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Objective To investigate the relationship between the severity of insomnia and the curative effect in acute stage in patients with major depressive disorder (MDD). Methods The Insomnia Severity Index (ISI) was used to evaluate and group the severity of insomnia in the 57 patients with MDD. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The 24－item Hamilton Depression Scale (HAMD24) was used to evaluate depressive symptoms, and the effect of acute stage (4～6 weeks) was evaluated with its reduction rate. The difference of curative effect was compared among patients with different insomnia levels. Results There was a significantly different recovery rate in acute stage in 3 groups of patients with mild, moderate and severe insomnia ( X2=22.34,P＜0.01). The severity of insomnia in patients with MDD (PSQI) was negatively correlated with the curative effect of acute stage (r=－0.44,P＜0.01). The total score, anxiety/somatization factor score, retardant factor score and despair factor score were significantly higher in severe insomnia group than in the moderate and mild insomnia groups after acute treatment (P＜0.01). Conclusion The severity of insomnia in patients with MDD can predict the curative effect in acute stage. The depressive patients with severe insomnia have residual anxiety/somatization, retardant, feelings of despair and other symptoms more obvious than mild and moderate insomnia patients after acute treatment.
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Objective To investigate walking ability of amputees with unilateral transtibial prosthesis. Methods From April to Decem-ber, 2016, 20 unilateral transtibial amputees (patients) and 20 healthy adults (controls) were tested with L test, balance test, 6-minute walk test (6MWT) and 1000 m walking outdoor on various terrain. Results There was no significant difference in time of L test between the am-putees wearing Solid Ankle Cushion Heel (SACH) and Storage Foot (t=0.675, P>0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (t0.05). Each parameter was significantly different in 6MWT between them (t>2.774, P4.130, P<0.001). Conclusion The walking ability of the unilateral transtibial ampu-tees wearing prostheses is different from normal people. The transtibial prosthetic feet that the amputees wear may impact their walking abil-ity.
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@#The foot overpronation is termed as pronation persisting more than 25%of stance phase in a walking cycle, which may re-sult from some antenatal or postnatal conditions. Overpronation would lead to abnormal alignment of ankle, knee, pelvis and spine, and re-sult in a set of syndromes of chronic pain. The Navicular Drop Test and the Foot Posture Index are often used as the assessment tools, how-ever, there are several empirical ways for clinic. Foot orthoses, special shoes, taping and training of muscle strength are effective on overpro-nation as well as chronic pain.
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Objective To systematically review the evaluation tools for walking ability of lower limb amputees wearing prostheses. Methods A computer-based search of PubMed, Wanfang Data and CNKI.net was performed for articles related to the evaluation of walking ability of lower limb amputees wearing prostheses published from January, 1995 to December, 2015. Results and Conclusion A total of 20 papers were selected, including 18 foreign literatures and 2 Chinese articles. There were many evaluation tools for walking ability of lower limb amputees wearing prostheses, and should be chosen according to the actual situation.
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Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Meth-ods 16 unilateral transfemoral amputees (patients) and 16 healthy adults (controls) were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significant-ly less in the patients than in the controls (P0.05). There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups (P<0.05). There were significant differences in time of outdoor 1000 m walk test and distance of indoor walking test be-tween amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint (P<0.05), but not in energy expen-diture of indoor and outdoor walking test. Conclusion The amputees with unilateral transfemoral prosthesis appear the inefficient in gait, and expend more energy. Their balance remains well. The transfemoral prosthesis the amputees wore may impact their walking ability.
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@#Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Methods 16 unilateral transfemoral amputees (patients) and 16 healthy adults (controls) were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significantly less in the patients than in the controls (P<0.05) in the indoor 6-minute walking test, and the cycle of gait and energy expenditure were significantly more (P<0.05); single support time, double and single/double support time were different (P<0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (P>0.05). There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups (P<0.05). There were significant differences in time of outdoor 1000 m walk test and distance of indoor walking test between amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint (P<0.05), but not in energy expenditure of indoor and outdoor walking test. Conclusion The amputees with unilateral transfemoral prosthesis appear the inefficient in gait, and expend more energy. Their balance remains well. The transfemoral prosthesis the amputees wore may impact their walking ability.
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Objective To compare the energy expenditure of a hemicorporectomy amputee moving with different mobility devices. Methods A middle-aged male hemicorporectomy amputee was measured with cardiopulmonary exercise test when moving with 4 kinds of transport:socket, cart, wheelchair, and prosthesis. Results The patient moved the slowest with prosthesis, fastest with wheelchair. The heart rate was the highest with prosthesis and lowest with cart. The absolute oxygen consumption, the relative volume of oxygen consumption and metabolic (Mets) were the most when hand walking with socket, and lowest with cart. Conclusion Hand walking with socket costs the larg-est energy when walking, and the rest are prosthesis, wheelchair, and cart.
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@#Objective To compare the walking ability between bilateral transtibial amputees and normal controls, and develope reference indexes of bilateral transtibial amptees' walking ability while wearing prostheses. Methods 11 bilateral transtibial amputees served as amputation group, 12 normal subjects served as controls. The indoor gait characteristics, outdoor time cost and energy consumption, and static balance of both groups were evaluated. Results After the indoor gait analysis, the average self-selected-speed of the amputees was 1.07 m/s, while the self-selected-speed of the normal people was 1.29 m/s. When the subjects walked with their self-selected-speed, there were significant differences in some of the gait spatial and temporal parameters between 2 groups (P<0.05). When the subjects walked on a specially designed 1 km outdoor trail, differences of energy consumption and time cost were also observed (P<0.05). Static balance presented no significant difference between 2 groups (P>0.05). Conclusion The walking ability of the bilateral transtibial amputees wearing prostheses is different from normal people. Quantitative evaluation of walking ability can provide more accurate reference for the rehabilitation of amputees.
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@#With the development of the industry, all the parts of bilateral hip disarticulation prosthesis have been improved. The patients with bilateral hip disarticulation prosthesis can achieve the swing-to gait or swing-through gait, even the reciprocal gait.
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@#ObjectiveTo design a reciprocal gait prosthesis connecting with the other prosthetic accessories for the bilateral hip disarticulation amputees.MethodsThe principle of reciprocal gait orthosis for paraplegia was used in the design, fitting reciprocal gait prosthesis for an amputee, which was compared with an ordinary bilateral Canadian type hip disarticulation prosthesis in the walking velocity and energy expenditure.ResultsThe amputee walked at lower energy expenditure and more like normal gait with reciprocal gait prosthesis while the walking velocity decreased, compared with the conventional prosthesis.ConclusionThis reciprocal gait prosthesis for bilateral hip disarticulation amputee needs less energy expenditure during walking like normal gait.
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@#This paper would review the effort of low limb orthoses on sports injury, especially the basic and clinical research in the treatment, rehabilitation and prevention.