Objective To explore the preventive effectiveness of early physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. Methods A total of 206 patients who underwent modified radical mastectomy for breast cancer in The First Affiliated Hospital of Henan University from June 2014 to June 2016, enrolled in this randomized controlled clinical trial. Then these patients were randomly divided into intervention group and control group equally. Patients in the control group received routine treatment, and the patients in the intervention group began to use the air pressure pump combined with the microwave physiotherapy on the second day after the radical surgery. The incidences of limb lymphedema in 6 months and 1 year after operation between the 2 groups were compared, and the influencing factors of arm lymphedema were explored. Results The clinical data of 195 patients were analyzed at end, including 99 patients of the intervention group and 96 patients of the control group. ① There were statistical significance in the incidences of arm lymphedema in 6 months and 1 year after operation between the 2 groups (P<0.05), that incidences of arm lymphedema in the intervention group were both lower than those of the control group at the2 time points [6 months after operation: 2.0% (2/99)vs. 9.4% (9/96); 1 year after operation: 5.1% (5/99) vs. 17.7% (17/96)]. ② The results of non-conditional logistic regression analysis shown that, age (OR=1.45, P=0.008), tumor location (OR=1.72, P<0.001), TNM stage (OR=2.01, P=0.033), the number of invasive axillary lymph nodes (OR=1.15, P=0.005), and postoperative radiotherapy (OR=1.23, P=0.016) were the influencing factors of arm lymphedema after modified radical mastectomy for breast cancer, patients with age older than 60 years, tumor position at the outside area, stage Ⅲ of TNM, the number of invasive axillary lymph nodes >5, and patients received radiotherapy after operation had high risk of arm lymphedema. Conclusion Early physiotherapy can effectively prevent the occurrence of arm lymphedema after modified radical mastectomy for breast cancer, and early physiotherapy should be performed for patients with high risk of arm lymphedema.
At present, fatigue state monitoring of upper limb movement generally relies solely on surface electromyographic signal (sEMG) to identify and classify fatigue, resulting in unstable results and certain limitations. This paper introduces the sEMG signal recognition and motion capture technology into the fatigue state monitoring process and proposes a fatigue analysis method combining an improved EMG fatigue threshold algorithm and biomechanical analysis. In this study, the right upper limb load elbow flexion test was used to simultaneously collect the biceps brachii sEMG signal and upper limb motion capture data, and at the same time the Borg Fatigue Subjective and Self-awareness Scale were used to record the fatigue feelings of the subjects. Then, the fatigue analysis method combining the EMG fatigue threshold algorithm and the biomechanical analysis was combined with four single types: mean power frequency (MPF), spectral moments ratio (SMR), fuzzy approximate entropy (fApEn) and Lempel-Ziv complexity (LZC). The test results of the evaluation index fatigue evaluation method were compared. The test results show that the method in this paper has a recognition rate of 98.6% for the overall fatigue state and 97%, 100%, and 99% for the three states of ease, transition and fatigue, which are more advantageous than other methods. The research results of this paper prove that the method in this paper can effectively prevent secondary injury caused by overtraining during upper limb exercises, and is of great significance for fatigue monitoring.
Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant’s functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists’ experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients’ movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.
【摘要】 目的 探討經腋靜脈穿刺中央靜脈置管后上肢深靜脈血栓形成情況。 方法 2007年1月-2009年12月共收治60例需行中央靜脈置管的患者，所有患者均通過腋靜脈穿刺行中央靜脈插管，并于拔除導管后行彩色多普勒超聲檢查了解雙側上肢深靜脈血栓形成情況。將腋靜脈穿刺側上肢作為穿刺組，對側上肢作為對照組，進行前瞻性對照研究，將兩組上肢深靜脈血栓發生率進行比較。 結果 60例患者中央靜脈置管平均時間為（14.7±7.4） d，對照組彩色多普勒超聲檢查無深靜脈血栓形成，穿刺組2例患者出現上肢深靜脈血栓形成的癥狀，無肺栓塞發生，28例患者（47%）拔除的導管周圍可見纖維蛋白套形成，經上肢彩色多普勒超聲檢查，5例患者（8.3%）腋靜脈不完全栓塞，2例患者（3.3%）腋靜脈完全栓塞。在中央靜脈置管時間≤6 d的患者中，無上肢深靜脈血栓形成；置管時間在7~14 d的患者中，2例（3.3%）腋靜脈血栓形成；5例（8.3%）腋靜脈血栓形成發生在置管時間≥15 d（Plt;0.01）。7例腋靜脈血栓形成患者，經2~3次穿刺成功，平均穿刺時間（10±2.5） min，與無腋靜脈血栓形成患者的平均穿刺所需時間（14±9）min比較，無統計學意義（Pgt;0.05）。 結論 經腋靜脈穿刺中央靜脈置管后上肢深靜脈血栓形成的發生率為11.6%。【Abstract】 Objective To determine the frequency of central venous catheter-induced thrombosis of the axillary vein. Methods Sixty patients in a medical-surgical intensive care unit who required central venous catheterization via the axillary vein from January 2007 to December 2009 were selected. On catheter removal, color doppler ultrasonography examination was performed on all the patient. The incidence of deep vein thrombosis in catheterized arms was compared with that in uncatheterized arms. This study was designed by prospective controlled study. Results Catheters were inserted for a mean duration of (14.7±7.4) days. Sixty patients who underwent axillary vein cannulation, one patient had clinical signs of arm vein thrombosis, and no patient had clinical sign of pulmonary embolism. Fibrin sleeves that developed around the catheters were observed in 28 patients (47%). Five patients (8.3%) had phlebographic signs of partial axillary vein thrombosis:nonobstructive clots adherent to the vessel wall and (or) the catheter. Two patients (3.3%) had color doppler ultrasonography signs of complete axillary vein thrombosis. No thrombosis was observed in patients with catheterizations lasting ≤6 days, two cases were observed for duration of 7-14 days, and five cases were observed for duration of ≥15 days (Plt;0.01). In seven patients with axillary vein thrombosis, the vessel was cannulated with fewer than three puncture attempts, and the mean duration for catheter insertion (10±2.5) minutes didn’t differ much from that of patients with no axillary vein thrombosis (14±9) minutes. Conclusion The axillary vein catheterization is associated with 11.6% frequency of upper-extremity deep vein thrombosis.
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.
ObjectiveTo systematically review the efficacy of Kinesio taping on upper limb function recovery in stroke patients.MethodsPubMed, The Cochrane Library, Web of Science, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of Kinesio taping on upper limb function recovery in stroke patients from inception to December 20th, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 13 RCTs involving 589 patients were included. The results of meta-analysis showed that compared with the control group, Kinesio taping significantly improved the FMA-UE score (MD=6.21, 95%CI 3.68 to 8.74, P<0.000 01), VAS score (MD=1.76, 95%CI 1.30 to 2.23, P<0.000 01), and MBI score (MD=10.28, 95%CI 8.43 to 12.13, P<0.000 01) of patients.ConclusionsCurrent evidence shows that the Kinesio taping can significantly improve the upper limb motor function, pain, and daily living ability of stroke patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
目的:初步評價健身鋼球鍛煉法治療乳腺癌根治性手術后上肢水腫的療效。方法:收集乳腺癌改良根治術后并發上肢水腫患者60例,按照就診順序隨機配對分為實驗組和對照組,每組各30例。實驗組術后采用健身鋼球鍛煉患側上肢的方法;對照組采用抬高患肢、向心性按摩和熱敷的傳統方法。結果:兩組患側上肢各部位術后1天均存在不同程度水腫(Plt;0.05),實驗組隨著時間的推移,其水腫程度不斷減輕(Plt;0.05),而對照組則在術后1周內變化不明顯(Pgt;0.05),并且其各部位腫脹率均高于實驗組,二者差異均有統計學意義(Plt;0.05)。結論:健身鋼球鍛煉法對乳腺癌根治性手術后上肢水腫具有一定的短期療效。
【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.