Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

Motivations and barriers to utilizing adult walking buses: An examination of demographic correlates of willingness to participate in a community-based walking program

Walking buses are a way to increase physical activity by encouraging people to walk rather than rely on motorized forms of transportation. Several communities support walking school buses as an alternative mode of pupil transportation to schools. A possible extension of this concept is the introduction of adult walking buses. Given the novelty of the concept, very little is currently known about the public’s perceptions regarding adult walking buses and their potential effectiveness to increase physical activity and decrease obesity among adults. To bridge this gap, this study examined motivations and barriers to participation in an adult walking bus program in Birmingham, Alabama using a comprehensive questionnaire survey. Analysis of over 340 responses revealed a positive reception of the concept among the survey responders. More specifically, 60.1% of the sample reported they would definitely or probably participate in a walking bus program. Results from nested ordinal logistic regression analysis indicate that health benefits are the strongest motivation for willingness to participate in a walking bus program. Sensitivity to environmental issues is also a significant predictor of willingness to participate across models. The most significant barrier to willingness to participate in a walking bus program is limited time. The significance of demographic variables (obesity, race/ ethnicity, and age) as predictors of willingness to participate is reduced once motivations and barriers are controlled. In conclusion, the positive response to the program among our sample is encouraging and suggests that adult walking buses should be explored further as an active alternative transportation option with a potential to improve the health and wellbeing of participants.

A Wire-Driven Series Elastic Mechanism Based on Ultrasonic Motor for Walking Assistive System

In order to improve the elderly people's quality of life,supporting their walking behaviors is a promising technology.Therefore,based on one ultrasonic motor,a wire-driven series elastic mechanism for walking assistive system is proposed and investigated in this research.In contrast to tradition,it innovatively utilizes an ultrasonic motor and a wire-driven series elastic mechanism to achieve superior system performances in aspects of simple structure,high torque/weight ratio,quiet operation,quick response,favorable electromagnetic compatibility,strong shock resistance,better safety,and accurately stable force control.The proposed device is mainly composed of an ultrasonic motor,a linear spring,a steel wire,four pulleys and one rotating part.To overcome the ultrasonic motor's insufficient output torque,a steel wire and pulleys are smartly combined to directly magnify the torque instead of using a conventional gear reducer.Among the pulleys,there is one tailored pulley playing an important role to keep the reduction ratio as 4.5 constantly.Meanwhile,the prototype is manufactured and its actual performance is verified by experimental results.In a one-second operating cycle,it only takes 86 ms for this mechanism to output an assistive torque of 1.6 N·m.At this torque,the ultrasonic motor's speed is around 4.1 rad/s.Moreover,experiments with different operation periods have been conducted for different application scenarios.This study provides a useful idea for the application of ultrasonic motor in walking assistance system.

Theoretical and Numerical Studies on the Coupling Deformation of Global Lateral Buckling and Walking of Submarine Pipeline

Buckling initiation devices/techniques,including sleepers,distributed buoyancy,snake lay,and residual curvature method(RCM),have recently been widely applied in engineering.These initiated buckles may induce a long pipeline to transform into multiple short pipeline segments,which promote the occurrence of pipeline walking.Thus,a pipeline,which is designed to buckle laterally,may laterally and axially displace over time when subjected to repeated heating and cooling cycles.This study aims to reveal the coupling mechanism of pipeline walking and global lateral buckling.First,an analytic solution is proposed to estimate the walking of pipeline segments between two adjacent buckles.Then,the sensitivity of this method to heating and cooling cycles is analyzed.Results show the applicability of the proposed walking analytical solution of buckling pipelines.Subsequently,an influence analysis of walking on global buckling,including the capacity of buckling initiation,buckling amplitude,buckling mode,and failure assessment of the buckling pipeline,is performed.The results reveal that the effect of walking on the buckling axial force is negligible.However,pipeline walking will aggravate the asymmetry of the pipeline buckling and the failure parameters of the pipeline during the post-buckling.

A new passive transfemoral prosthesis mechanism based on 3R36 knee and ESAR foot providing walking and squatting

Researchers have proposed various linkage mechanisms to connect knee and ankle joints for above-knee prosthe-ses,but most of them only offer natural walking.However,studies have shown that people assume a squatting posture during daily activities.This paper introduces a novel mechanism that connects the knee joint with the foot-ankle joint to enable both squatting and walking.The prosthetic knee used is the well-known 3R36,while the energy storing and return(ESAR)prosthetic foot is used for the ankle-foot joint.To coordinate knee and ankle joint movements,a six-bar linkage mechanism structure is proposed.Simulation results demonstrate that the proposed modular transfemoral prosthesis accurately mimics the motion patterns of a natural human leg during walking and squatting.For instance,the prosthesis allows a total knee flexion of more than 140°during squatting.The new prosthesis design also incorporates energy-storing mechanisms to reduce energy expenditure during walking for amputees.

Spatial search weighting information contained in cell velocity distribution

Cell migration plays a significant role in physiological and pathological processes.Understanding the characteristics of cell movement is crucial for comprehending biological processes such as cell functionality,cell migration,and cell–cell interactions.One of the fundamental characteristics of cell movement is the specific distribution of cell speed,containing valuable information that still requires comprehensive understanding.This article investigates the distribution of mean velocities along cell trajectories,with a focus on optimizing the efficiency of cell food search in the context of the entire colony.We confirm that the specific velocity distribution in the experiments corresponds to an optimal search efficiency when spatial weighting is considered.The simulation results indicate that the distribution of average velocity does not align with the optimal search efficiency when employing average spatial weighting.However,when considering the distribution of central spatial weighting,the specific velocity distribution in the experiment is shown to correspond to the optimal search efficiency.Our simulations reveal that for any given distribution of average velocity,a specific central spatial weighting can be identified among the possible central spatial weighting that aligns with the optimal search strategy.Additionally,our work presents a method for determining the spatial weights embedded in the velocity distribution of cell movement.Our results have provided new avenues for further investigation of significant topics,such as relationship between cell behavior and environmental conditions throughout their evolutionary history,and how cells achieve collective cooperation through cell-cell communication.

Characteristics of cell motility during cell collision

Quantitative examination of cellular motion and intercellullar interactions possesses substantial relevance for both biology and medicine.However,the effects of intercellular interactions during cellular locomotion remain under-explored in experimental research.As such,this study seeks to bridge this research gap,adopting Dictyostelium discoideum(Dicty)cells as a paradigm to investigate variations in cellular motion during reciprocal collisions.We aim to attain a comprehensive understanding of how cell interactions influence cell motion.By observing and processing the motion trajectories of colliding cells under diverse chemical environments,we calculated the diffusion coefficient(D)and the persistence time(τ),using mean square displacement.Our analysis of the relationship dynamics between D andτprior to the collisions reveals intricate and non-monotonic alterations in cell movements during collisions.By quantitatively scrutinizing theτtrend,we were able to categorize the cellular responses to interactions under different conditions.Importantly,we ascertained that the effect of cell interactions during collisions in Dicty cells emulates a classical sigmoid function.This discovery suggests that cellular responses might comply with a pattern akin to the Weber–Fechner law.

Mobility edges and localization characteristics in one-dimensional quasiperiodic quantum walk

We construct a one-dimensional quasiperiodic quantum walk to investigate the localization–delocalization transition.The inverse participation ratio and Lyapunov exponent are employed as two indexes to determine the mobility edge, a critical energy to distinguish the energy regions of extended and localized states. The analytical solution of mobility edge is obtained by the Lyapunov exponents in global theory, and the consistency of the two indexes is confirmed. We further study the dynamic characteristics of the quantum walk and show that the probabilities are localized to some specific lattice sites with time evolution. This phenomenon is explained by the effective potential of the Hamiltonian which corresponds to the phase in the coin operator of the quantum walk.

Strong invariance principle for a counterbalanced random walk

We study a counterbalanced random walkS_(n)=X_(1)+…+X_(n),which is a discrete time non-Markovian process andX_(n) are given recursively as follows.For n≥2,X_(n) is a new independent sample from some fixed law̸=0 with a fixed probability p,andX_(n)=−X_(v(n))with probability 1−p,where v(n)is a uniform random variable on{1;…;n−1}.We apply martingale method to obtain a strong invariance principle forS_(n).

Functional Capacity of Patients with Venous Thromboembolic Disease Six to Twelve Months after Treatment

Background: Venous thromboembolism (VTE) is among the leading causes of hospital-related disability-adjusted life years lost. We aimed to determine the prevalence and determinants of functional capacity impairment six to twelve months after an acute VTE event. Methods: This was a cross-sectional study conducted between January and April 2021 in two referral hospitals of Yaoundé, including consenting adult patients admitted to these hospitals six to twelve months ago for VTE. We excluded dead patients and those with any comorbidity or symptoms limiting physical activity. The functional outcome was assessed with the six-minute walk test. Functional capacity impairment was defined as walking distance lower than the expected value. Results: We included 27 cases in this study with a mean age of 53.2 ± 14.4 years. The prevalence of functional capacity impairment was 29.6% (95% CI: 14.8 - 48.1). Factors associated with poor functional outcome were obesity (OR: 59.5;95% CI: 4.6 - 767.2;p - 207.4;p = 0.017), massive PE (OR: 30;95% CI: 2.5 - 354;p = 0.004), and poor adherence to treatment (OR: 30.3;95% CI: 2.5 - 333.3;p = 0.004). Conclusion: Functional capacity impairment is common in the medium-term after VTE and factors associated with this poor outcome are obesity, the severity of the VTE, and poor adherence to treatment.

A Bayesian Mixture Model Approach to Disparity Testing

The topic of this article is one-sided hypothesis testing for disparity, i.e., the mean of one group is larger than that of another when there is uncertainty as to which group a datum is drawn. For each datum, the uncertainty is captured with a given discrete probability distribution over the groups. Such situations arise, for example, in the use of Bayesian imputation methods to assess race and ethnicity disparities with certain insurance, health, and financial data. A widely used method to implement this assessment is the Bayesian Improved Surname Geocoding (BISG) method which assigns a discrete probability over six race/ethnicity groups to an individual given the individual’s surname and address location. Using a Bayesian framework and Markov Chain Monte Carlo sampling from the joint posterior distribution of the group means, the probability of a disparity hypothesis is estimated. Four methods are developed and compared with an illustrative data set. Three of these methods are implemented in an R-code and one method in WinBUGS. These methods are programed for any number of groups between two and six inclusive. All the codes are provided in the appendices.

The Master of Tea

His second method is more direct:“Come to my house,let’s have tea.”With this method,you are destined to follow him.Needless to say,Cha Ye’s great prestige and seniority on Old Street makes you feel it is a great privilege if he asks you to tea.It was a sultry day in July.As Cha Ye strolled down the street,he noticed a noise.It was Mr.Hu,boss of the Heshengzhai Antique Shop.Cha Ye walked into the antique shop,where he saw Hu holding onto a strong man’s arm,not letting him go.

Comprehensive Rehabilitation Therapy of Traditional Chinese Medicine Combined with Modern Rehabilitation Training Improves the Spasticity and Motor Function of Hemiplegia after Stroke

Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.

从City Walk到乡村旅游

自2022年开始,一种名为City Walk(城市漫步)的旅行方式广受推崇,网上的路线攻略、结伴成团、报道评论越来越多。City Walk原是20世纪30年代发源于英国的一种城市旅游形式,指的是几个人在一起,在专业讲述员的带领下,有计划地行走在一条独特的道路上。但现在流行的这一概念更多指的是深入到城市的街巷、情境和空间,非功利化、无目的性地随意漫步游走,不受他人评价和引导的影响。

Transport in Astrophysics: VI. Ultra-High Energy Cosmic Rays

Two new solutions of the homogeneous diffusion equation in 1D are derived in the presence of losses and a trigonometric profile for a profile of density. A simulation for the ankle in the energy distribution of cosmic rays (CRs) is provided in the framework of the fine tuning of the involved parameters. A theoretical image for the overall diffusion of CRs in galactic coordinates is provided.

Kinematics and Dynamics Analysis of a Quadruped Walking Robot with Parallel Leg Mechanism

It is desired to require a walking robot for the elderly and the disabled to have large capacity,high stiffness,stability,etc.However,the existing walking robots cannot achieve these requirements because of the weight-payload ratio and simple function.Therefore,Improvement of enhancing capacity and functions of the walking robot is an important research issue.According to walking requirements and combining modularization and reconfigurable ideas,a quadruped/biped reconfigurable walking robot with parallel leg mechanism is proposed.The proposed robot can be used for both a biped and a quadruped walking robot.The kinematics and performance analysis of a 3-UPU parallel mechanism which is the basic leg mechanism of a quadruped walking robot are conducted and the structural parameters are optimized.The results show that performance of the walking robot is optimal when the circumradius R,r of the upper and lower platform of leg mechanism are 161.7 mm,57.7 mm,respectively.Based on the optimal results,the kinematics and dynamics of the quadruped walking robot in the static walking mode are derived with the application of parallel mechanism and influence coefficient theory,and the optimal coordination distribution of the dynamic load for the quadruped walking robot with over-determinate inputs is analyzed,which solves dynamic load coupling caused by the branches’ constraint of the robot in the walk process.Besides laying a theoretical foundation for development of the prototype,the kinematics and dynamics studies on the quadruped walking robot also boost the theoretical research of the quadruped walking and the practical applications of parallel mechanism.

Planning and Control of COP-Switch-Based Planar Biped Walking

Efficient walking is one of the main goals of researches on biped robots. A feasible way is to translate the understanding from human walking into robot walking, for example, an artificial control approach on a human like walking structure. In this paper, a walking pattern based on Center of Pressure （COP） switched and modeled after human walking is introduced firstly. Then, a parameterization method for the proposed walking gait is presented. In view of the complication, a multi-space planning method which divides the whole planning task into three sub-spaces, including simplified model space, work space and joint space, is proposed. Furthermore, a finite-state-based control method is also developed to implement the proposed walking pattern. The state switches of this method are driven by sensor events. For convincing verification, a 2D simulation system with a 9-1ink planar biped robot is developed. The simulation results exhibit an efficient walking gait.

Comparison of walking quality variables between incomplete spinal cord injury patients and healthy subjects by using a footscan plantar pressure system

The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury(SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can be obtained using a plantar pressure analysis system. Previous studies have reported step asymmetry in patients with bilateral SCI. However, the asymmetry of other parameters in patients with SCI has not been reported. This was a prospective, cross-sectional study, which included 23 patients with SCI, aged 48.1 ± 14.5 years, and 28 healthy subjects, aged 47.1 ± 9.8 years. All subjects underwent bare foot walking on a plantar pressure measurement device to measure walking speed and spatiotemporal parameters. Compared with healthy subjects, SCI patients had slower walking speed, longer stride time and stance time, larger stance phase percentage, and shorter stride length. The peak pressures under the metatarsal heads and toe were lower in SCI patients than in healthy subjects. In the heel, regional impulse and the contact area percentage in SCI patients were higher than those in healthy subjects. The symmetry indexes of stance time, step length, maximum force, impulse and contact area were increased in SCI patients, indicating a decline in symmetry. The results confirm that the gait quality, including spatiotemporal variables and plantar pressure parameters, and symmetry index were lower in SCI patients compared with healthy subjects. Plantar pressure parameters and symmetry index could be sensitive quantitative parameters to improve gait quality of SCI patients. The protocols were approved by the Clinical Research Ethics Committee of Shengjing Hospital of China Medical University(approval No. 2015 PS54 J) on August 13, 2015. This trial was registered in the ISRCTN Registry(ISRCTN42544587) on August 22, 2018. Protocol version: 1.0.

Retrospective study of effect of whole-body vibration training on balance and walking function in stroke patients

BACKGROUND Dysfunction in stroke patients has been a problem that we committed to solve and explore.Physical therapy has some effect to regain strength,balance,and coordination.However,it is not a complete cure,so we are trying to find more effective treatments.AIM To observe the effect of whole-body vibration training(WVT)on the recovery of balance and walking function in stroke patients,which could provide us some useful evidence for planning rehabilitation.METHODS The clinical data of 130 stroke participants who underwent conventional rehabilitation treatment in our hospital from January 2019 to August 2020 were retrospectively analyzed.The participants were divided into whole-body vibration training(WVT)group and non-WVT(NWVT)group according to whether they were given WVT.In the WVT group,routine rehabilitation therapy was combined with WVT by the Galileo Med L Plus vibration trainer at a frequency of 20 Hz and a vibration amplitude of 0+ACY-plusmn+ADs-5.2 mm,and in the NWVT group,routine rehabilitation therapy only was provided.The treatment course of the two groups was 4 wk.Before and after treatment,the Berg balance scale(BBS),3 m timed up-and-go test(TUGT),the maximum walking speed test(MWS),and upper limb functional reaching(FR)test were performed.RESULTS After 4 wk training,in both groups,the BBS score and the FR distance respectively increased to a certain amount(WVT=46.08±3.41 vs NWVT=40.22±3.75;WVT=20.48±2.23 vs NWVT=16.60±2.82),with P<0.05.Furthermore,in the WVT group,both BBS score and FR distance(BBS:18.32±2.18;FR:10.00±0.92)increased more than that in the NWVT group(BBS:13.29±1.66;FR:6.16±0.95),with P<0.05.Meanwhile,in both groups,the TUGT and the MWS were improved after training(WVT=32.64±3.81 vs NWVT=39.56±3.68;WVT=12.73±2.26 vs NWVT=15.04±2.27,respectively),with P<0.05.The change in the WVT group(TUGT:17.49±1.88;MWS:6.79±0.81)was greater than that in the NWVT group(TUGT:10.76±1.42;MWS:4.84±0.58),with P<0.05.CONCLUSION The WVT could effectively improve the balance and walking function in stroke patients,which may be good for improving their quality of life.

Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury:a prospective self-controlled study

Although a large number of trials in the SCI field have been conducted,few proven gains have been realized for patients.In the present study,we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury(SCI)subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale(AIS)Class A(AIS-A).A total of 320 clinically complete SCI subjects(271 male and 49 female),aged 16–60 years,received early(≤7 days,n=201)or delayed(8–30 days,n=119)surgical interventions to reduce intraspinal or intramedullary pressure.Fifteen days post-surgery,all subjects received a weight-bearing walking training with the“Kunming Locomotion Training Program(KLTP)”for a duration of 6 months.The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale(KLS).We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores.Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days,3 or 6 months indicating continued improvement in walking scores during the 6-month period.In conclusion,combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI,which generally shows little clinical recovery within the first year after injury and most are permanently disabled.This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital,China and registered at ClinicalTrials.gov(Identifier:NCT04034108)on July 26,2019.