An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mi...An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mismatch. Revision surgery reduced posterior dislocation, increased bearing plate thickness and rebalanced ligaments. A second dislocation occurred after revision surgery. The patient’s history was retaken and a hamstring spasm disease identified. A new revision utilized a more constrained design, without perioperative local nerve block. Two years following surgery, no further dislocation had occurred. A numerical musculoskeletal model of the case and implant configuration identified no trend to mobile bearing dislocation when regular muscle forces were applied. Muscle spasm is a risk factor for mobile bearing total knee arthroplasty dislocation, especially with femoral nerve block.展开更多
Aim:To evaluate the clinical usability of mechanomyography(MMG)in the evaluation of upper-limb spasticity states of hemiplegia patients with likelihood ratio analysis.Methods:The MMG signals from the 30 hemiplegia pat...Aim:To evaluate the clinical usability of mechanomyography(MMG)in the evaluation of upper-limb spasticity states of hemiplegia patients with likelihood ratio analysis.Methods:The MMG signals from the 30 hemiplegia patients'biceps and triceps were recorded with three-dimensional wireless accelerometer(Trigno Wireless System,Delsys Inc),when they extended or bent their elbow passively.At the same time,the physiotherapist assessed the MAS(Modified Ashworth Scale)of all the patients who participated in the study and would be divided them into four groups based on the MAS values(MAS0,MAS1,MAS1+and MAS2).The MMG sensors were built with triaxial accelerometers named as X,Y and Z that represent the muscle fibers lengthwise movement,the cross movement and the vertical the muscle moving direction,respectively.The root mean square(RMS)value of the MMG signal was calculated for analysis.Likelihood ratio analysis were used in the study.Results:All of the variables of the X,Y,Z axis of signals of MMG of BB and TB have related with muscle spasticity grading during passive elbow flexion in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient of Y axis signal of MMG of BB is the largest.The 5 variables of the X,Y,Z axis of signals of MMG of BB and X,Y axis of TB have related with Muscle spasticity grading during passive elbow extension in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient ofY axis signal of MMG of BB is the largest in equation and the Y axis signal of MMG of TB is second large.Conclusions:The effect of agonist is more than the antagonist during the MAS assessment,especially the muscle fibers cross movement and the vertical movement by the MMG assessment.展开更多
Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intrao...Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intraoperative AMR findings and postoperative results in patients with HFS were investigated before,展开更多
Objective: by comparing the two groups of perioperative patients under the nerve function, nursing quality score, clinical indicators, bad psychological mood, nursing satisfaction, complications, comfort score, qualit...Objective: by comparing the two groups of perioperative patients under the nerve function, nursing quality score, clinical indicators, bad psychological mood, nursing satisfaction, complications, comfort score, quality of life score application effect, expounds the advantages and disadvantages of rapid rehabilitation surgery nursing and routine rehabilitation surgery nursing methods. Methods: randomized group, observation group applied rapid rehabilitation surgical care during facial muscle spasm, and control group applied routine rehabilitation surgical care during the perioperative period of facial muscle spasm.Results: the two groups of patients with rapid rehabilitation surgery and routine rehabilitation surgery and grade I, grade, grade V), nursing quality scores, clinical indicators, adverse psychological mood, nursing satisfaction, complications, comfort scores, and quality of life scores (P <0.05).Conclusion: rapid rehabilitation surgery nursing muscle spasm perioperative patients' facial nerve function, nursing quality score, clinical indicators, bad psychological mood scores, nursing satisfaction, complications, comfort score, quality of life, so rapid rehabilitation surgery in facial spasm perioperative can be large-scale clinical promotion.展开更多
BACKGROUND Thiocolchicoside(TCC),a muscle relaxant with anti-inflammatory properties,is often used alongside nonsteroidal anti-inflammatory drugs(NSAIDs)to treat musculoskeletal pain.This synergistic approach leverage...BACKGROUND Thiocolchicoside(TCC),a muscle relaxant with anti-inflammatory properties,is often used alongside nonsteroidal anti-inflammatory drugs(NSAIDs)to treat musculoskeletal pain.This synergistic approach leverages the complementary mechanisms of action,providing more effective relief for conditions such as arthritis,muscle spasms,and soft tissue injuries.AIM To evaluate the comparative efficacy of the combination therapy of TCC and NSAIDs vs NSAID monotherapy in pain management.METHODS A systematic search of PubMed and Google Scholar databases through October 2024 was performed to evaluate the effectiveness of combined TCC and NSAID therapy vs NSAIDs alone.A retrospective analysis of electronic medical records from India spanning 3 years(2020-2023)examined treatment patterns and focused on clinical outcomes including pain relief,functional improvement,and adverse effects.Key metrics for assessment included visual analog scale scores and hand-to-floor distance,with secondary outcomes assessing patient satisfaction and adverse event(AE)incidence.RESULTS A systematic literature search revealed seven studies,involving 1137 subjects,aligning with the eligibility criteria from a total of 833 hits.Combination therapy using parenteral TCC with NSAIDs significantly reduced pain intensity[standardised mean difference(SMD):-1.33,P<0.001]and enhanced functional improvement(SMD:-1.08,P<0.001)compared to NSAIDs alone.Patients on combination therapy are 6.7 times more likely to experience over 30%pain relief and 5.2 times more likely to achieve over 50%pain relief.Post surgery pain reduction and patient satisfaction were notably higher in the combination group[odds ratio(OR)=10.14,P<0.001].There were no significant differences in mild/moderate AE rates between the groups(OR=1.30,P=0.378).CONCLUSION Evidence indicates that multimodal therapy,including parenteral TCC with NSAIDs,provides quicker and effective pain relief,reduces muscle spasms,and improves hand-to-floor distance compared to using NSAIDs or TCC alone.展开更多
Surgical treatment and ESI （epidural steroid injection） are widely used forms of treatment for cervical radiculopathy but they are controversial and burdensome for patients. To relief pain fast without side effects,...Surgical treatment and ESI （epidural steroid injection） are widely used forms of treatment for cervical radiculopathy but they are controversial and burdensome for patients. To relief pain fast without side effects, we devised a new minimally invasive treatment method that widens the facet joints to decompress nerve roots and release the muscle spasm in cervical radiculopathy with acupuncture needles with blunt tip and mini-scalpel, and named it modified acupuncture procedure. MAP （Modified acupuncture procedure） was administered for 37 patients （mean age = 53.1 years, follow-up = 14.2 months） with cervical radiculopathy who did not recover from 4 weeks of nonsurgical treatment. We analyzed clinical outcomes of patients before and after the procedure through VAS （Visual Analogue Scale） and NDI （Neck Disability Index）. On average, patients received 1.4 MAP （modified acupuncture procedures）. The VAS score difference on the day after procedure and at 1 year follow-up was 36.8 ± 26.5 （from 60.1 ± 25.3 at the baseline to 25.3 ± 17.8 at the reading） （P 〈 0.01） and 31.0 ± 30.4 （29.0 ± 21.8 at the reading） respectively. The NDI value dropped by 19.9 ± 18.3 （from 37.2 ± 19.7 at the baseline to 17.2 ± 15.0 at the reading） （P〈 0.01） on 1 year follow up. MAP was found to have clinical efficacy for cervical radiculopathy.展开更多
Objective:To study the dose-response relationship between different treatment parameters of extra-corporeal shock wave(ESW)and their effects on spasticity in children with cerebral palsy by the orthogonal design and t...Objective:To study the dose-response relationship between different treatment parameters of extra-corporeal shock wave(ESW)and their effects on spasticity in children with cerebral palsy by the orthogonal design and to select the best parameter scheme for clinical efficacy.Methods:From March 2020 to December 2020,80 children with spastic cerebral palsy were randomly divided into eight groups of 10 cases.Patients in each group received ESW with varying wave intensities(A),wave frequencies(B),number of shocks(C),and treatment frequencies(D),which were determined by a 4-factor-2-level orthogonal array design.Modified Ashworth Scale(MAS)and GMFM were scored before and after the study,and the difference during the study was calculated to evaluate the performance of each group.Results:The R-value of DMAS was RA>RD>RC>RB and that of DGMFM was RA>RC>RD>RB.The influence of the two levels for each factor was A1>A2,B2>B1,C2>C1,D2>D1.By the analysis of variance,the differences in factors A,C,and D were statistically significant(P<0.05).The optimal combination of ESW treatment parameters for the spasticity of cerebral palsy was 1.5 bar,10 Hz,2000 times,and twice a week.Conclusion:ESW is an effective treatment for spastic cerebral palsy and is worthy of clinical application.展开更多
文摘An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mismatch. Revision surgery reduced posterior dislocation, increased bearing plate thickness and rebalanced ligaments. A second dislocation occurred after revision surgery. The patient’s history was retaken and a hamstring spasm disease identified. A new revision utilized a more constrained design, without perioperative local nerve block. Two years following surgery, no further dislocation had occurred. A numerical musculoskeletal model of the case and implant configuration identified no trend to mobile bearing dislocation when regular muscle forces were applied. Muscle spasm is a risk factor for mobile bearing total knee arthroplasty dislocation, especially with femoral nerve block.
基金funded by the National Natural Science Foundation of China(#61135004,#51275101).
文摘Aim:To evaluate the clinical usability of mechanomyography(MMG)in the evaluation of upper-limb spasticity states of hemiplegia patients with likelihood ratio analysis.Methods:The MMG signals from the 30 hemiplegia patients'biceps and triceps were recorded with three-dimensional wireless accelerometer(Trigno Wireless System,Delsys Inc),when they extended or bent their elbow passively.At the same time,the physiotherapist assessed the MAS(Modified Ashworth Scale)of all the patients who participated in the study and would be divided them into four groups based on the MAS values(MAS0,MAS1,MAS1+and MAS2).The MMG sensors were built with triaxial accelerometers named as X,Y and Z that represent the muscle fibers lengthwise movement,the cross movement and the vertical the muscle moving direction,respectively.The root mean square(RMS)value of the MMG signal was calculated for analysis.Likelihood ratio analysis were used in the study.Results:All of the variables of the X,Y,Z axis of signals of MMG of BB and TB have related with muscle spasticity grading during passive elbow flexion in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient of Y axis signal of MMG of BB is the largest.The 5 variables of the X,Y,Z axis of signals of MMG of BB and X,Y axis of TB have related with Muscle spasticity grading during passive elbow extension in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient ofY axis signal of MMG of BB is the largest in equation and the Y axis signal of MMG of TB is second large.Conclusions:The effect of agonist is more than the antagonist during the MAS assessment,especially the muscle fibers cross movement and the vertical movement by the MMG assessment.
文摘Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intraoperative AMR findings and postoperative results in patients with HFS were investigated before,
文摘Objective: by comparing the two groups of perioperative patients under the nerve function, nursing quality score, clinical indicators, bad psychological mood, nursing satisfaction, complications, comfort score, quality of life score application effect, expounds the advantages and disadvantages of rapid rehabilitation surgery nursing and routine rehabilitation surgery nursing methods. Methods: randomized group, observation group applied rapid rehabilitation surgical care during facial muscle spasm, and control group applied routine rehabilitation surgical care during the perioperative period of facial muscle spasm.Results: the two groups of patients with rapid rehabilitation surgery and routine rehabilitation surgery and grade I, grade, grade V), nursing quality scores, clinical indicators, adverse psychological mood, nursing satisfaction, complications, comfort scores, and quality of life scores (P <0.05).Conclusion: rapid rehabilitation surgery nursing muscle spasm perioperative patients' facial nerve function, nursing quality score, clinical indicators, bad psychological mood scores, nursing satisfaction, complications, comfort score, quality of life, so rapid rehabilitation surgery in facial spasm perioperative can be large-scale clinical promotion.
文摘BACKGROUND Thiocolchicoside(TCC),a muscle relaxant with anti-inflammatory properties,is often used alongside nonsteroidal anti-inflammatory drugs(NSAIDs)to treat musculoskeletal pain.This synergistic approach leverages the complementary mechanisms of action,providing more effective relief for conditions such as arthritis,muscle spasms,and soft tissue injuries.AIM To evaluate the comparative efficacy of the combination therapy of TCC and NSAIDs vs NSAID monotherapy in pain management.METHODS A systematic search of PubMed and Google Scholar databases through October 2024 was performed to evaluate the effectiveness of combined TCC and NSAID therapy vs NSAIDs alone.A retrospective analysis of electronic medical records from India spanning 3 years(2020-2023)examined treatment patterns and focused on clinical outcomes including pain relief,functional improvement,and adverse effects.Key metrics for assessment included visual analog scale scores and hand-to-floor distance,with secondary outcomes assessing patient satisfaction and adverse event(AE)incidence.RESULTS A systematic literature search revealed seven studies,involving 1137 subjects,aligning with the eligibility criteria from a total of 833 hits.Combination therapy using parenteral TCC with NSAIDs significantly reduced pain intensity[standardised mean difference(SMD):-1.33,P<0.001]and enhanced functional improvement(SMD:-1.08,P<0.001)compared to NSAIDs alone.Patients on combination therapy are 6.7 times more likely to experience over 30%pain relief and 5.2 times more likely to achieve over 50%pain relief.Post surgery pain reduction and patient satisfaction were notably higher in the combination group[odds ratio(OR)=10.14,P<0.001].There were no significant differences in mild/moderate AE rates between the groups(OR=1.30,P=0.378).CONCLUSION Evidence indicates that multimodal therapy,including parenteral TCC with NSAIDs,provides quicker and effective pain relief,reduces muscle spasms,and improves hand-to-floor distance compared to using NSAIDs or TCC alone.
文摘Surgical treatment and ESI （epidural steroid injection） are widely used forms of treatment for cervical radiculopathy but they are controversial and burdensome for patients. To relief pain fast without side effects, we devised a new minimally invasive treatment method that widens the facet joints to decompress nerve roots and release the muscle spasm in cervical radiculopathy with acupuncture needles with blunt tip and mini-scalpel, and named it modified acupuncture procedure. MAP （Modified acupuncture procedure） was administered for 37 patients （mean age = 53.1 years, follow-up = 14.2 months） with cervical radiculopathy who did not recover from 4 weeks of nonsurgical treatment. We analyzed clinical outcomes of patients before and after the procedure through VAS （Visual Analogue Scale） and NDI （Neck Disability Index）. On average, patients received 1.4 MAP （modified acupuncture procedures）. The VAS score difference on the day after procedure and at 1 year follow-up was 36.8 ± 26.5 （from 60.1 ± 25.3 at the baseline to 25.3 ± 17.8 at the reading） （P 〈 0.01） and 31.0 ± 30.4 （29.0 ± 21.8 at the reading） respectively. The NDI value dropped by 19.9 ± 18.3 （from 37.2 ± 19.7 at the baseline to 17.2 ± 15.0 at the reading） （P〈 0.01） on 1 year follow up. MAP was found to have clinical efficacy for cervical radiculopathy.
基金supported by Foshan Science and Technology Bureau,GuangDong,China(Grant No.1920001001095).
文摘Objective:To study the dose-response relationship between different treatment parameters of extra-corporeal shock wave(ESW)and their effects on spasticity in children with cerebral palsy by the orthogonal design and to select the best parameter scheme for clinical efficacy.Methods:From March 2020 to December 2020,80 children with spastic cerebral palsy were randomly divided into eight groups of 10 cases.Patients in each group received ESW with varying wave intensities(A),wave frequencies(B),number of shocks(C),and treatment frequencies(D),which were determined by a 4-factor-2-level orthogonal array design.Modified Ashworth Scale(MAS)and GMFM were scored before and after the study,and the difference during the study was calculated to evaluate the performance of each group.Results:The R-value of DMAS was RA>RD>RC>RB and that of DGMFM was RA>RC>RD>RB.The influence of the two levels for each factor was A1>A2,B2>B1,C2>C1,D2>D1.By the analysis of variance,the differences in factors A,C,and D were statistically significant(P<0.05).The optimal combination of ESW treatment parameters for the spasticity of cerebral palsy was 1.5 bar,10 Hz,2000 times,and twice a week.Conclusion:ESW is an effective treatment for spastic cerebral palsy and is worthy of clinical application.
