The application of the strip-shaped cymba conchae orthosis in the nonsurgical correction of complex auricular deformity

Objective: This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods: Clinical data were collected from 2020 to 2021 for 6 patients who underwent correction using a stripshaped cymba conchae orthosis. The indications, corrective effects, and complications associated with use of the orthosis were analyzed. Results: There were four indications for treatment: cryptotia with helix adhesion;cryptotia with grade I microtia;cryptotia with excessive helix thickness;and auricular deformity beyond the treatment time window(≥6 months). Excellent corrective effects were observed in all 6 patients. Complications occurred in one patient, who recovered after symptomatic treatment. Conclusion: The use of a strip-shaped cymba conchae orthosis alone or combined with a U-shaped helix orthosis presents a feasible approach for correcting complex auricular deformities or deformities beyond the treatment time window in pediatric patients.

A Novel Knee Orthosis in the Treatment of Patellofemoral Pain Syndrome

Context: Patellofemoral Pain (PFPS) accounts for up to 25% of knee injuries in sports medicine clinics, with up to 91% of symptoms unresolved after conservative treatment at 5 years. The variability of response to treatment reflects its multi-factorial biomechanical etiologies. Bracing has been utilized to modify patellofemoral kinematics, generally by increasing patellofemoral contact area. The DJO Reaction orthosis is unique in its shock-absorbing elastomeric design, which is created to dissipate peak stress and enhance patellar tracking. Objective: To assess whether the DJO Reaction Brace reduces pain and improves functional outcomes in patients with chronic PFPS. Design: Cohort Series. Setting: Academic Sports Medicine Clinic. Patients: Twenty-two individuals between 18 and 40 years old with chronic patellofemoral pain have failed conservative treatment. Intervention: DJO Reaction Brace. Main Outcome Measures: Kujala Anterior Knee Pain Scale, Knee Injury and Osteoarthritis Outcome Score. Results: Seven males and 10 females with an age range of 19 - 39 years old complete the study. At an average follow-up time of 55 days, the Kujala score significantly improves by 9.8%, and KOOS Scores increase by the following statistically significant amounts: symptom 3.2%, pain 10.7%, sports and recreation 12.9%, quality of life 20.2%. Conclusion: The DJO Reaction orthosis reduces knee pain, increases function, and enhances quality of life with individuals with PFPS and is effective in the conservative care of patellofemoral pain syndrome.

Application of a paraplegic gait orthosis in thoracolumbar spinal cord injury

Paraplegic gait orthosis has been shown to help paraplegic patients stand and walk, although this method cannot be individualized for patients with different spinal cord injuries and functional recovery of the lower extremities. There is, however, a great need to develop individualized paraplegic orthosis to improve overall quality of life for paraplegic patients. In the present study, 36 spinal cord（below T4） injury patients were equally and randomly divided into control and observation groups. The control group received systematic rehabilitation training, including maintenance of joint range of motion, residual muscle strength training, standing training, balance training, and functional electrical stimulation. The observation group received an individualized paraplegic locomotion brace and functional training according to the various spinal cord injury levels and muscle strength based on comprehensive systematic rehabilitation training. After 3 months of rehabilitation training, the observation group achieved therapeutic locomotion in 8 cases, family-based locomotion in 7 cases, and community-based locomotion in 3 cases. However, locomotion was not achieved in any of the control group patients. These findings suggest that individualized paraplegic braces significantly improve activity of daily living and locomotion in patients with thoracolumbar spinal cord injury.

Customized Foot Orthosis Development by 3D Reconstruction of the CT Images

Clinicians can provide a means to better distribute the pressure around the foot, and can also correct the biomechanics of the foot by using a customized shoe insole. If detected early enough, orthopedic insoles can correct or prevent further complications. In this study the 3 Dimensional (D) model of the foot was used to fabricate a customized orthosis. The Computed Tomography (CT) images of patient’s foot having no muscle weakness and joint restriction were acquired. The gray intensities corresponding to the bones of the foot from the CT images were 3 dimensionally reconstructed. The 3D model of the foot was then imported into the CAD Software. Boolean operations were carried out in between the 3D foot model and a solid rectangular surface to create a customized foot orthosis. The exact contours and shape of the subject’s foot was acquired using the computerized method of fabricating an orthosis. The novel idea described in this study support, automating the process of designing a customized orthosis with the impression got from the 3 dimensionally modeled feet, thereby reducing the modeling time considerably. The simple technique used in this process will help in giving comfort and stability to the patient’s feet while walking.

Heat Setting Technology for the Glove of Flexible Medical Orthosis

In order to meet the curative effect,the glove of the flexible medical orthosis was designed to use nylon / spandex and polyester / spandex covered yarns to knit the glove by parts.For the purpose of confirming the best heat setting technology of the glove knitted by multicomponent materials, different heat setting technologies with different temperature and time were tested on the nylon / spandex and the polyester / spandex knitted fabrics.And the effects of the heat setting technology on dimensional stability and elastic recovery of the two kinds of fabrics were analyzed as well.The results show that in the proper range of temperature and time,dimensional stability and elastic recovery of the nylon / spandex knitted fabric become better with the increases of temperature and time.And dimensional stability of the polyester / spandex knitted fabric also turns good.But its elastic recovery doesn't change obviously.All the measured values were compared with each other.And the results indicate that dimensional stability and elastic recovery of these two kinds of fabrics both are great after the heat setting technology of temperature 180 ℃ and time 60 s.

Effects of a Cordura Material Ankle-Foot Orthosis on Balance Performance in Patients with Foot Drop

As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There are relatively few researches on the balance ability of patients with foot drop worldwide,while the balance ability will directly affect the walking ability for recovery,so the research is significant in the rehabilitation of foot drop. In the experiment,the Cordura material ankle-foot orthosis （AFO）,one of the world leading technology products,is chosen as the experimental equipment because of its well-known durability and strength. The experiment studied the balance performance of patients with foot drop before and after wearing Cordura material AFO. The Berg scale was evaluated to discuss the effect of the orthosis on balance ability in patients with foot drop. It has been found that the wearing equipment BBS scores were significantly improved. There were significant differences comparing with the control group（ P＆lt;0.05）.But in the course of treatment the Berg balance scale （BBS） scores reduced individually,mainly in terms of leg flexibility.

多功能斜颈矫形器配合手法矫正在小儿先天性肌性斜颈中的应用

目的:探讨应用多功能斜颈矫形器矫配合手法矫正在小儿先天性肌性斜颈畸形的效果。方法:本研究将60例先天性肌性斜颈患儿随机分成试验组和对照组,试验组在传统矫正手法治疗基础上采用多功能斜颈矫形器进行治疗,对照组单用手法矫正治疗,治疗3个月后,观察颈部处于不同体位时矫形器对于患儿的矫形情况。采用表面肌电进行数据分析,对颈部侧屈及旋转两种体位下进行胸锁乳突肌表面肌电(surface electromyography,sEMG)信号采集,得到每档患儿胸锁乳突肌肌电信号特征后进行分析。然后对斜颈患儿整体治疗进行评估。结果:在不同体位下检测患儿胸锁乳突肌时域均方根值(RMS),发现试验组患侧胸锁乳突肌表面肌电信号RMS值显著高于对照组,结果存在显著性差异(P<0.05);两组治疗前后存在显著性差异(P<0.01);从整体评估来看,试验组患儿治疗总有效率96.67%,明显高于对照组,差异具有显著性意义(P<0.01)。结论:对于先天性肌性斜颈早期患儿,本矫形器固定确切、可靠、舒适且具有可调节性,配合手法矫正使得临床疗效显著,很大程度上改善了患儿斜颈状况。

经后路脊柱侧弯患儿术中压力性损伤风险预测模型的构建

目的探讨经后路脊柱侧弯患儿术中压力性损伤的高危因素,并构建相应的风险预测模型。方法2021年10月~2023年2月间长沙市三家三甲医院进行的经后路脊柱侧弯矫形手术的患儿237例。根据是否发生压力性损伤分为损伤组(31例)与未损伤组(206例)。利用单因素分析和多因素Logistic回归分析筛选高危因素,并构建相应的风险预测模型。结果单因素分析结果显示,体质量指数(BMI)、术前皮肤情况、术前低蛋白血症、术前贫血、手术时间、术中体温和术中出血等因素与血管危象的发生有关。BMI、术前皮肤情况、术前低蛋白血症、手术时间和术中出血是影响经后路脊柱侧弯患儿术中压力性损伤发生的高危因素。基于高危因素建立列线图模型,其ROC曲线下面积为0.612,灵敏度为89.7%,特异度91.0%,说明本模型具有较好的风险预测能力。结论BMI、术前皮肤情况、术前低蛋白血症、手术时间和术中出血是影响经后路脊柱侧弯患儿术中压力性损伤发生的高危因素。

基于价值工程的儿童下肢主动训练矫正器设计

目的 为改善现有儿童下肢主动训练矫正器的外观品质与交互方式,提升产品的整体价值,基于价值工程理论(ValueEngineering,VE)提出一种儿童下肢主动训练矫正器改进设计。方法 首先,结合层次分析法对儿童下肢主动训练矫正器产品功能模块进行划分与功能权重量化;其次,依据价值工程计算原理依次求出各功能要素的功能系数、成本系数和价值系数,利用价值机会分析获取关键功能要素的改进设计方向,为整体价值提升提供设计指导;最后,运用模糊综合评价法对多个改进设计方案进行排序,最终确定优选设计方案。结论 设计评价与验证结果表明改进设计方案在矫正模块和训练模块方面的用户满意度有明显提升。将价值工程理论应用于儿童下肢主动训练矫正器改进设计中具有一定可行性和有效性,对相关产品设计有一定参考与借鉴意义。

青少年特发性脊柱侧弯矫形器分类比较与数字智能技术的应用进展

背景:矫形器治疗是目前轻中度脊柱侧弯的常用有效治疗方法,可延缓并抑制侧弯进展,降低严重畸形发生率。不同种类矫形器的适应证和应用特点及疗效各不相同。近年的数字化智能化新技术应用促进了新型矫形器的改进研发。目的:对临床上常用的脊柱侧弯矫形器进行分类比较,并阐述近年的数字化智能化等新技术应用进展,为矫形器的临床选择和新型矫形器改进研发提供参考。方法:通过计算机检索PubMed、Embase、IEEE、中国知网、万方医学数据库收录的相关文献。英文检索词为“scoliosis,orthosis,brace,progress,artificial intelligence,digitization”,中文检索词包括“脊柱侧弯,脊柱侧凸,矫形器,支具,进展,人工智能,数字化”,检索时限主要为2012-2022年,最终纳入56篇文献进行综述分析。结果与结论:①脊柱侧弯矫形器对轻中度青少年特发性脊柱侧弯具有较好疗效,通过Hueter-Volkmann定律,加速凹侧脊柱的生长,成功率较高,目前已广泛应用于该领域。②不同种类矫形器的适应证和应用特点及疗效各不相同,临床选择具有针对性。③脊柱侧弯矫形器向更加人性化的方向发展,注重患者的舒适度,制作过程从石膏铸型向计算机辅助制造转型,简洁卫生且矫正精度更高,患者的依从性明显提高。④脊柱侧弯矫形器向着数字化、智能化方向发展,目前已与人工智能、物联网等技术广泛融合,实时监测患者的矫形力、体温、依从性等,为患者提供更加精准的治疗。⑤目前脊柱侧弯矫形器仍存在较多不可忽视的缺陷,如影响发育、肌力下降、身体僵硬等,需要进一步的探索和完善。

拇外翻足三维有限元模型构建及其第1、2跖列生物力学分析

目的建立拇外翻足有限元模型,研究不同拉力下第1、2跖列的应力及位移变化情况。方法将采集的拇外翻病人足部CT图像导入Mimics软件,重建足部三维骨骼模型;利用3-matic软件对重建模型进行网格划分与体网格生成;将优化处理过的模型导入ANSYS中进行有限元分析,通过改变拉力大小、方向验证拉力与第1、2跖列的应力、位移之间的关系。结果对第1近节趾骨施加不同大小、方向的拉力,当力小于12 N时,随着拉力的增加,第1趾骨位移变化较为明显,拉力每增大2 N,位移约增加1 mm;当力大于12 N时,随着拉力的增加,第1趾骨应力不断增加,而位移只发生微小变化;而当力保持12 N不变,以15°间隔改变力的方向时,第1、2跖列的应力大小及其分布随方向的变化而改变,同时位移也会产生相应的变化,且当力的方向与第2趾骨方向越趋于垂直时,第1趾骨产生的位移越大。结论有限元分析技术可以形象、准确地分析第1、2跖列在不同拉力下的应力及位移变化情况,为拇外翻矫形器的设计奠定基础。

膝内翻矫形器械治疗膝关节骨性关节炎的临床观察

目的:探讨膝内翻矫形器械对膝关节骨性关节炎(KOA)患者的影响。方法:选择合并膝内翻的KOA患者60例,随机分为观察组和对照组。2组均采用基础治疗,在此基础上观察组采用膝内翻矫形器械,对照组采用常规牵引治疗。治疗4周后,采用疼痛视觉模拟评分(VAS)、关节活动度(ROM)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、美国特种外科医院膝关节评分(HSS)、胫股角(TFA)、膝间距(IC)评价膝关节功能。结果:4周治疗后,2组VAS、WOMAC、IC评分均较治疗前降低(P<0.01),观察组均低于对照组(P<0.01);2组HSS、TFA评分均较治疗前提高,观察组均高于对照组(P<0.01,0.05);2组组内和组间ROM评分比较差异无统计学意义。结论:膝内翻矫形器械可以减轻KOA患者的疼痛,提高活动功能,改善膝关节生物力线,减缓膝内翻进展,值得临床推广应用。

3D打印脊柱侧弯矫形器治疗青少年脊柱侧弯的多准则决策模型评价

背景:传统脊柱侧弯矫形器存在制作工艺流程复杂、加工周期长、贴合性差等缺点,3D打印脊柱侧弯矫形器具有制造精度高、个性化等优势。目的:基于多准则决策模型评价3D打印脊柱侧弯矫形器治疗脊柱侧弯的疗效。方法:回顾性收集2019年1月至2022年10月收治于中山陈星海中西医结合医院的72例脊柱侧弯患者的临床资料,根据治疗矫形器的不同分为2组,研究组23例采用3D打印脊柱侧弯矫形器治疗,传统组49例采用传统的聚丙烯脊模塑柱矫形器治疗。比较两组患者临床疗效以及并发症发生状况;建立3D打印脊柱侧弯矫形器治疗脊柱侧弯的多准则决策模型,并对两组效益值、风险值及决策模型的稳定性进行评价。结果与结论:①研究组患者治疗6个月后,顶椎偏移距离、Cobb角、顶椎旋转度、功能性运动评分、目测类比评分以及总有效率与传统组相比均显著改善,差异有显著性意义(P<0.05);②效益指标中对患者病情影响最大的是Cobb角,风险指标影响较大的是呼吸困难;③研究组和传统组治疗脊柱侧弯效益值分别为79和64,风险值分别为74和57,综合效益和风险值发现研究组治疗方法的效益-风险值比传统组高出16;④在0-100%风险相对权重范围内,研究组的效益-风险总值总是高于传统组,证明多准则决策模型的稳定性较好;⑤提示3D打印脊柱矫形器能够更好地恢复脊柱侧弯青少年的脊柱生理弯曲,提高治疗有效率。

形状记忆合金在辅助器具和康复设备中的应用

背景:随着科技的不断进步,新技术和新方法的引入将为形状记忆合金在辅助和康复领域的应用带来更多的可能性和新的突破。目的:通过综述形状记忆合金在辅助器具和康复设备中的应用现状,讨论它们的主要方法、技术和结果,归纳总结并提出建议,希望形状记忆合金能够不断优化,为辅助和康复设备的发展带来更多新的变革。方法:通过计算机检索万方、Pub Med和Web of Science数据库,以“形状记忆合金,应用进展,正畸,矫形,假肢,康复,特性,植入,力学性能,镍钛记忆合金,驱动”为中文检索词,以“Shape memory alloys,Application,Orthodontics,Orthopedic,Prosthetics,Rehabilitation,Properties,Implant,Drive,Progress,Prostheses”为英文检索词,最终纳入91篇文献进行综述。结果与结论:(1)形状记忆合金具有耐腐蚀性、耐磨性、生物相容性、抗疲劳性和抗扭结性等特性,相比其他传统材料(不锈钢、钛合金、钴铬合金等)具有更低的弹性模量且无生物毒性,适合作为假体长期植入体内。由于其具有形状记忆效应和优异的力学性能,遂主要作为驱动元件或作为连接设备和人体的桥梁应用于假肢、矫形器和康复设备中。(2)使用形状记忆合金驱动元件能够减轻设备质量、消除噪声、容易操作、便于携带和更好地辅助关节运动等,比起使用气动、液压和电气驱动方法的设备优势明显。(3)另外形状记忆合金在变形时能够产生恒久、稳定的应力,相比不锈钢、钛合金和铝合金矫形器具有更高的材料回收率且不用频繁更换调整,所以在矫治畸形方面更具实用价值。(4)目前形状记忆合金在矫形器中应用最多,在镫骨假体中的临床应用效果最好。而由于技术及成本等的限制,形状记忆合金在假肢和康复设备中的应用较少,且缺乏对应用效果的大样本研究。(5)虽然形状记忆合金在辅助和康复领域得到了一定的发展,但仍存在许多问题:对形状记忆合金进行精准控制很难;形状记忆合金的冷却速度慢;无法对其变形速度进行控制;缺乏对不同性状形状记忆合金的对比研究和专家共识;形状记忆合金成本高,价格贵。(6)未来应注意开发新型形状记忆合金,增加对比性研究,采用新技术、新方法(如4D打印等)解决目前存在的问题,从而研发出高性能的辅助器具和康复设备。

基于三点力原理对足内翻矫形器矫正效果的有限元分析

背景:三点力学是踝足矫形器矫正与预防足部各类疾病的有效方法,目前关于3D打印踝足矫形器的临床应用研究已普遍存在,但其涉及三点力学矫正的数值模拟与有限元分析报道相对较少,缺乏相关生物力学实验验证。目的:通过有限元法对踝足矫形器与足部复合模型进行三点力加载分析,观察在三点力干预下佩戴踝足矫形器的足部矫正效果,验证三点力的有效性及踝足矫形器的可靠性。方法:基于医学图像处理软件Mimics构建1例健康志愿者足踝三维模型,采用Rodin 4D与Geomagic逆向工程软件对各模型进行优化处理,设计个性化踝足矫形器模型。利用Solidworks软件对足踝模型进行内侧翻转10°以模拟足内翻病态,通过ANSYS软件结合三点力学原理对足部施力区进行静力加载,在满足人体足部痛阈时分析足踝各组织形变与应力变化,利用显示动力学进一步验证踝足矫形器施加三点力的有效性。结果与结论:(1)设计的个性化踝足矫形器具有预防足踝内翻和固定作用,在未穿戴踝足矫形器时,受到1 N·m内翻载荷后足踝内翻1.81mm,而穿戴踝足矫形器后仅为0.44mm,变形率降低75.7%,预防内翻效果明显增强;(2)仅冠状面矫正时,跟骨力系过小会加剧患者前足内翻,调整足跟内侧与内踝上方矫正力后,前足内翻角与跟骨位得到改善,但足部内侧趾骨区仍有不同程度内收移位,会加剧患者前足内收畸形;(3)冠状面、水平面两组三点力系统联合作用矫正效果优于单冠状面,表现为在足跟内侧、第一跖骨干内侧、外踝下方与内踝上方的力(25,10,10,20 N)作用下,前足内侧趾骨无内收移位,前足内翻角减小,并沿X轴外翻矫正1.395 mm,跟骨外翻矫正1.227mm,在变形比例放大云图下跟骨内翻角由10.21°矫正至7.25°,内翻角改善28.9%;(4)两平面三点力作用下,足底外侧跖骨负荷减小,内侧跖骨负荷增加,矫正后足底骨骼应力显著得到改善,进一步验证了三点力原理的可靠性,该研究为临床患者穿戴踝足矫形器治疗足内翻提供了重要理论支撑。

一种监测肩关节脱位的电刺激肩托马甲的设计

目的 肩关节脱位是外科常见疾病之一,病情易发且患者多以男性青壮年为主,因临床康复过程中无法及时跟进康复进程,病情复发率高,导致康复效果差,为解决此问题,本文设计了一款可监测肩关节脱位状况且具有电刺激功能的肩托马甲。方法 主体采用氯丁橡胶材料,首先对受试者量体裁制肩托马甲,并对肩托进行优化;然后使用霍尔传感器和可视化元件,设计了一种直观显示肩关节脱位位置的监测电路,通过使用555定时器,设计了配合监测电路的电刺激电路,通过电刺激片输出脉冲电刺激;编写误触判断程序,通过微处理器对误触进行剔除。结果 肩托马甲使受试者肩关节活动限制在相对安全范围内,有明显康复矫形效果。监测电路通过4个监测点位实时监测肩关节位置,并通过相对应位置的可视化元件显示,敏感度高,可重复性好;电刺激模块可配合监测电路,输出电压4.3 V,频率44 Hz低频脉冲;微处理器通过引脚触发时长可以对误触信号进行剔除。结论 实时监测肩关节脱位的电刺激肩托马甲实现了柔性支撑,通过集成霍尔传感器和电刺激装置,初步形成肩关节康复由评估到调整的康复闭环,设计合理可行,增强了康复效率,形成一个连续的、动态的康复过程,为临床及时跟进康复进程提供帮助。

EarWell耳廓矫形器治疗小儿先天性耳廓畸形的疗效及美学评价

目的:探讨EarWell耳廓矫形器治疗先天性耳廓形态畸形的疗效及美学效果。方法:选取2020年12月-2022年12月笔者医院治疗的100例(120耳)先天性耳廓形态畸形患儿,均采用EarWell耳廓矫形器治疗,最长佩戴8周。比较不同性别、年龄、畸形类型患儿的矫正效果、并发症及美学满意度。结果:整体矫正率为94.17%,并发症总发生率为6.67%,美学总满意度为91.67%;<90 d患儿的矫正率、美学满意度明显高于90~180 d患儿(P<0.05),并发症发生率明显低于90~180 d患儿(P<0.05)。不同性别患儿矫正率、美学满意度比较差异无统计学意义(P>0.05)。不同类型耳廓形态畸形的矫正率、美学满意度比较差异有统计学意义(P<0.05)。结论:EarWell耳廓矫形器治疗先天性耳廓形态畸形的疗效显著,美学效果好,并发症少,年龄越小,矫正及美学效果越好,不同类型耳廓形态畸形的矫正效果存在差异。

耳廓矫形器应用于先天性耳廓形态畸形患儿的疗效观察

目的研究耳廓矫形器在先天性耳廓形态畸形患儿中的应用效果。方法选取50例年龄在3 d~3个月的先天性耳廓形态畸形患儿,根据患儿年龄分为3~42 d组和43 d~3个月组,每组25例。两组患儿均使用耳廓矫形器进行矫治。随访3个月,观察50例患儿的整体矫治情况,比较两组患儿的矫治后耳廓外观疗效、初始矫治时间、不良事件发生情况、患儿家长满意度。结果50例先天性耳廓形态畸形患儿,经过耳廓矫形器矫治后,整体矫治优良率为86%(43/50),初始矫治时间为(27.94±5.99)d,不良事件发生率为20%(10/50),患儿家长总满意率为80%(40/50)。3~42 d组矫治后耳廓外观优良率96.00%显著高于43 d~3个月组的76.00%,初始矫治时间(25.55±5.42)d显著短于43 d~3个月组(30.33±6.95)d,不良事件发生率8.00%显著低于43 d~3个月组的32.00%,患儿家长对矫正后耳廓形态的总满意率92.00%显著高于43 d~3个月组的68.00%(P<0.05)。结论耳廓矫形器应用于先天性耳廓形态畸形患儿的整体疗效显著,安全可靠。患儿接受矫治的年龄越小,矫治疗效越好,矫治时间越短,不良事件越少,家长满意度越高,提示年龄越小,矫治的效果越满意,安全性更高。

动态腕手矫形器结合改良强制性运动疗法对脑卒中偏瘫患者上肢和手功能障碍的效果

目的观察动态腕手矫形器结合改良强制性运动疗法(mCIMT)对脑卒中偏瘫患者上肢及手功能的影响。方法2022年2月至2023年12月,复旦大学附属华山医院脑卒中恢复期患者32例,随机分为对照组(n=16)和试验组(n=16)。两组均接受常规康复训练,采用改良强制性运动疗法,每天健侧上肢佩戴约束手套4 h;试验组同时患侧上肢佩戴动态腕手矫形器4 h;每周5 d,连续3周。分别于治疗前后采用Wolf运动功能量表(WMFT)、手臂动作调查测试(ARAT)和握力评估上肢运动功能,动作活动记录量表(MAL)评估动作使用量(AOU)和动作完成质量(QOM),汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估情绪变化,采用表面肌电图观察训练前后患/健侧腕背伸肌均方根值(RMS)比。结果治疗后,两组WMFT、ARAT、MAL-QOM、HAMA评分和患/健侧腕背伸肌RMS比均改善(|t|>2.179,P<0.05),试验组WMFT和握力的进步值优于对照组(|t|>2.343,P<0.05);试验组握力、MAL-AOU和HAMD评分均改善(|t|>2.819,P<0.05)。结论动态腕手矫形器结合mCIMT可以促进偏瘫患者上肢和手功能的恢复。

可调踝足矫形器联合功能训练在改善颅脑损伤患者踝关节功能中的应用研究

目的:探讨可调踝足矫形器联合功能训练在改善颅脑损伤患者踝关节功能中的应用效果。方法:以2022年2-12月在江滨医院治疗的60例颅脑损伤患者为研究对象,随机分为观察组和对照组。观察组中男性20例,女性10例,平均年龄(39.10±10.98)岁;对照组中男性17例,女性13例,平均年龄(36.80±10.55)岁。对照组患者按康复治疗流程进行常规功能训练,观察组患者在常规功能训练的基础上使用可调踝足矫形器。比较两组患者的下肢跖屈肌痉挛程度和踝关节跖屈、内翻角度指标。结果:治疗8周后,观察组患者下肢跖屈肌痉挛程度(改良Ashworth痉挛量表)评分低于对照组,踝关节跖屈、内翻角度均小于对照组,差异均有统计学意义(均P<0.01)。结论:应用可调踝足矫形器联合功能训练可改善颅脑损伤患者踝关节功能。