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OBJECTIVE@#To investigate the effect of computer navigation gap balance technology on the recovery of lower limb function after total knee arthroplasty.@*METHODS@#The clinical data of 106 patients with knee osteoarthritis (OA) who underwent total knee arthroplasty from July 2018 to June 2019 were analyzed retrospectively. They were divided into measurement osteotomy group and space balance group according to different osteotomy techniques during total knee arthroplasty. There were 61 cases in osteotomy group, 24 males and 37 females;The age ranged from 45 to 77(63.35±4.26) years;According to K-L classification, 41 cases were grade Ⅲ and 20 cases were grade Ⅳ. intraoperative measurement osteotomy was performed. There were 45 cases in the gap balance group, 17 males and 28 females;Age 45 to 78(64.03±4.31) years;According to K-L classification, 29 cases were classified as grade Ⅲ and 16 cases as grade Ⅳ. computer navigation gap balance technology was implemented. The amount of intraoperative bleeding, operation time, incision length, hospital stay and postoperative complications were compared between two groups. The clinical efficacy was evaluated by Knee Society score(KSS) before operation and 12 months after operation.@*RESULTS@#Total of 106 patients were followed up for 12 to 18(20.38±3.25) months. There were significant differences in intraoperative bleeding and operation time between two groups(P<0.05). There was no significant difference in incision length and hospital stay between the two groups(P>0.05). At 12 months after operation, the total score of KSS in the gap balance group (173.59±14.50) was better than that in the osteotomy group (164.95±12.10)(P<0.05). There were no serious complications of poor prosthesis loosening between two groups during follow-up, and there was no significant difference in the incidence of other complications between two groups(P>0.05).@*CONCLUSION@#The application of computer navigation gap balance technology in total knee arthroplasty is conducive to the recovery of lower limb function in patients with OA, and there are no serious adverse complications and high safety.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Computers , Knee Joint/surgery , Knee Prosthesis , Lower Extremity , Osteoarthritis, Knee/surgery , Retrospective Studies , Technology , Treatment OutcomeABSTRACT
Objective:To evaluate the efficacy and long-term effect of functional electrical stimulation (FES) on cerebral palsy. Methods:Literature retrieval was carried out in the electronic databases of PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine Disc (CBM), CNKI, Wanfang Database and VIP. The time limit was from the establishment of these databases to March 26th, 2020. According to the inclusion and exclusion criteria, randomized controlled trials about FES for children with cerebral palsy were included. At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies. The data was analyzed with Review Manager 5.3 software. Results:A total of eleven studies with 513 children were included. The Gross Motor Function Measure-88 (GMFM-88) D/E scores (MD = 8.14, 95%CI 6.26 to 10.02, P < 0.001), GMFM-88 B score (MD = 8.77, 95%CI 4.00 to 13.53, P < 0.001), modified Ashworth Scale (MAS) score (MD = -1.05, 95%CI -1.25 to -0.84, P < 0.001), Kyphosis angle (MD = -10.67, 95%CI -12.21 to -9.13, P < 0.001), Cobb's angle (MD = -2.66, 95%CI -3.38 to -1.93, P < 0.001), step length (MD = 3.35, 95%CI 1.81 to 4.90, P < 0.001), walking speed (MD = 0.09, 95%CI 0.05 to 0.14, P < 0.001) and GMFM score at six weeks follow-up (MD = 4.84, 95%CI 1.90 to 7.77, P = 0.001) were better in FES group than in the control group. There was no significant difference in MAS score between two groups after six weeks of follow-up (MD = 0.04, 95%CI -0.30 to 0.37, P = 0.84). Conclusion:FES could improve the lower-limb and trunk function of children with cerebral palsy, however, the long-term effect of relieving muscle spasm was not significant.
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Background: Altered balance and lower limb muscle weakness are the common risk factors associated with falls in elderly. Objectives: The purpose of this study was to assess the efficacy of an exercise program on balance and lower limb functional level in elderly population with moderate risk of fall. Materials and Methods: An exercise program, including warm-up exercises, balancing exercises, strengthening exercises, flexibility, and cool-down exercises, was designed for this interventional study. A total of 50 participants were selected by simple random sampling method from the physiotherapy department of the hospital, Ahmedabad, and they were randomly allocated into an interventional group of 25 and a control group of 25 participants. The inclusion criteria included, age: 60–80 years, both men and women, and Berg balance scale (BBS) score of ≤45. The intervention group received the exercise program for 4 times/week for up to 6 weeks and the control group was kept in waiting period. Pre- and post-exercise programs, a comparison of all measures was done with focus on BBS and lower extremity functional scale as primary outcome measures to find out the efficacy of the treatment protocol. The general linear model: Repeated measures analysis of variance and the independent t-test was used for analysis and values of P < 0.05 were considered statistically significant. Results: A total of 50 participants including 28 females and 22 males aged 60–80 years with an average age of 69.2 ± 6.6 years were included in the study. The balance and lower limb functional level of the intervention group were significantly higher than the baseline values with large effect size. Furthermore, the intervention group showed statistically significant improvement in balance and lower limb function when compared with the control group. Conclusion: The randomized controlled trial indicated that the designed exercise program for elderly was effective, and there was a significant improvement in balance and lower limb functional level in participants who received the exercise program. This study suggested that elderly people with moderate risk of fall can minimize falls and related fractures by better balance and strength with exercises.
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OBJECTIVE: To explore the value of nerve trunk stimulation in the rehabilitation of lower limb function in the patients with cerebral apoplexy at convalescence stage. METHODS: According the random number table, the patients with the lower limb dysfunction of cerebral apoplexy at convalescence stage were divided into a control group and a treatment group, 42 cases in each group. The drug therapy and the routine rehabilitation training were provided in the two groups. Additionally, in the treatment group, the nerve trunk stimulation therapy was adopted， in which, Chize (LU5，stimulating point of radial nerve), Neiguan (PC6, stimulating point of median nerve), Xiaohai (SI8, stimulating point of ulnar nerve) were selected. In the control group, acupuncture intervention was supplemented. Before and after treatment, the peak torque (PT) of the lower flexor-extensor muscle of the knee joint, gait parameters，the score of the modified Ashworth spasm scale (MAS), the score of Fugl-Meyer motor assessment (FMA) and the score of Fugl-Meyer balance scale (FBS) were recorded. RESULTS: After the treatment, the PT of the lower flexor-extensor muscle of the knee joint，the scores of FMA and FBS，the step speed and frequency were all increased, the score of MAS and the difference in the stride between the left and the right were decreased as compared with those before treatment (P<0.01). After the treatment, The PT of the lower flexor-extensor muscle of the knee joint，the scores of FMA and FBS，the step speed and frequency in the treatment group were higher than those in the control group (P<0.01). The score of MAS and the difference in the stride between the left and the right in the treatment group were lower than those in the control group (P<0.01). CONCLUSION: Nerve trunk stimulation therapy quite effectively increases the muscle strength and relieves the muscle tension as well as improves the motor function, the balance and the walking pattern of the lower limbs. This therapy is significantly valuable in the rehabilitation of the lower limbs in the patients with cerebral apoplexy at convalescence stage.
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Objective:To explore the effect of somatosensory interactive games on lower-limb function after stroke. Methods:Randomized controlled trials (RCT) about the effectiveness of somatosensory interactive games on lower-limb function after stroke were retrieved from domestic and foreign databases, from inception to September, 2018. After literature quality evaluation, a meta-analysis was performed using RevMan5.3. Results:A total of 414 patients were included in eleven articles. Compared with routine rehabilitation measures, somatosensory interactive games improved Berg Balance Scale scores (WMD = 1.75, 95%CI 0.95~2.54, P < 0.001), increased stride frequency (SMD = 1.21, 95%CI 0.03~2.38, P = 0.04), decreased the time of Timed Up and Go Test (WMD = -4.21, 95%CI -7.36~-0.89, P = 0.01), and improved the motor function of lower limbs (SMD = 0.66, 95%CI 0.15~1.17, P = 0.01), but worked less in pace (SMD = 0.05, 95%CI -0.98~1.09, P = 0.92) and 10-metre Maximum Walking Speed (WMD = 3.54, 95%CI -1.12~8.20, P = 0.14). Conclusion:Compared with the routine rehabilitation, somatosensory interactive games can improve balance, walking and motor function. However, it is needed to further research on the pace and speed.
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Objective To evaluate the effect and safety of extracorporeal shock wave therapy ( ESWT) for knee osteoarthritis ( KOA) and its effect on the articular cartilage. Methods Sixty-three persons with KOA were randomly divided into an ESWT group ( n=32) and a control group ( n=31) . Both groups received routine knee mus-cle strength training, but the ESWT group was also given ESWT ( a total of 2000 pulses at 8 Hz and 2.5 bar pressure) once a week for four consecutive weeks. The control group was given sham therapy at 0.2 bar with the rest of the pa-rameters the same as in the ESWT group. All of the subjects were assessed using a visual analogue scale ( VAS) , the Western Ontario and McMaster Universities Osteoarthritis Score ( WOMAC) , the Lequesne Index and knee cartilage T2 values before as well as one and 8 weeks after the intervention. Results The average VAS score, WOMAC in-dex, and Lequesne index of the ESWT group at 8 weeks after the treatment were significantly better than those before the intervention, and significantly better than the control group' s averages. The T2 values of the ESWT group at 8 weeks after the treatment were significantly better than before the intervention, though not significantly different from those of the control group at that point. No serious adverse reactions occurred in either group, and all of the minor ad-verse reactions had disappeared before the end of the assessment period. Conclusion ESWT can significantly im-prove the lower limb functioning of KOA patients, and its influence on knee cartilage is within the safe range.
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Objective To investigate the effect of locking compression plate(LCP)and anatomi-cal plate(AP)in the treatment of closed tibial Pilon fracture and its influence on lower limb functional re-habilitation.Methods A total of 82 patients with closed tibial Pilon fractures were randomly divided into LCP internal fixation group(LCP group,n=41)and AP internal fixation group(AP group,n=41).The perioperative indexes and the incidence of postoperative complications were compared between the two groups.The ankle function was evaluated by American Orthopaedic Foot & Ankle Society Ankle Hindfoot Scale(AOFAS-AHS),the lower limb function was evaluated by Lysholm scale,the serum levels of inter-leukin-1β(IL-1β)and interleukin-6(IL-6)were detected.Results The intraoperative blood loss,opera-tion time,hospitalization time,first ground time,fracture healing time were(103. 34 ± 11. 34)ml, (47.65 ± 7.89)min,(9.01 ± 2.23)d,(5.31 ± 1.27)d,(16.23 ± 2.12)weeks in LCP group respective-ly,the AP group were(132.25 ± 34.41)ml,(60.54 ± 11.23)ml,(11.43 ± 2.57)d,(6.23 ± 1.56)d, (23.12 ± 3.31)weeks,respectively.The LCP group were significantly lower than AP group(P<0.05);The excellent rate of ankle function of LCP group was 95.12%,significantly higher than 82.93% in the AP group(P<0.05);The incidence of postoperative complications was 4.88% in the LCP group,which was significantly lower than 29.27% in the AP group(P<0.05);At 3,6 and 12 months after operation, the AOFAS-AHS scores in the LCP group were(69.52 ± 4.18)points,(78.89 ± 6.73)points and (87.23 ± 6.34)points respectively,the AP group were(65.09 ± 4.45)points,(70.13 ± 5.34)points and (76.69 ± 5.91)points respectively,the LCP group were significantly higher than AP group(P<0.05);At 3,6 and 12 months after operation,the Lysholm scores were(77.12 ± 6.43)points,(82.12 ± 7.81)points and(86.19 ± 8.11)points in LCP group,AP group were(67.25 ± 5.56)points,(72.21 ± 7.23)and (77.12 ± 7.54)points,the LCP group was significantly higher than AP group(P<0.05).At 3 d and 4 weeks after operation,the serum levels of IL-1β in LCP group were(0.37 ± 0.09)pg/ml,(0.19 ± 0.06) pg/ml,while in AP group were(0.45 ± 0.13)pg/ml,(0.27 ± 0.09)pg/ml;the serum levels of IL-6 in LCP group were(201.23 ± 30.12)ng/L,(102.23 ± 25.21)ng/L,while in AP group were(246.71 ± 41.23)ng/L,(158.95 ± 25.21)ng/L.The AP group were significantly lower than those in AP group(P<0.05).Conclusion LCP and AP in treatment of closed tibial Pilon fractures have a significant effect,but LCP can reduce the surgical trauma,shorten the operation time and postoperative recovery time,to a cer-tain extent,improve the ankle and lower limb function,and reduce the postoperative fixation fracture heal-ing and other complications.
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Objective To observe the effect of iliopsoas tensile vibration training on the walking ability of stroke survivors.Methods Thirty stroke survivors were randomly divided into an observation group and a control group,each of 15.Both groups were given traditional rehabilitation treatment,while the observation group was additionally provided with iliopsoas tensile vibration training.Both groups were evaluated in terms of the root mean square (RMS) of iliopsoas,active range of motion (A-ROM) of the hip joint,the kinematic parameters of gait and Berg balance scale (BBS) scores before and after the 4-week treatment.Results Before the treatment there were no significant differences between the two groups in any of the measurements.After the treatment improvement in all of the measurements was observed in both groups,with the average RMS iliopsoas,A-ROM,step length,step velocity and BBS score of the observation group significantly better than those of the control group.Conclusions Tensile vibration training of the iliopsoas can significantly improve the muscle excitability of the affected iliopsoas in stroke survivors,and improve their balance and walking ability.
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Objective To explore the effect of robot-assisted gait training on the standing and walking balance of persons with acute flaccid paralysis (AFP) resulting from hand-foot-and-mouth disease (HFMD).Methods Thirty-six persons with AFP resulting from HFMD were randomly divided into a control group and a training group,each of 18.Both groups were given conventional rehabilitation training,while the training group was additionally provided with robot-aided gait training.The control group received additional massage of their affected limbs.Before and after 15 days of treatment the subjects' standing and walking ability were evaluated using parts D and E of the gross motor function (GMFM) scale.Their balance was quantified using the Berg balance scale (BBS) and integrated surface electromyograms were recorded.Results There were no significant differences between the two groups before the treatment.After 6 weeks of treatment the average scores of both groups had improved significantly,with a significantly bigger increase observed in the training group.After the treatment,the average GMFM and BBS scores of the training group were significantly higher than those of the control group.Conclusion Gait training in addition to conventional rehabilitation training can significantly improve the standing,walking and balance of patients with HFMD resulting from AFP and promote their recovery.
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Objective To observe whether strength training of a healthy limb can produce a cross transport effect on the affected side.Methods Thirty hemiplegic stroke survivors were randomly divided into an experimental group and a control group,each of 15,using a random number table.Both groups received conventional rehabilitation,while the experimental group was given training to strengthen dorsiflexion and the isometric resistance of their healthy ankles for 6 weeks.The maximum voluntary contraction (MVC) and surface electromyography were measured before and after the training.The lower-extremity section of the simplified Fugl-Meyer motor function rating scale (FMA) was used to assess the subjects' motor function.Results After the training,the average FMA score of the experimental group was significantly better than before the treatment and also significantly better than that of the control group after the treatment.After the training,the average IEMGs of the tibialis anterior muscle and the gastrocnemius in the treatment group were significantly different from those of their ipsilateral side before the treatment and in the control group after treatment.Significant differences before and after the treatment were observed in the average MVC of both tibialis anterior and gastrocnemius muscles in the experimental group,and between the experimental group and control group averages.Conclusion Ankle strength training of hemiplegics' healthy limbs can strengthen the contralateral and antagonistic muscles,which indicates the cross transport of strength training.Isometric resistance training of the less-affected limb can improve the motor function of hemiplegics' lower extremities.
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Objective To observe the effect of acupuncture plus electromyographic biofeedback therapy (EMGBFT) on the nerve function, activities of daily life (ADL), biochemical indexes, and lower-limb function in cerebral stroke patients. Method Totally 102 cerebral stroke patients in recovery stage were recruited and allocated to an observation group and a control group by using the random number table, 51 cases in each group. The two groups were both given conventional treatment, based on which, the control group was given EMGBFT, while the observation group was given acupuncture plus EMGBFT. The treatment duration was 8 weeks in both groups. The changes of National Institute of Health Stroke Scale (NIHSS), ADL, endothelin 1 (ET-1), calcitonin gene-related peptide (CGRP), and Fugl-Meyer Assessment (FMA) of the lower-limb motor function were compared. Result The NIHSS scores dropped and ADL scores increased significantly in the two groups after the intervention (P<0.05);after the intervention, the NIHSS score of the observation group was lower than that of the control group and the ADL score was higher than that of the control group (P<0.05);in the observation group, the plasma ET-1 level decreased significantly and CGRP level increased significantly after the intervention (P<0.05);after the treatment, the plasma ET-1 level in the observation group was lower than that in the control group and the CGRP level was higher than that in the control group (P<0.05);the FMA scores increased markedly in both groups after the intervention (P<0.05);the FMA score of the observation group was higher than that of the control group after the treatment (P<0.05). Conclusion Acupuncture plus EMGBFT can significantly improve the nerve function and ADL, promote the recovery of lower-limb function, down-regulate the ET-1 level, and up-regulate the CGRP level in cerebral stroke patients.
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Objective To investigate the clinical efficacy of acupuncture at affected-limb gallbladder meridian points and its effect on the recovery of lower limb function in treating hemiplegia patients with cerebral infarction. Methods Sixty hemiplegia patients with cerebral infarction were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture at the gallbladder meridian points of the affected-side lower limb as main therapy and the control group, conventional acupuncture. After two courses of treatment, a pre-/post-treatment change in the Lower Extremity Fugl-Meyer Assessment score was observed in the two groups and post-treatment walking paces, pace lengths and incidences of strephenopodia were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the Lower Extremity Fugl-Meyer Assessment score in the two groups (P<0.01). There was a statistically significant post-treatment difference in the Lower Extremity Fugl-Meyer Assessment score between the treatment and control groups (P<0.05). There were statistically significant post-treatment differences in walking pace, pace length and the incidence of strephenopodia between the treatment and control groups (P<0.05).Conclusion Acupuncture at affected-limb gallbladder meridian points can improve lower limb function and reduce the incidence of strephenopodia in hemiplegia patients with cerebral infarction.
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Objective To observe the effect of core stability training combined with eye acupuncture on motor function in patients with hemiplegia after stroke.Methods Eighty patients with hemiplegia after stroke were randomly divided into a treatment group and a control group (40 cases in each).Both groups were given regular rehabilitation training, but the patients in the treatment group also were taught core stability training of their waist and abdominal muscle groups, their shoulder muscles, trunk and pelvis.They were also given eye acupuncture.A trunk control test (TCT) , Berg's balance scale (BBS), the modified Barthel index (MBI), functional ambulation categories (FACs) and the Fugl Meyer assessment scale (FMA) were used to assess motor function before and after treatment.Results At the end of 6 weeks of treatment, all of the measurements in both groups had significantly improved.The average TCT, BBS, MBI, FMA, and FAC scores of the treatment group significantly exceeded those of the control group.Conclusions Core stability training and eye acupuncture together can significantly improve the motor function of hemiplegic stroke survivors.The combination therapy is worthy of clinical popularization and application.
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Objective To investigate the effects of lower limb training combined with hyperbaric oxygen on motor function in a paretic lower limb and on the ability in the activities of daily living (ADL) of hemiplegic stroke survivors. Methods A total of 297 hemiplegic stroke patients received routine interventions and then were randomly divided into 3 groups. The hyperbaric oxygen group accepted hyperbaric oxygen, the training group accepted lower limb training, and the treatment group accepted both hyperbaric oxygen and lower limb training. Evalnations were carried out pretreatment and 30 d post treatment to assess the function of the paretic lower limb and ADL ability with the Fugl-Meyer assessment ( FMA), a modified Barthel index (MBI) , Berg's balance scale (BBS) and the timed up and go test (TUGT). Results FMA, MBI, BBS and TUGT scores in all 3 groups improved significantly compared with pretreatment. On the 30th day post treatment, the scores in the treatment group were significantly better than in the other two groups. Conclusions Lower limb training combined with hyperbaric oxygen can significantly improve motor function in the paretic lower limbs of stroke patients and their ADL performance.
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Objective To explore the therapeutic effects of isokinetic eccentric exercise (IEE)in patients with knee osteoarthritis. Methods Forty patients, including 70 knees with osteoarthritis, were measured and trained by use of Cybex-6000 and its isokinetic exercise system 3 times per week for 4 weeks. The peak of moment, single largest work, average power and accelerate energy of moment of isokinetic speed in 60?/s、120?/s and 180?/s were measured before and after exercise. The scores of pain and lower limb function were compared before and after IEE. Results The parameters of extensor and flexor groups were significantly increased after exercise, especially the parameters of knee flexors. The scores of pain and lower limb function were also improved. Conclusion IEE could improve effectively the function of knee extensors and flexors in patients with knee osteoarthritis, and relieve the pain.
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@#ObjectiveTo assess the value of comfortable and maximum walking speed of outcome measuring for locomotion recovery after stroke.Methods10m walking speed of 32 stroke subjects who were able to walk independently were tested in the freely chosen and maximum. The motor function of the paretic lower limb and balance were evaluated with the Fugl-Meyer Assessment,Berg Balance Scale and ambulatory item of Functional Independence Measure. The level of association between gait speeds and the clinical variables were examined with Pearson's correlation coefficients.ResultsComfortable walking speed were significantly positively related to maximum walking speed(r=0.953,P<0.001),and balance, motor function of the lower limb and ambulatory function were significantly positively related to comfortable and maximum walking speed(r=0.742-0.834,P<0.001).The relationship between comfortable walking speed and clinical variables was higher(r=0.787-0.834,P<0.001).Conclusions Both comfortable and maximum walking speed can reflect locomotion recovery after stroke, but comfortable walking speed is more pragmatic,securer and more sensitive.