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BACKGROUND:Three-dimensional (3D) motion analysis system combined with electromyograph cannot only objectively analyze movement function of the upper limb, but also exert an important role in exploring the exercise-related factors and the underlying mechanism. OBJECTIVE:To explore the influence of movement velocity and target location on kinematics and muscle activity in upper limb reaching. METHODS:Twelve healthy young adults reached for three different location targets (frontal, ipsilateral and contralateral) at self-selected and fast speeds to with the dominant right hand, respectively. Kinematic parameters and muscle activity were recorded by Vicon 3D motion analysis system and Noraxon wireless electromyograph, synchronously. RESULTS AND CONCLUSION:Reach path ratio became smal er when moving faster (P<0.001), while mean velocity, peak velocity and the time percentage of peak velocity increased (P<0.001). Posterior deltoid, biceps brachi and triceps brachi activation was higher during fast speed movement (P<0.001). Muscle activation of anterior deltoid was lower in ipsitralateral reaching than contralateral (P=0.001) and frontal reaching (P<0.001), and posterior deltoid was higher than contralateral reaching (P=0.019). Biceps brachi (P=0.039) and triceps brachi (P<0.001) activation was also higher in ipsitralateral reaching than frontal reaching. These results suggest that moving fast can contribute to more muscle activation, high velocity, smooth trajectory and increased movement quality. Posterior deltoid, elbow extension and flexion muscle activation are high in ipsitralateral reaching, while high anterior deltoid activation in contralateral reaching;therefore, target location result in muscle synergies.
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Objective To investigate the expression and significance of myeloid cell leukemia-1 (Mcl-1 )gene and protein in Hepatocellular Carcinoma(HCC).Methods The expression of Mcl-1 was detected respectively by Reverse Transcription-Polymerase Chain Reaction (RT-PCR),Western blot and ENVISION immunohistochemistry in 20 HCC specimens,19 liver cirrhosis(LC)specimens,and 12 control ones.Their relationship with clinical and pathological characteristics of HCC was investigated.Results The expression of Mcl-1 mRNA in the control group,LC group and HCC group was 0.52±0.17, 3.46±1.7,3.65±2.93,respectively.The level in HCC and LC group was statistically different compared with the control group,respectively (t=7.925,5.334,P<0.05).The relative expression of Mcl-1 protein in LC group (0.51±0.35)and HCC group (0.75±0.36)were significantly higher than that in the control group (0.21±0.19)(t=5.526,6.355,P<0.05).The positive expression rate of Mcl-1 in HCC group was 55.00% (11/20),significantly higher than that in the con-trol group 33.33% (4/12)(t=7.835,P<0.05).The positive expression of Mcl-1 was related to tumor necrosis and TNM staging (χ2=4.201,P<0.05).Conclusion Mcl-1 gene and protein are differentially expressed in HCC,LC and the control, which may be involved in the occurrence,development and malignant transformation of HCC.
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@#Objective To compare the effects of short- term high- intensity interval training (HIT) and moderate continuous training (MCT) on inflammatory mediators for healthy young males. Methods 19 healthy young male volunteers were randomized into HIT group (n=6), MCT group (n=7) and no training control (CON, n=6) group. The groups of HIT and MCT accepted treadmill exercise once per 2 days to 6 times (2 weeks), and the CON group did not accepted treadmill exercise. The levels of high-sensitive C-reactive protein (hs-CRP), interleukin (IL) -1α, IL-6 and tumor necrosis factor α (TNF-α) were detected 3 days before exercise, immediately after the first exercise, 3 days after the course. Results There was no difference among groups in the level of hs-CRP, IL-1α, IL-6 and TNF-α in all the time (P>0.05). The concentration of IL-1α increased in the MCT group after the first exercise (P<0.01), and also the concentration of IL-6 in the CON group after the course (P<0.05). Conclusion It needs further srudy for the significance of HIT and MCT in the levels of inflammatory media.
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Objective To compare the effects of short-term high-intensity interval training (HIT) and moderate continuous training (MCT) on inflammatory mediators for healthy young males. Methods 19 healthy young male volunteers were randomized into HIT group (n=6), MCT group (n=7) and no training control (CON, n=6) group. The groups of HIT and MCT accepted treadmill exercise once per 2 days to 6 times (2 weeks), and the CON group did not accepted treadmill exercise. The levels of high-sensitive C-reactive protein (hs-CRP), interleukin (IL)-1α, IL-6 and tumor necrosis factorα(TNF-α) were detected 3 days before exercise, immediately after the first exercise, 3 days after the course. Results There was no difference among groups in the level of hs-CRP, IL-1α, IL-6 and TNF-αin all the time (P>0.05). The concentration of IL-1αincreased in the MCT group after the first exercise (P<0.01), and also the concentration of IL-6 in the CON group after the course (P<0.05). Conclusion It needs further srudy for the significance of HIT and MCT in the levels of inflammatory media.
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BACKGROUND:Differences exist between the action execution of the dominant hand and the nondominant hand during daily lives. With the increasing of the age, the dominant hand and the nondominant hand play an equaly important role in the action execution and implementation during daily lives. Previous studies mainly focus on the muscle strength of upper limbs. However, studies on the influence of joint dynamic characteristics and trajectory deviation on the occupational activities have been increased gradualy. The three-dimension motion capture and analysis have become the reliable and valid standard of the assessment of the upper limb movement. OBJECTIVE:By using the three-dimensional kinematic analyze method, to colect the data of the healthy elderly people using the upper limbs to drink water respectively with the cups of different weights and to investigate whether there is a difference between dominant and nondominant hands under different weight-bearing conditions based on upper limb kinematics METHODS: Sixteen right-handed elder people were chosen to be the experimental subjects. The upper limb motion of drinking water with different weight was captured by Vicon Nexus. By Data modeling and trajectory filtering with pipeline and data normalizing with the Matlab, the three-dimensional angle and peak value of the velocity of the should, elbow and wrist joint in the bilateral upper limbs were analyzed and compared when lifting the cups of 100, 200 and 500 g. RESULTS AND CONCLUSION:The most significant difference could be found in the three-dimensional movement angle of the elbow joint when holding the weights: there were significant differences in 100 g horizontal plane (X axis) and sagittal plane (Z axis), 200 g frontal plane (Y axis) and sagittal plane (Z axis), and 500 g three-dimensional plane (P 0.05). These results show that there is a difference in the movement angle and angular velocity between the dominant hand and the nondominant hand when drinking water. A great change of movement angle could be found in the X axis of the elbow joint in the dominant hand, and a great change of the movement angle could be found in the Z axis of the elbow joint in the nondominant hand. The angluar velocity in the Y axis has better changes than in the Z axis. The size of the weights has no effect on the movement of bilateral upper limbs.
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@#Objective To investigate the correlation of motor function and emotion, cognition in patients after stroke. Methods 15 sub-acute stroke patients were included. They were assessed with Fugl-Meyer Assessment (FMA)、10 m walking speed, Hamilton Rating Scale for Depression (HAMD), Hamilton Rating Scale for Anxiety (HAMA), Mini-Mental State Examination (MMSE), modified Barthel Index (MBI) and SF-36. Fractional anisotropy (FA) values, apparent diffusion coefficient (ADC), and asymmetry indices of ADC and FA were obtained from diffusion tensor imaging. The correlation among them were analyzed. Results There was no correlation between the scores of FMA, 10 m walking speed and HAMD, HAMA, MMSE (P>0.05). The scores of HAMD, HAMA and MMSE correlated with emotional function of SF-36 (P<0.05). The HAMA score negatively correlated with body pain of SF-36. The FA value of the posterior limb of the internal capsule were negatively correlated with HAMD (P<0.05). Conclusion Neural network defect can cause emotion changes in stroke patients, but the motor function was not correlated with the emotion. Emotion and cognition may affect quality of life in these patients.
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Objective To investigate the effects of virtual reality prism adaptation on visuospatial neglect in stroke patients.Methods Thirty stroke patients with visuospatial neglect were studied.The subjects were divided into atreatment group and a control group.The subjects in the treatment group were treated with virtual reality prism adaptation and routine rehabilitation interventions for 2 weeks,while those in the control group were treated with routine rehabilitation interventions only.All the patients performed a battery of spatial attention tests including line bisection,letter cancellation,clock drawing and the Attention Network Test at the beginning and after 2 weeks of treatment.Results The virtual reality prism adaptation training had significant positive effects on all the measures of visuospatial neglect.Pair-wise comparisons confirmed significant differences between the treatment and control groups after 2 weeks of treatment with regard to all of the measures.Conclusions Virtual reality prism adaptation treatzment combined with routine rehabilitation can be more effective than conventional measures alone in improving the visuospatial performance of stroke survivors.
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BACKGROUND:Total hip arthroplasty is known to be a successful surgical procedure to al eviate hip pain and to regain gait ability, but there are many debates on whether patients’ gait could reach a normal level several years later. OBJECTIVE:To investigate spatiotemporal parameter characters of lower extremities in patients during walking in sequela period fol owing unilateral total hip arthroplasty, and to probe into patients’ walking abilities. METHODS:In accordance with the method of Case Database Data Analysis detected by Motion Reconstruction Laboratory, 14 patients at 5-10 years after total hip arthroplasty served as the experimental group, and 14 matched healthy persons served as the control group. Gait parameters of lower extremities during walking were col ected by Vicon Nexus. Spatiotemporal parameter characters of lower extremities during gait cycle were analyzed by using Polygon. RESULTS AND CONCLUSION:Compared with the control group, walking speed, cadence, stride length and step length decreased, but double support and opposite foot off increased on both affected and unaffected sides in the experimental group (P0.05). The results suggested that gaits of patients showed good gait symmetry at 5-10 years after surgery. However, they do not reach the level that observed in healthy subjects, and walking ability was poorer than normal persons. Systematic rehabilitation training is needed to improve walking ability.
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BACKGROUND:Most stroke patients affected walking dysfunction. Virtual reality-enhanced body weight-supported treadmil training has been proposed as a strategy for gait training of cerebral infarction subjects. OBJECTIVE:To evaluate the effectiveness of virtual reality-enhanced body weight-supported treadmil training on lower limb motor function in subacute cerebral infarction patients. METHODS:Twenty cerebral infarction patients (within 3 months of onset) were randomly divided into experiment group (virtual reality-enhanced body weight-supported treadmil training) and control group (conventional physiotherapy). Three-dimensional gait analysis in lower limb motor function was carried out before and after 3-week gait training. Intergroup and intragroup comparisons in the fol owing parameters were done before and after training:walking speed, cadence, step time, single limb support time (%), double limb support time (%), nonparetic swing (%), step length, pace, range of motion in the lower limb, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment. RESULTS AND CONCLUSION:No significant differences in patient’s gender, age, course of disease, affected. side, walking speed, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment were detected between the two groups before training (P>0.05). Fugl-Meyer Assessment and functional ambulation category were improved in patients of the two groups after training (P<0.05). The improvement in walking speed, cadence, step time in affected side, step time in healthy side, single limb support time in affected side (%), nonparetic swing (%), pace, step lengths in affected and healthy sides were better in the experimental group than those in the control group.
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BACKGROUND:The interaction of neural network and motor function in post-stroke brain tissue remains unclear. OBJECTIVE:To observe neural network impairment fol owing subacute stroke by using diffusion tensor imaging, and to investigate the relationship with neurological defects and motor dysfunction. METHODS:A total of 19 patients after subactue stroke and 20 healthy adults were examined with diffusion tensor imaging. The fol owing parameters were compared:fractional anisotropy, apparent diffusion coefficient, asymmetry indices of fractional anisotropy and apparent diffusion coefficient. The neurological defect and motor function were evaluated with the corresponding scales. The 10-meter walking speed was measured. The correlation of diffusion tensor imaging parameters with the scale scores and 10-meter walking speed was analyzed. RESULTS AND CONCLUSION:The stroke group exhibited reduced fractional anisotropy value asymmetry and fractional anisotropy value in bilateral posterior limbs of the internal capsule. Apparent diffusion coefficient value asymmetry and apparent diffusion coefficient value in the posterior limb of the internal capsule were lower than control unaffected side (P<0.05). Apparent diffusion coefficient value and apparent diffusion coefficient value asymmetry in posterior limb of the internal capsule showed a strong negative correlation with Fugl-Meyer assessment scores of the lower extremities (P<0.05). Diffusion tensor imaging parameters is closely linked with motor dysfunction of the lower extremities in subacute stroke patients. Local stroke lesion-caused neurological defect is the leading cause of motor dysfunction of the lower extremities.
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Objective To explore the outcome of body-weight-supported treadmill training on the kinetic data of lower limb in early stage of stroke.Methods Twenty-seven hemiplegic stroke patients at early stage were recruited and randomized to an experimental group(n =15) and a control group (n =12).Both groups were administered with routine neurological interventions.In addition,the control group was treated with conventional physiotherapy and over-ground walking training,while the experimental group was treated with body-weight-supported treadmill training.The speed of the treadmill walking was started at 0.22 m/s and increased to 0.60 ～ 0.80 m/s gradually.The percentage of the body-weight being supported was not more than 30％,the training time was 5 min per session at the beginning and was increased gradually to 20 ～ 40 min.Kinetic parameters were measured by using two force plates (AMT) and six cameras capture svstem (Vicon Nexus),and motor function was evaluated using Fugl-Meyer Assessment (FMA) at baseline and after three-week's therapy.Peak moment of lower limb joints,ground reaction force and motor function were analyzed.Results FMA scores were significantly improved (P ＜ 0.05) in both groups after treatment,but there was no significant differences (P ＜ 0.05) between the two group.Ground reaction force was significantly increased (P ＜ 0.05) after treatment in the experiment group,but not in control group (P ＞ 0.05).It showed that the hip extension moment at the affected side was significantly lower (P ＜ 0.05) in experiment group than in the control group,the ankle joint flexion and extension moment peak were improved to a significantly larger extend in the experimental group (P ＜ 0.05) than in the control group.In addition,the peak flexion and extension moment of the hip-knee joint and peak flexion and extension moment of the knee-ankle joint were also significantly different from those of the control group (P ＜ 0.05).Conclusion Body-weight-supported treadmill training can facilitate motor recovery of paretic extremity by increasing ground reaction force and load support of the affected lower limb,and help normalize the abnormal gait pattern of lower extremity of stroke patients.
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Objective To seek more direct evidence of the role of the posterior parietal cortex (PPC) in controlling visuospatial attention.Methods Forty healthy subjects took the Attention Network Test following continuous theta burst stimulation (cTBS) applied over the left or right PPC or sham stimulation.The Attention Network Test measures the alerting,orienting and executive control components of visual attention separately.Results Subjects responded to spatial cues significantly slower after cTBS.Alerting and orienting showed deficits after cTBS over the right PPC.cTBS over the left PPC resulted in significant improvements in alerting,but not in the orienting.Furthermore,there were significant differences in the alerting and orienting indices between cTBS over the left and right PPC,but not in the executive control index.Conclusions The results suggest that the right PPC is associated with spatial orienting and the alerting function.The findings supported the theory of inter-hemispheric competition for visuospatial attention.Visuospatial attention bias might be selectively modulated through cTBS.
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Objective To probe deficits in visuospatial attention using an attention network test (ANT) in patients with frontoparietal network lesions. Methods The ANT was used to measure the alertness, orienting and executive control abilities of 25 patients with local brain lesions, including 13 with frontal and 12 with parietal damage. Their results were compared with those of health adults. Results During ANT tasks, the patients' responses were significantly slower on each cue and target condition than controls', and showed deficits in their alerting and orienting networks. The efficiency of executive control was impaired in patients with frontal lesions, but increased with parietal lesions. Conclusions These findings suggest that the frontoparietal network is involved in alerting and orienting, but the executive control function may be selectively associated with the frontal lobe. ANT is an efficienttool for studying visual attention and cognition.
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@#ObjectiveTo evaluate the relationship between the level of thoracic complete spinal cord injury(SCI) and ambulatory function wearing Reciprocating Gait Orthosis(RGO) through three dimentional gait analysis, and to explore the quantitative indicators of reconstructing walking capacity of thoracic complete SCI patients.Methods10 patients with thoracic complete spinal cord injury of lesion level from T4 to T12 who had experienced RGO gait training for at least 3 months. Three dimentional gait analysis system of Vicon Nexus 1.2 was used to test and examine the gait speed, cadence, stride length, pelvic angle of rotation, hip range of motion(ROM), crutch force, angular velocity of hip flexion and extension phases, etc. Pearson's product moment correlation coefficient and Spearman rank correlation coefficient were used to examine the relationship between the level of spinal cord injury and the kinematic and kinetic values.ResultsThe mean cadence and stride length were (37.4±2.15) steps/min and (91.6±9.09) cm. The mean hip ROM, angular velocity of hip flexion and extension phases were (42.57 °±5.43 °), (20.88 °±2.18 °)/s and (124.75 °±9.31 °)/s respectively. The gait speed, stride length, peak crutch force, hip ROM, mean crutch force and angular velocity of hip extension phase all had significant pertinence with the level of spinal cord injury.ConclusionThe limitation of hip ROM and excessive load of upper limbs mainly result in ambulatory disorder in higher thoracic complete SCI patients who should be undertaken some rehabilitation training to reduce excessive physiological load in order to improve their ambulatory capacity.
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Objective To investigate any correlation between walking capacity, center of mass, and pelvic and hemiparetic lower limb motions in stroke survivors. Methods The kinematic variables studied included maximum walking speed, center of mass ( CoM ), pelvic movements and lower-limb movements on the paretic side. These were examined using a three-dimension motion analysis system as thirty-two post-stroke hemiparetic patients walked without aids. Results Average walking capacity was significantly correlated with lateral shifting of the CoM, with paretic limb hip extension, and with deficient knee flexion motions. There was a significant correlation between lateral CoM shifting and paretic limb hip extension and also deficient knee movement. Conclusions Walking capacity after stroke is associated with the lateral shifting of the CoM, paretic limb hip extension and deficient knee flexion. The lateral CoM shifting was associated with paretic limb hip extension and deficient knee movements.
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Objective To analyze the main causes of physical disability in adults in Guangdong province in China, and to provide prevention and treatment strategies. Methods Data on Guangdong from China's Second Na-tional Sample Survey on disability in 2006 were carefully collected. Physical disability was categorized according to different causes. In each category or group, multiple factors including the severity, distribution in urban or rural are-as, and the age of onset were analyzed with appropriate statistical methods. Prevention and treatment were then for-mulated based on the data. Results The severity of disability, distribution in rural and urban areas, and the age of onset were significantly different in different groups. The main cause was cerebral vascular diseases (16.7%). The incidence of physical disability was much higher in rural areas than that in urban areas (31.8% vs 68.2% ) except for brain trauma and toxication. The main cause for physical disability among young and middle-aged people was poly-myelitis (17.1% and 14.8% respectively) ; in old people it was osteoarthrosis (35.7%). Conclusions In order to lower the incidence of physical disability and to alleviate its severity, more work should be done in the prevention and treatment of cerebral vascular disease, spinal injury, cerebral palsy, polymyelitis and osteoarthrosis. In addition more financial and technical support is needed in rural areas.
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@#Objective To identify the differences in the status of rehabilitation demands of adults with different disability grades so as to seek out the beneficial strategies of rehabilitation for them.Methods The data on the rehabilitation demands of persons with different disability grades in every category of disabilities had been collected from the province of Guangdong in the Second National Sampling Survey of People with Disability.Results There were significant differences in the rehabilitation needs among persons with different disabilities grade in visual, hearing, physical, intelligence disabilities. There were no significant differences in the rehabilitation needs among persons with different disabilities grade in speech, mental disabilities.Conclusion The more severe disability the persons have the more medicine services they need，however，they little asked for other rehabilitation demands such as rehabilitation services, assistive device and so on.
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Objective To investigate the effect of cognition training on the recovery of balance after stroke. Methods forty-five hemiplegic strokd patents with cognition deficit were revruited and sddigned into an experimental group and a control group according to the results of an assessment with Loewenstein's Occupational Therapy Cognition Assessment battery (LOTCA). The patients in the two groups folloled routine systmatic rehabilitation programs. The patients in the (LOTCA). The patients in the two groups followed routine systmatic rehabilitation programs.The patiena in the experimental group received pertinent cognition training 5 days/week for 6 weeks. LOTCA,Brunel's Balance Assessment (BBA), the Berg Balance Scale (BBS) and Brunnatrom functional categories were enployed to evaluate the patients before and after treatment with regard to their cognition, balance control and motor function in their lower limbs. Results After treatment, there were statistically significant differences between preand post-treatment BBA and BBS scores in all groups. Average BBA, BBS and LOTCA scores in the experimental group were significantly higher than in the control group. The improvements in BBS, BBA and LOTCA scores in the experimental grou were significantly greater than in control group. Conclusion Cognition treatment can contribute significantly to improving balance and postural control among stroke survivors.
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Objective To know the indication for patients with spinal cord injury during the course of intermittent urethral catheterization.Methods Divided 33 patients with spinal cord injury into the experimental group(18 cases)and control group(15 cases)randomly.The indication of beginning in the experiment group was less than 500 ml transfusion per day,without press ulcer,more than 150 ml bladder capacity.The indication in the control group was＞28 cm H2O pressure of bladder.Compared the effects between the two groups.Results The incidence rate of infection in the experiment group was lower than control group,all the indexes of uretharal catheterization were better in the experiment group than those of in the control group.Conclusions The indication of less than 500ml transfusion per day,without press ulcer,more than 150 ml bladder capacity are proper.
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BACKGROUND:Pressure sensitive instrumented shoes are fast and easily used tools to measure ground reaction forces. Currently researches about the utilities of these systems in assessment of gait in children with neurological diseases have been started to run.OBJECTIVE: To find the gait characteristics of dynamic plantar pressure in children with spastic cerebral palsy. DESIGN: A cross-sectional study.SETTINGS: Department of Rehabilitation, Songgang People's Hospital; Department of Rehabilitation, Shenzhen Children's Hospital; Department of Rehabilitation Medicine, the First Affiliated Hospital of Sun Yat-sen University. PARTICIPANTS: ① Patient group: Twenty children with spastic cerebral palsy were selected from Shenzhen Children's Hospital from May 2004 to April 2005, including 9 boys and 11 girls, aged 26-66 months old, and they all could walk for more than 10 m independently. ② Normal control group: 52 healthy children with normal walking ability were enrolled, including 28 boys.and 24 girls, aged 35-76 months old.METHODS: Ultraflex gait analysis system was used to perform continuous plantar pressure tests of both groups of children. Diagram and data of dynamic plantar pressures in gait were recorded and analyzed with a computer. MAIN OUTCOME MEASURES: ① 10 sequential gait cycles were chosen from the continuous stable steps to calculate the average data with the software; ② Differences of the characteristic parameters of plantar pressure curve between the two groups.RESULTS: ① The curves of plantar pressure to time of testees in the normal control group were of the wave shapes with two peaks and one valley. Half of the CP children could not perform the two-peak shape pressure curve in the gait analysis. One kind of abnormal plantar pressure curve style was a wave shape with only one peak. Another kind of abnormal plantar pressure curve style was a shape showing asymmetry between sides and variation in different steps even in the same side. Two-peak shapes of dynamic plantar pressure were recorded in 10 CP children. ② Characteristic parameters picked up from the curves of plantar pressure had been compared between the two groups. Significant difference have been found in ts of both sides and tz1,tz2,tz3 on the right side between the two groups. It was shown that the single-limb support time of both sides in the CP children was longer than that in healthy children [left: (0.879± 0.658), (0.472±0.051) s; right: (0.818±0.682), (0.478±0.050) s; P ＜ 0.01]. The tz1 and tz3 on the right side in the CP children were longer and while the tz2 was shorter than those in the healthy children. CONCLUSION: ① Using dynamic plantar pressure gait analysis system, plantar pressure curves can be observed directly, and information about kinetic characters can be drawn straightly. ② Part of patients with spastic CP could not perform the two-peak shape pressure curves in gait analysis. In patient can be recorded of two-peak shape dynamic plantar pressure curves, ts of both sides are shorter than those in healthy children, tz1 and tz3 on the right side is longer and tz2 is shorter than those in healthy children.