While walkers are commonly prescribed to improve patient stability and ambulatory ability,quantitative study of the biomechanical and functional requirements for effective walker use is limited.To investigate the chan...While walkers are commonly prescribed to improve patient stability and ambulatory ability,quantitative study of the biomechanical and functional requirements for effective walker use is limited.To investigate the changes in wrist joint moments that occur with the use of a standard walker,a strain gauge-based walker instrumentation sys- tem was developed for the measurement of wrist joint moments.This walker dynamometer was integrated with an up- per extremity biomechanical model.Preliminary system data were collected for twelve healthy,right-handed young a- dults following informed consent.Bilateral upper extremity kinematic data were acquired with a six-camera motion a- nalysis system.Internal joint moments at the wrist were determined in the three clinical planes using the inverse dy- namics method.Results showed that during a walker-assisted gait there were several typical demands of wrist abduc- tor,adductor,flexor and external rotator.An interesting'bare phase'of wrist joint moments was also found in phase angle[-30°,30°]of gait cycle.Complete description of wrist joint moments during walker-assisted gait may pro- vide insight into walker use parameters and rehabilitative strategies.展开更多
目的研究记忆合金弓齿钉内固定联合复元活血汤治疗新鲜腕舟状骨骨折患者的疗效及对腕关节功能的影响。方法采用前瞻性研究,以医院2018年1月—2020年4月诊断并治疗的新鲜腕舟状骨骨折患者120例作为研究对象,采用信封法,将以上患者随机分...目的研究记忆合金弓齿钉内固定联合复元活血汤治疗新鲜腕舟状骨骨折患者的疗效及对腕关节功能的影响。方法采用前瞻性研究,以医院2018年1月—2020年4月诊断并治疗的新鲜腕舟状骨骨折患者120例作为研究对象,采用信封法,将以上患者随机分为观察组及对照组,每组60例,两组患者均采取记忆合金弓齿钉内固定治疗,观察组患者在此基础上联合采用复元活血汤进行治疗。比较两组患者的治疗效果、疼痛情况、腕关节功能、上肢功能评定量表(disabilities ofarm,shoulder and hand,DASH)评分以及不良反应之间的差异。结果观察组患者的治疗优良率(91.67%,55/60)显著高于对照组(78.33%,47/60),差异存在统计学意义(χ^(2)=4.182,P=0.041);治疗后,两组患者的视觉模拟评分法(visual analog scale,VAS)评分均显著降低,且观察组患者3 d、7 d VAS评分显著低于对照组(t=6.925,P=0.000;t=4.243,P=0.000),治疗4周后,观察组患者掌屈(t=30.828,P=0.000)、背伸(t=4.697,P=0.000)、桡偏(t=3.811,P=0.000)、尺偏(t=2.782,P=0.000)的活动范围显著高于对照组,观察组患者的DASH评分A部分(t=5.597,P=0.000)、B部分(t=9.193,P=0.000)、总分(t=5.176,P=0.000)均显著低于对照组,两组患者发生骨不连、伤口感染以及骨坏死情况之间的差异不存在统计学意义(P>0.05)。结论记忆合金弓齿钉内固定联合复元活血汤治疗新鲜腕舟状骨骨折,患者的腕关节功能恢复显著,疼痛情况下降,治疗效果显著。展开更多
基金Supported by National Natural Science Foundation of China(60501005)Key Program of Tianjin SciePnee Technology Support Plan(07ZCKFSF01300)
文摘While walkers are commonly prescribed to improve patient stability and ambulatory ability,quantitative study of the biomechanical and functional requirements for effective walker use is limited.To investigate the changes in wrist joint moments that occur with the use of a standard walker,a strain gauge-based walker instrumentation sys- tem was developed for the measurement of wrist joint moments.This walker dynamometer was integrated with an up- per extremity biomechanical model.Preliminary system data were collected for twelve healthy,right-handed young a- dults following informed consent.Bilateral upper extremity kinematic data were acquired with a six-camera motion a- nalysis system.Internal joint moments at the wrist were determined in the three clinical planes using the inverse dy- namics method.Results showed that during a walker-assisted gait there were several typical demands of wrist abduc- tor,adductor,flexor and external rotator.An interesting'bare phase'of wrist joint moments was also found in phase angle[-30°,30°]of gait cycle.Complete description of wrist joint moments during walker-assisted gait may pro- vide insight into walker use parameters and rehabilitative strategies.
文摘目的:观察病灶清除植骨融合联合外固定架治疗腕关节结核的临床疗效。方法:2015年10月至2019年5月,采用病灶清除植骨融合联合外固定术治疗25例晚期腕关节结核患者,男14例,女11例;年龄40~74 (60.72±8.45)岁;病程5~24 (11.52±7.61)个月;左腕结核11例,右腕结核14例,合并窦道形成者5例。术后继续规律抗结核,观察患者治疗前后视觉模拟疼痛评分(vasual analogue scale,VAS)、炎症指标、Gartland-Werley腕关节功能评分、上肢功能评分(disabilities of the arm,shoulder and hand,DASH)。结果:25例患者获得随访,时间12~36(19.7±6.3)个月,末次随访患者切口愈合可,均无结核、感染复发。术前1周与术后3个月VAS分别为(5.16±1.14)、(1.68±0.80)分,红细胞沉降率(enythrocyte sedimentation rate,ESR)分别为(44.20±20.56)、(14.44±1.14) mm·h^(-1),C反应蛋白(C-reactive protein,CRP)为(12.37±7.95)、(4.30±3.37) mg·L^(-1),各时间点比较差异均有统计学意义(P<0.01)。术前1周与术后1年Gartland-Werley腕关节功能评分分别为(21.32±3.44)、(14.96±1.37)分,两者比较差异有统计学意义(P<0.01);DASH由术前1周的(70.52±7.95)分,提高至术后1年的(28.84±2.30)分(P<0.01)。末次随访所有患者结核病无复发。结论:采用病灶清除植骨融合联合外固定术治疗腕关节结核近期临床疗效满意。
文摘目的研究记忆合金弓齿钉内固定联合复元活血汤治疗新鲜腕舟状骨骨折患者的疗效及对腕关节功能的影响。方法采用前瞻性研究,以医院2018年1月—2020年4月诊断并治疗的新鲜腕舟状骨骨折患者120例作为研究对象,采用信封法,将以上患者随机分为观察组及对照组,每组60例,两组患者均采取记忆合金弓齿钉内固定治疗,观察组患者在此基础上联合采用复元活血汤进行治疗。比较两组患者的治疗效果、疼痛情况、腕关节功能、上肢功能评定量表(disabilities ofarm,shoulder and hand,DASH)评分以及不良反应之间的差异。结果观察组患者的治疗优良率(91.67%,55/60)显著高于对照组(78.33%,47/60),差异存在统计学意义(χ^(2)=4.182,P=0.041);治疗后,两组患者的视觉模拟评分法(visual analog scale,VAS)评分均显著降低,且观察组患者3 d、7 d VAS评分显著低于对照组(t=6.925,P=0.000;t=4.243,P=0.000),治疗4周后,观察组患者掌屈(t=30.828,P=0.000)、背伸(t=4.697,P=0.000)、桡偏(t=3.811,P=0.000)、尺偏(t=2.782,P=0.000)的活动范围显著高于对照组,观察组患者的DASH评分A部分(t=5.597,P=0.000)、B部分(t=9.193,P=0.000)、总分(t=5.176,P=0.000)均显著低于对照组,两组患者发生骨不连、伤口感染以及骨坏死情况之间的差异不存在统计学意义(P>0.05)。结论记忆合金弓齿钉内固定联合复元活血汤治疗新鲜腕舟状骨骨折,患者的腕关节功能恢复显著,疼痛情况下降,治疗效果显著。
