Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical managemen...Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.展开更多
To achieve human lower limbs rehabilitation training, the exoskeleton lower limbs rehabilitation robot is designed. Through respective motor driving, the retarding mechanism and telescopic adjusting mechanism, the fun...To achieve human lower limbs rehabilitation training, the exoskeleton lower limbs rehabilitation robot is designed. Through respective motor driving, the retarding mechanism and telescopic adjusting mechanism, the function of human walking is accomplished. After the design of the mechanical structure, the finite element analysis is carried out on the important parts and the control system is achieved by Single Chip Microcomputer.展开更多
Objective: To describe the epidemiological, clinical and paraclinical characteristics of osteoarthritis of the lower limbs in obese patients at the Cocody University Teaching Hospital. Methodology: This was an analyti...Objective: To describe the epidemiological, clinical and paraclinical characteristics of osteoarthritis of the lower limbs in obese patients at the Cocody University Teaching Hospital. Methodology: This was an analytical cross-sectional study carried out in the rheumatology department of the Cocody UTH in Abidjan (Ivory Coast) from March 1 to April 30 2023. Patients who came for rheumatology consultation presenting with mechanical arthralgia of the lower limbs, who were obese, had radiographic images were included. All patients without radiographic images were excluded. Obesity was defined as a body mass index (BMI) greater than or equal to 30 kg/m. The Chi<sup>2</sup> test was used to compare proportions and determine the existence of associations between osteoarthristis and obesity, obesity severity and radiographic stage of osteoarthritis as well as the functional impact. A p-value below a predefined threshold (p = 0,05) indicates a significant relationship between the variables. Result: Out of 185 patients received for osteoarthritis of the lower limbs during the study period, 136 were obese (74%). There were 115 women (84.6%) with an average age of 56.03 with a standard deviation of 12.72 years (extremes: 22 and 84 years). The main socio-professional category was the informal sector (30%). The majority of patients had a low socio-economic level (80.2%) and lived in urban areas (92.6%). The most common past medical history was hypertension (33.08%) followed by peptic ulcer disease (16.91%). Patients had a body mass index class 1 (81.6%), class 2 (15.40%) and class 3 (2.90%). The average duration of symptom progression until diagnosis was 11 months. Genu varum was the main static disorder (56.10%) and the knee joint was the dominant topography (90.4%) with a bilateral localization (80%). The average Lequesne index was greater than 8 (59.5%). The Kellgren and Lawrence radiographic stages were stage 1 (9.20%), stage 2 (46.90%), stage 3 (29.20%) and stage 4 (6.90%). The Obesity severity was significantly associated with osteoarthritis of the knee (p = 0.042). There was no statistically significant association between obesity severity and radiographic stage of osteoarthritis (p = 0.163) or functional impact (p = 0.180). Conclusion: Osteoarthritis of the lower limbs affected obese women and was dominated by stage 2 osteoarthritis of the knee (Kellgren and Lawrence). There is an association between the severity of obesity and osteoarthritis of the knee.展开更多
Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, ...Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, and carries an increased risk of morbidity and mortality. The aim of this study was to assess the knowledge of patients and their carers about obliterative arteriopathy of the lower limbs at Conakry University Hospital. Material and Methods: We conducted a descriptive cross-sectional study lasting 3 months, from March 12 to June 12, 2022 in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). Following free and informed consent, they were interviewed on the basis of a pre-established questionnaire. Socio-demographic data (age, gender, level of education) were collected, and knowledge of obliterative arterial disease of the lower limbs. Results: The study involved 159 people, comprising 106 patients (66.66%) and 53 accompanying persons (33.34%) in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). The 60 to 79 age group was the most represented (44.7%), with an average age of 55.4 ± 15.9 years and extremes of 20 to 84 years. Half (47.8%) had not attended school, and almost all (96.4%) of those who had attended school had a low level of education (primary and secondary). Almost all of them (91.2%) had never heard of AOMI. Only 5% identified at least one risk factor, diabetes, hypertension and smoking. Amputation was the most frequently identified complication. About 98% did not know that AOMI is associated with myocardial infarction and stroke, and 93.7% did not know of any complications. Almost all the participants (99.4%) had poor knowledge of the following complications. Conclusion: Obliterative arterial disease of the lower limbs could be prevented or delayed by screening and controlling risk factors. Our results show a huge deficit in knowledge of this pathology, including risk factors, preventive measures, clinical signs and complications among patients and their relatives. A study conducted outside the hospital environment would provide a better understanding of the extent to which the general population is unaware of this disease.展开更多
Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the ...Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.展开更多
Objective: to evaluate the value of echocardiography and deep venous ultrasound in the diagnosis of PTE. Fifty patients with PTE who were admitted to our hospital from January 2019 to January 2020 were selected and th...Objective: to evaluate the value of echocardiography and deep venous ultrasound in the diagnosis of PTE. Fifty patients with PTE who were admitted to our hospital from January 2019 to January 2020 were selected and the diagnosis results were analyzed based on the ultrasonic examination of deep veins of lower limbs. Results: a total of 42 cases of right heart enlargement, 8 cases of expansion of the main pulmonary artery and its left and right branches, 2 cases of echo, 2 cases of hyperecho and 2 cases of isoecho were observed. The deep veins of lower limbs were mainly DVT of unilateral or bilateral lower limbs. Conclusion: the clinical value of combined echocardiography and deep venous ultrasound in the diagnosis of PTE is discussed in order to provide reference for early detection of PTE.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> An open fracture is an injury in which the fracture site and/or hematom...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and lead</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of January 2015 to the 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">40 </span><span style="font-family:Verdana;">years. There were 147 (75.4%) males and 48 (24.6%) females giving a sex-ratio</span><span style="font-family:Verdana;"> of 3.1:1. The most common cause was road traffic crashes 142 (72.8%). In 98 cases (50.3%)</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the left side was more involved. The tibia was the most common long bone affected in 75 (38.5%) cases. Comminuted fracture was the most common fracture pattern encountered in 126 cases (64.6%). A total of 76 (39%) fractures were graded Gustilo-Anderson IIIA. External fixator was used in 112 cases (57.1%) and internal fixator in 86 cases (42.9%). We recorded 127 (65.1%) cases of wound infection and 143 (73.3%) cases of limb shortening as the most common complications. Other complications include</span><span style="font-family:Verdana;">: </span><span style="font-family:Verdana;">20 cases (17.1%) of mal-union, 27 cases (22.5%) of delayed union, 18 cases (15.1%) of non-union and 50 cases (38.5%) chronic osteomyelitis. We recorded a mortality of 2.1%. Gustilo IIIB and IIIC were associated to chronic osteomyelitis (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.02). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Open fractures of long bones of the lower limb affect the active age group of the population and road traffic crashes</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">are the most common causes. It tends to affect the left side and the tibia being the most fractured long bone. A reasonable proportion of these fractures subsequently get infected. Comminuted fracture is the common fracture pattern.</span>展开更多
Objective: this study aims to explore a new clinical multiparameter diagnostic formula for lower limb atherosclerotic stenosis / occlusion based on the retrospective data of 429 patients at Peking University Hospital....Objective: this study aims to explore a new clinical multiparameter diagnostic formula for lower limb atherosclerotic stenosis / occlusion based on the retrospective data of 429 patients at Peking University Hospital. Methods: this study is a retrospective study. A number of patients with color Doppler ultrasound from November 2013 to October 2021 and improved the test and measurement of common risk factors for atherosclerosis in the same period. A total of 429 cases were selected as the study data. According to the color Doppler ultrasound results, it was divided into the "normal / plaque group" and the "stenosis / occlusion group", including 300 cases in the "normal / plaque group" and 129 cases in the stenosis / occlusion group. Variables included in the diagnostic model screening in this study included age, sex, BMI, ApoA1, ApoB, HbA1c, Hcy, SUA, T C, L DL-C, H DL-C, TG, and blood pressure. Diagnostic models were constructed using logistic regression for variable screening using backward methods. Diagnostic efficacy was evaluated using ROC curves for both single measures and the final diagnostic formula. Results: after a variable screening, The final diagnostic formula is as follows: 0.07 Age (year) + Gender (male value of 0);Female value of-1.38) + HDL-C (normal value of 0;Low side to take a value of 0.79;High value-0.71) + ApoA1 (normal value 0;Low side to take the value of-0.75;High value-0.04) + HbA1c (normal value 0;High value 0.54) + SUA (normal value 0;High value-1.19) + B P (normal value 0;Normal high value value-0.67;Hypertension values were taken at 0.11) -5.17. The optimal threshold of this diagnostic formula is-0.852, specificity of 0.713, sensitivity of 0.760, and the area under the ROC curve is 0.79, which is greater than the area under the R OC curve of any single index in the diagnostic formula. It is a new index of more diagnostic value than other single risk factor indicators in the formula. Conclusion: the diagnosis of lower limb atherosclerotic stenosis / occlusion is of good clinical utility, and the first attempt to use the integration of atherosclerosis risk factors for multiple parameters, and then derive a new diagnostic index, providing a new idea and method for the prevention and treatment of atherosclerosis.展开更多
Objective: to study and analyze the value of computer body layer scanning angiography (CTA) imaging used in lower extremity vascular occlusion lesions. Methods: 30 patients with suspected lower limb vascular occlusive...Objective: to study and analyze the value of computer body layer scanning angiography (CTA) imaging used in lower extremity vascular occlusion lesions. Methods: 30 patients with suspected lower limb vascular occlusive disease admitted to our hospital from May 2021 to January 2022 were included. The examinations received in the hospital included CTA imaging and digital subtraction angiography. The later examination results were the gold standard to evaluate the diagnostic efficacy of CTA imaging in lower limb vascular occlusive disease. Results: in this group, 27 suspected cases of lower extremity vascular diseases were confirmed by digital subtraction angiography, including 7 cases of lower extremity vascular occlusion, 20 cases of lower extremity vascular stenosis (8 cases of severe, 8 cases of moderate, 4 cases of mild), 26 cases of lower extremity vascular diseases diagnosed by CTA, 7 cases of lower extremity vascular occlusion, 19 cases of lower extremity vascular stenosis (7 cases of severe, 8 cases of moderate, 4 cases of mild). There was no statistical difference in the detection rate of disease types between the two examination methods (P > 0.05). With reference to digital subtraction angiography, the coincidence rate, specificity and sensitivity of CTA imaging in the diagnosis of lower limb vascular occlusive diseases were 96.67%, 100.00% and 96.30% respectively. Conclusion: the sensitivity and specificity of CTA in the diagnosis of lower extremity vascular occlusive disease are both high.展开更多
BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neu...BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.展开更多
Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients....Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.展开更多
Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age w...Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
The lower limb assisted exoskeleton is a prominent area of research within the field of exoskeleton technology.However,several challenges remain,including the development of flexible actuators,high battery consumption...The lower limb assisted exoskeleton is a prominent area of research within the field of exoskeleton technology.However,several challenges remain,including the development of flexible actuators,high battery consumption,the risk of joint misalignment,and limited assistive capabilities.This paper proposes a compact flexible actuator incorporating two elastic elements named Adjustable Energy Storage Series Elastic Actuator(AES-SEA),which combining an adjustable energy storage device with a series elastic actuator for application in exoskeleton hip joints.This design aims to enhance energy efficiency and improve assistive effects.Subsequently,we introduce a novel knee joint bionic structure based on a pulley-groove configuration and a four-link mechanism,designed to replicate human knee joint motion and prevent joint misalignment.Additionally,we propose an innovative controller that integrates concepts from Linear Quadratic Regulator(LQR)control and virtual tunnel for level walking assistance.This controller modulates the assisted reference trajectory using the virtual tunnel concept,enabling different levels of assistance both inside and outside the tunnel by adjusting the parameters Q and R.This approach enhances the assisting force while ensuring the safety of human-computer interaction.Finally,metabolic experiments were conducted to evaluate the effectiveness of the exoskeleton assistance.展开更多
To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a...To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a non-fully anthropomorphic design,attaching only at the thigh and ankle with a backward-knee configuration to mimic natural human knee movement.The design incorporates a single elastic element at the hip for gravity compensation and dual elastic elements at the knee for terrain adaptability,which adjust based on walking context.The design’s effectiveness was assessed by measuring metabolic cost reduction and motor output torque under various walking conditions.Results showed significant metabolic cost savings of 5.8–8.8%across different speeds and a 7.9%reduction during 9°incline walking on a flat indoor surface.Additionally,the spring element decreased hip motor output torque by 7–15.9%and knee torque by 8.1–14.2%.Outdoor tests confirmed the design’s robustness and effectiveness in reducing motor torque across terrains,highlighting its potential to advance multi-terrain adaptive exoskeleton research.展开更多
Gait coordination in lower limbs plays a critical role in maintaining stability of the human body during walking.For transfemoral amputees,the absence of limbs disrupts this coordination,reducing prosthesis control ac...Gait coordination in lower limbs plays a critical role in maintaining stability of the human body during walking.For transfemoral amputees,the absence of limbs disrupts this coordination,reducing prosthesis control accuracy.Hip-knee coordination mapping offers a feasible solution for lower-limb prosthesis control,involving the generation of a reference trajectory for the knee joint by leveraging information from the hip.However,current reference trajectories are usually derived from static models,which cannot generate reference trajectories robustly when dealing with perturbations.Therefore,this paper introduces a time-dependent model based on the Delayed Feedback Reservoir(DFR)for hip-knee coordination in lower-limb prosthetic control.Experimental results show that DFR outperforms classical gait planning approaches when facing perturbations,achieving a 20%lower Root Mean Square Error(RMSE)and reducing residuals by up to 18.14 degrees.This research contributes to understanding gait mapping approaches and emphasizes the potential of time-dependent models for robust and strong lower-limb prosthetic control.The discovery provides a novel way to enhance the perturbation adaptability of prosthetic control.展开更多
BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicat...BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications.However,the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus(T2DM).AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis(n=1913)and lower limb atherosclerosis groups(n=2515)based on lower limb arterial ultrasonography results.At hospital admission,baseline serum RBP levels were assessed,and all subjects were categorized into three groups(Q1-Q3)based on RBP tertiles.Logistic regression,restricted cubic spline regression,subgroup analysis,and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.RESULTS Among 4428 individuals with T2DM,2515(56.80%)had lower limb atherosclerosis.Logistic analysis showed that lower limb atherosclerosis risk increased by 1%for every 1 unit rise in serum RBP level(odds ratio=1.01,95%confidence interval:1.00-1.02,P=0.004).Patients in the highest tertile group(Q3)had a higher lower limb atherosclerosis risk compared to the lowest tertile group(Q1)(odds ratio=1.36,95%confidence interval:1.12-1.67,P=0.002).The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile(P for trend=0.005).Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk(non-linear P<0.05).Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.展开更多
Focusing on the rehabilitation training of hemiplegia patients,this paper proposes a gait-planning strategy based on a central pattern generator and an adaptive time-delay control scheme that utilizes recursive termin...Focusing on the rehabilitation training of hemiplegia patients,this paper proposes a gait-planning strategy based on a central pattern generator and an adaptive time-delay control scheme that utilizes recursive terminal sliding mode for lower limb rehabilitation exoskeleton robots.The central pattern generator network plans a reference gait trajectory for the affected leg,synchronized with the movement of the healthy leg.The proposed adaptive time-delay control scheme possesses a model-independent property due to the mechanism of time-delay estimation,with adaptive control gains that enhance the resilience against system perturbations and a recursive terminal sliding mode control component to achieve a fast convergence rate.According to the Lyapunov stability criterion,it is proved that the gait trajectory-tracking error is uniformly ultimately bounded.Experiments are conducted on a lower limb exoskeleton experimental platform,and the experimental results demonstrate the effectiveness and superiority of the proposed strategies.展开更多
As an essential tool for quantitative analysis of lower limb coordination,optical motion capture systems with marker-based encoding still suffer from inefficiency,high costs,spatial constraints,and the requirement for...As an essential tool for quantitative analysis of lower limb coordination,optical motion capture systems with marker-based encoding still suffer from inefficiency,high costs,spatial constraints,and the requirement for multiple markers.While 3D pose estimation algorithms combined with ordinary cameras offer an alternative,their accuracy often deteriorates under significant body occlusion.To address the challenge of insufficient 3D pose estimation precision in occluded scenarios—which hinders the quantitative analysis of athletes’lower-limb coordination—this paper proposes a multimodal training framework integrating spatiotemporal dependency networks with text-semantic guidance.Compared to traditional optical motion capture systems,this work achieves low-cost,high-precision motion parameter acquisition through the following innovations:(1)spatiotemporal dependency attention module is designed to establish dynamic spatiotemporal correlation graphs via cross-frame joint semantic matching,effectively resolving the feature fragmentation issue in existing methods.(2)noise-suppressed multi-scale temporal module is proposed,leveraging KL divergence-based information gain analysis for progressive feature filtering in long-range dependencies,reducing errors by 1.91 mm compared to conventional temporal convolutions.(3)text-pose contrastive learning paradigm is introduced for the first time,where BERT-generated action descriptions align semantic-geometric features via the BERT encoder,significantly enhancing robustness under severe occlusion(50%joint invisibility).On the Human3.6M dataset,the proposed method achieves an MPJPE of 56.21 mm under Protocol 1,outperforming the state-of-the-art baseline MHFormer by 3.3%.Extensive ablation studies on Human3.6M demonstrate the individual contributions of the core modules:the spatiotemporal dependency module and noise-suppressed multi-scale temporal module reduce MPJPE by 0.30 and 0.34 mm,respectively,while the multimodal training strategy further decreases MPJPE by 0.6 mm through text-skeleton contrastive learning.Comparative experiments involving 16 athletes show that the sagittal plane coupling angle measurements of hip-ankle joints differ by less than 1.2°from those obtained via traditional optical systems(two one-sided t-tests,p<0.05),validating real-world reliability.This study provides an AI-powered analytical solution for competitive sports training,serving as a viable alternative to specialized equipment.展开更多
文摘Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.
基金Supported by Science and Technology Department of Anhui Province Regional Innovation Projects and Qiushi Plan(JZ2015QSJH0245)
文摘To achieve human lower limbs rehabilitation training, the exoskeleton lower limbs rehabilitation robot is designed. Through respective motor driving, the retarding mechanism and telescopic adjusting mechanism, the function of human walking is accomplished. After the design of the mechanical structure, the finite element analysis is carried out on the important parts and the control system is achieved by Single Chip Microcomputer.
文摘Objective: To describe the epidemiological, clinical and paraclinical characteristics of osteoarthritis of the lower limbs in obese patients at the Cocody University Teaching Hospital. Methodology: This was an analytical cross-sectional study carried out in the rheumatology department of the Cocody UTH in Abidjan (Ivory Coast) from March 1 to April 30 2023. Patients who came for rheumatology consultation presenting with mechanical arthralgia of the lower limbs, who were obese, had radiographic images were included. All patients without radiographic images were excluded. Obesity was defined as a body mass index (BMI) greater than or equal to 30 kg/m. The Chi<sup>2</sup> test was used to compare proportions and determine the existence of associations between osteoarthristis and obesity, obesity severity and radiographic stage of osteoarthritis as well as the functional impact. A p-value below a predefined threshold (p = 0,05) indicates a significant relationship between the variables. Result: Out of 185 patients received for osteoarthritis of the lower limbs during the study period, 136 were obese (74%). There were 115 women (84.6%) with an average age of 56.03 with a standard deviation of 12.72 years (extremes: 22 and 84 years). The main socio-professional category was the informal sector (30%). The majority of patients had a low socio-economic level (80.2%) and lived in urban areas (92.6%). The most common past medical history was hypertension (33.08%) followed by peptic ulcer disease (16.91%). Patients had a body mass index class 1 (81.6%), class 2 (15.40%) and class 3 (2.90%). The average duration of symptom progression until diagnosis was 11 months. Genu varum was the main static disorder (56.10%) and the knee joint was the dominant topography (90.4%) with a bilateral localization (80%). The average Lequesne index was greater than 8 (59.5%). The Kellgren and Lawrence radiographic stages were stage 1 (9.20%), stage 2 (46.90%), stage 3 (29.20%) and stage 4 (6.90%). The Obesity severity was significantly associated with osteoarthritis of the knee (p = 0.042). There was no statistically significant association between obesity severity and radiographic stage of osteoarthritis (p = 0.163) or functional impact (p = 0.180). Conclusion: Osteoarthritis of the lower limbs affected obese women and was dominated by stage 2 osteoarthritis of the knee (Kellgren and Lawrence). There is an association between the severity of obesity and osteoarthritis of the knee.
文摘Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, and carries an increased risk of morbidity and mortality. The aim of this study was to assess the knowledge of patients and their carers about obliterative arteriopathy of the lower limbs at Conakry University Hospital. Material and Methods: We conducted a descriptive cross-sectional study lasting 3 months, from March 12 to June 12, 2022 in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). Following free and informed consent, they were interviewed on the basis of a pre-established questionnaire. Socio-demographic data (age, gender, level of education) were collected, and knowledge of obliterative arterial disease of the lower limbs. Results: The study involved 159 people, comprising 106 patients (66.66%) and 53 accompanying persons (33.34%) in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). The 60 to 79 age group was the most represented (44.7%), with an average age of 55.4 ± 15.9 years and extremes of 20 to 84 years. Half (47.8%) had not attended school, and almost all (96.4%) of those who had attended school had a low level of education (primary and secondary). Almost all of them (91.2%) had never heard of AOMI. Only 5% identified at least one risk factor, diabetes, hypertension and smoking. Amputation was the most frequently identified complication. About 98% did not know that AOMI is associated with myocardial infarction and stroke, and 93.7% did not know of any complications. Almost all the participants (99.4%) had poor knowledge of the following complications. Conclusion: Obliterative arterial disease of the lower limbs could be prevented or delayed by screening and controlling risk factors. Our results show a huge deficit in knowledge of this pathology, including risk factors, preventive measures, clinical signs and complications among patients and their relatives. A study conducted outside the hospital environment would provide a better understanding of the extent to which the general population is unaware of this disease.
文摘Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.
文摘Objective: to evaluate the value of echocardiography and deep venous ultrasound in the diagnosis of PTE. Fifty patients with PTE who were admitted to our hospital from January 2019 to January 2020 were selected and the diagnosis results were analyzed based on the ultrasonic examination of deep veins of lower limbs. Results: a total of 42 cases of right heart enlargement, 8 cases of expansion of the main pulmonary artery and its left and right branches, 2 cases of echo, 2 cases of hyperecho and 2 cases of isoecho were observed. The deep veins of lower limbs were mainly DVT of unilateral or bilateral lower limbs. Conclusion: the clinical value of combined echocardiography and deep venous ultrasound in the diagnosis of PTE is discussed in order to provide reference for early detection of PTE.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and lead</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of January 2015 to the 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">40 </span><span style="font-family:Verdana;">years. There were 147 (75.4%) males and 48 (24.6%) females giving a sex-ratio</span><span style="font-family:Verdana;"> of 3.1:1. The most common cause was road traffic crashes 142 (72.8%). In 98 cases (50.3%)</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the left side was more involved. The tibia was the most common long bone affected in 75 (38.5%) cases. Comminuted fracture was the most common fracture pattern encountered in 126 cases (64.6%). A total of 76 (39%) fractures were graded Gustilo-Anderson IIIA. External fixator was used in 112 cases (57.1%) and internal fixator in 86 cases (42.9%). We recorded 127 (65.1%) cases of wound infection and 143 (73.3%) cases of limb shortening as the most common complications. Other complications include</span><span style="font-family:Verdana;">: </span><span style="font-family:Verdana;">20 cases (17.1%) of mal-union, 27 cases (22.5%) of delayed union, 18 cases (15.1%) of non-union and 50 cases (38.5%) chronic osteomyelitis. We recorded a mortality of 2.1%. Gustilo IIIB and IIIC were associated to chronic osteomyelitis (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.02). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Open fractures of long bones of the lower limb affect the active age group of the population and road traffic crashes</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">are the most common causes. It tends to affect the left side and the tibia being the most fractured long bone. A reasonable proportion of these fractures subsequently get infected. Comminuted fracture is the common fracture pattern.</span>
文摘Objective: this study aims to explore a new clinical multiparameter diagnostic formula for lower limb atherosclerotic stenosis / occlusion based on the retrospective data of 429 patients at Peking University Hospital. Methods: this study is a retrospective study. A number of patients with color Doppler ultrasound from November 2013 to October 2021 and improved the test and measurement of common risk factors for atherosclerosis in the same period. A total of 429 cases were selected as the study data. According to the color Doppler ultrasound results, it was divided into the "normal / plaque group" and the "stenosis / occlusion group", including 300 cases in the "normal / plaque group" and 129 cases in the stenosis / occlusion group. Variables included in the diagnostic model screening in this study included age, sex, BMI, ApoA1, ApoB, HbA1c, Hcy, SUA, T C, L DL-C, H DL-C, TG, and blood pressure. Diagnostic models were constructed using logistic regression for variable screening using backward methods. Diagnostic efficacy was evaluated using ROC curves for both single measures and the final diagnostic formula. Results: after a variable screening, The final diagnostic formula is as follows: 0.07 Age (year) + Gender (male value of 0);Female value of-1.38) + HDL-C (normal value of 0;Low side to take a value of 0.79;High value-0.71) + ApoA1 (normal value 0;Low side to take the value of-0.75;High value-0.04) + HbA1c (normal value 0;High value 0.54) + SUA (normal value 0;High value-1.19) + B P (normal value 0;Normal high value value-0.67;Hypertension values were taken at 0.11) -5.17. The optimal threshold of this diagnostic formula is-0.852, specificity of 0.713, sensitivity of 0.760, and the area under the ROC curve is 0.79, which is greater than the area under the R OC curve of any single index in the diagnostic formula. It is a new index of more diagnostic value than other single risk factor indicators in the formula. Conclusion: the diagnosis of lower limb atherosclerotic stenosis / occlusion is of good clinical utility, and the first attempt to use the integration of atherosclerosis risk factors for multiple parameters, and then derive a new diagnostic index, providing a new idea and method for the prevention and treatment of atherosclerosis.
文摘Objective: to study and analyze the value of computer body layer scanning angiography (CTA) imaging used in lower extremity vascular occlusion lesions. Methods: 30 patients with suspected lower limb vascular occlusive disease admitted to our hospital from May 2021 to January 2022 were included. The examinations received in the hospital included CTA imaging and digital subtraction angiography. The later examination results were the gold standard to evaluate the diagnostic efficacy of CTA imaging in lower limb vascular occlusive disease. Results: in this group, 27 suspected cases of lower extremity vascular diseases were confirmed by digital subtraction angiography, including 7 cases of lower extremity vascular occlusion, 20 cases of lower extremity vascular stenosis (8 cases of severe, 8 cases of moderate, 4 cases of mild), 26 cases of lower extremity vascular diseases diagnosed by CTA, 7 cases of lower extremity vascular occlusion, 19 cases of lower extremity vascular stenosis (7 cases of severe, 8 cases of moderate, 4 cases of mild). There was no statistical difference in the detection rate of disease types between the two examination methods (P > 0.05). With reference to digital subtraction angiography, the coincidence rate, specificity and sensitivity of CTA imaging in the diagnosis of lower limb vascular occlusive diseases were 96.67%, 100.00% and 96.30% respectively. Conclusion: the sensitivity and specificity of CTA in the diagnosis of lower extremity vascular occlusive disease are both high.
基金Supported by the Central Guided Local Science and Technology Development Fund Project for Science and Technology Innovation Base Construction,No.Guike ZY24212046National Natural Science Foundation of China,No.U22A2092+3 种基金Guangxi Education Science“the 14th Five-Year Plan”2024 Special Project“Research on Steam Education Practice in Rehabilitation Engineering”,No.2024ZJY304the Research Basic Ability Enhancement Program for Young and Middle-aged Teachers of Guangxi,No.2025KY2255the Innovation Project of GUET Graduate Education,No.2025YCXB010Natural Science Research Project of Guilin Life and Health Career Technical College,No.2025GKKY04.
文摘BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.
文摘Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.
文摘Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
基金supported by Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology(MISIMT-2021-4)the Fundamental Research Funds for the Central Universities(N2329001).
文摘The lower limb assisted exoskeleton is a prominent area of research within the field of exoskeleton technology.However,several challenges remain,including the development of flexible actuators,high battery consumption,the risk of joint misalignment,and limited assistive capabilities.This paper proposes a compact flexible actuator incorporating two elastic elements named Adjustable Energy Storage Series Elastic Actuator(AES-SEA),which combining an adjustable energy storage device with a series elastic actuator for application in exoskeleton hip joints.This design aims to enhance energy efficiency and improve assistive effects.Subsequently,we introduce a novel knee joint bionic structure based on a pulley-groove configuration and a four-link mechanism,designed to replicate human knee joint motion and prevent joint misalignment.Additionally,we propose an innovative controller that integrates concepts from Linear Quadratic Regulator(LQR)control and virtual tunnel for level walking assistance.This controller modulates the assisted reference trajectory using the virtual tunnel concept,enabling different levels of assistance both inside and outside the tunnel by adjusting the parameters Q and R.This approach enhances the assisting force while ensuring the safety of human-computer interaction.Finally,metabolic experiments were conducted to evaluate the effectiveness of the exoskeleton assistance.
基金sponsored by the Fundamental Research Funds for the Central Universities[N2329001].
文摘To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a non-fully anthropomorphic design,attaching only at the thigh and ankle with a backward-knee configuration to mimic natural human knee movement.The design incorporates a single elastic element at the hip for gravity compensation and dual elastic elements at the knee for terrain adaptability,which adjust based on walking context.The design’s effectiveness was assessed by measuring metabolic cost reduction and motor output torque under various walking conditions.Results showed significant metabolic cost savings of 5.8–8.8%across different speeds and a 7.9%reduction during 9°incline walking on a flat indoor surface.Additionally,the spring element decreased hip motor output torque by 7–15.9%and knee torque by 8.1–14.2%.Outdoor tests confirmed the design’s robustness and effectiveness in reducing motor torque across terrains,highlighting its potential to advance multi-terrain adaptive exoskeleton research.
基金supported by the National Natural Science Foundation of China(Grant Nos.12372065,12372022,and 11932015)Shanghai Pilot Program for Basic Research—Fudan University(Grant No.21TQ1400100-22TQ009).
文摘Gait coordination in lower limbs plays a critical role in maintaining stability of the human body during walking.For transfemoral amputees,the absence of limbs disrupts this coordination,reducing prosthesis control accuracy.Hip-knee coordination mapping offers a feasible solution for lower-limb prosthesis control,involving the generation of a reference trajectory for the knee joint by leveraging information from the hip.However,current reference trajectories are usually derived from static models,which cannot generate reference trajectories robustly when dealing with perturbations.Therefore,this paper introduces a time-dependent model based on the Delayed Feedback Reservoir(DFR)for hip-knee coordination in lower-limb prosthetic control.Experimental results show that DFR outperforms classical gait planning approaches when facing perturbations,achieving a 20%lower Root Mean Square Error(RMSE)and reducing residuals by up to 18.14 degrees.This research contributes to understanding gait mapping approaches and emphasizes the potential of time-dependent models for robust and strong lower-limb prosthetic control.The discovery provides a novel way to enhance the perturbation adaptability of prosthetic control.
基金The study was approved by the ethics committee of Southwest Hospital,the First Affiliated Hospital of Army Medical University of Chinese People's Liberation Army(No.KY2024007).
文摘BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications.However,the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus(T2DM).AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis(n=1913)and lower limb atherosclerosis groups(n=2515)based on lower limb arterial ultrasonography results.At hospital admission,baseline serum RBP levels were assessed,and all subjects were categorized into three groups(Q1-Q3)based on RBP tertiles.Logistic regression,restricted cubic spline regression,subgroup analysis,and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.RESULTS Among 4428 individuals with T2DM,2515(56.80%)had lower limb atherosclerosis.Logistic analysis showed that lower limb atherosclerosis risk increased by 1%for every 1 unit rise in serum RBP level(odds ratio=1.01,95%confidence interval:1.00-1.02,P=0.004).Patients in the highest tertile group(Q3)had a higher lower limb atherosclerosis risk compared to the lowest tertile group(Q1)(odds ratio=1.36,95%confidence interval:1.12-1.67,P=0.002).The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile(P for trend=0.005).Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk(non-linear P<0.05).Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.
基金supported by the National Natural Science Foundation of China(62473337,62003305)the Key Research and Development Program of Zhejiang Province(2024C03040,2022C03029)the funding of Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang Province(2023R01006).
文摘Focusing on the rehabilitation training of hemiplegia patients,this paper proposes a gait-planning strategy based on a central pattern generator and an adaptive time-delay control scheme that utilizes recursive terminal sliding mode for lower limb rehabilitation exoskeleton robots.The central pattern generator network plans a reference gait trajectory for the affected leg,synchronized with the movement of the healthy leg.The proposed adaptive time-delay control scheme possesses a model-independent property due to the mechanism of time-delay estimation,with adaptive control gains that enhance the resilience against system perturbations and a recursive terminal sliding mode control component to achieve a fast convergence rate.According to the Lyapunov stability criterion,it is proved that the gait trajectory-tracking error is uniformly ultimately bounded.Experiments are conducted on a lower limb exoskeleton experimental platform,and the experimental results demonstrate the effectiveness and superiority of the proposed strategies.
基金supported by the Major Sports Research Projects of Jiangsu Provincial Sports Bureau in 2022(No.ST221101).
文摘As an essential tool for quantitative analysis of lower limb coordination,optical motion capture systems with marker-based encoding still suffer from inefficiency,high costs,spatial constraints,and the requirement for multiple markers.While 3D pose estimation algorithms combined with ordinary cameras offer an alternative,their accuracy often deteriorates under significant body occlusion.To address the challenge of insufficient 3D pose estimation precision in occluded scenarios—which hinders the quantitative analysis of athletes’lower-limb coordination—this paper proposes a multimodal training framework integrating spatiotemporal dependency networks with text-semantic guidance.Compared to traditional optical motion capture systems,this work achieves low-cost,high-precision motion parameter acquisition through the following innovations:(1)spatiotemporal dependency attention module is designed to establish dynamic spatiotemporal correlation graphs via cross-frame joint semantic matching,effectively resolving the feature fragmentation issue in existing methods.(2)noise-suppressed multi-scale temporal module is proposed,leveraging KL divergence-based information gain analysis for progressive feature filtering in long-range dependencies,reducing errors by 1.91 mm compared to conventional temporal convolutions.(3)text-pose contrastive learning paradigm is introduced for the first time,where BERT-generated action descriptions align semantic-geometric features via the BERT encoder,significantly enhancing robustness under severe occlusion(50%joint invisibility).On the Human3.6M dataset,the proposed method achieves an MPJPE of 56.21 mm under Protocol 1,outperforming the state-of-the-art baseline MHFormer by 3.3%.Extensive ablation studies on Human3.6M demonstrate the individual contributions of the core modules:the spatiotemporal dependency module and noise-suppressed multi-scale temporal module reduce MPJPE by 0.30 and 0.34 mm,respectively,while the multimodal training strategy further decreases MPJPE by 0.6 mm through text-skeleton contrastive learning.Comparative experiments involving 16 athletes show that the sagittal plane coupling angle measurements of hip-ankle joints differ by less than 1.2°from those obtained via traditional optical systems(two one-sided t-tests,p<0.05),validating real-world reliability.This study provides an AI-powered analytical solution for competitive sports training,serving as a viable alternative to specialized equipment.
