Through the transformation of hydraulic constraints into the objective functions associated with a water supply network rehabilitation problem, a non-dominated sorting Genetic Algorithm-II (NSGA-II) can be used to sol...Through the transformation of hydraulic constraints into the objective functions associated with a water supply network rehabilitation problem, a non-dominated sorting Genetic Algorithm-II (NSGA-II) can be used to solve the altered multi-objective optimization model. The introduction of NSGA-II into water supply network optimal rehabilitation problem solves the conflict between one fitness value of standard genetic algorithm (SGA) and multi-objectives of rehabilitation problem. And the uncertainties brought by using weight coefficients or punish functions in conventional methods are controlled. And also by in-troduction of artificial inducement mutation (AIM) operation, the convergence speed of population is accelerated;this operation not only improves the convergence speed, but also improves the rationality and feasibility of solutions.展开更多
The patients with brain diseases(e.g.,Stroke and Amyotrophic Lateral Sclerosis(ALS))are often affected by the injury of motor cortex,which causes a muscular weakness.For this reason,they require rehabilitation with co...The patients with brain diseases(e.g.,Stroke and Amyotrophic Lateral Sclerosis(ALS))are often affected by the injury of motor cortex,which causes a muscular weakness.For this reason,they require rehabilitation with continuous physiotherapy as these diseases can be eased within the initial stages of the symptoms.So far,the popular control system for robot-assisted rehabilitation devices is only of two types which consist of passive and active devices.However,if there is a control system that can directly detect the motor functions,it will induce neuroplasticity to facilitate early motor recovery.In this paper,the control system,which is a motor recovery system with the intent of rehabilitation,focuses on the hand organs and utilizes a brain-computer interface(BCI)technology.The final results depict that the brainwave detection for controlling pneumatic glove in real-time has an accuracy up to 82%.Moreover,the motor recovery system enables the feasibility of brainwave classification from the motor cortex with Artificial Neural Networks(ANN).The overall model performance reveals an accuracy up to 96.56%with sensitivity of 94.22%and specificity of 98.8%.Therefore,the proposed system increases the efficiency of the traditional device control system and tends to provide a better rehabilitation than the traditional physiotherapy alone.展开更多
Cognitive impairments are commonly observed in patients with multiple sclerosis and are associated with lower levels of quality of life.No consensus has been reached on how to tackle effectively cognitive decline in t...Cognitive impairments are commonly observed in patients with multiple sclerosis and are associated with lower levels of quality of life.No consensus has been reached on how to tackle effectively cognitive decline in this clinical population non-pharmacologically.This exploratory case-control study aims to investigate the effectiveness of a hypothesis-based cognitive training designed to target multiple domains by promoting the synchronous co-activation of different brain areas and thereby improve cognition and induce changes in functional connectivity in patients with relapsing-remitting multiple sclerosis.Forty-five patients(36 females and 9 males,mean age 44.62±8.80 years)with clinically stable relapsing-remitting multiple sclerosis were assigned to either a standard cognitive training or to control groups(sham training and nonactive control).The standard training included twenty sessions of computerized exercises involving various cognitive functions supported by distinct brain networks.The sham training was a modified version of the standard training that comprised the same exercises and number of sessions but with increased processing speed load.The non-active control group received no cognitive training.All patients underwent comprehensive neuropsychological and magnetic resonance imaging assessments at baseline and after 5 weeks.Cognitive and resting-state magnetic resonance imaging data were analyzed using repeated measures models.At reassessment,the standard training group showed significant cognitive improvements compared to both control groups in memory tasks not specifically targeted by the training:the Buschke Selective Reminding Test and the Semantic Fluency test.The standard training group showed reductions in functional connectivity of the salience network,in the anterior cingulate cortex,associated with improvements on the Buschke Selective Reminding Test.No changes were observed in the sham training group.These findings suggest that multi-domain training that stimulates multiple brain areas synchronously may improve cognition in people with relapsing-remitting multiple sclerosis if sufficient time to process training material is allowed.The associated reduction in functional connectivity of the salience network suggests that training-induced neuroplastic functional reorganization may be the mechanism supporting performance gains.This study was approved by the Regional Ethics Committee of Yorkshire and Humber(approval No.12/YH/0474)on November 20,2013.展开更多
目的通过网状Meta分析评价不同干预措施对阴道产后盆底肌力恢复的效果。方法计算机检索Pubmed、Embase、Web of Science、中国知网、万方数据库和中国生物医学文献服务系统,搜集有关阴道分娩产妇产后早期康复的文献,检索时限设定为建库...目的通过网状Meta分析评价不同干预措施对阴道产后盆底肌力恢复的效果。方法计算机检索Pubmed、Embase、Web of Science、中国知网、万方数据库和中国生物医学文献服务系统,搜集有关阴道分娩产妇产后早期康复的文献,检索时限设定为建库至2021年11月,采用Cochrance手册对纳入的文献进行风险评估,然后采用StataMP 14.2进行网状Meta分析。结果共纳入研究20项,涉及研究对象3537名产妇。网状Meta分析结果显示,对提高阴道分娩产妇盆底肌肌力临床效果排序依次为生物反馈训练+阴道哑铃训练、产后盆底功能锻炼(PFMT)+产后康复教育、PFMT+电刺激+生物反馈训练、PFMT+Bobath球训练、阴道哑铃训练、PFMT+电刺激、电刺激、PFMT+生活干预、PFMT、PFMT+产后瑜伽锻炼+会阴部按摩、产后常规护理。结论生物反馈训练+阴道哑铃训练对提高阴道分娩产妇产后盆底肌肌力效果最佳。展开更多
目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library...目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、中国知网、维普和万方数据库的相关文献,收集从建库至2022年11月发表的关于探讨下肢康复外骨骼机器人改善脑卒中患者下肢运动功能的随机对照临床试验。由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具和Jadad量表对纳入文献进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入22篇文献,Jadad评分显示均为高质量文献,共865例患者,试验组436例、对照组429例。②Meta分析结果显示,与对照组相比,外骨骼机器人可显著提高脑卒中患者下肢运动功能(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)评分(MD=2.63,95%CI:1.87-3.38,P<0.05)、平衡功能(Berg Balance Scale,BBS)评分(MD=3.62,95%CI:1.21-6.03,P<0.05)、站起-走测试量表(Timed Up and Go,TUG)评分(MD=-2.77,95%CI:-4.48至-1.05,P<0.05)和步频(MD=3.15,95%CI:1.57-4.72,P<0.05),但对功能性步行量表(Functional Ambulation Category Scale,FAC)评分(MD=0.30,95%CI:-0.01-0.61,P>0.05)和6 min步行测试(6-minute walk test,6MWT)评分(MD=3.77,95%CI:-6.60-14.14,P>0.05)的提高不明显。③网状Meta分析结果显示,FMA-LE评分:平地行走式外骨骼(MD=10.23,95%CI:3.81-27.49,P<0.05)和减重式外骨骼(MD=33.66,95%CI:11.49-98.54,P<0.05)与常规康复治疗相比均能改善FMA-LE评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;BBS评分:减重式外骨骼(MD=79.86,95%CI:2.34-2725.99,P<0.05)与常规康复治疗相比能显著改善BBS评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;FAC评分:平地行走式外骨骼(MD=1.38,95%CI:1.00-1.90,P<0.05)与常规康复治疗相比能显著改善FAC评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗;TUG评分:减重式外骨骼与常规康复治疗相比(MD=0.07,95%CI:0.01-0.51,P<0.05)能显著改善TUG评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗。结论:康复外骨骼机器人可以改善脑卒中患者平衡、步行以及日常生活活动能力,其中减重式外骨骼在提高下肢运动功能和平衡功能方面疗效更优,平地行走式外骨骼在提高功能性步行和转移能力方面疗效更佳。展开更多
目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索...目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索时限为建库至2024年1月,采用Stata17.0软件进行文献的质量评价与数据分析。结果共纳入13项研究,涉及9种锻炼方式和994例患者。网状Meta分析结果表明,在改善肩部屈曲功能方面,水疗法和渐进式康复操的效果优于常规护理(均P<0.05),其中以水疗法的效果最佳;在改善肩部伸展功能方面,渐进式康复操、本体感觉神经肌肉促进术、推拿的效果优于常规护理(均P<0.05),其中以渐进式康复操的效果最佳;在改善肩部外旋功能方面,渐进式康复操的效果优于常规护理(P<0.05);在改善肩部内旋功能方面,涉及的锻炼方式两两比较均未产生统计学差异;在缓解疼痛方面,抗阻力训练的干预效果优于常规护理(P<0.05)。结论水疗法能更好地改善肩部屈曲功能,渐进式康复操在改善肩部伸展、外旋功能方面更具优势,抗阻力训练改善肩部疼痛的效果最优。展开更多
目的:系统评价功能电刺激、肌电生物反馈、踝足矫形器、肌内效贴、重复经颅磁刺激5种不同康复疗法对脑卒中足下垂患者下肢运动功能的干预效果。方法:计算机检索EMbase、Web of Science、The Cochrane Library、CBM、PubMed、CNKI、WanFa...目的:系统评价功能电刺激、肌电生物反馈、踝足矫形器、肌内效贴、重复经颅磁刺激5种不同康复疗法对脑卒中足下垂患者下肢运动功能的干预效果。方法:计算机检索EMbase、Web of Science、The Cochrane Library、CBM、PubMed、CNKI、WanFang Data和VIP数据库。搜索5种康复疗法治疗脑卒中后足下垂的随机对照试验,检索时限为从建库至2022年7月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用STATA软件及ADDIS软件进行网状Meta分析。结果:共纳入40个随机对照试验,包括2749例患者。Meta分析结果显示,在运动、平衡及日常生活能力方面,功能电刺激、踝足矫形器、肌电生物反馈的疗效均优于常规康复,踝足矫形器最优。结论:踝足矫形器在改善脑卒中足下垂患者下肢运动功能、平衡及日常生活能力方面较其他4种疗法更有优势,但受纳入文献数量及质量的限制,结论待更多高质量研究进一步验证。展开更多
目的:评价7种康复运动对脑卒中病人平衡和步行功能的影响。方法:检索PubMed、Web of Science、EMbase、the Cochrane Library、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于康复运动对脑卒中病人平衡和步行功能影...目的:评价7种康复运动对脑卒中病人平衡和步行功能的影响。方法:检索PubMed、Web of Science、EMbase、the Cochrane Library、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于康复运动对脑卒中病人平衡和步行功能影响的随机对照试验。检索时限为建库至2023年3月28日。由2名研究者独立进行文献筛选、内容提取、质量评价。采用Stata 17.0进行网状Meta分析。结果:纳入16篇文献,包括1006例研究对象,涉及7种康复运动。网状Meta分析结果显示,与常规康复运动相比,核心稳定训练、抗阻训练、运动想象疗法、镜像疗法、水中运动、虚拟现实技术均可改善脑卒中病人平衡功能(P<0.05);核心稳定训练、抗阻训练、运动想象疗法、镜像疗法、虚拟现实技术可改善脑卒中病人步行功能(P<0.05);概率排序中核心稳定训练均居首位。结论:多种康复运动可改善脑卒中病人平衡和步行功能,核心稳定训练效果最佳。展开更多
基金the Natural Science Key Foundation of Heilongjiang Province of China (No. ZJG0503) China-UK Sci-ence Network from Royal Society UK
文摘Through the transformation of hydraulic constraints into the objective functions associated with a water supply network rehabilitation problem, a non-dominated sorting Genetic Algorithm-II (NSGA-II) can be used to solve the altered multi-objective optimization model. The introduction of NSGA-II into water supply network optimal rehabilitation problem solves the conflict between one fitness value of standard genetic algorithm (SGA) and multi-objectives of rehabilitation problem. And the uncertainties brought by using weight coefficients or punish functions in conventional methods are controlled. And also by in-troduction of artificial inducement mutation (AIM) operation, the convergence speed of population is accelerated;this operation not only improves the convergence speed, but also improves the rationality and feasibility of solutions.
基金the Declaration of Helsinki,and the protocol was approved by the Ethics Committee of Suranaree University of Technology(License EC-61-14 COA No.16/2561)the Thailand Research Fund through the RoyalGolden Jubilee Ph.D.Program(Grant No.PHD/0148/2557).
文摘The patients with brain diseases(e.g.,Stroke and Amyotrophic Lateral Sclerosis(ALS))are often affected by the injury of motor cortex,which causes a muscular weakness.For this reason,they require rehabilitation with continuous physiotherapy as these diseases can be eased within the initial stages of the symptoms.So far,the popular control system for robot-assisted rehabilitation devices is only of two types which consist of passive and active devices.However,if there is a control system that can directly detect the motor functions,it will induce neuroplasticity to facilitate early motor recovery.In this paper,the control system,which is a motor recovery system with the intent of rehabilitation,focuses on the hand organs and utilizes a brain-computer interface(BCI)technology.The final results depict that the brainwave detection for controlling pneumatic glove in real-time has an accuracy up to 82%.Moreover,the motor recovery system enables the feasibility of brainwave classification from the motor cortex with Artificial Neural Networks(ANN).The overall model performance reveals an accuracy up to 96.56%with sensitivity of 94.22%and specificity of 98.8%.Therefore,the proposed system increases the efficiency of the traditional device control system and tends to provide a better rehabilitation than the traditional physiotherapy alone.
文摘Cognitive impairments are commonly observed in patients with multiple sclerosis and are associated with lower levels of quality of life.No consensus has been reached on how to tackle effectively cognitive decline in this clinical population non-pharmacologically.This exploratory case-control study aims to investigate the effectiveness of a hypothesis-based cognitive training designed to target multiple domains by promoting the synchronous co-activation of different brain areas and thereby improve cognition and induce changes in functional connectivity in patients with relapsing-remitting multiple sclerosis.Forty-five patients(36 females and 9 males,mean age 44.62±8.80 years)with clinically stable relapsing-remitting multiple sclerosis were assigned to either a standard cognitive training or to control groups(sham training and nonactive control).The standard training included twenty sessions of computerized exercises involving various cognitive functions supported by distinct brain networks.The sham training was a modified version of the standard training that comprised the same exercises and number of sessions but with increased processing speed load.The non-active control group received no cognitive training.All patients underwent comprehensive neuropsychological and magnetic resonance imaging assessments at baseline and after 5 weeks.Cognitive and resting-state magnetic resonance imaging data were analyzed using repeated measures models.At reassessment,the standard training group showed significant cognitive improvements compared to both control groups in memory tasks not specifically targeted by the training:the Buschke Selective Reminding Test and the Semantic Fluency test.The standard training group showed reductions in functional connectivity of the salience network,in the anterior cingulate cortex,associated with improvements on the Buschke Selective Reminding Test.No changes were observed in the sham training group.These findings suggest that multi-domain training that stimulates multiple brain areas synchronously may improve cognition in people with relapsing-remitting multiple sclerosis if sufficient time to process training material is allowed.The associated reduction in functional connectivity of the salience network suggests that training-induced neuroplastic functional reorganization may be the mechanism supporting performance gains.This study was approved by the Regional Ethics Committee of Yorkshire and Humber(approval No.12/YH/0474)on November 20,2013.
文摘目的通过网状Meta分析评价不同干预措施对阴道产后盆底肌力恢复的效果。方法计算机检索Pubmed、Embase、Web of Science、中国知网、万方数据库和中国生物医学文献服务系统,搜集有关阴道分娩产妇产后早期康复的文献,检索时限设定为建库至2021年11月,采用Cochrance手册对纳入的文献进行风险评估,然后采用StataMP 14.2进行网状Meta分析。结果共纳入研究20项,涉及研究对象3537名产妇。网状Meta分析结果显示,对提高阴道分娩产妇盆底肌肌力临床效果排序依次为生物反馈训练+阴道哑铃训练、产后盆底功能锻炼(PFMT)+产后康复教育、PFMT+电刺激+生物反馈训练、PFMT+Bobath球训练、阴道哑铃训练、PFMT+电刺激、电刺激、PFMT+生活干预、PFMT、PFMT+产后瑜伽锻炼+会阴部按摩、产后常规护理。结论生物反馈训练+阴道哑铃训练对提高阴道分娩产妇产后盆底肌肌力效果最佳。
文摘目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、中国知网、维普和万方数据库的相关文献,收集从建库至2022年11月发表的关于探讨下肢康复外骨骼机器人改善脑卒中患者下肢运动功能的随机对照临床试验。由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具和Jadad量表对纳入文献进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入22篇文献,Jadad评分显示均为高质量文献,共865例患者,试验组436例、对照组429例。②Meta分析结果显示,与对照组相比,外骨骼机器人可显著提高脑卒中患者下肢运动功能(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)评分(MD=2.63,95%CI:1.87-3.38,P<0.05)、平衡功能(Berg Balance Scale,BBS)评分(MD=3.62,95%CI:1.21-6.03,P<0.05)、站起-走测试量表(Timed Up and Go,TUG)评分(MD=-2.77,95%CI:-4.48至-1.05,P<0.05)和步频(MD=3.15,95%CI:1.57-4.72,P<0.05),但对功能性步行量表(Functional Ambulation Category Scale,FAC)评分(MD=0.30,95%CI:-0.01-0.61,P>0.05)和6 min步行测试(6-minute walk test,6MWT)评分(MD=3.77,95%CI:-6.60-14.14,P>0.05)的提高不明显。③网状Meta分析结果显示,FMA-LE评分:平地行走式外骨骼(MD=10.23,95%CI:3.81-27.49,P<0.05)和减重式外骨骼(MD=33.66,95%CI:11.49-98.54,P<0.05)与常规康复治疗相比均能改善FMA-LE评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;BBS评分:减重式外骨骼(MD=79.86,95%CI:2.34-2725.99,P<0.05)与常规康复治疗相比能显著改善BBS评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;FAC评分:平地行走式外骨骼(MD=1.38,95%CI:1.00-1.90,P<0.05)与常规康复治疗相比能显著改善FAC评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗;TUG评分:减重式外骨骼与常规康复治疗相比(MD=0.07,95%CI:0.01-0.51,P<0.05)能显著改善TUG评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗。结论:康复外骨骼机器人可以改善脑卒中患者平衡、步行以及日常生活活动能力,其中减重式外骨骼在提高下肢运动功能和平衡功能方面疗效更优,平地行走式外骨骼在提高功能性步行和转移能力方面疗效更佳。
文摘目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索时限为建库至2024年1月,采用Stata17.0软件进行文献的质量评价与数据分析。结果共纳入13项研究,涉及9种锻炼方式和994例患者。网状Meta分析结果表明,在改善肩部屈曲功能方面,水疗法和渐进式康复操的效果优于常规护理(均P<0.05),其中以水疗法的效果最佳;在改善肩部伸展功能方面,渐进式康复操、本体感觉神经肌肉促进术、推拿的效果优于常规护理(均P<0.05),其中以渐进式康复操的效果最佳;在改善肩部外旋功能方面,渐进式康复操的效果优于常规护理(P<0.05);在改善肩部内旋功能方面,涉及的锻炼方式两两比较均未产生统计学差异;在缓解疼痛方面,抗阻力训练的干预效果优于常规护理(P<0.05)。结论水疗法能更好地改善肩部屈曲功能,渐进式康复操在改善肩部伸展、外旋功能方面更具优势,抗阻力训练改善肩部疼痛的效果最优。
文摘在下肢康复机器人的康复训练过程中,模型参数、环境干扰等不确定性因素会影响机器人轨迹跟踪的精度。针对这一问题,提出了一种基于径向基函数(Radial Basis Function,RBF)神经网络的自适应补偿控制,该控制方法能够提高机械系统轨迹跟踪的精确性。首先,设计一款具有4种工作模式、运动稳定的闭链卧式下肢康复机器人结构;然后,利用拉格朗日方法求解动力学名义模型,将康复装置的模型参数以及外界干扰等不确定性因素分离出来,并设计基于RBF神经网络的自适应补偿算法对其进行逼近控制;最后,通过Matlab/Simulink环境对其进行仿真验证,证明了该控制策略的有效性。结果显示,在人体步态曲线轨迹跟踪中,提出的基于RBF神经网络的自适应补偿算法相比传统的模糊比例-积分-微分(Proportional Integral Derivative,PID)控制的方法响应速度快、跟踪效果好,且髋关节和膝关节轨迹跟踪的角度误差峰值分别为0.08°和0.13°,远小于患者下肢在康复运动中的转动角度。设计了单腿样机试验,试验结果表明,采用的RBF补偿自适应控制器能够实现高精度的跟踪结果,也能够满足患者在康复训练中安全性的要求。
