ABSTRACT
Objective To observe the influence of low or middle power microwave radiation on tissues adja-cent to titanium alloy implants. Methods Titanium alloy internal fixation plates were implanted into the upper femur of the right side of New Zealand white rabbits, the left femurs served as the control. Then the femurs were exposed to 20, 40, 60, or 80 W of microwave radiation at a frequency of 2450 MHz for 30 minutes, and real-time temperature of the implants and its adjacent muscles were recorded. The nerve conduction study of the sciatic nerve was performed by stimulating the nerve and recording from gastrocnemius in both groups. Finally, all the rabbits were sacrificed and histo-logical studies were performed on nerve and muscle sections. Results Compared to the control limbs, temperatures of limbs with titanium alloy implants increased significantly when exposed to microwave radiation at 60 and 80 W ( P0.05). Pathological examination showed obvious congestion and bleeding in the intercellular spaces of skeletal muscle cells in the experiment group when exposed to radiation at 60 W, with no ob-vious pathological changes found in the sciatic nerve. However, when exposed to radiation at 80 W, vacuoles appeared in myocytes, the cellular structure was destroyed and the myelin sheath of the sciatic nerve swelled. Conclusion Ex-posure to microwave irradiation at 20 and 40 W, but not 60 and 80 W exerts no adverse effects on nerves and muscles adjacent to titanium alloy internal fixation plates. Consequently, continuous wave microwave irradiation at low powers (20~40 W) is a safer auxiliary treatment for limbs with titanium alloy implants.
ABSTRACT
BACKGROUND:Smal-needle-knife therapy for knee osteoarthritis has no uniform location, operation and mechanisms of action. Studies have proved that exercise therapy can enhance muscle strength, increase stability of the knee, improve joint range of motion, and effectively relieve pain. OBJECTIVE:To observe the clinical effect of smal-needle-knife therapy combined with exercise therapy for treatment of knee osteoarthritisvia a randomized controled clinical trial. METHODS:122 patients were randomly divided into treatment group (n=61; smal-needle-knife therapy combined with exercise therapy) and control group (n=61; low-frequency therapy combined with exercise therapy). Then, clinical efficacy in the two groups were assessed by statistical analysis of visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), sweling degree of the knee joint, quadriceps circumference, flexion and extension of the knee joint before and after treatment. Meanwhile, adverse reactions in patients were recorded for safety evaluation. RESULTS AND CONCLUSION:(1) The visual analog scale and WOMAC scores in the two groups were both significantly improved at 2 weeks after treatment (P < 0.05). Moreover, these scores in the treatment group were significantly lower than those in the control group (P < 0.05). (2) At 12 weeks after treatment, the WOMAC score in the treatment group was better than that in the control group (P< 0.05), and the range of motion of the knee joint was also better in the treatment group than the control group (P< 0.05). (3) According to the full analysis set and per protocol set, the total efficiency rats in the treatment group were both superior to those in the control group (P< 0.001). (4) In the treatment group, there were four cases of surgery, four cases lost to folow-up, and two cases of mild adverse reactions; in the control group, there were six cases of surgery, three cases lost to folow-up, and no adverse reaction. Taken together, smal-needle-knife therapy and physiotherapy both have certain clinical effects on knee osteoarthritis. Smal-needle-knife therapy combined with exercise therapy is superior to physiotherapy combined with exercise therapy in the total efficiency. Folow-up results of 3 months have been confirmed, but long-term effects need further exploration.
ABSTRACT
BACKGROUND:Low power microwave irradiation has been shown to promote the healing of fractures with internal fixation;however, its action mechanisms on the skeletal muscle around the fracture site are unclear. OBJECTIVE:To study the effects of low power microwave irradiation (20 W) on the proliferation ability of skeletal muscle satel ite cel s in a rabbit model of femoral fracture with internal fixation. METHODS:Forty male New Zealand rabbits were used to establish femoral fracture fol owed by internal fixation models, and then were equal y randomized into spontaneous recovery and microwave treatment groups. Low power microwave irradiation (20 W) was given for 30 consecutive days in the microwave treatment group on day 4 after modeling, while no microwave irradiation was given in the spontaneous recovery group. Rabbit thigh muscles adjacent to the implant were obtained to isolate skeletal muscle satel ite cel s. Immunohistochemical staining, hematoxylin-eosin staining and quantitative RT-PCR were used to evaluate the ability of the proliferation and differentiation of skeletal muscle satel ite cel s. RESULTS AND CONCLUSON:Hematoxylin-eosin staining showed that there was no significant difference in the morphology and histology of skeletal muscle tissues between the spontaneous recovery and microwave treatment groups. However, the relative mRNA expression of MyoG in the cultured skeletal muscle satel ite cel s in vitro and the number ofα-sarcometric actin-postive cel s in the microwave treatment group were significantly increased compared with the spontaneous recovery group (P<0.05). The proliferative ability of skeletal muscle satel ite cel s was inhibited at the early stage, but not at the later stage. Our results suggest that low power microwave irradiation (20 W) can promote the proliferation and differentiation of skeletal muscle satel ite cel s around the implant in a rabbit model of femoral fracture with internal fixation, and thereby confirm the efficacy and safety of low power microwave irradiation for the internal fixation of fractures.
ABSTRACT
The stroke rehabilitation evaluation system has been designed and developed in view of the present practice status of clinical rehabilitation medicine. The system not only implements patient information collection and rehabilitation evaluation, but also outputs individual rehabilitation program automatically according to evaluation outcome.
Subject(s)
Humans , Outcome Assessment, Health Care , Methods , Software Design , Stroke RehabilitationABSTRACT
This review paper presents the current design & development progress and challenges of computer rehabilitation evaluation system.
Subject(s)
Computer Systems , Outcome Assessment, Health Care , Methods , Software Design , User-Computer InterfaceABSTRACT
@# Objective To explore an economic and effective management strategy for lumbar disc herniation (LDH) in community health center. Methods 62 LDH patients treated in Xujiahui community health center (observation group), 48 LDH patients treated in Huajing community health center (control group A) and 55 LDH patients treated in Shanghai 6th People's Hospital (control group B) were included.The observation group was managed by associate professor from Shanghai 6th People's Hospital and accepted different treatment strategy in mild, medium and heavy grades. The control groups A and B were managed routinely. 3 month later, costs of illness were computed and curative effects were accessed in 3 groups. Results There was no difference in curative effects between observation group and control group B (P>0.05), but better than control group A (P<0.05). The observation group cost the least among the groups (P<0.05). Conclusion Graded treatment strategy united with tertiary hospital is an economic and effective mode for LDH management in community health center.
ABSTRACT
Objective To investigate the effects of different intensities and different radiation durations of 2450MHz microwaves on activation of extracellular-regulated kinase (ERK)-1/2 in cultured mouse fibroblast in vitro.Methods The fibroblasts isolated from mouse skin and cultured were directly radiated with different intensities and different durations of microwave.After direct radiation with 2450MHz microwave (0.3 W/cm2, 0.5W/cm2, 1W/cm2 ) for 15min or 30min, anti-phosphorylation extracellular-regulated kinase( ERK-1/2 ) antibody was analyzed by Western blot technique to observe phosphorylation changes of fibroblasts protein ERK-1/2.and activation of mitogen-activated progein kinase(MAPK) signal conductive pathways.Results After microwave radiation with 0.3W/cm2, 0.5W/cm2, 1W/cm2for 15min, activation of ERK-1/2 increased significantly (P < 0.05 ) ; but after 30min radiation with 0.3 W/cm2,0.5W/cm2, 1W/cm2, activation of ERK-1/2 decreased significantly(P<0.05).Conclusion It is concluded that different intensities microwave may activate different signals of fibroblasts in dose-dependent manner in vitro.Different microwave radiations can induce different activations in MAPK signal conductive pathways.
ABSTRACT
Objective To investigate the effects of ultrashortwave (USW) diathermy and electrical stimulation (ES) used in combination with nerve growth factor (NGF) in the treatment of experimental sciatic nerve injury.Methods Sixty adult Wistar rats were randomly divided into a normal control group, a model group, an NGF group,a physiotherapy group and a combined treatment group. A model of sciatic nerve injury was established in the latter four groups. Beginning on the 2nd day after the operation, no treatment was given in the model group, NGF was injected in the NGF group, diathermy and ES were administrated to rats in the physiotherapy group, and the combined treatment group was treated with USW diathermy, EW and NGF. Function, electrophysiology and morphology were evaluated at the 2nd, 7th, 14th and 30th days after the operation Results The average sciatic nerve function index (SFI), nerve conduction velocity (NCV) and nerve regeneration in the NGF, physiotherapy and combined treatment groups were significantly better than in the model group, with those in the combined treatment group improved to the greatest extent. At the 30th day there was no significant difference between the combined treatment group and the normal control group in terms of SFI, NCV, axon regeneration or myelin sheath thickness. The number of myelinated nerve fibers and the average axon diameter in the combined treatment group and normal control group were significantly higher than those in the model, NGF or physiotherapy group. Conclusions With NGF injection, additional application of USW diathermy and ES may significantly enhance the regeneration of the sciatic nerve and aid functional recovery after injury.
ABSTRACT
@#The Community Health Care Centre of Xujiahui, Shanghai tries to integrate the community-based rehabilitation for orthopedic chronic diseases into the primary health care system within the general practices. This paper would discuss its features, problem, and prospect.
ABSTRACT
@#ObjectiveTo observe the effect of the designed cervical orthosis(CO) and the finished collar in the treatment of vertebroarterial cervical spondylopathy.Methods70 patients with vertebral artery type cervical spondylosis were divided into designed cervical orthosis group (35 casese) and the finished collar group (35 casese) separately.ResultsThe excellent and good rate of the designed cervical orthosis group was 94-3% while that of the finished collar group was 71-4%. There was significant difference between the two groups after 4 weeks of treatment(P<0-01).ConclusionThe designed cervical orthosis(CO) in the treatment of vertebroarterial cervical spondylopathy is more effective than finished collar.
ABSTRACT
Objective To explore the reliability and validity of the simplified Chinese version of the Oswestry disability index (SCODI) and the curative effect of community-based rehabilitation for patients with lumbar disc herniation (LDH). Methods 165 patients with LDH received community-based rehabilitation according to the severity of their LDH. Before treatment and after 3 months, the SCODI, the Roland-Morris disability questionnaire (RMDQ) and a visual analogue scale (VAS) were used to evaluate the effects. The reliability and validity of the SCODI was thus tested. The reliability analysis included internal consistency as measured by Cronbach's coefficient,and test-retest reliability as measured by an interclass correlation coefficient (ICC). The validity analysis used Spearman's correlation coefficient (for concurrent efficacy validity) and factor analysis (for construct validity). The correlation between SCODI, RMDQ and VAS results was analyzed. Results There was statistically significant functional improvement and better QOL in LDH patients after community-based rehabilitation. The SCODI showed good validity and reliability. There was significant correlation among the SCODI, RMDQ and VAS results. Conclusion Community-based rehabilitation can significantly alleviate symptoms for patients with LDH and improve their QOL.The SCODI is a reliable and valid instrument for measuring the curative effect of community-based rehabilitation on patients with LDH.
ABSTRACT
Objective To investigate the regenerating effect of muscle satellite cells autografted onto mus-cles injured by chronic compartment syndrome (CCS). Methods Twenty-four adult rabbits were randomly divided into an experimental group (model-transplantation), a non-graft group (model) and a control group (transplanta-tion). The CCS model was established in the experimental and non-graft groups. Transplantation was done in the ex-perimental and control groups. Satellite cells from the experimental and control group rabbits were isolated and then proliferated in vitro. The specific protein was identified by immnochemistry before engrafting. Then the 4',6-diamidi-no-2-phenylindole-tagged satellite cells were transplanted back to the original soleus muscles. After transplantation,the proliferation and differentiation of the satellite cells in vivo was observed and morphological changes at the site of the injury were compared by HE staining. Results At the 28th day after grafting, the satellite cells from the com-pressed soleus muscles in the experimental group had increased significantly, whereas those in the control group had remained the same. In both the graft group and the non-graft group, HE staining showed a large cluster of myofibers and interstitial fibers necrosed in the compressed muscle, while the skeletal muscle fibers and interstitial fibers were in-tact in the control group. At the 28th day after engrafting, the engrafted muscle showed much repair; but the non-en-grafted muscle demonstrated dominant fibrosis. The morphology of the skeletal muscle in the control group was normal.Conclusions Autografting of muscle satellite cells after a small amount of expansion in vitro could improve their regen-eration efficiency for repairing a large cluster of damaged myofibers caused by chronic compartment syndrome.
ABSTRACT
@#Objective Practice and exploration in relation to development with large general hospital and community-based care of rehabilitation programs.Methods Utilization of advantage resources for competition and effective combination of community-based health care system can develope community-based care of rehabilitation programs.Results Feasibile plan finished in the primary and community-based health care system and technology resource can provide a theoretical basis for sustainable development.Conclusion Education of skill and rehabilitation guidance can enhance service rehabilitation in community-based.
ABSTRACT
@#Objective To investigate the incidence of osteoarthritis disease, related factor and need of rehabilitation services. Methods 13579 questionnaires were sent randomly to the permanents resident in Xuhui District, and 12419 returned. Results The morbidity of cervical syndrome, lumbar diseases, knee osteoarthritis were 22.74%, 31.45%, and 23.37%, and more in females (P＜0.01). 23.12%, 16.59%, 20.12% patients with cervical syndrome, lumbar diseases, knee osteoarthritis accepted rehabilitation respectively, and 28.08%,36.05%, 34.18% accepted self-exercise. The top 3 complications were hypertension, cardiovascular diseases, and gastropathy. Conclusion It is important to improve the rehabilitation intervention and health education to the females and the elders, as well as the community health services and the community general practice team.
ABSTRACT
Objective To investigate the effects of 2 450 MHz microwave irradiation on the proliferation of cultured mouse fibroblasts in vitro, and the related gene and protein expressions. Methods Cells from mouse skin were directly radiated with microwaves of different intensities for different periods. The proliferation of fibroblasts was assayed by the MTT method, and the effects of microwave radiation on the fibroblast cell cycle were measured by flow eytometry. The mRNA expression of types Ⅰ and Ⅲ procollagen was detected by real-time RT-PCR. Anti-phosphoryl- ation extracellular-regulated kinase (ERK-1/2) antibody was introduced in immunofluorescence staining analysis to observe any changes in the phosphorylation of fibroblast protein ERK. Results ① 5 W/cm2 or 1.0 W/cm2 irradia- tion for 5 min, 15 min, or 30 min did not significantly decrease fibroblast proliferation, but irradiation at 5 W/cm2 for more than 5min caused a significant decrease in fibroblast proliferation. ②After 5 W/cm2 irradiation for 5 min, the percentage of cells in the G0/G1phase was significantly increased, and ERK was activated immediately after irradia- tion. ③The mRNA expression of type Ⅰ procollagen was down-regulated after microwave irradiation, and the magni- tude of the decreased expression correlated positively with the duration of irradiation. Thirty minutes of microwave ir- radiation at 1 W/cm2 or 5 minutes at 5 W/cm2 significantly down-regulated the mRNA expression of type Ⅰ procolla- gen and the ratio of types Ⅰ and Ⅲ. Conclusion High-intensity microwaves may inhibit the proliferation of fibro-blasts in a dose-dependent manner in vitro and down-regulate procollagen mRNA expression, which might be achieved by activating mitogen-activated protein kinase signal transduction gateways.
ABSTRACT
BACKGROUND: There is a close correlation between telomere length and cell senescence, immortalization or canceration. OBJECTIVE: To explore the significance of telomere length diversifies in the chronic compartment syndrome in lumbosacral region. DESIGN, TIME AND SETTING: A comparative observation was performed at the State-Level Key Medical Genomics Laboratory, Shanghai Jiao Tong University School of Medicine from July 2007 to February 2008. PARTICIPANTS: The vertical spinal muscular tissue samples were taken from people aged 29-49 years old [mean aged (34.7?12.6) years] including 10 normal people and 15 patients with chronic compartment syndrome. According to the age, the normal were divided into the aged 30-37, and aged 38-45 groups. The abnormal were divided into aged 29-34, aged 35-43 and aged 44-49 groups, with 5 samples in each group. METHODS: DNA was extracted from samples of each group. Telomere length in vertical organizations spinal muscular skeletal muscle was measured by Southen Blotting hybrid technology. MAIN OUTCOME MEASURES: Telomerase length of erector spinal muscles in patients and normal people. RESULTS: The mean telomere length in patients with chronic compartment syndrome was obvious shorter than that of the normal people, which has significant difference (P
ABSTRACT
BACKGROUND:Evaluation plan for the neuro-musculo-skeletal system model and motor function was little.However,the three-dimensional gait analysis can transfer qualitative analysis and object description which widely used in orthopedics and rehabilitation medicine to quantitative evaluation with more objective and precise.OBJECTIVE:To evaluate gait kinematics and kinetic changes after total knee replacement based on 12 months follow up using three-dimensional gait analysis.DESIGN,TIME AND SETTING:The comparative observation and case-control study was performed in the Gait Analysis Room of the Department of Rehabilitation Medicine in the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University from January 2007 to May 2008.PARTICIPANTS:Ten patients with knee osteoarthritis following total knee replacement were chosen as treatment group;concurrently,ten patients whose baseline data were matched with the treatment group without problems in nerve,muscle,skeletal system and equilibrium were selected as the control group.METHODS:Ten patients in the treatment group underwent rehabilitation training,then compared time-distance,kinematic,and mechanical parameters which were measured at 3,6,12 months after total knee replacement with the control group.MAIN OUTCOME MEASURES:Time-distance parameter,kinematic parameter,mechanical parameter and knee functional scores.RESULTS:Pace,step frequency,gait speed,and time of injured leg standing were notably decreased,while time of uninjured leg standing,duration of gait cycle were obvious prolonged compared with the control group(P
ABSTRACT
BACKGROUND:Gait analysis enable to convert qualitative analysis and description used for a long time in orthopedic examination and rehabilitative treatment into objective and precise quantitative assessment. At the present, with the development of science and technology, three-dimensional (3D) gait analysis is more and more widely, extensively used in orthopedic surgery and rehabilitation medicine abroad, while much less in China.OBJECTIVE: To study the parameters of time-distance, kinematics, kinetic and electromyography (EMG) in healthy subjects and patients with backbone, hip, knee or ankle joint diseases.DESIGN: Comparative observation and control study.PARTICIPANTS: From December 2004 to July 2005, 40 healthy subjects and 112 patients suffering from backbone and hip, knee, ankle joint disease were selected from the Department of Rehabilitative Medicine, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University and analyzed by three dimensional gait analysis system (VICON 612 system made by Britain VICON Company). 112 patients including 42 males with the mean age of (46.2 ± 2.3) years and 70 females with the mean age (41.2 ± 3.5) years were screened by skilled clinicians after surgical and rehabilitative treatment.Among them there were 21 patients with cervical vertebra, 26 patients with prolapse of lumbar intervertebral disc and lumbar spinal stenosis. The number of hip, knee, ankle joint disease was 12, 34, 19 respectively. Total hip replacement was included in hip joint disease, anterior cruciate ligament (ACL) reconstruction was included in knee joint disease, talipes equinovarus was included in ankle joint disease. Meanwhile, 40 healthy subjects who were 20-40 years old, male or female, without any clinical symptom of backbone and limbs volunteered in the study.METHODS :Gait analysis were carried out on 40 healthy volunteers and 112 operational and rehabilitative treatment patients with spinal and lower limb diseases using VICON 612 system made by Britain VICON Company.MAIN OUTCOME MEASURES: The time-distance parameters (cadence, step length, walking speed), kinematics parameters (knee flexion/extension degree, hip flexion/extension degree, ankle dorsi/plantar degree), kinetic parameters (knee force in Z axis, hip force in Z axis, normalized force in Z axis) and EMG parameters (vastus lateralis SEMG) of lower limbs were examined.RESULTS: A total of 40 healthy subjects and 112 patients were involved in the analysis of results. ① Time-distance parameter: Cadence, as well as step length and walking speed of patients with backbone disease, patients with hip joint disease, patients with knee joint disease, and patients with ankle joint disease were lower than those of healthy subjects,and the difference between two groups was significant (P ＜ 0.05-0.01). ② Kinematic and kinetic parameters of all joints in upper limbs: One year after left ACL knee reconstruction, the extension of left knee in initial contact phase was 9° less than that of right one and the stress in Z axis of left knee was much less than that of right one; One year after left THA,the flexion of left hip in initial contact phase was 8.5° less than that of right one, the extension of left hip in terminal stance phase was 3° less than that of right one, during stance phase the stress in Z axis of left hip was much less than that of right one; As to an infantile paralysis patient with talipes equinovarus, the dorsiflexion of left ankle in initial contact phase was 12° less than that of right one, the plantar flexion of left ankle in terminal stance phase was 5° less than that of right one. The stress in Z axis of left ankle during stance phase was much less than that of right one. However, the difference in range of motion and stress in Z axis was not significant between the left and right knee joint in healthy people. ③ One year after left total knee arthroplasty, the dynamic surface electromyogram signals of left vastus lateralis is much lower than that of right vastus lateralis in a gait cycle.CONCLUSION: 3D gait analysis enables tprovide objective basis for making operation scheme for orthopedic surgery and after-operation rehabilitation therapy, and assessing curative effect of rehabilitation therapy.
ABSTRACT
Objective To discuss pathogenesis of low back pain induced by chronic compartment syndrome. Method Thirty patients who had definite chronic lumboscaral compartment syndrome without other lumbal diseases were choosed respectively to test muscle force of lumbar and abdomen,intra-sacrospinal muscle pressure,blood routine,ESR,CK,CK-MM,LDH and LDHs.All patients received decompressive operation.Skeletal muscle specimens taken from sacrospinal muscle in each operation were possessed for histological and ultrastructuml observation. Result All of enzyme tests were normal.The author could observe the dissolved degeneration of part of sacrospinal muscle fibers,muscle fiber hypertrophy,and a small quantity of inflammatory cell infiltration with a light microscope.Focal solution of muscle fiber,the aggregation of mitochondria around the nucleus,the increase of lipid droplet and lysosome in cyte,and the proliferation and differentiation of muscle satellite cell could be observed with an electron microscope. Conclusion Pathogenesis of chronic lumboscaral compartment syndrome may be as followed.Intra-compartmental pressures increase,causing metabolism disturbance of the tissues under fascia compartment,damaging skeletal muscle chronically,then inflammatory factors are released,which stimulates posterior branch of spinal nerves,and finally induces low back pain.
ABSTRACT
Objective To study the methods of clinic al diagnosis and treatment of chronic lumbar pain induced by chronic compartment s yndrome. Methods Thirty-nine patients with chronic lumbar pain induced by chronic compartment syndrome were recruited. Their diagno sis was confirmed by physical examination and measurement of of lumbar muscle in tra-compartment pressure. Micro-invasive opening decompression of the lumbar c ompartment was performed for treating these patients. Therapeutic exercises of t he lumbar and abdomen muscles were administered 2-days after operation. Results After treatment, the symptoms were significantly r elieved, distance of walk in creased as compared with those before operation. Th e ranges of trunk flexion and extension were increased. A comparison with the pr etreatment showed that the lumbar muscle intra-compartment pressures at rest du ring movement and 6 min after movement were decreased(6.6?0.7 vs 11.1?0.7),(16 0.3?11.15 vs 188.1?12.08)and(6.9?0.8 vs 14.1?1.2)mmHg, respectively ( P