RESUMEN
ObjectiveTo explore the effect of core muscles training based on spinal fine-tuning manipulation on lumbar facet joint disorders. MethodsFrom February, 2021 to February, 2022, 80 patients with lumbar facet joint disorders in Huadong Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and observation group (n = 40) randomly. Both groups received routine treatment and spinal fine-tuning manipulation, while the observation group received core muscles training in addition, for six weeks. They were assessed with Japanese Orthopaedic Association (JOA) scores, Short-Form of McGill Pain Questionnaire and World Health Organization Quality of Life-BREF before and after treatment. The recurrence rate was observed after three months follow-up. ResultsThe scores of all the scales improved after treatment (t > 5.751, P < 0.001), and improved more in the observation group than in the control group (t > 2.051, P < 0.05). After three months follow-up, the recurrence rate was 7.89% (3/38) in the observation group, less than 28.13% (9/32) in the control group (χ2 = 5.005, P = 0.025). ConclusionCombination of core muscles training may improve lumbar function, reduce lumbar pain, reduce recurrence and improve quality of life for patients with lumbar facet joint disorders.
RESUMEN
ObjectiveTo construct a framework of PICO for occupational therapy to improve upper extremity function in stroke patients based on World Health Organization Family of International Classifications (WHO-FICs), and to analyze the functional outcome of major occupational therapies to improve upper extremity in stroke. MethodsUsing the WHO-FICs framework, the databases such as Web of Science, PubMed, CNKI and SinoMed were searched for literature related to occupational therapy interventions for upper extremity function in stroke patients from the date of establishment to October, 2022, and the contents of the literature were extracted for a systematic review. ResultsTen randomized controlled trials from six countries were finally included, involving 382 participants (≥ 18 years old). The literatures were mainly from the fields of rehabilitation medicine, physics and rehabilitation medicine, neuroscience, bioengineering medicine, occupational therapy and other research fields, and were published mainly after 2013. The quality of the included literatures was evaluated using Physiotherapy Evidence Database (PEDro) scale with a mean score of 7.5. Based on the WHO-FICs framework, the types of diseases included intracerebral haemorrhage (8B00), cerebral ischemic stroke (8B11), subarachnoid hemorrhage (8B01), abnormality of tonus and reflex (MB47), and hemiplegia (MB53). The main dysfunctions of the upper extremity after stroke included mobility of joint functions (b710), stability of joint functions (b715), muscle power functions (b730), muscle tone functions (b735), motor reflex functions (b750), control of voluntary movement functions (b760), involuntary movement functions (b765). Activity and participation included activity of upper limb, such as lifting and carrying objects (d430), hand and arm use (d445), and fine hand use (d440); and the daily life activities and social participation, such as self-care (d510-d570), domestic life (d610-d660), major life areas (d810-d879), community, social and civic life (d910-d950). Therapeutic interventions on body functions included electrical stimulation of muscle functions (MU2.SC.BP), assistance and guidance of exercise for involuntary movement reaction (MV2.PG.ZZ); therapeutic interventions involving activity and participation were training in lifting and carrying (SIA.PH.ZZ), training in fine hand use (SIG.PH.ZZ), exercises of arm and hand use (SIJ.PH.ZZ), self care (SM1-SMH), household tasks (SO2-SOD), and playing games (SXD.PH.ZZ); 15 to 60 minutes a time, three to ten times a week, for three to eight weeks, in hospital or at home. The outcomes of the intervention were divided into three levels. At the body function level, patients had improved neuromotor conduction function, reflex function, casual motor control, coordination and speed, joint mobility, and grip strength. At the activity and participation level, there were enhancements in upper limb mobility and speed, fine hand function and speed, frequency and quality of upper limb activity participation, and the capacities of daily living and reduced difficulty in daily activity tasks. In terms of whole functioning, patients had acquired quality of life and well-being and acquainted a feeling of pleasure and accomplishment. ConclusionA PICO framework was constructed for occupational therapy based on WHO-FICs. The health conditions included intracerebral haemorrhage, cerebral ischemic stroke, subarachnoid hemorrhage, abnormality of tonus and reflex, and hemiplegia. Upper extremity motor dysfunction mainly included dysfunction of voluntary motor control, low or hyperactive motor reflexes, abnormalities in muscle tone, impaired muscle coordination, poor stability of joint activities, and reduced muscle strength, etc. Activity limitation and participation restriction were manifested as functioning in the fields of arm and hand activity participation, fine manual activity, and activities of daily living and social participation. Therapeutic interventions at body function level included brain-computer interface-based functional electrical stimulation and unimanual mirror therapy; therapeutic interventions at activity and participation level included action observation training, bimanual mirror therapy, task-oriented training, bilateral arm training and upper extremity robotics training. The health and functional benefits included the improvements in upper extremity motor function, upper extremity mobility and participation levels, activities of daily living and social participation, and quality of life and well-being.
RESUMEN
Objective To analyze gait characteristics of patients with spastic cerebral palsy (CP) before and after functional selective posterior rhizotomy (FSPR) surgery, so as to evaluate curative effects of the surgery objective ly. MethodsFifteen patients with spastic CP to be treated by FSPR were selected. The VICON three-dimensional (3D) motion analysis system and AMTI 3D force plates were used to collect and analyze the spatiotemporal gait parameters, kinematic and dynamic parameters before and after FSPR surgery. Results After the surgery, the left and right support phases were longer,and the left-side step length was significantly larger. The step height, velocity and the max displacement of center of gravity (COG) in coronal plane were smaller than those before surgery.The sagittal plane angle (flexion and extension angle) of the knee during initial landing was significantly increased, while no significant differences were found in that of the hip and ankle.The range of motion (ROM) of the left/right hip, knee and ankle in sagittal plane was increased to some extent during walking, with statistical differences. The ROM of right ankle in coronal plane was also increased obviously. The minimum flexion angle of the right knee and the maximum plantar flexion angle of the left/right ankle were significantly reduced. The maximum vertical forces of left and right support phases were significantly increased, while no significant differences were found in torque of lower limbs. Conclusions The 3D gait analysis can be used to evaluate the effect of FSPR on patients with spastic CP. The spasticity of patients with spastic CP is relieved after FSPR surgery, and the spatiotemporal gait parameters and kinematics parameters are improved significantly. But the improvement of dynamic parameters was not obvious, and further rehabilitation treatment is needed.
RESUMEN
Objective To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery,and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).Methods Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery,and were evaluated by using 3-meter timed up and go test(TUG),minimum mental state examination(MMSE),idiopathic normal pressure hydrocephalus grading scale (iNPHGS) and modified Rankin scale (mRS) before and one year after CSF shunt procedures.The ventricular volume,brain volume,pericerebral CSF volume,total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated:the relative ventricular volume,brain volume ratio,pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume.Results The scores of gait,cognitive function and urinary function were improved after surgery in iNPH patients (all P ＜ 0.05).There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume,brain volume ratio,pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait,cognitive function and urinary function before surgery,and with the degree of symptom improvement one year after surgery in iNPH patients (all P ＞ 0.05).There was no significant difference in intracranial compartment volumes between patients having improvement in mRS,TUG,MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P＞0.05).Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait,cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume,brain volume ratio,pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery,and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason,preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.
RESUMEN
Objective@#To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH).@*Methods@#Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume.@*Results@#The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P<0.05). There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait, cognitive function and urinary function before surgery, and with the degree of symptom improvement one year after surgery in iNPH patients(all P>0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05).@*Conclusions@#Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.
RESUMEN
Fall has seriously impaired the quality of life of old people. The main risk factors for fall in the old people are concerned with balance dysfunction which is caused by ageing. Taiji Quan exercise can promote the lower limb muscle strength, proprioception, neuro-muscular reaction, gait and cognition of the old people, that plays a role in fall prevention.
RESUMEN
Low back pain (LBP) is one of the most common types of disability affecting individuals in Western countries, and the as-sessment of LBP-related disabilities represents a significant challenge. The disability assessment scales in LBP are commonly used in clini-cal diagnosis and treatment as well as evaluation system for clinical research, such as Oswestry Disability Index (ODI), Roland Morris Dis-ability Questionnaire (RMDQ), and Quebec Back Pain Disability Scale (QBPDS). This article focused on the clinical applications, reliability and validity, strength and limitations of these scales, to help the clinical application and scientific research for the LBP disability scale.
RESUMEN
@#Cognitive impairment, including the decline of attention, memory and executive function, is commonly complicated in stroke patients, which may result in falls. Stroke patients with cognitive impairment usually complicate gait disorder, such as abnormal walking velocity or width, which also result in falls.
RESUMEN
Balance dysfunction in stroke was mainly caused by proprioception disorder, visual impairment, vestibular dysfunction, poor integration function in the central nervous system, core muscle strength decrease, and decrease in muscle coordination ability and cognitive dysfunction. This article described how to improve the balance function of patients from pathological factors, and systematically reviewed the latest research progress in the treatment of balance disorder after stroke. The clinical exercise therapy and the use of computers and other high-tech treatment can effectively improve the balance function of patients. These methods should be combined according to the pathologi-cal factors of patients with balance disorders.
RESUMEN
The abnormal gait after stroke was mainly related to the decreasing strength with increasing tension of paretic lower limb muscles. Surface electromyography (sEMG) can respond to the neuromuscular function, that is valuable for abnormal gait analysis for stroke patients. This paper mainly introduced the anatomical basis with sEMG features of walking, the performance of abnormal gait and ab-normal gait analysis based on sEMG. It focused on the advances of sEMG in the analysis of temporal patterns and activating characteristics of muscles associated with abnormal gait, as well as abnormal gait pattern.
RESUMEN
@#Surface electromyography (sEMG), as an objective and quantitive assessment tool, has been used to evaluate the hand neural- muscle dysfunction after stroke in recent years. This paper reviews related literatures in nearly 10 years, which mainly introduced the common parameters of sEMG for the hand neural-muscle function, focused on the application of sEMG to estimate hand neural-muscle dysfunction after stroke.
RESUMEN
Knee osteoarthritis (KOA) is a common degenerative joint disease. Biomechanics of lower extremity plays an important role in KOA. Foot progression angle, with the advantages of non-invasive, convenience, has been attached great importance by people gradually. Changing foot progression angle may effect the knee adduction torque, tibia rotation, muscle activity, which leads to change the load of the knee joint, and alleviate the pain, improve the function of knee joint and the quality of life of the patients.
RESUMEN
Surface electromyography (sEMG), as an objective and quantitive assessment tool, has been used to evaluate the hand neu-ral-muscle dysfunction after stroke in recent years. This paper reviews related literatures in nearly 10 years, which mainly introduced the common parameters of sEMG for the hand neural-muscle function, focused on the application of sEMG to estimate hand neural-muscle dys-function after stroke.
RESUMEN
Objective To determine the influence of aerobic exercise on advanced glycation end products (AGEs)in plasma using a rat model of type 2 diabetes,and to provide an experimental basis for explaining the rehabilitative mechanism of aerobic exercise in type 2 diabetes.Methods Fifty-two healthy 8-week-old male SpragueDawley rats were allocated at random into a normal control group(n=10)and a type 2 diabetes model group(n=42).The latter were overfed with a high-sugar,high-fat and high-energy diet for 4 weeks,then 30ms/kg of streptozotocin was injected intraperitoneally to create a model of type 2 diabetes.Thirty diabetic rats were then allocated at random into a diabetes control group,a low intensity exercise group and a moderate intensity exercise group with 10 in each group.The treadmill exercise was administered to the animals in the low and moderate exercise groups accordingly.Results Compared with the normal control group,plasma AGEs increased significantly in the diabetes control and moderate intensity exercise groups.Compared with the diabetes control group,AGEs in the lower intensity exercise group were significantly lower.Compared with the moderate intensity exercise group,plasma AGEs in the low intensity exercise group were somewhat lower,but not significantly.Conclusion Aerobic exercise can reduce plasma AGE levels in rats with a model of type 2 diabetes.The effect is probably related to decreasing excessive blood glncose and the exercise intensity.
RESUMEN
@#ObjectiveTo examine the effects of proprioceptive neuromuscular facilitation(PNF) techniques on lower limb motor function of strokes and its mechanism.MethodsWe used simple random sampling and cross-section survey design. PNF Contract Relax Agonist Contract(PNF-CRAC) techniques were applied to 44 stroke patients. Surface electromyography values(sEMG) was recorded from rectus femoris and hamstring of stroke patients with both low limbs. ResultsPNF-CRAC techniques not only caused the irradiation of muscles activities in the contralateral extremity during unilateral exercise, but also increased agonist EMG activities and the motor control of knee joint in strokes.ConclusionPNF-CRAC techniques can improve the knee stability and enhance the recovery of motor function in paretic lower limb.
RESUMEN
@# Objective To explore the characteristics of muscular power changes of knee joint and static balance in the elderly patients with knee osteoarthritis(KOA).Methods Isokinetic test and computerized static posturography were performed in 59 patients with KOA(KOA group) and 50 age-matched controlled subjects(conrtol group). The parameters were recorded.Results Peak torque, total work, average power and torque acceleration energy significantly decreased in KOA group compared with the control group at the low velocity of concentric pattern(P<0.05), while hamstring/quadriceps value increased statistically(P<0.05);The values of covered area, length of path, length/area statistically increased in KOA group compared with the control group only when eyes closed (P<0.01), and so did it in KOA group when eyes closed compared with eyes opened(P<0.05); There was significant relationship between length/area and hamstring/quadriceps value.Conclusion The ability of balance declined as knee muscular power decreased in the patients with KOA, especially the non-spontaneous decrease of extensor and flexor power of the knee joint.
RESUMEN
@#Objective To study the factors related with balance ability of the elder.Methods 37 persons above 60 years were assessed with the balanced function reflectoscope reflector,grouped according to their exercise practice.Results The length of locus and length/envelope area as eyes closed increased significantly compared with that as eyes opened in the less exercise group(P<0.05),while they were increased significantly compared with those in the more exercise group either when eyes closed or opened(P<0.05).Conclusion The exercise practice can improve the balances function of the old persons.
RESUMEN
Objective To study the effects of rehabilitation interventions on the earthquake injured to reduce the incidences of disability,to improve the recovery of overall function of the wounded in the earthquake and to guarantee their return to family and society.Methods The rehabilitation team·work provided one-month comprehensive intervention on 92 fracture patients after earthquake and assessed with scale of participate and activities ability,before,after and in the middle of intervention.Results The ability of understanding and communication,moving body,taking care of oneself,getting along with others,undertaking daily activities.social participating and the scores from the scale of participate and activities ability improved significantly(P<0.05).Conclusion Rehabilitation interventions with team-work can effectively enhance the abilities of the earthquake injured to participate in activities and improve quality of life.
RESUMEN
@# The surface electromyography (sEMG) is the noninvasive method which can record and measure the changes of local muscle activities. The sEMG's amplitude and frequence signal will change with muscular movement. sEMG application in present study on muscle fatigue is a reliable predictor of muscle functional level. The researches on the sEMG signals changes of limb muscles of hemiplegic patients will take a important role in providing scientific evidence for the neural rehabilitation training after stroke.