Precisión y fiabilidad de la medición del índice tobillo-brazo utilizando un dispositivo oscilométrico versus el método Doppler / Accuracy and reliability of ankle-brachial index measurement using an oscillometric device versus the Doppler method

Introducción: la medición del índice tobillo-brazo (ITB) es una prueba de primera línea y con alta precisión diagnóstica para detectar la enfermedad vascular periférica (EVP). El método Doppler, considerado el estándar de oro, requiere del dispositivo y de un operador capacitado, lo que limita su uso en la atención primaria. Como alternativa, un método oscilométrico que emplea un dispositivo de presión arterial automático es una prueba simple y accesible que podría minimizar los sesgos del observador y eliminar la necesidad de capacitación especial. Objetivos: validar la capacidad diagnóstica de un dispositivo oscilométrico automatizado frente al método Doppler para la medición del ITB. Materiales y métodos: se incluyeron pacientes con diabetes mellitus tipo 1 y 2 (DM1 y DM2), mayores de 50 años, con uno o más factores de riesgo cardiovascular. Luego de que los pacientes permanecieran 5 minutos acostados, se registró la presión arterial sistólica (PAS) con tensiómetro Welch Allyn DS 45-11 y Doppler Vascular Contec Sonoline B 8 Mhz en ambas arterias tibiales posteriores y en arteria braquial derecha. Posteriormente se realizaron los mismos registros con monitor de presión arterial automático modelo Omrom HEM-7130. Se calculó el ITB de cada miembro inferior y las capacidades diagnósticas (sensibilidad [S-, especificidad [E], concordancia por coeficiente kappa, valor predictivo positivo [VPP] y valor predictivo negativo [VPN]) del método oscilométrico para detectar un ITB patológico por Doppler (≤0,90). Resultados: se evaluaron 66 pacientes, 52 varones y 14 mujeres, 7 con DM1 y 59 con DM2, 69 años de edad (DS 9,8), con una antigüedad de la DM de 18,05 años (DS 12,01). La prevalencia de EVP detectada por Doppler (ITB ≤0,90) fue del 16,7% (IC 95% 9,9-23,4). El método oscilométrico para detectar un ITB ≤0,90 por Doppler mostró una S del 72,7% (IC 95% 51,8-93,6), una E del 96,3% (IC 95% 92,4-100), una concordancia del 92,4% (IC 95% 87,5-97,3), un VPP del 80,0% (IC 95% 59,9-100) y un VPN del 94,6% (IC 95% 90,0-99,3). Conclusiones: el alto VPN hallado (condición esencial para un método de screening) significa que si el método oscilométrico da un ITB >0,90, hay un 94,6% de posibilidad de que el ITB por Doppler no sea ≤0,90. El VPP de 80% encontrado significa que si el ITB oscilométrico es ≤0,90, hay un 80% de posibilidad de que el ITB Doppler sea verdaderamente ≤0,90. Por lo tanto, consideramos que la simple medición del ITB con el método oscilométrico podría recomendarse en la atención primaria, donde se requieren métodos rápidos, fáciles y confiables.

Introduction: the measurement of the ankle-brachial index (ABI) is a first-line test with high diagnostic accuracy for the detection of peripheral vascular disease. The Doppler method, considered the gold standard, requires the device and a trained operator, which limits its use in primary care. Alternatively, an oscillometric method using an automated blood pressure device is a simple and affordable test that could minimize observer bias and eliminate the need for special training. Objectives: to validate the diagnostic capacity of an automated oscillometric device against the Doppler method for ABI measurement. Materials and methods: diabetes mellitus type 1 and 2 (DM1 and DM2) patients older than 50 years with 1 or more cardiovascular risk factors were included. After 5 minutes lying down, SBP was recorded with a Welch Allyn DS 45-11 sphygmomanometer and Contec Sonoline B 8 Mhz Vascular Doppler in both posterior tibial arteries and in the right brachial artery. Subsequently, the same recordings were made with an Automatic Blood Pressure Monitor Model Omrom HEM-7130. The ABI of each lower limb and the diagnostic capabilities (sensitivity [S], specificity [E], concordance by kappa coefficient, positive predictive value [PPV] and negative predictive value [NPV] of the oscillometric method to detect a pathological ABI were calculated by Doppler (≤0.90). Results: 66 patients were evaluated, 52 men and 14 women, 7 DM1 and 59 DM2, 69 years old (SD 9.8) with a history of diabetes of 18.05 years (SD 12.01). The prevalence of PVD detected by Doppler (ABI ≤0.90) was 16.7% (95% CI 9.9-23.4). The oscillometric method to detect an ABI ≤0.90 by Doppler showed an S of 72.7% (95% CI 51.8-93.6), an E of 96.3% (95% CI 92.4-100), a concordance of 92.4% (95% CI 87.597.3), a PPV of 80.0% (95% CI 59.9-100) and a NPV of 94.6% (95% CI 90 .0-99.3). Conclusions: the high NPV found (essential condition for a screening method) means that if the oscillometric method gives an ABI >0.90, there is a 94.6% chance that the Doppler ABI is not ≤0.90. The PPV of 80% found means that if the oscillometric ABI is ≤0.90, there is an 80% chance that the Doppler ABI is truly ≤0.90. Therefore, we consider that the simple measurement of ABI with the oscillometric method could be recommended in primary care, where fast, easy and reliable methods are adequate.

Acute effect of different loads on muscle performance and perceived exertion in young women / Efecto agudo de distintas cargas sobre el desempeño muscular y el esfuerzo percibido en mujeres jóvenes / Efeito agudo de diferentes cargas no desempenho muscular e esforço percebido em mulheres jovens

ABSTRACT Introduction: Load reduction using the repetition maximum (RM) method may be necessary to promote higher numbers of repetitions, and consequently, higher total volume, time under tension, and perceived exertion ratings. Objective: To compare the effects of different leg press exercise loads on number of repetitions, total volume, time under tension, and perceived exertion. Methods: Eighteen women university students (23.9 ± 3.8 years) performed two experimental sessions with 90% and 100% of 10-12 RM in a balanced crossover design. Results: The number of repetitions of the second and third sets, the total volume, and time under tension at 90% of 10-12 RM was statistically higher than at 100% of 10-12 RM ( p < 0.05). The perceived exertion of the first and second sets and the training load (perceived exertion x duration of sessions) were higher at 100% of the 10-12 RM session ( p < 0.05). Conclusion: A small reduction in load results in a greater number of repetitions, total volume, and time under tension. The session with the higher load appeared to induce higher perceived exertion and training load. Thus, scientists and coaches might consider lower loads to maximize the number of repetitions, total volume, and time under tension, which may cause greater long-term muscular adaptations. Level of evidence II; Comparative prospective study.

RESUMEN Introducción: La reducción de la carga por el método de las repeticiones máximas (RM) puede ser necesaria para promover un mayor número de repeticiones y, consecuentemente, un mayor volumen total, tiempo bajo tensión y calificaciones del esfuerzo percibido. Objetivo: Comparar los efectos de diferentes cargas del ejercicio de prensa de piernas sobre el número de repeticiones, volumen, tiempo bajo tensión y esfuerzo percibido. Métodos: Dieciocho estudiantes universitarios (23,9 ± 3,8 años) realizaron dos sesiones experimentales con el 90% y el 100% de 10-12 RM en un diseño trasversal equilibrado. Resultados: El número de repeticiones de la segunda y tercera serie, el volumen total y el tiempo bajo tensión al 90% de 10-12 RM fue estadísticamente mayor que al 100% de 10-12 RM (p < 0,05). El esfuerzo percibido de la primera y segunda serie y la carga de entrenamiento (esfuerzo percibido x duración de las sesiones) fueron superiores en la sesión realizada al 100% de 10-12 RM (p < 0,05). Conclusión: Una pequeña reducción de la carga da lugar a un mayor número de repeticiones, volumen total y tiempo bajo tensión. La sesión con mayor carga indujo un mayor esfuerzo percibido y carga de entrenamiento. Por lo tanto, los científicos y entrenadores pueden considerar cargas más bajas para maximizar el número de repeticiones, el volumen total y el tiempo bajo tensión, lo que puede causar mayores adaptaciones musculares a largo plazo. Nivel de evidencia II; Estudio prospectivo comparativo.

RESUMO Introdução: A redução da carga pelo método das repetições máximas (RM) pode ser necessária para promover maior número de repetições e, consequentemente, maior volume total, tempo sob tensão e classificações do esforço percebido. Objetivo: Comparar os efeitos de diferentes cargas do exercício leg press no número de repetições, volume total, tempo sob tensão e percepção de esforço. Métodos: Dezoito universitárias (23,9 ± 3,8 anos) realizaram duas sessões experimentais com 90% e 100% de 10-12 RM em desenho transversal balanceado. Resultados: O número de repetições da segunda e terceira séries, volume total e tempo sob tensão a 90% de 10-12 RM foi estatisticamente maior do que a 100% de 10-12 RM (p < 0,05). A percepção do esforço da primeira e segunda séries e a carga de treinamento (percepção do esforço x duração das sessões) foram maiores na sessão realizada com 100% de 10-12 RM (p < 0,05). Conclusão: Uma pequena redução da carga resulta em maior número de repetições, volume total e tempo sob tensão. A sessão com maior carga induziu maior percepção do esforço e carga de treinamento. Assim, cientistas e treinadores podem considerar cargas menores para maximizar o número de repetições, o volume total e o tempo sob tensão, o que pode causar maiores adaptações musculares a longo prazo. Nível de evidência II; Estudo prospectivo comparativo.

Muscle strength and psychometric properties of the health-related quality of life in patients with soft tissue sarcoma resection in the thigh

Abstract Objectives: The aim of this study was to evaluate the effect of STS resection in the thigh on MS and the HRQoL. Methods: Fourteen adults patients with STS in the thigh who underwent wide resection and limb preservation were evaluated. The patients were submitted to the Mini-Mental State Examination (MMSE). A hand-held dynamometer was used to measure the MS the flexors, adductors, abductors, and extensors muscles of the operated and non-operated thighs and between the dominant and non-dominant operated sides. The Musculoskeletal Tumor Society (MSTS) and Short Form Health Survey-36 (SF-36) questionnaires were applied to quantify the psychometric properties of the HRQoL. The data were submitted to statistical analysis using the Wilcoxon test (MS), and Mann-Whitney and Spearman correlation (MSTS and SF-36) (α = 0.05). Results: There was no significant difference in MS between the operated side and the non-operated side, and between the dominant and non-dominant operated side (ρ > 0.05). The MSTS presented a significant difference in the emotional acceptance for patients submitted to radiotherapy (ρ = 0.029). The SF-36 showed significant differences in the emotional aspect for patients submitted to chemotherapy (ρ = 0.027) and in the social aspect between the dominant and non-dominant operated side (ρ = 0.024). Conclusions: The HRQoL of adult patients is hampered after the treatment of STS even when MS is maintained.

Effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury / 浙江大学学报·医学版

OBJECTIVES@#To investigate the effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury.@*METHODS@#A total of 80 patients with incomplete spinal cord injury caused by thoracolumbar fracture admitted in Ningbo Yinzhou No.2 Hospital from April 2020 to December 2021 were randomly divided into control group and study group, with 40 cases in each group. In addition to routine training, the control group received torso training on stable surface and the study group received torso training on unstable surface. The gait, lower limb muscle strength, balance function, lower limb function, mobility and nerve function of the two groups were compared.@*RESULTS@#After treatment, the stride length, stride frequency and comfortable walking speed improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05). The muscle strength of quadriceps femoris, gluteus maximus, hamstring, anterior tibialis and gastrocnemius were improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05); the total trajectories of static eye opening and static eye closing gravity center movement in the two groups were significantly shorter (all P<0.05), and the improvements in the study group were more significant (all P<0.05). The dynamic stability limit range and the American Spinal Injury Association (ASIA) lower extremity motor score, Berg balance scale, modified Barthel index scale in the two groups were significantly higher (all P<0.05), and these scores in study group were significantly higher than those in the control group (all P<0.05). Both groups showed a significant improvement in ASIA grade (all P<0.05), and the improvement in the study group was significantly better (P<0.05).@*CONCLUSIONS@#Torso training on unstable surface can effectively improve the gait and lower limb muscle strength of patients with incomplete spinal cord injury and improve the lower limb motor function.

Effects of different intensity of wearable lower limb rehabilitation robot-assisted training on lower limb function after stroke / 中国康复理论与实践

ObjectiveTo explore the effects of different intensity of wearable lower limb rehabilitation robot-assisted training on walking function, lower limb motor function, balance function and functional independence of stroke patients. MethodsFrom November, 2021 to December, 2022, 60 stroke patients hospitalized in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), observation group 1 (n = 20) and observation group 2 (n = 20). All the groups received routine rehabilitation, while the control group received routine walking training 30 minutes a day, the observation group 1 received wearable lower limb rehabilitation robot-assisted training 30 minutes a day, and the observation group 2 received wearable lower limb rehabilitation robot-assisted training 60 minutes a day, for four weeks. They were assessed with Functional Ambulation Category scale (FAC), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Rivermead Mobility Index (RMI) before and after treatment. ResultsOne case in the observation group 1 and three cases in the observation group 2 dropped down. The FAC, FMA-LE, BBS and RMI scores improved in all the three groups after treatment (|Z| > 3.448, |t| > 8.102, P < 0.001), and there was no significant difference in all the indexes among the three groups (|H| < 4.643, F = 1.454, P > 0.05); however, the improvement of BBS score was more in the observation group 1 than in the control group (P < 0.05), and the improvement of all the indexes was more in the observation group 2 than in the control group (P < 0.05). ConclusionThe wearable lower limb rehabilitation robot-assisted training may promote the recovery of walking function, lower limb motor function, balance function and functional independence of stroke patients, and high-intensity training seems to be more effective.

Mechanism design and analysis of a simple leg-sliding rehabilitation equipment / 中国康复理论与实践

ObjectiveTo design a simple leg-sliding rehabilitation equipment for patients with lower limb dysfunction who need to exercise their leg muscles in bed at the early stage of rehabilitation. MethodsThe mechanism scheme was designed using the crank slider transmission system. The kinematic model was established and the structural dimensions were determined according to the human joint mobility, analysis and verification were then implemented; and the strutural strength of the machanism was verified, and based on the analysis, a protype was built to verify the feasibility of proposed scheme. ResultsThe range of joint activities of the proposed mechanism was in line with the normal human joint activities, the structural strength met the requirements, the prototype operated smoothly, and the actual running speed was basically consistent with the theoretical planning speed. ConclusionThis design could meet the needs of rehabilitation training for bedridden patients with lower limb dysfunction at the early stage of rehabilitation. It has the advantages of small size and light weight, which provides reference value for promoting the development of miniaturized and lightweight lower extremity rehabilitation equipment.

Repetitive transcranial magnetic stimulation for lower limb dysfunction post stroke: a scoping review / 中国康复理论与实践

ObjectiveTo summarize and analyze the protocols of repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke lower limb dysfunction. MethodsLiterature about rTMS for lower limb dysfunction of patients post stroke were retrieved from Web of Science, PubMed, CNKI, and Wanfang Data from inception to August 17, 2022. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature quality, data extraction and scoping review were performed by two researchers. ResultsA total of 21 studies were included, in which 20 studies suggested that rTMS treatment could promote the recovery of lower limb motor function after stroke. One study showed negative result. rTMS interventions were reported safe, with no serious adverse reactions. There were great heterogeneity in the demographic and clinical information, study protocols, stimulation parameters, coil types, targets of stimulation, and motor-evoked potential measurement in the included studies. ConclusionThe future protocols of rTMS need to be combined with stroke stage and severity of injury. There is a demand for more real vs. sham rTMS studies, reporting similar designs with sufficient information, to achieve a significant level of evidence regarding the use of rTMS in post-stroke patients.

Correlation analysis of serum MMP-1 and MMP-2 levels with lower extremity deep venous thrombosis after operation for lower limb fracture / 中国骨伤

OBJECTIVE@#To investigate the relationship between serum matrix metalloproteinase-1(MMP-1) and matrix metalloproteinase-2(MMP-2) and the formation of deep venous thrombosis(LDVT) in lower extremity patients after surgery for lower extremity fracture, and to analyze the value of MMP-1 and MMP-2 in predicting the occurrence of LDVT after lower extremity fracture.@*METHODS@#From June 2018 to December 2021, 352 patients who planned to receive surgical treatment of lower limb fracture in our hospital were selected as the research objects. Venous blood was collected at 1, 2 and 3 days after surgery, respectively, and serum MMP-1 and MMP-2 levels were detected. The incidence of LDVT during hospitalization was analyzed, and the risk factors of postoperative LDVT in patients with lower limb fracture surgery and the predictive value of MMP-1 and MMP-2 for LDVT were analyzed.@*RESULTS@#LDVT occurred in 40 patients (LDVT group), the incidence of LDVT was 11.36%, and 312 patients did not occurred(no occurred group). The serum levels of MMP-1 and MMP-2 in LDVT group increased gradually after surgery; the serum levels of MMP-1 and MMP-2 in the no occurred group increased slightly after surgery at 2 days and then decreased at 3 days after surgery (P<0.01);the serum levels of MMP-1 and MMP-2 in LDVT group were higher than those in the no occurred group at 2 days and 3 days after surgery (P<0.05). Serum levels of MMP-1 and MMP-2 were positively correlated with serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor -α (TNF-α) in LDVT patients at 2 days and 3 days postoperatively (P<0.05). Operative time, MMP-1 and MMP-2 postoperative 3 days were related to the occurrence of LDVT after lower limb fracture (P<0.01). The area under the curve(AUC) predicted by MMP-1 and MMP-2 postoperative 3 days for LDVT after lower limb fracture was 0.738 and 0.744 respectively, and the AUC predicted by combined MMP-1 and MMP-2 was 0.910, which was higher than that predicted by single indicator(Z=2.819 and 2.025, P<0.05).@*CONCLUSION@#High levels of MMP-1 and MMP-2 after lower extremity fracture are closely related to the occurrence of LDVT, and 3 d mMP-1 and MMP-2 after surgery maybe used as evaluation indexes for LDVT risk prediction.

Advances in peripatellar osteotomy for treating recurrent patellar dislocation / 中国修复重建外科杂志

OBJECTIVE@#To summarize the progress of research related to the surgical treatment of recurrent patellar dislocation by peripatellar osteotomy in clinical practice, in order to provide reference for clinical treatment.@*METHODS@#The recent literature on peripatellar osteotomy for recurrent patellar dislocation at home and abroad was reviewed, and the bony structural abnormalities, imaging diagnosis, and treatment status were summarized.@*RESULTS@#Abnormalities in the bony anatomy of the lower limb and poor alignment lead to patellofemoral joint instability through the quadriceps pulling force line and play an important role in the pathogenesis of recurrent patellar dislocation. Identifying the source of the deformity and intervening with peripatellar osteotomy to restore the biomechanical structure of the patellofemoral joint can reduce the risk of soft tissue surgical failure, delay joint degeneration, and achieve the target of treatment.@*CONCLUSION@#In the clinical diagnosis and treatment of recurrent patellar dislocation, the factors causing patellofemoral joint instability should be comprehensively evaluated to guide the selection of surgery and personalized treatment.

Effect of video-based mirror therapy on lower limb motor function of stroke patients at recovery stage / 中国康复理论与实践

ObjectiveTo observe the effect of video-based mirror therapy on lower limb motor function, walking ability, and balance of stroke patients at recovery stage. MethodsFrom January to October, 2022, 43 stroke patients in Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and mirror therapy group (n = 21). Both groups received routine rehabilitation, and the mirror therapy group received video-based mirror therapy additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC) and Berg Balance Scale (BBS) before and after treatment. ResultsAfter treatment, the scores of FMA-LE, FAC and BBS improved significantly in both groups (|t| > 6.205, P < 0.001), and the scores of FMA-LE and BBS were better in the mirror therapy group than in the control group (|t| > 2.164, P < 0.05). ConclusionCombining with video-based mirror therapy could facilitate to improve the lower limb motor function and balance ability of stroke patients at recovery stage.

Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury / 中国康复理论与实践

ObjectiveTo observe the characteristics of gait symmetry and its influencing factors in patients with incomplete spinal cord injury (ISCI). MethodsFrom May, 2018 to November, 2021, 34 patients with ISCI in Beijing Bo'ai Hospital were divided into symmetrical injury of lower limb (SI) group and asymmetrical injury of lower limb (ASI) group according to the lower extremities motor score (LEMS). Three dimensional motion acquisition system and plantar pressure acquisition system were used for gait test. The symmetry indexes of step length, stance time and swing time were caculated. ResultsThe symmetry indexes of step length, stance time and swing time were significant lower in SI group than in ASI group (|t| > 2.619, P < 0.01). Stance time and swing time significantly correlated to the difference of bilateral LEMS in ASI group (r > 0.468, P < 0.01). Discriminant analysis showed that gait parameter equations were different for patients with different symmetry of lower limb injuries. ConclusionThe symmetry of lower limb motor function impacts gait symmetry for patients with ISCI, especially the difference value of bilateral total LEMS. Gait parameters can be used to determine the symmetry of lower limb injury in patients with ISCI.

Combining extracorporeal shock wave treatment with proprioceptive neuromuscular facilitation can improve the lower limb motor function of stroke survivors with foot drop / 中华物理医学与康复杂志

Objective:To observe any effect of combining extracorporeal shock wave stimulation with proprioceptive neuromuscular facilitation (PNF) on the lower limb motor function of stroke survivors with foot drop.Methods:Thirty-six stroke survivors with foot drop were randomly divided into an extracorporeal shock wave group, a PNF group and a combination group, each of 12. The extracorporeal shock wave group and PNF group were given those therapies alone, while the combination group was provided with both. The extracorporeal shock wave therapy protocol was 2000 times on each muscle at an intensity of 2.5 bar and a frequency of 10Hz, twice a week for 4 weeks, while the PNF was provided at least 3 times per week for 4 weeks. Before and after the intervention, all of the participants were evaluated using the modified Ashworth scale (MAS), the 10-metre walk test (10 MWT) and the Fugl-Meyer lower limb motor function scale (FMA). Active range of the ankle joint and toe out angle were also observed.Results:After the intervention the lower limb muscle tone had decreased significantly in 8 of the PNF group members and in 9 of those in the extracorporeal shock wave group, but it has decreased significantly in all 12 members of the combination group. And the average magnitude of the improvement was also significantly greater in the combination group than in the other two groups. Moreover, significant differences were observed in the active range of the ankle joint after the treatment in the combination group, but not in the other two groups. After the intervention the average 10 MWT times and FMA scores of the PNF and combination groups had improved significantly, but not those of the extracorporeal shock wave group, but significant improvement in toe out angles was observed in all three groups, though the average improvement in the combination group was significantly greater than in the other 2 groups.Conclusion:Combining extracorporeal shock waves with PNF can effectively improve the lower limb motor function of stroke survivors with foot drop.

Training in a wearable exoskeleton improves the lower limb motor recovery of stroke survivors / 中华物理医学与康复杂志

Objective:To explore any differential effect of training wearing a unilateral exoskeleton on the lower-limb motor function of stroke survivors.Methods:Forty stroke survivors were randomly divided into an exoskeleton group ( n=20) and a control group ( n=20). The control group performed conventional lower extremity exercise training while the exoskeleton group received exoskeleton-assisted lower-limb physical therapy. Each participant received eighteen 40-minute training sessions over three weeks. Before and after the intervention, the walking ability, lower-limb function, balance and ability in the activities of daily living of both groups were evaluated. Integrated electromyography (iEMG) of the rectus femoris and tibialis anterior of both legs was also recorded during sit-to-stand transitions to assess the activation of the affected muscles and the symmetry of bilateral muscle activation. Results:After the three weeks, significant improvement was observed in all of the measurements in both groups, but with the exoskeleton group scoring significantly better on average in functional ambulation category grading (1.63±0.72). Both groups′ iEMGs had also improved significantly compared with before treatment, but the exoskeleton group′s average result was by that time significantly better than the control group′s average.Conclusions:A wearable exoskeleton can effectively improve the rehabilitation of walking, lower limb movement, balance and skill in the activities of daily living of persons with subacute stroke. It better activates the affected lower limb muscles and improves the symmetry of bilateral lower limb muscle activation.

A Case of Thromboembolism and Deep Venous Thrombosis after Transfemoral Amputation with Short Stump / The Japanese Journal of Rehabilitation Medicine

An 82-year-old patient underwent a left transfemoral amputation due to a malignant soft tissue tumor. He developed symptoms of chest pain and hypoxia on the 32nd day after the operation. These symptoms were caused by deep venous thrombosis (DVT) of the stump and acute pulmonary thromboembolism (PTE), for which he was treated with anticoagulant therapy. Shortly after treatment he could resume a rehabilitation therapy. Patients with a lower extremity amputation have a higher risk of developing a DVT because of immobility and increased venous pooling in the residual limb. Even with a short stump as in this case, it is important to actively train the range of motion of the joint and try to prevent DVT.

A Case of Thromboembolism and Deep Venous Thrombosis after Transfemoral Amputation with Short Stump / The Japanese Journal of Rehabilitation Medicine

An 82-year-old patient underwent a left transfemoral amputation due to a malignant soft tissue tumor. He developed symptoms of chest pain and hypoxia on the 32nd day after the operation. These symptoms were caused by deep venous thrombosis (DVT) of the stump and acute pulmonary thromboembolism (PTE), for which he was treated with anticoagulant therapy. Shortly after treatment he could resume a rehabilitation therapy. Patients with a lower extremity amputation have a higher risk of developing a DVT because of immobility and increased venous pooling in the residual limb. Even with a short stump as in this case, it is important to actively train the range of motion of the joint and try to prevent DVT.

Development and Application of Lower Limb Exoskeleton Rehabilitation Robot / 中山大学学报(医学科学版)

With the deepening of the aging of society， there are more and more patients with motor dysfunction of lower limb，and rehabilitation therapy for these patients is becoming more and more important. Since the 1980s， exoskeleton robots for lower-limb rehabilitation have been applied to the rehabilitation for patient with dyskinesia， especially those with dyskinesia caused by neurological diseases such as stroke. These exoskeleton robots are wearable， nonlinear and complex mechanical devices， which deserve to be studied and widely applied. In this review， the research status， clinical application and challenges of exoskeleton robots for lower-limb rehabilitation are described in three aspects according to the difference of the therapeutic sites of exoskeleton rehabilitation robots， and on the basis， the development trend of exoskeleton robots for lower-limb rehabilitation is prospected.

Effect of repetitive transcranial magnetic stimulation on walking of stroke patients at recovery stage / 中国康复理论与实践

ObjectiveTo investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on walking function of stroke patients at recovery stage. MethodsFrom January, 2021 to January, 2022, 60 stroke inpatients at recovery stage from Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the groups accepted conventional rehabilitation therapy and lower limb robot-assisted training, while group B accepted pseudo-rTMS, and group C accepted high-frequency rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT) and gait analysis before and after treatment. ResultsThe score of FMA-LE, TUGT, pace, stride width, stride, double support phase time, affected side support phase time, affected side swing phase time, healthy side support phase time and healthy side swing phase time improved after treatment in all the groups (|t| > 5.990, P < 0.001), and all the indexes improved the most in group C (F > 3.210, P < 0.05), except double support phase time. ConclusionHigh-frequency rTMS could facilitate the recovery of lower limb function and walking of stroke patients at recovery stage.

Repercussions of balance training on soccer players' lower limb injuries / Repercussões do treino de equilíbrio nas lesões de membro inferior nos jogadores de futebol / Repercusiones del entrenamiento de equilibrio en las lesiones de los miembros inferiores en los jugadores de fútbol

ABSTRACT Introduction Soccer is a combative event that requires particular skills and physical fitness. The unique soccer characteristics determine the high incidence of joint injuries in the lower limbs. In this regard, balance training has proven to be particularly important, as research indicates a reduction in lower limb injuries justified by the gain in the athletes' muscle control capacity. Objective This paper analyzes the repercussions of balance training on lower limb injuries in soccer players. Methods 16 soccer players were randomly divided into experimental and control groups, without statistical difference. Both performed routine training first, with subsequent adherence to balance training by the experimental group. The experiment lasted eight weeks, and the balance training was based on an exercise protocol of approximately 30 minutes, three times a week, for eight weeks. Indexers on recovery from lower limb injury were statistically analyzed and compared. Results After balance training, soccer players in the experimental group improved faster. At the same time, the lower limb injury was effectively improved. Conclusion The balance training method can reduce the probability of lower limb injuries in soccer players. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução O futebol é um evento combativo que requer habilidades e aptidão física altamente específicas. As características especiais do futebol determinam a alta incidência de lesões articulares nos membros inferiores dos seus esportistas. O treinamento de equilíbrio tem se mostrado particularmente importante nesse aspecto pois pesquisas indicam a redução das lesões nos membros inferiores justificada pelo ganho na capacidade de controle muscular dos atletas. Objetivo Este artigo analisa as repercussões do treino de equilíbrio sobre as lesões nos membros inferiores dos jogadores de futebol. Métodos 16 jogadores de futebol foram divididos aleatoriamente em grupos experimentais e de controle, sem diferença estatística. Ambos executaram primeiramente o treinamento de rotina, com adesão posterior ao treinamento de equilíbrio pelo grupo experimental. A duração do experimento foi de oito semanas, o treino de equilíbrio consistiu na execução de um protocolo de exercícios com duração aproximada de 30 minutos, três vezes por semana, durante 8 semanas. Foram analisados e comparados estatisticamente os indexadores na recuperação da lesão dos membros inferiores. Resultados Após o treinamento de equilíbrio, os jogadores de futebol do grupo experimental melhoraram mais rapidamente. Ao mesmo tempo, a lesão dos membros inferiores foi efetivamente melhorada. Conclusão O método de treinamento de equilíbrio pode reduzir a probabilidade de lesões nos membros inferiores dos jogadores de futebol. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción El fútbol es un evento combativo que requiere habilidades muy específicas y una buena forma física. Las características especiales del fútbol determinan la elevada incidencia de las lesiones articulares en los miembros inferiores de sus deportistas. El entrenamiento del equilibrio ha demostrado ser especialmente importante en este aspecto, ya que las investigaciones indican una reducción de las lesiones en los miembros inferiores, justificada por la ganancia en la capacidad de control muscular de los deportistas. Objetivo Este trabajo analiza las repercusiones del entrenamiento del equilibrio en las lesiones de las extremidades inferiores en los jugadores de fútbol. Métodos 16 jugadores de fútbol fueron divididos aleatoriamente en los grupos experimental y de control, sin diferencia estadística. Ambos realizaron un primer entrenamiento de rutina, con la posterior adhesión al entrenamiento de equilibrio por parte del grupo experimental. La duración del experimento fue de ocho semanas, el entrenamiento del equilibrio consistió en la ejecución de un protocolo de ejercicios con una duración aproximada de 30 minutos, tres veces por semana, durante 8 semanas. Se analizaron y compararon estadísticamente los índices de recuperación de las lesiones de las extremidades inferiores. Resultados Tras el entrenamiento del equilibrio, los futbolistas del grupo experimental mejoraron más rápidamente. Al mismo tiempo, la lesión de la extremidad inferior mejoró eficazmente. Conclusión El método de entrenamiento del equilibrio puede reducir la probabilidad de lesiones en las extremidades inferiores en los jugadores de fútbol. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Neuromyelitis optica presenting as neurogenic bladder

Neuromyelitis optica(NMO) is an immune mediated disease of central nervous system primarily affecting optic nerves, spinal cord and brain stem. This case report describes a 24-year-old male with no comorbidities presented with high grade fever followed by proximal lower limbweakness and bilateral hydrouretero nephrosis without any lower urinary tract obstruction. He had clinical features of conus-cauda lesion with MRI spine showing features of longitudinally extensive transverse myelitis (LETM) and brain MRI showing involvement of splenium of corpus callosum. He improved with steroid therapy with in a period of 2 weeks and oral steroid was tapered of and stopped within a period of two months. There wasno relapse of symptoms so far.

Effect of air endurance training on athlete's lower limb explosive strength / Efeito do treinamento de resistência do ar na força explosiva dos membros inferiores do atleta / Efecto del entrenamiento de resistencia del aire en la fuerza explosiva de los miembros inferiores del atleta

ABSTRACT Introduction: The explosion force is the neuromuscular system's capacity to overcome resistance with the highest possible contraction speed. It is the result of a kinetic combination between power and speed. The effect of outdoor resistance training is used in several athletics areas to improve the explosive power of the lower limbs. However, there are still few studies focused on basketball athletes. Objective: Verify the effect of outdoor resistance training on the explosive power of the lower limbs of basketball players. Methods: The article uses mathematical statistics and randomized controlled trials by analytical comparison to explore the influence of compound training methods on basketball players' lower explosive limb power. Results: There was no performance gain in the control group at 30 days. Was an improved ability in the experimental group jumping after high-intensity composite training. Conclusion: Compound training plays a crucial role in improving lower limb explosive power in college basketball players. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução: A força de explosão é a capacidade que o sistema neuromuscular tem de superar resistências com a maior velocidade de contração possível. É resultado de uma combinação cinética entre potência e velocidade. O efeito do treinamento de resistência ao ar livre é utilizado em várias áreas do atletismo para melhorar o poder explosivo dos membros inferiores, porém ainda existem poucos estudos focados nos esportistas de basquete. Objetivo: Verificar o impacto do efeito do treinamento de resistência ao ar no poder explosivo dos membros inferiores dos jogadores de basquete. Métodos: O artigo usa estatística matemática e estudo randomizado controlado por comparação analítica para explorar a influência de métodos de treinamento compostos no poder dos membros explosivos inferiores dos jogadores de basquete. Resultados: Em 30 dias não houve ganho de desempenho no grupo controle em 30 dias. Após o treinamento composto de alta intensidade, a capacidade de salto foi significativamente aprimorada no grupo experimental. Conclusão: O treinamento composto desempenha um papel fundamental na melhoria do poder explosivo dos membros inferiores nos jogadores de basquete universitário. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción: La fuerza de explosión es la capacidad que tiene el sistema neuromuscular para vencer resistencias con la mayor velocidad de contracción posible. Es el resultado de una combinación cinética entre potencia y velocidad. El efecto del entrenamiento de resistencia al aire libre se utiliza en varios ámbitos del atletismo para mejorar la potencia explosiva de los miembros inferiores, sin embargo, todavía hay pocos estudios centrados en los deportistas de baloncesto. Objetivo: Verificar el impacto del efecto del entrenamiento de resistencia al aire libre sobre la potencia explosiva de los miembros inferiores de los jugadores de baloncesto. Métodos: El artículo utiliza la estadística matemática y el ensayo controlado aleatorio por comparación analítica para explorar la influencia de los métodos de entrenamiento compuesto en la potencia explosiva de las extremidades inferiores de los jugadores de baloncesto. Resultados: No hubo ganancia de rendimiento en el grupo de control a los 30 días. Tras el entrenamiento compuesto de alta intensidad, la capacidad de salto mejoró significativamente en el grupo experimental. Conclusión: El entrenamiento compuesto desempeña un papel clave en la mejora de la potencia explosiva de las extremidades inferiores en los jugadores de baloncesto universitarios. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.