs for end-stage osteoarthritis. All operations were performed by a single senior surgeon or under his supervision using the same operative technique. Based on the corrected PCO change, we divided all cases into two groups： group A （corrected PCO change _〉0 mm, 58 knees） and group B （corrected PCO change 〈0 ram, 31 knees）. One-year postoperatively, clinical and radiographic variables from the two groups were compared by independent t-test. The as- sociations between the corrected PCO changes and the improvements of clinical variables in all patients were analyzed by Pearson linear correlation. Results： One-year postoperatively, the Knee Society Scores, the Western Ontario and McMaster Uni- versities Osteoarthritis Index, non-weight-bearing active and passive range of knee flexion, flexion contracture, extensor lag, and their improvements had no statistical differences between the two groups （all p 〉 0.05）. The corrected PCO change was not significantly correlated with the improvement of any clinical variable （all p 〉 0.05）. Group A demonstrated greater flexion than group B during active weight bearing （p 〈 0.05）. Conclusions： Restoration of PCO plays an important role in the optimization of active knee flexion during weight-bearing conditions after posterior-stabilized TKA, while it has no benefit to non-weight-bearing knee flexion or any other clinical result.
文摘BACKGROUND Considering the limited effectiveness of clinical interventions for knee osteoarthritis(KOA),it is necessary to continue to explore appropriate and effective treatment strategies to improve the condition of KOA patients.AIM To clarify the influence of ankle flexion and extension exercises combined with a psychological intervention on the psychological status and activities of daily living(ADLs)of patients with KOA.METHODS The research participants were 116 KOA patients admitted to The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine between May 2019 and May 2022,including 54 patients receiving routine treatment,care and psychological intervention(control group)and 62 patients additionally treated with ankle flexion and extension exercises(research group).The two groups were comparatively analyzed in terms of psychological status(Self-rating Anxiety/Depression Scale,SDS/SAS),ADLs,knee joint function(Lysholm Knee Scoring Scale),pain(Visual Analog Scale,VAS),fatigue(Multidimensional Fatigue Inventory,MFI),and quality of life(QoL;Short-Form 36 Item Health Survey,SF-36).RESULTS After evaluation,it was found that the postinterventional SDS,SAS,VAS,and MFI scores in the research group were significantly reduced compared with the baseline(before the intervention)values and those of the control group,while the postinterventional Lysholm,ADL and SF-36 scores were markedly elevated.CONCLUSION Therefore,ankle flexion and extension exercises are highly effective in easing negative psychological status,enhancing ADLs,daily living ability,knee joint function and QoL,and relieving pain and fatigue in KOA patients,thus warranting clinical promotion.
基金supported by the National Natural Science Foundation of China,No.81371663,61534003the Top-notch Academic Programs Project of Jiangsu Higher Education Institutions of China,No.PPZY2015B135
文摘Rebuilding the damaged motor function caused by spinal cord injury is one of the most serious challenges in clinical neuroscience.The function of the neural pathway under the damaged sites can be rebuilt using functional electrical stimulation technology.In this study,the locations of motor function sites in the lumbosacral spinal cord were determined with functional electrical stimulation technology.A three-dimensional map of the lumbosacral spinal cord comprising the relationship between the motor function sites and the corresponding muscle was drawn.Based on the individual experimental parameters and normalized coordinates of the motor function sites,the motor function sites that control a certain muscle were calculated.Phasing pulse sequences were delivered to the determined motor function sites in the spinal cord and hip extension,hip flexion,ankle plantarflexion,and ankle dorsiflexion movements were successfully achieved.The results show that the map of the spinal cord motor function sites was valid.This map can provide guidance for the selection of electrical stimulation sites during the rebuilding of motor function after spinal cord injury.
文摘Purpose The present study examined the effects of a reciprocal,slow velocity forearm flexion and extension task on fatigue-induced changes in isokinetic torque,agonist and antagonist muscle activation,and coactivation ratios at slow and moderate velocities.Methods Nine women(mean±SD:age=21.0±1.7 years;body mass=68.1±8.2 kg;height=167.4±7.2 cm)completed pre-testing for forearm flexion and extension isokinetic peak torque at 60 and 180°/s,a fatiguing task of 50 maximal,recip-rocal,isokinetic muscle actions at 60°/s,and post-testing.The amplitude(AMP)of the electromyographic(EMG)signals from the biceps and triceps were simultaneously recorded.Torque and EMG AMP were normalized to the corresponding values from the pre-testing peak torque movements.Repeated measures ANOVAs and pairwise comparisons were used to identify mean changes in torque,EMG AMP,and coactivation ratios.Results The torque analyses indicated significant decreases from pre-to post-testing for forearm flexion(14.1%±5.0%;P<0.001)and extension(25.4%±12.2%;P<0.001)at 60°.At 180°/s there was a significant decrease,collapsed across the forearm movements(24.7%±11.7%;P<0.001).For EMG AMP and coactivation ratios,there were no changes(P>0.05)from pre-to post-testing for either velocity or movement.Conclusions The torque responses were velocity-specific,with greater fatigability exhibited for forearm extension versus flexion at 60°/s,but no differences at 180°/s.The parallel EMG AMP responses between the agonist and antagonist muscles for both velocities supported the lack of fatigue-induced changes in coactivation ratios.Thus,our results demonstrated that fatigue-induced decreases in torque were not attributable to increases in antagonist activation or coactivation.
