:Surface electromyogram(sEMG)processing and classication can assist neurophysiological standardization and evaluation and provide habitational detection.The timing of muscle activation is critical in determining vario...:Surface electromyogram(sEMG)processing and classication can assist neurophysiological standardization and evaluation and provide habitational detection.The timing of muscle activation is critical in determining various medical conditions when looking at sEMG signals.Understanding muscle activation timing allows identication of muscle locations and feature validation for precise modeling.This work aims to develop a predictive model to investigate and interpret Patellofemoral(PF)osteoarthritis based on features extracted from the sEMG signal using pattern classication.To this end,sEMG signals were acquired from ve core muscles over about 200 reads from healthy adult patients while they were going upstairs.Onset,offset,and time duration for the Transversus Abdominus(TrA),Vastus Medialis Obliquus(VMO),Gluteus Medius(GM),Vastus Lateralis(VL),and Multidus Muscles(ML)were acquired to construct a classication model.The proposed classication model investigates function mapping from real-time space to a PF osteoarthritis discriminative feature space.The activation feature space of muscle timing is used to train several large margin classiers to modulate muscle activations and account for such activation measurements.The fast large margin classier achieved higher performance and faster convergence than support vector machines(SVMs)and other state-of-the-art classiers.The proposed sEMG classication framework achieved an average accuracy of 98.8%after 7 s training time,improving other classication techniques in previous literature.展开更多
High incidence of patellofemoral pain and patellofemoral joint osteoarthritis was found following anterior cruciate ligament(ACL)reconstruction.The unstability of patellofemoral joint might be an important contributio...High incidence of patellofemoral pain and patellofemoral joint osteoarthritis was found following anterior cruciate ligament(ACL)reconstruction.The unstability of patellofemoral joint might be an important contribution factor.This study was designed to define the relationship between the unstability of patellofemoral joint and quadriceps femoris atrophy.Twenty patients underwent MRI scan before ACL reconstruction and every two weeks after surgery,until 12 weeks.The merchant’s patellar congruence angle,lateral inclination angle,and quadriceps femoris muscle cross-sectional area were measured and the relationship between the changes of angles and the ratio of quadriceps femoris atrophy was studied by multiple regression analysis.Significant quadriceps femoris atrophy was observed after ACL reconstruction during the follow-up period of 12 weeks.The merchant’s patellar congruence angle and lateral inclination angle significantly changed after surgery.The alterations of the merchant’s patellar congruence angle were significantly correlated with the atrophy ratio of vastus medialis(coefficient=-5.76)and vastus lateralis(coefficient=8.35)during the follow-up period of 12 weeks.The alterations of lateral inclination angle were significantly correlated with the atrophy ratio of vastus medialis(coefficient=20.62),vastus lateralis(coefficient=-11.38)and rectus femoris(coefficient=-0.469)during the follow-up period 12 weeks.To sum up,ACL reconstruction can alleviate the dysfunction of patellofemoral joint to a certain extent.But,the unbalanced atrophy of quadriceps femoris once again destroyed the stability of patellofemoral joint following the operation,which might be one cause of patellofemoral joint pain and early onset of osteoarthritis after ACL reconstruction.So,rehabilitation training that focuses on quadriceps femoris especially the vastus medialis shortly following operation is suggested.展开更多
Chondromalacia and patellofemoral osteoarthritis are common diseases that cause pain and disablement of the knee. Conservative therapy is not always effective. Since 1983 we have used isolated polyethylene patellar pr...Chondromalacia and patellofemoral osteoarthritis are common diseases that cause pain and disablement of the knee. Conservative therapy is not always effective. Since 1983 we have used isolated polyethylene patellar prosthesis for patella resurfacing of 19 patients with patellofemoral osteoarthritis. After an average of 44. 9 months follow-up, we found the treatment was not as satisfactory as earlier trials. The main reason is the wide erosion of femoral condyle caused by the polyethylene patella. To overcome this shortness, we designed a new type of patellofemoral prosthesis which is named Y-L-Q. From January . 1991 to November. 1 993, we used this prosthesis to treat 16 knees of 13 patients with patellofemoral osteoarthritis. Most of those patients improved both symptomatically and functionally. The good to excellent results rate was 87. 5% (1 4/16 knees) at the time of an average 16 months follow-up. The early results of our experience with patellofemoral resurfacing are encouraging. And extended follow-ups are in progress.展开更多
Background:Impairments in hamstring strength,flexibility,and morphology have been associated with altered knee biomechanics,pain,and function.Determining the presence of these impairments in individuals with gradual-o...Background:Impairments in hamstring strength,flexibility,and morphology have been associated with altered knee biomechanics,pain,and function.Determining the presence of these impairments in individuals with gradual-onset knee disorders is important and may indicate targets for assessment and rehabilitation.This systematic review aimed to synthesize the literature to determine the presence of impairments in hamstring strength,flexibility,and morphology in individuals with gradual-onset knee disorders.Methods:Five databases(MEDLINE,Embase,CINAHL,SPORTDiscus,and Web of Science)were searched from inception to September 2022.Only studies comparing hamstring outcomes(e.g.,strength,flexibility,and/or morphology)between individuals with gradual-onset knee disorders and their unaffected limbs or pain-free controls were included.Meta-analyses for each knee disorder were performed.Outcome-level certainty was assessed using the Grading of Recommendations Assessment,Development,and Evaluation,and evidence gap maps were created.Results:Seventy-nine studies across 4 different gradual-onset knee disorders(i.e.,knee osteoarthritis(OA),patellofemoral pain(PFP),chondromalacia patellae,and patellar tendinopathy)were included.Individuals with knee OA presented with reduced hamstring strength compared to pain-free controls during isometric(standard mean difference(SMD)=-0.76,95%confidence interval(95%CI):-1.32 to-0.21)and concentric contractions(SMD=-0.97,95%CI:-1.49 to-0.45).Individuals with PFP presented with reduced hamstring strength compared to painfree controls during isometric(SMD=-0.48,95%CI:-0.82 to-0.14),concentric(SMD=-1.07,95%CI:-2.08 to-0.06),and eccentric contractions(SMD=-0.59,95%CI:-0.97 to-0.21).No differences were observed in individuals with patellar tendinopathy.Individuals with PFP presented with reduced hamstring flexibility when compared to pain-free controls(SMD=-0.76,95%CI:-1.15 to-0.36).Evidence gap maps identified insufficient evidence for chondromalacia patellae and hamstring morphology across all gradual-onset knee disorders.Conclusion:Our findings suggest that assessing and targeting impairments in hamstring strength and flexibility during rehabilitation may be recommended for individuals with knee OA or PFP.展开更多
目的:探讨改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎的临床疗效。方法:选择改良Iwano分期Ⅲ期髌股关节骨关节炎患者60例,按就诊顺序采用随机数字表随机分为观察组和对照组,每组30例。观察组采用改良髌骨外侧关节面部分切...目的:探讨改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎的临床疗效。方法:选择改良Iwano分期Ⅲ期髌股关节骨关节炎患者60例,按就诊顺序采用随机数字表随机分为观察组和对照组,每组30例。观察组采用改良髌骨外侧关节面部分切除术治疗,对照组采用双醋瑞因胶囊口服联合透明质酸钠注射液膝关节腔内注射治疗。分别于治疗前和末次随访时,采用Merchant法在髌骨轴位X线片上测量髌股适合角判定髌股关节力线情况,并分别采用髌骨改良Kujala评分和美国膝关节协会评分(knee society score,KSS)评价髌股关节和膝关节整体功能。结果:60例患者均获随访,随访时间20~30个月,中位数24个月。治疗前2组患者髌股适合角、髌骨改良Kujala评分、膝关节KSS评分比较,组间差异均无统计学意义[23.07°±10.30°,23.60°±10.05°,t=0.203,P=0.840;(15.93±3.32)分,(14.50±2.87)分,t=1.788,P=0.079;(110.40±15.18)分,(109.13±16.05)分,t=0.314,P=0.755];末次随访时,观察组髌股适合角优于对照组,髌骨改良Kujala评分、膝关节KSS评分高于对照组[11.91°±7.36°,24.13°±9.71°,t=5.495,P=0.000;(32.03±4.20)分,(18.13±7.79)分,t=8.604,P=0.000;(156.77±9.30)分,(115.00±20.25)分,t=10.266,P=0.000]。结论:与双醋瑞因胶囊口服联合透明质酸钠注射液膝关节腔内注射相比,改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎,在恢复髌股关节力线、改善髌股关节和膝关节整体功能方面疗效更佳。展开更多
基金work was supported by the National Research Foundation of Korea(NRF)Grant funded by the Korean government(MSIT)(NRF-2016R1D1A1A03934816)and by Chowis。
文摘:Surface electromyogram(sEMG)processing and classication can assist neurophysiological standardization and evaluation and provide habitational detection.The timing of muscle activation is critical in determining various medical conditions when looking at sEMG signals.Understanding muscle activation timing allows identication of muscle locations and feature validation for precise modeling.This work aims to develop a predictive model to investigate and interpret Patellofemoral(PF)osteoarthritis based on features extracted from the sEMG signal using pattern classication.To this end,sEMG signals were acquired from ve core muscles over about 200 reads from healthy adult patients while they were going upstairs.Onset,offset,and time duration for the Transversus Abdominus(TrA),Vastus Medialis Obliquus(VMO),Gluteus Medius(GM),Vastus Lateralis(VL),and Multidus Muscles(ML)were acquired to construct a classication model.The proposed classication model investigates function mapping from real-time space to a PF osteoarthritis discriminative feature space.The activation feature space of muscle timing is used to train several large margin classiers to modulate muscle activations and account for such activation measurements.The fast large margin classier achieved higher performance and faster convergence than support vector machines(SVMs)and other state-of-the-art classiers.The proposed sEMG classication framework achieved an average accuracy of 98.8%after 7 s training time,improving other classication techniques in previous literature.
基金the National Natural Science Foundation of China(No.81171760).
文摘High incidence of patellofemoral pain and patellofemoral joint osteoarthritis was found following anterior cruciate ligament(ACL)reconstruction.The unstability of patellofemoral joint might be an important contribution factor.This study was designed to define the relationship between the unstability of patellofemoral joint and quadriceps femoris atrophy.Twenty patients underwent MRI scan before ACL reconstruction and every two weeks after surgery,until 12 weeks.The merchant’s patellar congruence angle,lateral inclination angle,and quadriceps femoris muscle cross-sectional area were measured and the relationship between the changes of angles and the ratio of quadriceps femoris atrophy was studied by multiple regression analysis.Significant quadriceps femoris atrophy was observed after ACL reconstruction during the follow-up period of 12 weeks.The merchant’s patellar congruence angle and lateral inclination angle significantly changed after surgery.The alterations of the merchant’s patellar congruence angle were significantly correlated with the atrophy ratio of vastus medialis(coefficient=-5.76)and vastus lateralis(coefficient=8.35)during the follow-up period of 12 weeks.The alterations of lateral inclination angle were significantly correlated with the atrophy ratio of vastus medialis(coefficient=20.62),vastus lateralis(coefficient=-11.38)and rectus femoris(coefficient=-0.469)during the follow-up period 12 weeks.To sum up,ACL reconstruction can alleviate the dysfunction of patellofemoral joint to a certain extent.But,the unbalanced atrophy of quadriceps femoris once again destroyed the stability of patellofemoral joint following the operation,which might be one cause of patellofemoral joint pain and early onset of osteoarthritis after ACL reconstruction.So,rehabilitation training that focuses on quadriceps femoris especially the vastus medialis shortly following operation is suggested.
文摘Chondromalacia and patellofemoral osteoarthritis are common diseases that cause pain and disablement of the knee. Conservative therapy is not always effective. Since 1983 we have used isolated polyethylene patellar prosthesis for patella resurfacing of 19 patients with patellofemoral osteoarthritis. After an average of 44. 9 months follow-up, we found the treatment was not as satisfactory as earlier trials. The main reason is the wide erosion of femoral condyle caused by the polyethylene patella. To overcome this shortness, we designed a new type of patellofemoral prosthesis which is named Y-L-Q. From January . 1991 to November. 1 993, we used this prosthesis to treat 16 knees of 13 patients with patellofemoral osteoarthritis. Most of those patients improved both symptomatically and functionally. The good to excellent results rate was 87. 5% (1 4/16 knees) at the time of an average 16 months follow-up. The early results of our experience with patellofemoral resurfacing are encouraging. And extended follow-ups are in progress.
基金This work was supported by the Sao Paulo Research Foundation(FAPESP),which provided scholarships to HSL(Grant No.2021/09393-1)RVB(Grant No.2021/08644-0)and a research grant to FMA(Grant No.2020/14715-5).The financial sponsors played no role in the design,execution,analysis and interpretation of data,or the writing of the study。
文摘Background:Impairments in hamstring strength,flexibility,and morphology have been associated with altered knee biomechanics,pain,and function.Determining the presence of these impairments in individuals with gradual-onset knee disorders is important and may indicate targets for assessment and rehabilitation.This systematic review aimed to synthesize the literature to determine the presence of impairments in hamstring strength,flexibility,and morphology in individuals with gradual-onset knee disorders.Methods:Five databases(MEDLINE,Embase,CINAHL,SPORTDiscus,and Web of Science)were searched from inception to September 2022.Only studies comparing hamstring outcomes(e.g.,strength,flexibility,and/or morphology)between individuals with gradual-onset knee disorders and their unaffected limbs or pain-free controls were included.Meta-analyses for each knee disorder were performed.Outcome-level certainty was assessed using the Grading of Recommendations Assessment,Development,and Evaluation,and evidence gap maps were created.Results:Seventy-nine studies across 4 different gradual-onset knee disorders(i.e.,knee osteoarthritis(OA),patellofemoral pain(PFP),chondromalacia patellae,and patellar tendinopathy)were included.Individuals with knee OA presented with reduced hamstring strength compared to pain-free controls during isometric(standard mean difference(SMD)=-0.76,95%confidence interval(95%CI):-1.32 to-0.21)and concentric contractions(SMD=-0.97,95%CI:-1.49 to-0.45).Individuals with PFP presented with reduced hamstring strength compared to painfree controls during isometric(SMD=-0.48,95%CI:-0.82 to-0.14),concentric(SMD=-1.07,95%CI:-2.08 to-0.06),and eccentric contractions(SMD=-0.59,95%CI:-0.97 to-0.21).No differences were observed in individuals with patellar tendinopathy.Individuals with PFP presented with reduced hamstring flexibility when compared to pain-free controls(SMD=-0.76,95%CI:-1.15 to-0.36).Evidence gap maps identified insufficient evidence for chondromalacia patellae and hamstring morphology across all gradual-onset knee disorders.Conclusion:Our findings suggest that assessing and targeting impairments in hamstring strength and flexibility during rehabilitation may be recommended for individuals with knee OA or PFP.
文摘目的:探讨改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎的临床疗效。方法:选择改良Iwano分期Ⅲ期髌股关节骨关节炎患者60例,按就诊顺序采用随机数字表随机分为观察组和对照组,每组30例。观察组采用改良髌骨外侧关节面部分切除术治疗,对照组采用双醋瑞因胶囊口服联合透明质酸钠注射液膝关节腔内注射治疗。分别于治疗前和末次随访时,采用Merchant法在髌骨轴位X线片上测量髌股适合角判定髌股关节力线情况,并分别采用髌骨改良Kujala评分和美国膝关节协会评分(knee society score,KSS)评价髌股关节和膝关节整体功能。结果:60例患者均获随访,随访时间20~30个月,中位数24个月。治疗前2组患者髌股适合角、髌骨改良Kujala评分、膝关节KSS评分比较,组间差异均无统计学意义[23.07°±10.30°,23.60°±10.05°,t=0.203,P=0.840;(15.93±3.32)分,(14.50±2.87)分,t=1.788,P=0.079;(110.40±15.18)分,(109.13±16.05)分,t=0.314,P=0.755];末次随访时,观察组髌股适合角优于对照组,髌骨改良Kujala评分、膝关节KSS评分高于对照组[11.91°±7.36°,24.13°±9.71°,t=5.495,P=0.000;(32.03±4.20)分,(18.13±7.79)分,t=8.604,P=0.000;(156.77±9.30)分,(115.00±20.25)分,t=10.266,P=0.000]。结论:与双醋瑞因胶囊口服联合透明质酸钠注射液膝关节腔内注射相比,改良髌骨外侧关节面部分切除术治疗严重髌股关节骨关节炎,在恢复髌股关节力线、改善髌股关节和膝关节整体功能方面疗效更佳。
