ObjectiveTo investigate the effects of pulmonary rehabilitation on the exercise capacity and quality of life in patients with stable chronic obstructive pulmonary disease (COPD) for a optimal strategy for pulmonary rehabilitation. MethodsOne hundred and six patients with COPD in stable stage were divided into group B (n=37), group C (n=36), and group D(n=33) based on GOLD 2011.Each group of patients were randomly subdivided into a control group(usual care), a pulmonary rehabilitation strategy group 1 (breathing training), and a pulmonary rehabilitation strategy group 2 (breathing training and exercise training), and they were intervened for 24 weeks.Pulmonary function(FEV1%pred), COPD Assessment Test (CAT), modified British Medical Research Council dyspnea scale(mMRC), BODE index and 6-minute walking distance(6MWD) were compared before and after intervention. ResultsAfter pulmonary rehabilitation intervening for 24 weeks, in group B and group C, pulmonary rehabilitation strategy group 2 showed the best effect, CAT, mMRC, BODE index, and 6MWD were proved significantly different before and after pulmonary rehabilitation (P < 0.05).In group D, all indexes had no significant difference between pulmonary rehabilitation strategy group 1 and group 2 before and after pulmonary rehabilitation (P > 0.05), but they were better than those of the control group.Correlation analysis showed that CAT score had significant correlation with FEV1 % pred, mMRC, BODE index and 6MWD (P < 0.01). ConclusionPatients with different subgroup of COPD based on GOLD 2011 may take different pulmonary rehabilitation strategies to achieve the optimal effect.
Objective To investigate the effect of lower limb rehabilitation robot combined with virtual reality training on walking ability after anterior cruciate ligament reconstruction (ACLR). Methods Patients after ACLR treated in the Rehabilitation Medical Center of the Second Hospital of Jiaxing between May 2019 and July 2021 were selected. The patients were randomly divided into two groups. The patients with conventional ACLR rehabilitation training + lower limb rehabilitation robot combined with virtual reality training were used as the treatment group, and only the patients with conventional ACLR rehabilitation training were used as the control group. The rehabilitation training lasted for 8 weeks. After 4 and 8 weeks of treatment, the two groups were evaluated by Lysholm knee score scale (LKSS), Holden walking score and Gait watch gait analysis. Results A total of 40 patients were included, with 20 patients in each group. There was no significant difference between the two groups in LKSS score, Holden walking score and Gait watch gait analysis dynamic data at 4 weeks of treatment (P>0.05). After 8 weeks of treatment, the LKSS score [(77.74±5.53) vs. (69.53±5.26) points], Holden walking score [(4.79±0.34) vs. (4.45±0.39) points] and Gait watch gait analysis dynamic data [step size: (78.35±2.43) vs. (73.64±3.35) cm, step frequency: (115.10±4.49) vs. (107.71±5.14) step/min, step speed: (108.63±8.55) vs. (96.78±8.47) cm/s] of the treatment group were better than those of the control group (P<0.05), The above indexes of the two groups were improved compared with those at 4 weeks of treatment (P<0.05). Conclusion Lower limb rehabilitation robot combined with virtual reality training can effectively improve walking ability after ACLR.
Objective To analyze the effects of different surgical methods on postoperative pulmonary function and exercise capacity in patients with non-small cell lung cancer (NSCLC), so as to explore whether it can effectively improve pulmonary function and promote the recovery of exercise capacity by reducing the number of trocars ports and the resection of normal lung tissues. Methods The clinical data of NSCLC patients who underwent surgery in the First Affiliated Hospital of Hebei North University from January 2016 to June 2019 were collected retrospectively. According to the surgical methods, they were divided into three groups: single utility port video-assisted thoracic surgery (SP-VATS) segmentectomy group, SP-VATS lobectomy group and three port video-assisted thoracic surgery (TP-VATS) lobectomy group. The changes of pulmonary function [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal voluntary ventilation (MVV)] and 6-minute walking distance (6MWD) at different time points [1st day before the operation (T0); 3rd day (T1), 7th day (T2), 1st month (T3), 3rd month (T4), 6th month (T5) and 1st year (T6) after the operation] were compared among the three groups. Results A total of 342 patients were included, including 102 in SP-VATS segmentectomy group, 116 in SP-VATS lobectomy group and 124 in TP-VATS lobectomy group. Except for pathological type and TNM stage (P<0.05), there was no significant difference in general information, preoperative pulmonary function or 6MWD among the three groups (P>0.05). The pulmonary function and 6MWD of the three groups before and after operation were not affected by pathological type or TNM stage (P>0.05). Except at T6 time point (P>0.05), there were significant differences in postoperative pulmonary function and 6MWD among the three groups at T1-T5 time points (P<0.05). Intra group comparison of pulmonary function and 6MWD in the three groups showed that the operation had the least impact on patients in SP-VATS segmentectomy group with the fastest recovery, followed by SP-VATS lobectomy group, and SP-VATS lobectomy group was the worst. Conclusions Video-assisted thoracoscopic for NSCLC can improve pulmonary function and promote the recovery of exercise capacity by reducing the number of trocars ports and the resection of normal lung tissues. However, this advantage is mainly reflected in the early postoperative stage.
ObjectivesTo systematically review the efficacy of Nordic walking on prognosis of cardiovascular diseases. MethodsPubMed, Web of Science, EMbase, The Cochrane Library, CBM, CNKI and VIP databases were electronically searched to collect intervention studies on the efficacy of Nordic walking on prognosis of cardiovascular diseases from inception to June, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 studies involving 328 patients were included. The results of meta-analysis showed that: compared with control group, there were an obvious decrease in the values of LDL (MD=–11.38, 95%CI –17.51 to –5.25, P=0.000 3), TG (MD=–21.14, 95%CI –32.33 to–9.96, P=0.000 2), SBP (MD=–7.96, 95%CI ?11.45 to –4.46, P<0.000 01) and TC, DBP, BMI (P<0.05). However, there were no obvious differences between two groups in HDL. ConclusionsNordic walking can improve the prognosis of patients with cardiovascular diseases, yet the long-term effect is unclear. Due to limited quality and quantity of the included studies, more higher quality studies are required to verify above conclusions.
Objective To systematically review the rehabilitation effect of isokinetic muscle training on knee muscle strength, functional walking ability and dynamic balance in post-stroke patients. Methods PubMed, Ovid Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang databases were searched online for randomized controlled trials on isokinetic muscle training of lower limbs in post-stroke patients. The retrieval time was from inception to October, 2022. Endnote X9 software was used to manage the literature. Cochrane Manual 5.1.0 was used for quality assessment, and RevMan 5.4 software was used for meta-analysis. Results A total of 20 randomized controlled trials were included in the study, with the intervention group using isokinetic muscle training of the lower extremities or combined with conventional rehabilitation training and the control group using conventional rehabilitation training and/or other intervention, with a total of 1448 study subjects. Meta-analysis results showed that the differences in knee flexion peak torque [mean difference (MD)=5.85 N·m, 95% confidence interval (CI) (4.84, 6.85) N·m, P<0.00001], knee extension peak torque [MD=9.09 N·m, 95%CI (4.83, 13.36) N·m, P<0.0001], Time Up Go test [MD=–4.70 s, 95%CI (–6.68, –2.72) s, P<0.00001], 10-meter walking test [MD=–4.71 s, 95%CI (–9.12, –0.31) s, P=0.04], Fugl-Meyer Lower Extremity Motor Function Assessment score [MD=6.61, 95%CI (3.52, 9.70), P<0.0001], and Berg Balance Scale score [MD=5.61, 95%CI (0.91, 10.31), P=0.02] were statistically significant. Conclusion Isokinetic training may improve knee strength and functional walking ability in post-stroke patients, but there is still no strong evidence of improvement in motor function and balance.
We carried out study on surface electromyogram (sEMG) signal generated from cluster muscles in trunk and lower limbs on condition of human body walking with heavily burdened shoulder to explore functional status and fatigue property of human muscles and to offer an important reference for finding better ways of loading, improving the performance and design of backpack as well as weight-bearing system more suitable for ergonomics. We measured and obtained surface electromyography signals from the primary muscles clusters in neck, shoulder, back and leg of 20 test recipients loaded with different burdens on their shoulders. The eigenvalue of mean power frequency (MPF) were processed with SPSS 16.0. It could be concluded that with the increase of loading weights, male are more likely to be fatigued due to dramatic decrease of trapezius' MPF. While for the female test recipients, the cervical extensor muscles' MPF dropped significantly and were more easily fatigued. Moreover, there was a remarkable difference in terms of electromyography signal before and after the weight reaches certain limit (P<0.05) . The maximum weight limit loaded on shoulders for man is 12% of the total bodyweight while such limit for woman is just 9%.
Objective To explore the postural control of children with autism spectrum disorder (ASD) under different sensory information inputs. Methods A total of 15 ASD children aged 4-12 years who visited the National Autism Center of China Rehabilitation Research Center between November 2022 and December 2024 were randomly selected, and 15 typically developmental (TD) children matched in age and gender were recruited from the children of staff at the China Rehabilitation Research Center. Postural control tests during static standing and walking were conducted respectively. The postural control and walking abilities under different conditions were compared between the two groups of children, and the standing and walking abilities across these conditions within each group were compared to analyze the effects of the conditions on standing and walking. Results There were statistically significant differences between the two groups of children in the center of pressure (COP) 95% confidence ellipse area (P<0.001) and COP path length (P<0.001) during static standing. There was a statistically significant difference in the gait line length difference between the two groups of children when walking at a speed of 1.0 km/h (P<0.001), but no statistically significant difference when walking at a speed of 2.0 km/h (P>0.05). There was no statistically significant difference in the anterior-posterior position between the two groups of children (P>0.05). For ASD children, there were statistically significant differences in the COP 95% confidence ellipse area and COP path length when standing with eyes open and closed (P<0.05), while for TD children, there was no statistically significant difference (P>0.05). When walking at different speeds, there were statistically significant differences in the gait line length difference and the anterior-posterior position among ASD children (P<0.05), while there was no statistically significant difference among TD children (P>0.05). Conclusions Compared with TD children, ASD children have postural control disorders, and poor walking stability and coordination ability. Under different sensory input conditions, the postural control ability of ASD children varies greatly. Sensory-motor intervention should be carried out for ASD children to improve their postural control ability, walking stability and coordination ability.
ObjectiveTo investigate the effect of pulmonary rehabilitation on pulmonary function,perception of dyspnea and quality of life in stable COPD patients of different severity. Methods300 patients with COPD in stable stage were divided into a moderate COPD group (n=120),a severe COPD group (n=100) and a very severe COPD group (n=80). Each group was randomly subdivided into a control group and a treatment group. The treatment groups received pulmonary rehabilitation for 6 months in addition to usual care,and the control groups received usual care without pulmonary rehabilitation. Pulmonary function(FEV1),6 minute walking distance (6MWD),modified medical research council (mMRC) scale,and acute exacerbation frequency of COPD were compared before and after intervention and among groups. ResultsAfter pulmonary rehabilitation for 6 months,the quality of life score and 6MWD were significantly improved in the treatment groups with moderate,severe,very severe COPD,and the increscent of 6MWD was greatest in the severe COPD patients. The mMRC of the patients with very severe COPD improved significantly after pulmonary rehabilitation(P<0.05). Lung function before and after the intervention in three groups all showed no significant difference (P>0.05). The acute exacerbation frequency of the severe COPD patients was significantly reduced by pulmonary rehabilitation (P<0.05), while there was no significant change in the moderate and very severe groups (P>0.05). ConclusionPulmonary rehabilitation can improve exercise tolerance and quality of life of COPD patients with different severity,reduce acute exacerbation frequency in severe COPD,reduce the dyspnea degree in very severe COPD. Pulmonary rehabilitation is a cost-effective treatment for stable COPD.
Objectives To analyze the effect of sling exercise therapy on the walking ability of children with spastic hemiplegia and cerebral palsy, and to provide a scientific basis for clinical treatment. Methods Children with spastic hemiplegia and cerebral palsy who were treated in the Department of Rehabilitation of Children’s Hospital of Shanghai from July 2018 to July 2019 were selected as the research subjects. The children were divided into conventional treatment group and sling exercise therapy group by random number table method. The routine treatment group was given routine rehabilitation training, and the sling exercise therapy group was given combined sling exercise therapy on the basis of routine treatment. The Gross Motor Function Measure (GMFM)-88-item E functional area score, Clinical Spasticity Index (CSI) and Berg Balance Scale (BBS) score were compared between the two groups. Results A total of 36 children were included, with 18 cases in each group. There was no significant difference in gender, age and hemiplegia side between the two groups (P>0.05). All children completed the trial without adverse reactions. Before treatment, there was no significant difference in BBS, CSI and GMFM-88 E functional area scores between the two groups (P>0.05). After 3 months of treatment, the above scores of the two groups were improved compared with those before treatment (P<0.05). The improvement of the above scores in the sling exercise therapy group after treatment was better than that in the conventional treatment group. The difference of BBS, CSI, and GMFM-88 E functional area scores in the sling exercise therapy group before and after treatment was 8.94±4.15, 2.44±0.71, and 7.28±3.23, respectively, the difference of the above scores before and after treatment in the conventional treatment group was 4.50±4.15, 1.83±0.79, and 2.89±1.64, respectively, and the differences were statistically significant (P<0.05). Conclusion Combined use of sling exercise therapy can better improve the walking ability of children with spastic hemiplegia and cerebral palsy, which is worthy of clinical promotion and application.
This research is to develop a weight-loss walking rehabilitation training system based on differential air pressure. The system adopted Proportion-Integral-Derivative (PID) algorithm to improve the precision of weight loss, taking MSP430F149 microprocessor of Texas Instruments as the core of pressure control system. The training software is designed based on Microsoft Visual C++ 6.0 of Microsoft. The system can provide comfortable training environment for patients with lower limb motor function impediment, and can collect electromyographic signals from patients, so as to further the scientific and normative management of the patient's information. Based on this training system, the initial bearing weight, bearing weight after maximum weight loss, and maximum weight loss percentage of 10 normal adults’ lower limbs were collected. It was found that the intraclass correlation coefficient (ICC) values were all greater than 0.6. The training system has a good reliability, which can provide scientific data for clinical weight-loss lower limb rehabilitation training.