<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic dra...<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.展开更多
AIM To evaluate the lower-limb muscle oxygenation in hemodialysis(HD) patients and identify the factors associating with muscle oxygenation.METHODS Sixty-seven HD patients(53 men and 14 women; mean age, 67.1 ± 1....AIM To evaluate the lower-limb muscle oxygenation in hemodialysis(HD) patients and identify the factors associating with muscle oxygenation.METHODS Sixty-seven HD patients(53 men and 14 women; mean age, 67.1 ± 1.2 years; mean HD duration, 5.6 ± 0.9 years) were recruited. In addition, 15 healthy individuals(nine men and six women; mean age, 38.2 ± 4.6 years) were recruited as the control group. Lower-limb muscle regional saturation of oxygen(rS O_2) was monitored on the lateral side of the gastrocnemius muscle before HD using an INVOS 5100C(Covidien Japan, Tokyo, Japan), which utilizes near-infrared spectroscopy. Here, we evaluated the association between lower-limb muscle rS O_2 and clinical parameters.RESULTS The r SO_2 values were significantly lower in patients undergoing HD than in healthy individuals(50.0%± 1.7% vs 76.8% ± 2.5%, P < 0.001). Lower-limb muscle r SO_2 showed significant positive correlations with diastolic blood pressure, blood urea nitrogen concentration, serum creatinine concentration, serum potassium concentration, serum inorganic phosphate concentration, and serum albumin concentration as well as negative correlation with HD duration. We conducted a multiple linear regression analysis using parameters that were significantly correlated with the lower-limb muscle r SO_2 in a simple linear regression analysis. Multiple regression analysis demonstrated that lowerlimb muscle r SO_2 was independently associated with serum inorganic phosphate(standardized coefficient: 0.27) and serum albumin concentrations(standardized coefficient: 0.24). In addition, there were no differences in lower-limb muscle r SO_2 between diabetic and nondiabetic HD patients. This study has several limitations. Firstly, its sample size was relatively small. Secondly, we could not evaluate the association between lowerlimb muscle r SO_2 and calculated nutritional markers, including normalized protein catabolic rate and body mass index, anthropometric measurements representing nutritional status, and the severity of protein-energy wasting. Finally, we did not routinely examine the arterial vascular status of HD patients without symptoms of peripheral artery disease. As such, it is possible that some HD patients with subclinical peripheral artery disease may have been included in this study.CONCLUSION In HD patients, the oxygenation of lower-limb muscle tissue was associated with serum inorganic phosphate and albumin concentrations, both of which represent nutritional status.展开更多
Modern human has different body proportion from early hominids and great apes.Comparing with others,in general,modern human adults have relatively long lower limb and heavier body weight.Since the lower limbs provide ...Modern human has different body proportion from early hominids and great apes.Comparing with others,in general,modern human adults have relatively long lower limb and heavier body weight.Since the lower limbs provide support to the whole body and play an important role in walking,it is proposed that the ratio of the lower limb to the whole body for modern human could be beneficial to bipedal walking.This study tried to estimate the muscle parameters of the lower limb in walking for the subjects with various body proportions.Using a simplified musculoskeletal model,some muscle parameters of the lower limb,e.g.muscle force,stress,work and power,were estimated for modern human adult,child,AL 288-1(the fossil specimens of Australopithecus afarensis,3.18 million years old)and apes.The results show that with the body proportion modern human adult spends less muscle work and power in walking than other subjects.The results imply that using the cost of transport(i.e.the muscle work of the lower limb per unit of displacement)as the criteria,the early hominids,if their body proportions were structurally similar to AL 288-1,could evolve towards what modern human adult looks like,in order to save energy during bipedal walking.展开更多
Unilateral motor impairment can disrupt the coordination between the joints,impeding the patient’s normal gait.To assist such patients to walk normally and naturally,an adaptive control algorithm based on inter-joint...Unilateral motor impairment can disrupt the coordination between the joints,impeding the patient’s normal gait.To assist such patients to walk normally and naturally,an adaptive control algorithm based on inter-joint coordination was proposed in this work for lower-limb exoskeletons.The control strategy can generate the reference trajectory of the affected leg in real time based on a motion coordination model between the joints,and adopt an adaptive controller with virtual windows to track the reference trajectory.Long Short-Term Memory(LSTM)network was also adopted to establish the coordination model between the joints of both lower limbs,which was optimized by preprocessing angle information and adding gait phase information.In the adaptive controller,the virtual windows were symmetrically distributed around the reference trajectory,and its width was adjusted according to the gait phase of the auxiliary leg.In addition,the impedance parameters of the controller were updated online to match the motion capacity of the affected leg based on the spatiotemporal symmetry factors between the bilateral gaits.The LSTM coordination model demonstrated good accuracy and generality in the gait database of seven individuals,with an average root mean square error of 3.5 and 4.1 for the hip and knee joint angle estimation,respectively.To further evaluate the control algorithm,four healthy subjects walked wearing the exoskeleton while additional weights were added around the ankle joint to simulate an asymmetric gait.From the experimental results,it was shown that the algorithm improved the gait symmetry of the subjects to a normal level while exhibiting great adaptability to different subjects.展开更多
文摘<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.
文摘AIM To evaluate the lower-limb muscle oxygenation in hemodialysis(HD) patients and identify the factors associating with muscle oxygenation.METHODS Sixty-seven HD patients(53 men and 14 women; mean age, 67.1 ± 1.2 years; mean HD duration, 5.6 ± 0.9 years) were recruited. In addition, 15 healthy individuals(nine men and six women; mean age, 38.2 ± 4.6 years) were recruited as the control group. Lower-limb muscle regional saturation of oxygen(rS O_2) was monitored on the lateral side of the gastrocnemius muscle before HD using an INVOS 5100C(Covidien Japan, Tokyo, Japan), which utilizes near-infrared spectroscopy. Here, we evaluated the association between lower-limb muscle rS O_2 and clinical parameters.RESULTS The r SO_2 values were significantly lower in patients undergoing HD than in healthy individuals(50.0%± 1.7% vs 76.8% ± 2.5%, P < 0.001). Lower-limb muscle r SO_2 showed significant positive correlations with diastolic blood pressure, blood urea nitrogen concentration, serum creatinine concentration, serum potassium concentration, serum inorganic phosphate concentration, and serum albumin concentration as well as negative correlation with HD duration. We conducted a multiple linear regression analysis using parameters that were significantly correlated with the lower-limb muscle r SO_2 in a simple linear regression analysis. Multiple regression analysis demonstrated that lowerlimb muscle r SO_2 was independently associated with serum inorganic phosphate(standardized coefficient: 0.27) and serum albumin concentrations(standardized coefficient: 0.24). In addition, there were no differences in lower-limb muscle r SO_2 between diabetic and nondiabetic HD patients. This study has several limitations. Firstly, its sample size was relatively small. Secondly, we could not evaluate the association between lowerlimb muscle r SO_2 and calculated nutritional markers, including normalized protein catabolic rate and body mass index, anthropometric measurements representing nutritional status, and the severity of protein-energy wasting. Finally, we did not routinely examine the arterial vascular status of HD patients without symptoms of peripheral artery disease. As such, it is possible that some HD patients with subclinical peripheral artery disease may have been included in this study.CONCLUSION In HD patients, the oxygenation of lower-limb muscle tissue was associated with serum inorganic phosphate and albumin concentrations, both of which represent nutritional status.
基金Supported in part by the grants fromthe BiotechnologyBiological Sciences Research Council,the Leverhulme Trustthe Natural Environment Research Council,U.K.
文摘Modern human has different body proportion from early hominids and great apes.Comparing with others,in general,modern human adults have relatively long lower limb and heavier body weight.Since the lower limbs provide support to the whole body and play an important role in walking,it is proposed that the ratio of the lower limb to the whole body for modern human could be beneficial to bipedal walking.This study tried to estimate the muscle parameters of the lower limb in walking for the subjects with various body proportions.Using a simplified musculoskeletal model,some muscle parameters of the lower limb,e.g.muscle force,stress,work and power,were estimated for modern human adult,child,AL 288-1(the fossil specimens of Australopithecus afarensis,3.18 million years old)and apes.The results show that with the body proportion modern human adult spends less muscle work and power in walking than other subjects.The results imply that using the cost of transport(i.e.the muscle work of the lower limb per unit of displacement)as the criteria,the early hominids,if their body proportions were structurally similar to AL 288-1,could evolve towards what modern human adult looks like,in order to save energy during bipedal walking.
基金supported by the Graduate Scientific Research and Innovation Foundation of Chongqing,China(CYB19062)the China Scholarship Council(CSC202206050121).
文摘Unilateral motor impairment can disrupt the coordination between the joints,impeding the patient’s normal gait.To assist such patients to walk normally and naturally,an adaptive control algorithm based on inter-joint coordination was proposed in this work for lower-limb exoskeletons.The control strategy can generate the reference trajectory of the affected leg in real time based on a motion coordination model between the joints,and adopt an adaptive controller with virtual windows to track the reference trajectory.Long Short-Term Memory(LSTM)network was also adopted to establish the coordination model between the joints of both lower limbs,which was optimized by preprocessing angle information and adding gait phase information.In the adaptive controller,the virtual windows were symmetrically distributed around the reference trajectory,and its width was adjusted according to the gait phase of the auxiliary leg.In addition,the impedance parameters of the controller were updated online to match the motion capacity of the affected leg based on the spatiotemporal symmetry factors between the bilateral gaits.The LSTM coordination model demonstrated good accuracy and generality in the gait database of seven individuals,with an average root mean square error of 3.5 and 4.1 for the hip and knee joint angle estimation,respectively.To further evaluate the control algorithm,four healthy subjects walked wearing the exoskeleton while additional weights were added around the ankle joint to simulate an asymmetric gait.From the experimental results,it was shown that the algorithm improved the gait symmetry of the subjects to a normal level while exhibiting great adaptability to different subjects.
