To reduce the complexity of the configuration and control strategy for shoulder rehabilitation exoskeleton,a 2R1R1P2R serial of shoulder exoskeleton based on gravity balance is proposed.Based on three basic rotatory s...To reduce the complexity of the configuration and control strategy for shoulder rehabilitation exoskeleton,a 2R1R1P2R serial of shoulder exoskeleton based on gravity balance is proposed.Based on three basic rotatory shoulder joints,an exact kinematic constraint system can be formed between the exoskeleton and the upper arm by introducing a passive sliding pair and a center of glenohumeral(CGH)unpowered compensation mechanism,which realizes the human-machine kinematic compatibility.Gravity balance is used in the CGH compensation mechanism to provide shoulder joint support.Meanwhile,the motion of the compensation mechanism is pulled by doing reverse leading through the arm to realize the kinematic self-adaptive,which decreases control complexity.Besides,a simple and intuitive spring adjustment strategy is proposed to ensure the gravity balance of any prescribed quality.Furthermore,according to the influencing factors analysis of the scapulohumeral rhythm,the kinematic analysis of CGH mechanism is performed,which shows that the mechanism can fit the trajectory of CGH under various conditions.Finally,the dynamic simulation of the mechanism is carried out.Results indicate that the compensation torques are reduced to below 0.22 N·m,and the feasibility of the mechanism is also verified.展开更多
Objective: To evaluate the effects of core stability exercise (CST) on rehabilitation in stroke patients with hemiplegia. Methods: Randomly controlled trials about the effects of CST on rehabilitation in stroke pa...Objective: To evaluate the effects of core stability exercise (CST) on rehabilitation in stroke patients with hemiplegia. Methods: Randomly controlled trials about the effects of CST on rehabilitation in stroke patients with hemiplegia were searched in the database, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, CBM and VIP. Search terms include “core stability training / core stability exercise / core stabilization training / core stabilization exercise/ core strength training / core strength exercise” and “stroke / brain ischemia / cerebral infarction / cerebral hemorrhage / intracranial thrombosis / brain hemorrhage / cerebrovascular disorder /cerebrovascular accident, cerebrovascular disease / hemiplegia / hemiparesis/ stroke rehabilitation”. Study screening, data extraction and quality assessment were conducted by two researchers independently. Data was analyzed using RevMan 5.3 software. Results: Totally 11 studies and 704 patients were included with 352 patients in experiment group and 352 in control group. Results of meta-analysis showed that combination of CST and conventional rehabilitation had better effects on trunk control [MD = 10.44, 95% CI (8.83-12.04), P 〈 0.001], banlace [MD = 5.6, 95% CI (4.81-6.39), P 〈 0.001], activities of daily living [MD = 12.06, 95% CI (7.65-16.46), P 〈 0.001], ambulation functional [MD = 0.72, 95% CI (0.32-1.12), P 〈 0.001] and walking speed [MD = 3.39, 95% CI (2.03-4.76), P 〈 0.001] than conventional rehabilitation, but there is no clear difference on walking stride [MD = 2.52, 95% CI (-0.25-5.29), P = 0.07] between two groups. Conclusion: CST together with conventional rehabilitation can better improve trunk control, banlace, activities of daily living, ambulation functional and walking speed in stroke patients compared with conventional rehabilitation, but can not make the walking stride better significantly. However, since the conclusion of this meta-analysis was drawn based on middle quality RCTs, future high quality researchs should be conducted to confirm its positive intervention effects.展开更多
Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This conceptanalysis will provide a framework for clinical decision-making and intervention to improve patients’ ...Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This conceptanalysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence tocardiac rehabilitation programme. Method: Walker and Avant’s framework was used to analysis the concept ofadherence. Results: Adherence is defined as patients collaboration with health care provider, active involvement in thetreatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributesof adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents ofadherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors.Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standardinstrument to measure adherence. Conclusion: Based on the concept analysis, in order to improve patients’ adherence tocardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan andpromote patients’ self-efficacy and prevention relapse.展开更多
Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients ...Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to developself-management strategies and enables them to improve their ability in symptom self-management of home-basedrehabilitation. Method: Walker and Avant’s framework (2011) was used to analyse the concept of self-management.Results: Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation,problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge andsocial support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes andquality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Managementscale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether thisinstrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thusfurther research is needed. Conclusion: According to the concept analysis, nurses should encourage cancer patients toinvolve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management ofhome-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.展开更多
基金The National Natural Science Foundation of China(No.51675098)。
文摘To reduce the complexity of the configuration and control strategy for shoulder rehabilitation exoskeleton,a 2R1R1P2R serial of shoulder exoskeleton based on gravity balance is proposed.Based on three basic rotatory shoulder joints,an exact kinematic constraint system can be formed between the exoskeleton and the upper arm by introducing a passive sliding pair and a center of glenohumeral(CGH)unpowered compensation mechanism,which realizes the human-machine kinematic compatibility.Gravity balance is used in the CGH compensation mechanism to provide shoulder joint support.Meanwhile,the motion of the compensation mechanism is pulled by doing reverse leading through the arm to realize the kinematic self-adaptive,which decreases control complexity.Besides,a simple and intuitive spring adjustment strategy is proposed to ensure the gravity balance of any prescribed quality.Furthermore,according to the influencing factors analysis of the scapulohumeral rhythm,the kinematic analysis of CGH mechanism is performed,which shows that the mechanism can fit the trajectory of CGH under various conditions.Finally,the dynamic simulation of the mechanism is carried out.Results indicate that the compensation torques are reduced to below 0.22 N·m,and the feasibility of the mechanism is also verified.
文摘Objective: To evaluate the effects of core stability exercise (CST) on rehabilitation in stroke patients with hemiplegia. Methods: Randomly controlled trials about the effects of CST on rehabilitation in stroke patients with hemiplegia were searched in the database, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, CBM and VIP. Search terms include “core stability training / core stability exercise / core stabilization training / core stabilization exercise/ core strength training / core strength exercise” and “stroke / brain ischemia / cerebral infarction / cerebral hemorrhage / intracranial thrombosis / brain hemorrhage / cerebrovascular disorder /cerebrovascular accident, cerebrovascular disease / hemiplegia / hemiparesis/ stroke rehabilitation”. Study screening, data extraction and quality assessment were conducted by two researchers independently. Data was analyzed using RevMan 5.3 software. Results: Totally 11 studies and 704 patients were included with 352 patients in experiment group and 352 in control group. Results of meta-analysis showed that combination of CST and conventional rehabilitation had better effects on trunk control [MD = 10.44, 95% CI (8.83-12.04), P 〈 0.001], banlace [MD = 5.6, 95% CI (4.81-6.39), P 〈 0.001], activities of daily living [MD = 12.06, 95% CI (7.65-16.46), P 〈 0.001], ambulation functional [MD = 0.72, 95% CI (0.32-1.12), P 〈 0.001] and walking speed [MD = 3.39, 95% CI (2.03-4.76), P 〈 0.001] than conventional rehabilitation, but there is no clear difference on walking stride [MD = 2.52, 95% CI (-0.25-5.29), P = 0.07] between two groups. Conclusion: CST together with conventional rehabilitation can better improve trunk control, banlace, activities of daily living, ambulation functional and walking speed in stroke patients compared with conventional rehabilitation, but can not make the walking stride better significantly. However, since the conclusion of this meta-analysis was drawn based on middle quality RCTs, future high quality researchs should be conducted to confirm its positive intervention effects.
文摘Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This conceptanalysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence tocardiac rehabilitation programme. Method: Walker and Avant’s framework was used to analysis the concept ofadherence. Results: Adherence is defined as patients collaboration with health care provider, active involvement in thetreatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributesof adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents ofadherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors.Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standardinstrument to measure adherence. Conclusion: Based on the concept analysis, in order to improve patients’ adherence tocardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan andpromote patients’ self-efficacy and prevention relapse.
文摘Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to developself-management strategies and enables them to improve their ability in symptom self-management of home-basedrehabilitation. Method: Walker and Avant’s framework (2011) was used to analyse the concept of self-management.Results: Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation,problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge andsocial support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes andquality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Managementscale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether thisinstrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thusfurther research is needed. Conclusion: According to the concept analysis, nurses should encourage cancer patients toinvolve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management ofhome-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.