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Objective:Using ultrasound imaging technology to evaluate the contraction characteristics of diaphragm in patients with chronic low back pain.Methods:Twenty nine patients with chronic low back pain and 26 healthy persons recruited from the rehabilitation department of the Third Affiliated Hospital of Sun Yat-sen University from November 2019 to April 2020 were selected and divided into the low back pain (LBP) group and the healthy control group. The thickness of the diaphragm (Tdi) of the subjects during deep breathing was evaluated by portable color Doppler ultrasound equipment under different body positions. The subjects were required to perform maximum inspiration for total lung capacity (TLC) and expiration for functional residual capacity (FRC) in the supine and standing position, respectively. The end-inspiratory diaphragm thickness (TdiTLC) and end-expiratory diaphragm thickness (TdiFRC) were recorded, and the diaphragmatic thickening fraction (DTF) was calculated. The general data of subjects with lower back pain and the correlation between Oswestry Dysfunction Index (ODI) and diaphragm function were analyzed; The diaphragm function of healthy control group and LBP group were compared; The receiver operating characteristic (ROC) curve of Tdi and DTF in the diagnosis of lower back pain were analyzed.Results:ODI lifting score was negatively correlated with standing TdiTLC ( r=-0.50, P<0.01). In intra-group comparison, the TdiTLC and TdiFRC values of healthy subjects in standing position were increased compared with those in supine position ( t=6.115, 7.314, all P<0.001); In standing position, TdiTCL and TdiFRC values in LBP group were increased compared with those in supine position ( t=2.834, 4.673, all P<0.01). In comparison between groups, TdiTLC values in supine and standing position of LBP group were significantly lower than those in healthy control group ( t=2.597, 3.338, all P<0.05); In standing position, TdiFRC of patients in LBP group was significantly lower than that of healthy control group ( t=2.098, P=0.041) and DTF value of patients in LBP group was significantly lower than that of healthy control group ( t=2.902, P=0.006). When TdiTCL≤3.3 mm in supine position was used to predict low back pain, the diagnostic sensitivity and specificity were 78.6% and 53.8%, respectively, and the area under the curve was 0.661. When TdiTCL≤4.5 mm in standing position was used to predict low back pain, the diagnostic sensitivity and specificity were 95.7% and 46.2%, respectively, and the area under the curve was 0.759. When DTF≤81.3% in standing position was used to predict low back pain, the diagnostic sensitivity and specificity were 52.2% and 84.6%, respectively, and the area under the curve was 0.698. Conclusions:It is found in our study that the diaphragm contractile function of patients with lower back pain is worse than that of normal subjects, and the difference was significant in standing position. We suggest that the right-side ultrasound image acquisition in the patient′s standing position is helpful to ensure the accuracy and objectivity of the measurement results. TdiTCL≤4.5 mm or DTF≤81.3% in standing position can be used as one of the reference indexes for the combined diagnosis of chronic low back pain.
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Objective:To investigate the knowledge of the disease and demands of medical intervention in high-risk individuals of arteriosclerotic cardiovascular diseases (ASCVD).Methods:The 10-year ASCVD incidence risk prediction model was used to screen ASCVD high-risk individuals from Luohu district of Shenzhen city. From October 2018 to April 2019,a semi-structured in-depth interview was conducted among ASCVD high-risk individuals selected by stratified sampling method according to age, gender and educational level. The original data were analyzed with Colaizzi′s seven-step analysis method.Results:Total 37 interviewees were enrolled with an average age of (65.2±8.9) years and with an average ASCVD risk value of (14.2±3.2). Three themes were extracted from the interview, including: (1) Majority interviewees had better Knowledge about the hazards and risk factors of ASCVD; (2) Most of the interviewees had lower medical demands; (3) The interviewees were more likely to focus on symptomatic diseases or diseases disturbing them.Conclusions:The asymptomatic high-risk ASCVD individuals generally have better awareness of ASCVD and less demands for intervention. The result indicates that for health education, not only the knowledge, but also the attitude and behavior should be enhanced.
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Objective To analyze the effect of ultrasound-guided glucocorticoid injection on different pathologies of the shoulder retrospectively.Methods Clinical data were collected describing 75 patients with shoulder pain who received ultrasound-guided glucocorticoid injection and finished 3 month follow-ups in the rehabilitation clinic of the Third Affiliated Hospital of Sun Yat-sen University between April and September of 2017.The patients were divided into three groups based on their different injection sites:group 1 was injected at the subacromial bursa alone,group 2 was injected at both the subacromial bursa and the coracoid bursa,while group 3 was injected at the subacromial bursa and the long head of the tendon sheath of the biceps brachii.A shoulder pain and disability index (SPADI) was used to quantify the pain and disability of each patient before and after the injection.Results Significant improvement was observed in the average pain and disability scores of all groups at 1 week,1 month and 3 months after the injection.Moreover,significant and continuous improvement was observed in the average pain and disability scores of groups 1 and 3,as well as the average disability score of group 2 from right after the injection until the last follow-up.However,no significant differences were found in the average pain score between one and three months after the injection.There was no significant difference among the 3 groups in the average pain and disability scores before and immediately after the injection.Conclusion Ultrasound-guided glucocorticoid injection is effective and persistent for treating shoulder pain with different pathologies.
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Objective To assess the effects of rehabilitation training on lower extremity muscle function in stroke patients using velocity-encoded phase-contrast MRI ( VE-PC MRI). Methods Twenty-nine stroke patients at the convalescence stage were divided into a treatment group (14 cases) and a control group (13 cases).The subjects performed calf muscles stretches supine in a scanner bed with voluntary ankle flexion-extension movements.Imaging data were collected from the tibialis anterior muscle (TA),the medial head of the gastrocnemius (MG) and the soleus muscle (SOL) of the affected side.The treatment group also underwent rehabilitation including treadmill training,while the control group received only walking training without the treadmill.Barthel index (BI) and Berg balance scale (BBS) scores were measured after rehabilitation. Results Compared with baseline,the contraction velocity of the TA (phases 2 to 7),the MG (phases 12 to 18 ) and the SOL (phases 13 to 16) on the affected side increased significantly in the treatment group.In the control group,the contraction velocity of the calf muscles on the affected side improved,but fewer phases were significant-for the TA phase 4,for the MG phases 13 to 15 and for the SOL phase 15.In both groups,BBS and BI scores improved significantly compared with baseline.The average improvement in the treatment group was significantly greater than that in the control group. Conclusions Rehabilitation including treadmill training can improve calf muscle contraction function on stroke patients' affected side,and also their ADL performance and balance.VE-PC MR1 can provide quantitative in vivo measurements of the contraction function of stroke patients' calf muscles.
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Objective To explore the effect of ankle strategy stability limit training on balance and gait in recovering stroke patients with hemiplegia. Methods Forty recovering stroke patients were randomized into an intervention group and a control group.The patients in the intervention group were given ankle strategy stability limit training using visual feedback on the static long sets of a Smart Equitest Balance Master (SEBM) machine.Those in the control group practiced routine postural balance training using mirror visual feedback in parallel bars.Both groups of patients practiced balance and posture control for 30 minutes,once daily,6 days a week for two weeks. Both groups were also given routine therapy and other rehabilitation.The patients' balance function was evaluated using the Berg Balance Scale (BBS),and their gait was assessed using the walk across technique (WA). Results There was no significant difference between the two groups with regard to general information,BBS scores or WA results before treatment.After 2 weeks of treatment,BBS scores as well as the step length and pace in the WA improved significantly in both groups,but all improved significantly more in the intervention group.There was no significant difference in width of gait. Conclusion Ankle strategy stability limit training can enhance weight-bearing on stroke patients' affected foot as well as their balance and the symmetry of their steps.
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Objective To observe the effect of electrical stimulation of the pelvic floor muscles (PES) combined with acupuncture on urinary dysfunction in patients with spinal cord injury (SCI). Methods Sixty-two patients with SCI were randomly divided into a treatment group ( n =31 ) and a control group ( n =31 ).All subjects received routine bladder function training and a drinking water schedule for 8 weeks.In addition,the treatment group was given PES 30-40 min/d 6 times/week and acupuncture for 30 min/d,6 times/week for the 8 weeks.Residual volume of urine was evaluated using ultrasound and a daily voiding diary.Uurodynamic examinations and catheter extraction were used to assess the urinary function pre- and post-treatment. Results No significant difference was found between the two groups before treatment,but after 8 weeks of treatment the residual volume of urine detected by ultrasound and voiding frequency were significantly lower in the treatment group than in the control group.First desire to urinate and maximal urinary bladder capacities in the treatment group were also significant higher than in the control group.The efficacy of treatment was also sustained significantly longer in the treatment group. Conclusion PES combined with acupuncture therapy is more effective than routine bladder function training for SCI patients with urinary dysfunction.