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
Human-robot safety is an important topic in wearable robotics,especially in supernumerary robotic limbs(SRLs).The proposal of flexible joint improves human-robot safety strategy,which allows physical contact between h...Human-robot safety is an important topic in wearable robotics,especially in supernumerary robotic limbs(SRLs).The proposal of flexible joint improves human-robot safety strategy,which allows physical contact between human and robots,rather than strictly limiting the human-robot motion.However,most researchers focus on the variable stiffness features of flexible joints,but few evaluate the performance of the flexible joint in the human-robot collision.Therefore,the performance of two typical flexible joints,including the series elastic joint(SEJ)and the passive variable stiffness joint(PVSJ),are compared through dynamic collision experiments.The results demonstrate that the SEJ absorbs 40.7%-58.7%of the collision force and 34.2%-45.2%of the collision torque in the driven-torque below 4 N·m and driven-speed of 3-7(°)/s,which is more stable than PVSJ.In addition,the stiffness error of SEJ is measured at 5.1%,significantly lower than the 23.04%measured in the PVSJ.The huge stiffness error of PVSJ leads to its unreliability in buffering collision.Furthermore,we analyze results and confirm that SEJ has a more stable human-robot safety performance in buffering dynamic collision.Consequently,the SEJ is suitable in SRLs for human-robot safety in our scenario.展开更多
OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral h...OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage through a network Meta-analysis.METHODS:A computer-based search was conducted in 8 databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Pub Med,Cochrane Library,Web of Science,Scopus,and Embase,from their inception until February 19,2023.Randomized controlled trials(RCTs)investigating the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage were included.Two researchers independently screened the literature,extracted data from the included studies,and performed quality assessment using the Cochrane Collaboration's standards.The software Stata 17.0 was used to create a network evidence graph for each combination of Traditional Chinese Medicine external treatment methods and rehabilitation training,and to generate a publication bias funnel plot.Network Meta-analysis was conducted using Rev Man 5.3 to assess the risk of bias in the included studies,with mean difference(MD)used for continuous variables and odds ratio(OR)used for dichotomous variables.If there was good consistency among the included studies(P>0.05),a consistency model was applied for data analysis.If there was poor consistency among the included studies(P<0.05),an inconsistency model was used.RESULTS:A total of 27 studies involving 2113 patients with limb dysfunction caused by cerebral hemorrhage were included.The results of the network Meta-analysis indicated that the combined use of 7 Traditional Chinese Medicine external treatment methods and rehabilitation training was more effective in improving limb function in patients with cerebral hemorrhage compared to rehabilitation training alone.In terms of improving simplified Fugl-Meyer Assessment(FMA)scores,the effectiveness ranking was as follows:acupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>massage+rehabilitation training>electroacupuncture+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training>Chinese herbal fumigation+rehabilitation training.In terms of improving Barthel Index(BI)scores,the effectiveness ranking was as follows:electroacupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>acupuncture+rehabilitation training>massage+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine fumigation+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training.CONCLUSION:Based on existing literature evidence,our findings suggest the following:(a)The combination of the seven commonly used external treatment methods with rehabilitation training is superior to using rehabilitation training alone for the treatment of hemiplegia resulting from cerebral hemorrhage.(b)In terms of improving FMA scores,the combination of acupuncture and rehabilitation training shows the most significant effectiveness.(c)In terms of improving BI scores,the combination of electro-acupuncture and rehabilitation training demonstrates the most significant effectiveness.Therefore,we still need more multicenter,large-sample,high-quality randomized controlled trials to further validate the findings of this study.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
The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and e...The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.展开更多
Background: The prevalence of penetrating arterial trauma of limbs remains unknown in Toamasina. Their management remains a challenge due to lack of protocol and late in admission of victims. The aim of this study was...Background: The prevalence of penetrating arterial trauma of limbs remains unknown in Toamasina. Their management remains a challenge due to lack of protocol and late in admission of victims. The aim of this study was to describe etiology and surgical management of penetrating traumatic arterial injuries of limbs in Toamasina. Material and Methods: This was a retrospective and descriptive study for 6 years period (from 1st January 2017 to 31th December 2022) performed at Vascular Surgery Unit of Morafeno Teaching Hospital in Toamasina, Madagascar, including all patients who underwent surgery due to penetrating traumatic arterial injuries of limbs. Demographics, circumstance of accident, symptomatology, characteristics of arterial injury, surgical procedures and outcomes were analyzed. Results: Thirty-five cases of penetrating arterial trauma of limbs were recorded. The most victims were young (mean age = 31.27) male (96.43%). Arterial injuries were due to stab wounds in 85.17% of cases. The most common symptoms were bleeding (89.12%) and pulseless (46.73%). Most patients (82.85%) used tourniquets to control the bleeding before admission. Lesions were laceration (34.28%), transection (48.57%) and avulsion (17.14%). Arterial injuries were located in upper extremities in 20 cases (71.42%). The most involved vessels were the brachial artery (45.71%) and radial artery (34.28%). Surgical procedures were end-to-end anastomosis (45.71%), lateral arteriorraphy (25.71%), interposition of reverse saphenous vein graft (17.14%) and ligation (8.57%). Primary amputation was performed for 1 patient after delayed acute ischemia (2.85%). There was no death among patients who underwent surgery. The overall limb salvage rate was 97.14%. Conclusion: Stabs were the most common etiology of penetrating arterial injuries in Toamasina. Surgical results were satisfactory despite the late in admission of majority of victims.展开更多
Objective:To study the effect of the upper limbs on dosage in Gamma Knife treatment.Methods:The design function of the Luna-260^(TM) Gamma Knife Radiotherapy Planning System was utilized,using a body phantom to simula...Objective:To study the effect of the upper limbs on dosage in Gamma Knife treatment.Methods:The design function of the Luna-260^(TM) Gamma Knife Radiotherapy Planning System was utilized,using a body phantom to simulate conventional treatment sites.Twenty sampling points were set for irradiation locations.Using five different collimator sizes commonly used in body treatments,treatment plans were designed under conditions with and without upper limbs,and sampling point irradiation time comparison data was collected to calculate and analyze dose error rates.Results:Across the 20 sampling points,the dose error range was from-16.09%to 0 when comparing treatment plans without upper limbs to those executed with upper limbs present,and from 0 to 19.75%in the reverse comparison.With the same prescription dose,location,and collimator size,dose error increased as the irradiation site moved closer to the upper limbs and decreased as the distance increased.Conclusion:In Gamma Knife treatment,the dose error decreases as the irradiation site is further from the upper limbs and increases when closer.Consistency in upper limb positioning is essential during Gamma Knife localization,planning,and execution.Although small,the upper limbs can significantly impact dosage,requiring stringent quality control to ensure the precision of treatment doses,thus safeguarding the effectiveness and safety of patient treatments.展开更多
Nursing plays an important part in the rehabilitation of residual limbs and the utilization of artificial limbs after the attack of the earthquake,which also prevent and reduce the damage severity,supplement and impro...Nursing plays an important part in the rehabilitation of residual limbs and the utilization of artificial limbs after the attack of the earthquake,which also prevent and reduce the damage severity,supplement and improve functional state,increase quality of life and strengthen the social life participating capacity of the amputees. According to the Guiding Principles for Adaptation and Utilization of Common Assistive Devices for Injury of the Wounded in Earthquake [1]compiled jointly by CDPF and Ministry of Health,to further promote the development of scientific work for rehabilitation of the wounded in the earthquake,improve the whole level and efficacy of medical remedy and rehabilitation,and maximally reduce the severity of disability,this study mainly interpreted the precautions to the post-amputation nursing for residual limbs of the wounded,hoping to provide reference for medical staff who will receive patients for amputation to implement rehabilitation therapy.展开更多
It is significant to develop a robot hand with high rigidity by a 6-DOF parallel manipulator（PM）.However,the existing6-DOF PMs include spherical joint which has less capability of pulling force bearing,less rotation...It is significant to develop a robot hand with high rigidity by a 6-DOF parallel manipulator（PM）.However,the existing6-DOF PMs include spherical joint which has less capability of pulling force bearing,less rotation range and lower precision under alternately heavy loads.A novel 6-DOF PM with three planar limbs and equipped with three fingers is proposed and its kinematics and statics are analyzed systematically.A 3-dimension simulation mechanism of the proposed manipulator is constructed and its structure characteristics is analyzed.The kinematics formulae for solving the displacement,velocity,acceleration of the platform,the active legs and the fingers are established.The statics formulae are derived for solving the active forces of PM and the finger mechanisms.An analytic example is given for solving the kinematics and statics of proposed manipulator and the analytic solved results are verified by the simulation mechanism.It is proved from the error analysis of analytic solutions and simulation solutions that the derived analytic formulae are correct and provide the theoretical and technical foundations for its manufacturing,control and application.展开更多
This paper focuses on the problem of the adaptive robust control of a lower limbs rehabilitation robot(LLRR) that is a nonlinear system running under passive training mode. In reality, uncertainties including modeling...This paper focuses on the problem of the adaptive robust control of a lower limbs rehabilitation robot(LLRR) that is a nonlinear system running under passive training mode. In reality, uncertainties including modeling error, initial condition deviation, friction force and other unknown external disturbances always exist in a LLRR system. So, it is necessary to consider the uncertainties in the unilateral man-machine dynamical model of the LLRR we described. In the dynamical model, uncertainties are(possibly fast) time-varying and bounded. However, the bounds are unknown. Based on the dynamical model, we design an adaptive robust control with an adaptive law that is leakagetype based and on the framework of Udwadia-Kalaba theory to compensate for the uncertainties and to realize tracking control of the LLRR. Furthermore, the effectiveness of designed control is shown with numerical simulations.展开更多
Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. ...Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. Methods: Form January, 2019 to December, 2019, 80 cerebrovascular disease patients were recruited, and had been divided into control group (n = 40) and observation group (n = 40), randomly. The control groups received conventional rehabilitation treatment, for 40 minutes per day, while observation group received conventional rehabilitation treatment, for 20 minutes per day, and virtual reality technology treatment, 20 minutes per day, 5 days a week for 4 weeks. Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and ADL before and after treatment. Results: Before treatment, the scores of WMFT, FMA-UE and MBI were no significant difference between two groups (P > 0.05). The scores improved in both groups after treatment (P < 0.01), and were higher in the observation group than in the control group (P < 0.05). Conclusion: The somatosensory interaction technology combined with virtual reality technology could facilitate to improve the upper limbs function and ADL in cerebrovascular disease patients.展开更多
Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT)....Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT). Materials and Methods: A descriptive retrospective study of 46 already diagnosed cases of lower limb DVT. Results: Out of 46 cases of DVT, 71.74% were females. The majority of patients (93.47%) were affected in unilateral lower limb with significant predominance (65.22%) to affect the left lower limb (p Conclusion: Lower limb deep venous thrombosis affects left lower limb more than right and females more than males. Superficial femoral vein (SFV) and common femoral vein (CFV) are the most common affected veins. Lower limb DVT predominantly present in acute stage with venous distension and absent blood flow.展开更多
BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe...BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.展开更多
BACKGROUND: The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living. Several factors are needed in the self-recovery of the patients, and the most imp...BACKGROUND: The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living. Several factors are needed in the self-recovery of the patients, and the most important one is to reduce spasm. Some mechanical repetitive movements can affect and change the excitability of motor neurons. OBJECTIVE: To observe the effect of repetitive training on ameliorating spasm of upper limbs of hemiplegic patients. DESIGN: A self-controlled observation before and after training. SETTING: Department of Rehabilitation, Xuanwu Hospital of Capital Medical University. PARTICIPANTS: Seven hemiplegic patients induced by brain injury were selected from the Department of Rehabilitation, Xuanwu Hospital, Capital Medical University from March to June in 2005. Inclusive criteria: ① Agreed and able to participate in the 30-minute training of hand function; ② Without disturbance of understanding. The patients with aphasia or apraxia, manifestation of shoulder pain, and severe neurological or mental defects. For the 7 patients, the Rivermead motor assessment (RMA) scores ranged 0-10 points, the Rivermead mobility index (RMI) ranged 1-3, and modified Ashworth scale (MAS) was grade 2-4. Their horizontal extension of shoulder joint was 0°-30°, anteflextion was 0°-50°, internal rotation was 50°-90°, external rotation was 0°-10°; and the elbow joint could extend for 15°-135°. METHODS: The viva 2 serial MOTOmed exerciser (Reck Company, Germany) was used. There were three phases of A-B-A. ① The phase A lasted for 1 week. The patient sat on a chair facting to the MOTOmed screen, and did the circumduction of upper limbs forwardly, 30 minutes a day and 5 days a week. ② The phase B lasted for 3 weeks. The training consisted of forward circumduction of upper limbs for 15 minutes, followed by backward ones for 15 minutes and 5-minute rest. ③ The training in the phase A was performed again for 2 weeks. The extensions of upper limbs were recorded at phase A, the extension and flexion of elbow joints were recorded at phase B, and the extensions were recorded at the second A phase. All the patients were evaluated by the same therapeutist. ① RMA was used to evaluate the motor function completely, including the motor control of both upper and lower limbs, but only the data of upper limbs were recommended to be used. The flexibility and concordance of upper limbs were described by detecting the ability of hand to move objects with 15 items, 2 grades for each item: 0 for could not complete and 1 for could complete. ② RMI was used to measure the flexion and extension of elbow joint and shoulder joint, the scores ranged from 0 (no movement and no obvious muscle contraction) to 5 (close to normal movement). ③ MAS was used to evaluate the muscle tension in clinic. Grade 1 for without abnormal increase of muscle tension, and grade 5 for muscle rigidity, and it was unable for passive movement. ④ Ranges of motion of elbow joint and should joint were measured using protractor. MAIN OUTCOME MEASURES: ① The strength of each limb to persist for 40 s recorded by two hand pedals; ② Changes of muscle tensions detected by the two hand pedals; ③ Changes of muscle contraction at the flexion and extension of ipsilateral limb recorded by EMG; ④ Minimal moment of iplateral end foot; ⑤ RMA; ⑥ RMI; ⑦ MAS; ⑧ Ranges of motion of elbow joints and shoulder joints. RESULTS: The functions were evaluated at 6 weeks after training. ① The strength of each limb to persist for 40 s was recorded, and the strength of the ipsilateral limb changed obviously from 20%-40% to 50%-70%. ② The muscle tensions detected by the two hand pedals changed from 2.2-4.0 N·m to 0.2-1.0 N·m. ③ EMG displayed that along with the enhancement of fast movements, the strength curve increased (the EMG for the extension of elbow joints were obvious). ④ The minimal moment of iplateral end foot was 5.0 N·m. ⑤ The RMA scores ranged 15-30 points. ⑥ The RMI ranged 4-5. ⑦ MAS were grades 0-2. ⑧ For shoulder joints, the ranges of motion were 90°-180° for external extension, 90° for anteflexion, 90° for internal rotation and 50°-75° for external rotation; For elbow joints, the extension of active movements was close to 0°. CONCLUSION: After repetitive movements, the strength of upper limb increased, the range of motion enlarged, and spasm reduced.展开更多
Most numbness and pain in the limbs iscaused by invasion of pathogenic wind,cold anddampness into the deficient body,blocking themeridians of the limbs with stagnation of Qi orblood,and diffusion of impeded body fluid...Most numbness and pain in the limbs iscaused by invasion of pathogenic wind,cold anddampness into the deficient body,blocking themeridians of the limbs with stagnation of Qi orblood,and diffusion of impeded body fluids.Ramulus Cinnamomi has the property of warm-展开更多
The syndrome of atrophic paralysis of thelimbs refers to a group of diseases characterizedby atrophy and weakness of the limbs.Patientswith this syndrome are unable to move theirlimbs voluntarily,which may be accompan...The syndrome of atrophic paralysis of thelimbs refers to a group of diseases characterizedby atrophy and weakness of the limbs.Patientswith this syndrome are unable to move theirlimbs voluntarily,which may be accompaniedby numbness and muscular atrophy.This diseaseis more commonly seen in the lower limbs.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
Pain and gangrene in limbs due to Buerger’s disease, Raynaud’s phenomenon andatherosclerosis are a great problern to manage in modern medicine. Vasodilators, sympathectomy andprogressive amputations cannot solve the...Pain and gangrene in limbs due to Buerger’s disease, Raynaud’s phenomenon andatherosclerosis are a great problern to manage in modern medicine. Vasodilators, sympathectomy andprogressive amputations cannot solve the problem. Electr0acupuncture shows very good results so that drugs and surgery may be spared. Total 32 cases (Buerger’s 27, Raynaud’s 4, atherosc1erosis 1 )were treated with acupuncture needling and electrostimulation. Acupoints used were Weizhong (BL4O ), Taixi (KI 3), Zusanli (ST 36), Jiexi (ST 41 ), Bafeng (Extra), Neiguan (PC 6), Hegu (LI4 ), Baxie (Extra) . The frequency of electrostimulation at acupoints was 100- 500 cycles per minute.Daily treatment was carried out the first 1O days, then the times of treatment reduced. The therapywas maintained once in two beths. Of 27 cases of Buerger’s disease, 19 cases (82. 6 % ) were healed. Pain was relieved but uker not healed in 1 case (4. 3% ). Failure was 3 (13% ). 3/4 (75 % ) ofRaynaud’s cases, pain and gungrene were fully control1ed; the展开更多
Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the m...Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the mortality among octogenarians was as high as 29%regardless of the type of intervention and that re-vascularization was associated with high peripro-cedural mortality.[2]A previous study had already shown that reconstructive surgery for elderly indi-viduals over 80 years old resulted in a significantly higher mortality rate than that for patients between 70 and 80 years old,whereas endovascular inter-vention and primarily conservative treatment had comparable prognoses.[3]Consistently,another study showed that the risks of both overall and am-putation-free survival were significantly lower with endovascular treatment than with bypass surgery in patients with critical limb ischemia.[4]A systematic review and meta-analysis of 27 studies(15 cohort and 12 randomized controlled trials)with 1642 pa-tients suggests that conservative treatment may be considered for nonreconstructable patients with critical limb ischemia;[5]however,because a high risk of bias and serious inconsistencies were found in the included studies,the meta-analysis provided low-quality evidence.In contrast,a small cohort study with 49 patients suggests that amputation im-proved quality of life and health status in fragile elderly individuals.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 the Na⁃tional Natural Science Foundation of China(No.U22A20204)the Innovation Foundation from National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation Foundation(No.23-NCRC-CXJJ-ZD3-8)。
文摘Human-robot safety is an important topic in wearable robotics,especially in supernumerary robotic limbs(SRLs).The proposal of flexible joint improves human-robot safety strategy,which allows physical contact between human and robots,rather than strictly limiting the human-robot motion.However,most researchers focus on the variable stiffness features of flexible joints,but few evaluate the performance of the flexible joint in the human-robot collision.Therefore,the performance of two typical flexible joints,including the series elastic joint(SEJ)and the passive variable stiffness joint(PVSJ),are compared through dynamic collision experiments.The results demonstrate that the SEJ absorbs 40.7%-58.7%of the collision force and 34.2%-45.2%of the collision torque in the driven-torque below 4 N·m and driven-speed of 3-7(°)/s,which is more stable than PVSJ.In addition,the stiffness error of SEJ is measured at 5.1%,significantly lower than the 23.04%measured in the PVSJ.The huge stiffness error of PVSJ leads to its unreliability in buffering collision.Furthermore,we analyze results and confirm that SEJ has a more stable human-robot safety performance in buffering dynamic collision.Consequently,the SEJ is suitable in SRLs for human-robot safety in our scenario.
基金Supported by the Key Research and Development Plan Project of Shaanxi Province:Standardized Diagnosis and Treatment Protocol for Cerebral Hemorrhage with Integrated Traditional Chinese and Western Medicine and Research on its Therapeutic Mechanisms(No.2019ZDLSF04-06-01)the National Key Research and Development Plan Project:Development and Implementation of a Clinical Research Information Sharing System for Traditional Chinese Medicine(No.2017YFC1703500,No.2017YFC1703502)the Discipline Innovation Team Building Project of Shaanxi University of Chinese Medicine:Innovative Research Team for the Construction of Integrated Traditional Chinese and Western Medicine Cerebrovascular Disease Diagnosis and Treatment System and Its Clinical Application(No.2019-YL15)。
文摘OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage through a network Meta-analysis.METHODS:A computer-based search was conducted in 8 databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Pub Med,Cochrane Library,Web of Science,Scopus,and Embase,from their inception until February 19,2023.Randomized controlled trials(RCTs)investigating the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage were included.Two researchers independently screened the literature,extracted data from the included studies,and performed quality assessment using the Cochrane Collaboration's standards.The software Stata 17.0 was used to create a network evidence graph for each combination of Traditional Chinese Medicine external treatment methods and rehabilitation training,and to generate a publication bias funnel plot.Network Meta-analysis was conducted using Rev Man 5.3 to assess the risk of bias in the included studies,with mean difference(MD)used for continuous variables and odds ratio(OR)used for dichotomous variables.If there was good consistency among the included studies(P>0.05),a consistency model was applied for data analysis.If there was poor consistency among the included studies(P<0.05),an inconsistency model was used.RESULTS:A total of 27 studies involving 2113 patients with limb dysfunction caused by cerebral hemorrhage were included.The results of the network Meta-analysis indicated that the combined use of 7 Traditional Chinese Medicine external treatment methods and rehabilitation training was more effective in improving limb function in patients with cerebral hemorrhage compared to rehabilitation training alone.In terms of improving simplified Fugl-Meyer Assessment(FMA)scores,the effectiveness ranking was as follows:acupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>massage+rehabilitation training>electroacupuncture+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training>Chinese herbal fumigation+rehabilitation training.In terms of improving Barthel Index(BI)scores,the effectiveness ranking was as follows:electroacupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>acupuncture+rehabilitation training>massage+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine fumigation+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training.CONCLUSION:Based on existing literature evidence,our findings suggest the following:(a)The combination of the seven commonly used external treatment methods with rehabilitation training is superior to using rehabilitation training alone for the treatment of hemiplegia resulting from cerebral hemorrhage.(b)In terms of improving FMA scores,the combination of acupuncture and rehabilitation training shows the most significant effectiveness.(c)In terms of improving BI scores,the combination of electro-acupuncture and rehabilitation training demonstrates the most significant effectiveness.Therefore,we still need more multicenter,large-sample,high-quality randomized controlled trials to further validate the findings of this study.
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The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.
文摘Background: The prevalence of penetrating arterial trauma of limbs remains unknown in Toamasina. Their management remains a challenge due to lack of protocol and late in admission of victims. The aim of this study was to describe etiology and surgical management of penetrating traumatic arterial injuries of limbs in Toamasina. Material and Methods: This was a retrospective and descriptive study for 6 years period (from 1st January 2017 to 31th December 2022) performed at Vascular Surgery Unit of Morafeno Teaching Hospital in Toamasina, Madagascar, including all patients who underwent surgery due to penetrating traumatic arterial injuries of limbs. Demographics, circumstance of accident, symptomatology, characteristics of arterial injury, surgical procedures and outcomes were analyzed. Results: Thirty-five cases of penetrating arterial trauma of limbs were recorded. The most victims were young (mean age = 31.27) male (96.43%). Arterial injuries were due to stab wounds in 85.17% of cases. The most common symptoms were bleeding (89.12%) and pulseless (46.73%). Most patients (82.85%) used tourniquets to control the bleeding before admission. Lesions were laceration (34.28%), transection (48.57%) and avulsion (17.14%). Arterial injuries were located in upper extremities in 20 cases (71.42%). The most involved vessels were the brachial artery (45.71%) and radial artery (34.28%). Surgical procedures were end-to-end anastomosis (45.71%), lateral arteriorraphy (25.71%), interposition of reverse saphenous vein graft (17.14%) and ligation (8.57%). Primary amputation was performed for 1 patient after delayed acute ischemia (2.85%). There was no death among patients who underwent surgery. The overall limb salvage rate was 97.14%. Conclusion: Stabs were the most common etiology of penetrating arterial injuries in Toamasina. Surgical results were satisfactory despite the late in admission of majority of victims.
文摘Objective:To study the effect of the upper limbs on dosage in Gamma Knife treatment.Methods:The design function of the Luna-260^(TM) Gamma Knife Radiotherapy Planning System was utilized,using a body phantom to simulate conventional treatment sites.Twenty sampling points were set for irradiation locations.Using five different collimator sizes commonly used in body treatments,treatment plans were designed under conditions with and without upper limbs,and sampling point irradiation time comparison data was collected to calculate and analyze dose error rates.Results:Across the 20 sampling points,the dose error range was from-16.09%to 0 when comparing treatment plans without upper limbs to those executed with upper limbs present,and from 0 to 19.75%in the reverse comparison.With the same prescription dose,location,and collimator size,dose error increased as the irradiation site moved closer to the upper limbs and decreased as the distance increased.Conclusion:In Gamma Knife treatment,the dose error decreases as the irradiation site is further from the upper limbs and increases when closer.Consistency in upper limb positioning is essential during Gamma Knife localization,planning,and execution.Although small,the upper limbs can significantly impact dosage,requiring stringent quality control to ensure the precision of treatment doses,thus safeguarding the effectiveness and safety of patient treatments.
文摘Nursing plays an important part in the rehabilitation of residual limbs and the utilization of artificial limbs after the attack of the earthquake,which also prevent and reduce the damage severity,supplement and improve functional state,increase quality of life and strengthen the social life participating capacity of the amputees. According to the Guiding Principles for Adaptation and Utilization of Common Assistive Devices for Injury of the Wounded in Earthquake [1]compiled jointly by CDPF and Ministry of Health,to further promote the development of scientific work for rehabilitation of the wounded in the earthquake,improve the whole level and efficacy of medical remedy and rehabilitation,and maximally reduce the severity of disability,this study mainly interpreted the precautions to the post-amputation nursing for residual limbs of the wounded,hoping to provide reference for medical staff who will receive patients for amputation to implement rehabilitation therapy.
基金Supported by National Natural Science Foundation of China(Grant No.51175447)Key Planned Project of Hebei Province,China(Grant No.11962127D)
文摘It is significant to develop a robot hand with high rigidity by a 6-DOF parallel manipulator（PM）.However,the existing6-DOF PMs include spherical joint which has less capability of pulling force bearing,less rotation range and lower precision under alternately heavy loads.A novel 6-DOF PM with three planar limbs and equipped with three fingers is proposed and its kinematics and statics are analyzed systematically.A 3-dimension simulation mechanism of the proposed manipulator is constructed and its structure characteristics is analyzed.The kinematics formulae for solving the displacement,velocity,acceleration of the platform,the active legs and the fingers are established.The statics formulae are derived for solving the active forces of PM and the finger mechanisms.An analytic example is given for solving the kinematics and statics of proposed manipulator and the analytic solved results are verified by the simulation mechanism.It is proved from the error analysis of analytic solutions and simulation solutions that the derived analytic formulae are correct and provide the theoretical and technical foundations for its manufacturing,control and application.
基金supported by the National Natural Science Foundation of China(51505116)the Fundamental Research Funds for the Central Universities(JZ2016HGTB0716)+2 种基金Natural and Science Foundation of Anhui Province(1508085SME221)China Postdoctoral Science Foundation(2016M590563)the Science and Technology Public Relations Project of Anhui Province(1604a0902181)
文摘This paper focuses on the problem of the adaptive robust control of a lower limbs rehabilitation robot(LLRR) that is a nonlinear system running under passive training mode. In reality, uncertainties including modeling error, initial condition deviation, friction force and other unknown external disturbances always exist in a LLRR system. So, it is necessary to consider the uncertainties in the unilateral man-machine dynamical model of the LLRR we described. In the dynamical model, uncertainties are(possibly fast) time-varying and bounded. However, the bounds are unknown. Based on the dynamical model, we design an adaptive robust control with an adaptive law that is leakagetype based and on the framework of Udwadia-Kalaba theory to compensate for the uncertainties and to realize tracking control of the LLRR. Furthermore, the effectiveness of designed control is shown with numerical simulations.
文摘Objective: To explore the effects of the somatosensory interaction technology combined with virtual reality technology on upper limbs function and activities of daily living (ADL) in cerebrovascular disease patients. Methods: Form January, 2019 to December, 2019, 80 cerebrovascular disease patients were recruited, and had been divided into control group (n = 40) and observation group (n = 40), randomly. The control groups received conventional rehabilitation treatment, for 40 minutes per day, while observation group received conventional rehabilitation treatment, for 20 minutes per day, and virtual reality technology treatment, 20 minutes per day, 5 days a week for 4 weeks. Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and ADL before and after treatment. Results: Before treatment, the scores of WMFT, FMA-UE and MBI were no significant difference between two groups (P > 0.05). The scores improved in both groups after treatment (P < 0.01), and were higher in the observation group than in the control group (P < 0.05). Conclusion: The somatosensory interaction technology combined with virtual reality technology could facilitate to improve the upper limbs function and ADL in cerebrovascular disease patients.
文摘Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT). Materials and Methods: A descriptive retrospective study of 46 already diagnosed cases of lower limb DVT. Results: Out of 46 cases of DVT, 71.74% were females. The majority of patients (93.47%) were affected in unilateral lower limb with significant predominance (65.22%) to affect the left lower limb (p Conclusion: Lower limb deep venous thrombosis affects left lower limb more than right and females more than males. Superficial femoral vein (SFV) and common femoral vein (CFV) are the most common affected veins. Lower limb DVT predominantly present in acute stage with venous distension and absent blood flow.
基金a grant from the Tackle Key Problem and Planning Projectin Science and Technology of Hebei Province,No.052761224
文摘BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.
文摘BACKGROUND: The main aim of rehabilitation is to ameliorate motor function and use the damaged limbs in the activities of daily living. Several factors are needed in the self-recovery of the patients, and the most important one is to reduce spasm. Some mechanical repetitive movements can affect and change the excitability of motor neurons. OBJECTIVE: To observe the effect of repetitive training on ameliorating spasm of upper limbs of hemiplegic patients. DESIGN: A self-controlled observation before and after training. SETTING: Department of Rehabilitation, Xuanwu Hospital of Capital Medical University. PARTICIPANTS: Seven hemiplegic patients induced by brain injury were selected from the Department of Rehabilitation, Xuanwu Hospital, Capital Medical University from March to June in 2005. Inclusive criteria: ① Agreed and able to participate in the 30-minute training of hand function; ② Without disturbance of understanding. The patients with aphasia or apraxia, manifestation of shoulder pain, and severe neurological or mental defects. For the 7 patients, the Rivermead motor assessment (RMA) scores ranged 0-10 points, the Rivermead mobility index (RMI) ranged 1-3, and modified Ashworth scale (MAS) was grade 2-4. Their horizontal extension of shoulder joint was 0°-30°, anteflextion was 0°-50°, internal rotation was 50°-90°, external rotation was 0°-10°; and the elbow joint could extend for 15°-135°. METHODS: The viva 2 serial MOTOmed exerciser (Reck Company, Germany) was used. There were three phases of A-B-A. ① The phase A lasted for 1 week. The patient sat on a chair facting to the MOTOmed screen, and did the circumduction of upper limbs forwardly, 30 minutes a day and 5 days a week. ② The phase B lasted for 3 weeks. The training consisted of forward circumduction of upper limbs for 15 minutes, followed by backward ones for 15 minutes and 5-minute rest. ③ The training in the phase A was performed again for 2 weeks. The extensions of upper limbs were recorded at phase A, the extension and flexion of elbow joints were recorded at phase B, and the extensions were recorded at the second A phase. All the patients were evaluated by the same therapeutist. ① RMA was used to evaluate the motor function completely, including the motor control of both upper and lower limbs, but only the data of upper limbs were recommended to be used. The flexibility and concordance of upper limbs were described by detecting the ability of hand to move objects with 15 items, 2 grades for each item: 0 for could not complete and 1 for could complete. ② RMI was used to measure the flexion and extension of elbow joint and shoulder joint, the scores ranged from 0 (no movement and no obvious muscle contraction) to 5 (close to normal movement). ③ MAS was used to evaluate the muscle tension in clinic. Grade 1 for without abnormal increase of muscle tension, and grade 5 for muscle rigidity, and it was unable for passive movement. ④ Ranges of motion of elbow joint and should joint were measured using protractor. MAIN OUTCOME MEASURES: ① The strength of each limb to persist for 40 s recorded by two hand pedals; ② Changes of muscle tensions detected by the two hand pedals; ③ Changes of muscle contraction at the flexion and extension of ipsilateral limb recorded by EMG; ④ Minimal moment of iplateral end foot; ⑤ RMA; ⑥ RMI; ⑦ MAS; ⑧ Ranges of motion of elbow joints and shoulder joints. RESULTS: The functions were evaluated at 6 weeks after training. ① The strength of each limb to persist for 40 s was recorded, and the strength of the ipsilateral limb changed obviously from 20%-40% to 50%-70%. ② The muscle tensions detected by the two hand pedals changed from 2.2-4.0 N·m to 0.2-1.0 N·m. ③ EMG displayed that along with the enhancement of fast movements, the strength curve increased (the EMG for the extension of elbow joints were obvious). ④ The minimal moment of iplateral end foot was 5.0 N·m. ⑤ The RMA scores ranged 15-30 points. ⑥ The RMI ranged 4-5. ⑦ MAS were grades 0-2. ⑧ For shoulder joints, the ranges of motion were 90°-180° for external extension, 90° for anteflexion, 90° for internal rotation and 50°-75° for external rotation; For elbow joints, the extension of active movements was close to 0°. CONCLUSION: After repetitive movements, the strength of upper limb increased, the range of motion enlarged, and spasm reduced.
文摘Most numbness and pain in the limbs iscaused by invasion of pathogenic wind,cold anddampness into the deficient body,blocking themeridians of the limbs with stagnation of Qi orblood,and diffusion of impeded body fluids.Ramulus Cinnamomi has the property of warm-
文摘The syndrome of atrophic paralysis of thelimbs refers to a group of diseases characterizedby atrophy and weakness of the limbs.Patientswith this syndrome are unable to move theirlimbs voluntarily,which may be accompaniedby numbness and muscular atrophy.This diseaseis more commonly seen in the lower limbs.
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Pain and gangrene in limbs due to Buerger’s disease, Raynaud’s phenomenon andatherosclerosis are a great problern to manage in modern medicine. Vasodilators, sympathectomy andprogressive amputations cannot solve the problem. Electr0acupuncture shows very good results so that drugs and surgery may be spared. Total 32 cases (Buerger’s 27, Raynaud’s 4, atherosc1erosis 1 )were treated with acupuncture needling and electrostimulation. Acupoints used were Weizhong (BL4O ), Taixi (KI 3), Zusanli (ST 36), Jiexi (ST 41 ), Bafeng (Extra), Neiguan (PC 6), Hegu (LI4 ), Baxie (Extra) . The frequency of electrostimulation at acupoints was 100- 500 cycles per minute.Daily treatment was carried out the first 1O days, then the times of treatment reduced. The therapywas maintained once in two beths. Of 27 cases of Buerger’s disease, 19 cases (82. 6 % ) were healed. Pain was relieved but uker not healed in 1 case (4. 3% ). Failure was 3 (13% ). 3/4 (75 % ) ofRaynaud’s cases, pain and gungrene were fully control1ed; the
文摘Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the mortality among octogenarians was as high as 29%regardless of the type of intervention and that re-vascularization was associated with high peripro-cedural mortality.[2]A previous study had already shown that reconstructive surgery for elderly indi-viduals over 80 years old resulted in a significantly higher mortality rate than that for patients between 70 and 80 years old,whereas endovascular inter-vention and primarily conservative treatment had comparable prognoses.[3]Consistently,another study showed that the risks of both overall and am-putation-free survival were significantly lower with endovascular treatment than with bypass surgery in patients with critical limb ischemia.[4]A systematic review and meta-analysis of 27 studies(15 cohort and 12 randomized controlled trials)with 1642 pa-tients suggests that conservative treatment may be considered for nonreconstructable patients with critical limb ischemia;[5]however,because a high risk of bias and serious inconsistencies were found in the included studies,the meta-analysis provided low-quality evidence.In contrast,a small cohort study with 49 patients suggests that amputation im-proved quality of life and health status in fragile elderly individuals.
