AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic...AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients’ mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors, calcium antagonists, anticoagulants, antithrombotics, antidepressants, anti-epileptics. RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident. Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13), sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury. CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients. Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere, and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.展开更多
Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-...Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-assisted walking gait. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the walker frame. During walking process, this system collected the reaction forces between patient's upper extremities and walker and converted them into RTG morphologic curves of dynamic gait stability in temporal and spatial domains. To demonstrate the potential usefulness of RTG, preliminary clinical trials were done with paraplegic patients. The gait stability levels of two walking cases with 4- and 12-week FES training from one subject were quantified (0.43 and 0.19) from the results of temporal and spatial RTG. Relevant instable phases in gait cycle and dangerous inclinations of patient's body during walking process were also brought forward. In conclusion, the new RTG method is practical for distinguishing more useful gait stability information for FES system control.展开更多
A non-specific symptom of one or more physical, or psychological processes in which screaming, shouting, complaining, moaning, cursing, pacing, fidgeting or wandering pose risk or discomfort, become disruptive or unsa...A non-specific symptom of one or more physical, or psychological processes in which screaming, shouting, complaining, moaning, cursing, pacing, fidgeting or wandering pose risk or discomfort, become disruptive or unsafe or interfere with the delivery of care are called agitation. Individuals in agitation manifest their condition through ＂pain behavior＂, which includes facial expressions. Clinicians regard the patient＇s facial expression as a valid indicator for pain and pain intensity. Hence, correct interpretation of the facial agitation of the patient and its correlation with pain is a fundamental step in designing an automated pain assessment system. Computer vision techniques can be used to quantify agitation in sedated patients in Intensive Care Unit （ICU）. In particular, such techniques can be used to develop objective agitation measurements from patient motion. In the case of paraplegic patients, whole body movement is not available, and hence, monitoring the whole body motion is not a viable solution. Hence in this case, the author measured head motion and facial grimacing for quantifying facial patient agitation in critical care based on Fuzzy k-NN.展开更多
Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patien...Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel＇s score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach. Results： There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a longterm complication in follow-up. Conclusions： The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.展开更多
As the conventional reciprocating gait orthosis(RGO)has been deemed incapable of facilitating the patients’passive movement with significant gait discrepancies and distortion,in addition to characteristics such as po...As the conventional reciprocating gait orthosis(RGO)has been deemed incapable of facilitating the patients’passive movement with significant gait discrepancies and distortion,in addition to characteristics such as poor stability,and negligible knee joint rehabilitation,a power assisted reciprocating gait orthosis(PARGO)was designed.Drive devices were added to the hip and knee joints of the RGO.Through efficient implementation of structural components,the number of the required motors was reduced,therefore decreasing the weight of the orthosis.The PARGO knee joint’s structural principle was analyzed to characterize the effect of the PARGO’s single-axis knee joint design on wear comfort,thereby providing a basis for the wear of the PARGO.By analyzing the sagittal movement patterns of the hip and knee joints during normal human gait,kinematic analysis was carried out to obtain the input patterns of the PARGO hip and knee joint drive motors,enabling the patients to more accurately reproduce the normal gaits of hip and knee joints during the rehabilitation training with the aid of the PARGO,and the control process of the PARGO was studied.Finally,a prototype of the PARGO was developed,and experimentation was carried out to demonstrate the feasibility of the improved orthosis.展开更多
OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were ra...OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 weeks.The primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after treatment.The secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).On Fugl-Meyer evaluation,functional movement of the upper limb was also improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).CONCLUSION:Standardized acupuncture-massage therapy may have curative effects on shoulder-hand syndrome in hemiplegia patients.展开更多
文摘AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients’ mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors, calcium antagonists, anticoagulants, antithrombotics, antidepressants, anti-epileptics. RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident. Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13), sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury. CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients. Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere, and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.
基金Supported by National Natural Science Foundation of China (No.60501005)Key Programof Tianjin Science Technology Support Plan(No.2007-68)
文摘Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-assisted walking gait. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the walker frame. During walking process, this system collected the reaction forces between patient's upper extremities and walker and converted them into RTG morphologic curves of dynamic gait stability in temporal and spatial domains. To demonstrate the potential usefulness of RTG, preliminary clinical trials were done with paraplegic patients. The gait stability levels of two walking cases with 4- and 12-week FES training from one subject were quantified (0.43 and 0.19) from the results of temporal and spatial RTG. Relevant instable phases in gait cycle and dangerous inclinations of patient's body during walking process were also brought forward. In conclusion, the new RTG method is practical for distinguishing more useful gait stability information for FES system control.
文摘A non-specific symptom of one or more physical, or psychological processes in which screaming, shouting, complaining, moaning, cursing, pacing, fidgeting or wandering pose risk or discomfort, become disruptive or unsafe or interfere with the delivery of care are called agitation. Individuals in agitation manifest their condition through ＂pain behavior＂, which includes facial expressions. Clinicians regard the patient＇s facial expression as a valid indicator for pain and pain intensity. Hence, correct interpretation of the facial agitation of the patient and its correlation with pain is a fundamental step in designing an automated pain assessment system. Computer vision techniques can be used to quantify agitation in sedated patients in Intensive Care Unit （ICU）. In particular, such techniques can be used to develop objective agitation measurements from patient motion. In the case of paraplegic patients, whole body movement is not available, and hence, monitoring the whole body motion is not a viable solution. Hence in this case, the author measured head motion and facial grimacing for quantifying facial patient agitation in critical care based on Fuzzy k-NN.
文摘Objective： To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis （AS） and the effect of combined anterior and posterior operation. Methods： Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D according to Frankel＇s score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. All patients underwent surgical procedures by combined anterior and posterior approach. Results： There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a longterm complication in follow-up. Conclusions： The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.
基金The Research Foundation for Key Program of Beijing(Grant No.D141100003614001)
文摘As the conventional reciprocating gait orthosis(RGO)has been deemed incapable of facilitating the patients’passive movement with significant gait discrepancies and distortion,in addition to characteristics such as poor stability,and negligible knee joint rehabilitation,a power assisted reciprocating gait orthosis(PARGO)was designed.Drive devices were added to the hip and knee joints of the RGO.Through efficient implementation of structural components,the number of the required motors was reduced,therefore decreasing the weight of the orthosis.The PARGO knee joint’s structural principle was analyzed to characterize the effect of the PARGO’s single-axis knee joint design on wear comfort,thereby providing a basis for the wear of the PARGO.By analyzing the sagittal movement patterns of the hip and knee joints during normal human gait,kinematic analysis was carried out to obtain the input patterns of the PARGO hip and knee joint drive motors,enabling the patients to more accurately reproduce the normal gaits of hip and knee joints during the rehabilitation training with the aid of the PARGO,and the control process of the PARGO was studied.Finally,a prototype of the PARGO was developed,and experimentation was carried out to demonstrate the feasibility of the improved orthosis.
基金Supported by The Fund of Research into Treatment of Diseases with Acupuncturea-clinically Applied Research Task of Sichuan Provincial Tcm Administration in 2008
文摘OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 weeks.The primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after treatment.The secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).On Fugl-Meyer evaluation,functional movement of the upper limb was also improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).CONCLUSION:Standardized acupuncture-massage therapy may have curative effects on shoulder-hand syndrome in hemiplegia patients.
