ObjectiveTo investigate the effect of virtual scene simulation training combined with midium frequency impulse electrotherapy on upper limb function and daily living ability of hemiplegia patients.MethodsFrom March to October 2019, 50 hemiplegic patients were recruited and randomly assigned to the trial group and the control group, with 25 patients in each group. The control group was given routine rehabilitation training, while the trial group was given virtual scene simulation training and medium frequency impulse electrotherapy on the basis of routine rehabilitation training. The Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Simple Test for Evaluating Hand Function (STEF), and Modified Barthel Index (MBI) were used to assess patients’ upper limb function and daily living ability before treatment and after 8 weeks of treatment.ResultsBefore treatment, the FMA-UE, STEF, and MBI scores of the trial group vs. the control group were 22.88±5.18 vs. 23.44±6.26, 40.12±4.82 vs. 41.44±4.54, and 51.40±7.29 vs. 48.60±7.00, respectively, and none of the between-group differences was statistically significant (P>0.05); after 8 weeks of treatment, the FMA-UE, STEF, and MBI scores of the two groups were 39.48±6.35 vs. 33.52±6.53, 59.08±7.54 vs. 52.52±5.83, and 71.00±8.78 vs. 62.40±9.37, respectively, and all of the between-group differences were statistically significant (P<0.05). After 8 weeks of treatment, the FMA-UE, STEF and MBI scores of the two groups of patients were significantly improved compared with those before treatment (P<0.05), and the improvement of each score of the trial group was significantlybetter than that of the control group (P<0.05). No stroke recurrence, electric burn, or other adverse reactions occurred in the two groups after treatment. ConclusionVirtual scene simulation training combined with midium frequency impulse electrotherapy can effectively improve the upper limb function of patients with hemiplegia and improve their quality of life.
ObjectiveTo systematically review the efficacy of three transcranial direct current stimulation protocols (anodal stimulation, cathodal stimulation, and bipolar stimulation) on upper extremity function interventions in stroke patients. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of three transcranial direct current stimulation protocols on upper extremity function interventions in stroke patients from inception to April 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, the network meta-analysis was performed by using R software and ADDIS software. ResultsA total of 64 RCTs involving 3 968 patients were included. The results of network meta-analysis showed that, the probability order of the three stimulation methods on FMA-U, MBI, NIHSS score was: anode>bipolar>cathode>control. In addition, the probability order on ARAT and BBT score was: anode>cathode>bipolar>control. ConclusionCurrent evidence shows that the intervention effect of anodic stimulation on upper limb function of stroke patients may be better. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
OBJECTIVE: To study the clinical result of treating firearm-wound with the vessel pedicel tissue flap. METHODS: From May 1992 to October 2000, 21 cases of firearm-wound of upper limbs underwent transplantation with the vessel pedicel tissue flap. Of them, the locations of the wound were upper arm in 11 cases, forearm in 7 cases, hand in 3 cases. The size of wound was 1.0 cm x 0.5 cm to 8.0 cm x 6.5 cm; the wound course was 3 minutes to 8 hours with an average of 3 hours and 30 minutes. The patients were followed up 3 months to 2 years. RESULTS: In 21 cases, the results were excellent in 19 cases and poor in 2 cases. The good rate was 90.5%. CONCLUSION: Treatment of firearm-wound with vessel pedicel tissue flap has the good effect.
In order to help the patients with upper-limb disfunction go on rehabilitation training, this paper proposed an upper-limb exoskeleton rehabilitation robot with four degrees of freedom (DOF), and realized two control schemes, i.e., voice control and electromyography control. The hardware and software design of the voice control system was completed based on RSC-4128 chips, which realized the speech recognition technology of a specific person. Besides, this study adapted self-made surface eletromyogram (sEMG) signal extraction electrodes to collect sEMG signals and realized pattern recognition by conducting sEMG signals processing, extracting time domain features and fixed threshold algorithm. In addition, the pulse-width modulation(PWM)algorithm was used to realize the speed adjustment of the system. Voice control and electromyography control experiments were then carried out, and the results showed that the mean recognition rate of the voice control and electromyography control reached 93.1% and 90.9%, respectively. The results proved the feasibility of the control system. This study is expected to lay a theoretical foundation for the further improvement of the control system of the upper-limb rehabilitation robot.
Objective To evaluate the effects of different ways of exercise training on elderly patients with chronic obstructive pulmonary disease ( COPD) , which focuse on the changes of cardiopulmonary exercise function and COPD symptoms. Methods 54 cases of elderly patients with stable COPD were randomly allocated to a control ( 15 cases) , a lower-limb ( 20 cases) , or a upper-Limb and lower-Limb combined exercise group ( 19 cases) . All patients received conventional medical therapy.Meanwhile, the exercise groups received training for 16 weeks. The improvements of resting spirometry,cardiopulmonary exercise test ( CPET) , and dyspnea ( Borg scale rating) were evaluated before and after the training scheme. Results There was no significant difference in resting spirometry after exercise training( P gt;0. 05) . Exercise tolerance and Borg scale were improved in both exercise groups significantly than baseline ( P gt;0. 05) and the control group ( P gt;0. 05) . VE@ 50% Vo2max was improved significantly in the combined group( 4. 81 ±0. 70 vs. 2. 49 ±1. 15, P lt; 0. 001) . Breathing reserve ( BR) was elevated in bothexercise groups than the control ( P lt; 0. 01) , and the improvement in the combined group was more significant ( 9. 79 ±1. 57 vs. - 1. 36 ±2. 82, P lt; 0. 001) . Gas exchange response ( VD /VT ) was slightly improved after rehabilitation in the combined group( P lt;0. 05) . Borg scale after rehabilitation was correlatedwith FEV1% pred, BR, and Vo2 /kg after rehabilitation[ Borg = 9. 516 - 0. 174 ×FEV1% pred - 0. 156 × (Vo2 /kg) - 0. 023 ×BR] . Conclusions Upper-limb combined with lower-limb exercise training can markedly improve the level of aerobic capacity and ventilation in elderly patients with stable COPD, and then improve the exercise tolerance.
Exoskeleton nursing robot is a typical human-machine co-drive system. To full play the subjective control and action orientation of human, it is necessary to comprehensively analyze exoskeleton wearer’s surface electromyography (EMG) in the process of moving patients, especially identifying the spatial distribution and internal relationship of the EMG information. Aiming at the location of electrodes and internal relation between EMG channels, the complex muscle system at the upper limb was abstracted as a muscle functional network. Firstly, the correlation characteristics were analyzed among EMG channels of the upper limb using the mutual information method, so that the muscle function network was established. Secondly, by calculating the characteristic index of network node, the features of muscle function network were analyzed for different movements. Finally, the node contraction method was applied to determine the key muscle group that reflected the intention of wearer’s movement, and the characteristics of muscle function network were analyzed in each stage of moving patients. Experimental results showed that the location of the myoelectric collection could be determined quickly and efficiently, and also various stages of the moving process could effectively be distinguished using the muscle functional network with the key muscle groups. This study provides new ideas and methods to decode the relationship between neural controls of upper limb and physical motion.
ObjectiveTo investigate the effects of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) on upper limb dysfunction of stroke patients.MethodsPatients with stroke who were hospitalized in the Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-Sen University from July 2018 to January 2020 were selected. The patients were divided into tDCS group, VR group and combined treatment group by random number table method. All three groups received conventional rehabilitation treatment. Based on this, tDCS group received 2.0 mA tDCS treatment, VR group received 20 min VR treatment, and combined treatment group received the same tDCS and VR treatment. Before and 4 weeks after treatment, the Fugl-Meyer assessment-upper limb (FMA-UL), Wolf motor function test (WMFT) and modified barthel index (MBI) were used to evaluate the upper limb motor function and activities of daily life (ADL) of the three groups.ResultsA total of 45 patients were included, 15 in each group. No adverse reactions or fall off occurred during the treatment. Before treatment, there were no significant difference in FMA-UL, WMFT-Times, WMFT functional ability scores (WMFT-FAS), and MBI between the three groups (P>0.05). After 4 weeks of treatment, the FMA-UL, WMFT-Times, WMFT-FAS, and MBI scores of the three groups were significantly improved compared with those before treatment (P<0.05); the MBI score of the combination treatment group was significantly better than the tDCS group and VR group, and the FMA-UL was significantly better than the tDCS group, and the differences were statistically significant (P<0.05). Also, there were no significant differences in the improvement of FMA-UL, WMFT-Times, WMFT-FAS, and MBI scores between the tDCS group and the VR group (P>0.05); the differences of FMA-UL, WMFT-Times, WMFT-FAS, and MBI scores before and after treatment in the combined treatment group, which were significantly better than those in tDCS group and VR group (P<0.05). ConclusiontDCS combined with virtual reality can significantly improve the upper limb motor function and ADL ability of stroke patients, and the effect is superior to tDCS or VR treatment solely.
【Abstract】 Objective To investigate the operative techniques and cl inical results of repairing the soft tissue defectsof forearm and hand with free peroneal perforator-based sural neurofasciocutaneous flap. Methods From May 2006 toJanuary 2007, 6 patients including 5 males and 1 female were treated. Their ages ranged from 22 years to 51 years. They were injured by motor vehicle accidents (2 cases), or crushed by machines (4 cases), with skin defect of hand in 1 case, skin defect of hand associated with tendon injuries and metacarpal fractures in 2 cases, skin defect of forearm in 2 cases, and forearm skin defects with fractures of radius and ulna in 1 case. The areas of soft tissue defect ranged from 16 cm × 7 cm to 24 cm × 10 cm. The debridement and the primary treatment to tendons or bones were performed on emergency. And free flaps were transplanted when the wound areas were stable at 4 to 7 days after the emergent treatment. During the operation, the flaps were designed along the axis of the sural nerve nutrient vessels according to the shape and size of the soft tissue defects, with the peroneal perforator above the lateral malleolus as the pedicle and along with a part of the peroneal artery for vascula anastomosis. Then the flaps were harvested and transferred to the reci pient sites with the peroneal vartey anastomosed to the radial (or ulnar) artery and the peroneal veins to one of the radial (or ulnar) veins and the cephal ic vein, respectively. The flap size ranged from 18 cm × 8 cm to 25 cm × 12 cm. The donor areas were closed by skin grafts. Results The 5 flaps survived after the surgery. Partial inadequate venous return and distal superficial necrosis happened in only 1 case, which also got secondary heal ing by changing dressing and anti-infective therapy. The donor sites reached primary heal ing completely. The followed-up in all the patients for 6 to 13 months revealed that the appearance and function of the flaps were all satisfactory, and no influence on ambulation of donor site was found. Conclusion Peroneal perforator-based sural neurofasciocutaneous flap has the advantages of favourable appearance, constant vascular pedicle, rel iable blood supply, large size of elevation and minor influence on the donor site. And the free transfer of this flap is an ideal procedure to repair the large soft tissue defects of forearm and hand.
The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using SolidWorks software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3°by comparing the angle-time curves obtained from calculation with those from motion simulation.