强直性脊柱炎患者胸廓活动度与脊柱运动能力的关系

目的探讨强直性脊柱炎患者胸廓活动度与脊柱各个椎间角度之间的相关关系。方法应用脊柱形态测量仪测量41例强直性脊柱炎患者不同姿势下的脊柱形态并对患者胸廓活动度进行测量,对胸廓活动度与脊柱形态相关的数据进行相关分析。结果胸廓活动度与前屈位姿势下腰椎总体曲度明显正相关(P<0.01),与前屈位姿势下L1/2、L2/3、L4/5椎间角度正相关(P<0.05);与直立位姿势下L1/2椎间角度、L2/3椎间角度、腰椎总体曲度,后伸位姿势下L1/2椎间角度、L3/4椎间角度、腰椎总体曲度负相关(P<0.05)。结论在强直性脊柱炎患者脊柱运动能力中,胸廓活动度与腰椎运动能力关系密切。     

基于太极拳动作相关性康复训练模式研究

目的:探讨太极拳标准动作的运动模式。方法:受试者按照杨式太极拳"云手"动作进行演练。实验全程使用美国Motion Analysis三维动作捕捉系统进行数据采集,采集肘部、肩部、头部和躯干部运动数据,并对数据进行主成分分析方法。结果:所入选的各关节运动数据均呈相关性(P0.01),头部旋转角度与躯干旋转角度呈明显相关性(相关系数0.993,P0.01),头部旋转角度与肩关节屈曲角度呈相关性(P0.01),肩关节屈曲角度与肘关节屈曲角度呈相关性(P0.01);主成分分析结果显示,以躯干旋转角度为因变量、肘关节屈曲角度、肩关节屈曲角度、头部旋转角度为自变量时,各关节均参与完成了云手动作(P0.01)。结论:太极拳云手动作可以划分为2个运动成分,康复训练时采取分解各主要成分进行分步教学,再进行完整动作整合训练,这将加快康复患者学习动作的进程,提高动作协调性,以达到高效快速训练的目的。     

基于惯性传感单元的步行膝关节载荷预测

目的：基于惯性传感单元构建步态过程中膝关节力学载荷的计算方法。方法：将4个惯性传感器分别固定在志愿者的躯干、大腿、小腿和足的接近质心位置,光学动作捕捉系统和力台同步采集运动学数据。构建人体运动生物力学模型,结合Ortho Load髋关节力学载荷数据库中的标准数据,计算志愿者膝关节力学载荷。结果：步态中,基于惯性传感单元计算的膝关节力学载荷与膝关节数据库、三维光学动作捕捉系统和力台相比,膝关节力在矢状面具有良好的相关性,平均相关系数分别为0.76和0.97,膝关节力矩在矢状面具有良好的相关性,平均相关系数分别为0.85和0.93。结论：基于惯性传感单元的运动数据采集系统和建模计算方法真实可靠,可为准确捕捉多运动场景下膝关节的力学载荷提供解决方案。     

体质综合指数落后地区女性与全国成年女性体质指标的比较

目的:了解和掌握体质综合指数落后地区成年女性的体质现状,客观评价该人群的健康水平。方法:①调查对象:实验于2005-06/08在体质综合指数落后的贵州省六盘水市钟山区和水城县抽取20～59岁女性成年人,意识清晰、无明显生理缺陷、具备生活自理能力,在了解试验目的和程序后均志愿加入进行体质调查。按年龄段分组,5岁为1组,105人/组,共840人。②实验方法:严格按照《2005年国民体质监测工作手册》的要求确定测试指标,以身高、体质量、胸围、腰围、臀围、上臂皮褶厚度、肩胛皮褶厚度、腹部皮褶厚度作为形态类指标;以安静脉搏、收缩压、舒张压、肺活量、台阶指数作为功能类指标;以握力、背力、纵跳、1min仰卧起坐、坐位体前屈、闭眼单脚站立、选择反应时作为素质指标。同时对测试对象进行询问访谈,内容包括工作生活方式、习惯、体育锻炼现状等。结果:840人均进入结果分析。①体质综合指数落后地区与全国成年女性形态指标的比较:与全国均值比较,体质综合指数落后地区成年女性各年龄段身高均降低,除50～54岁年龄段外,其他各年龄段均存在显著差异(P<0.01);胸围均降低,除25～29岁、35～44岁年龄段外,其他各年龄段均存在显著差异(P<0.01);腰围除45～59岁年龄段升高外,其他各年龄段均降低(P<0.01);臀围均降低,除40～44岁年龄段外,其他各年龄段均存在显著差异(P<0.05,0.01);体质量及上臂、肩胛、腹部皮褶厚度均明显低于全国均值(P<0.05,0.01)。②体质综合指数落后地区与全国成年女性机能状况的比较:与全国均值比较,体质综合指数落后地区成年女性各年龄段心率、肺活量、台阶指数均低于全国均值(P<0.05,0.01);除55～59岁年龄段外,其他各年龄段收缩压均显著升高(P<0.05,0.01);20～29岁年龄段舒张压显著升高(P<0.01)。③体质综合指数落后地区与全国成年女性素质状况的比较:与全国均值比较,体质综合指数落后地区成年女性各年龄段握力、纵跳、仰卧起坐均低于全国均值(P<0.01);背力均低于全国均值,除20～24岁年龄段外,其他各年龄段均存在显著性差异(P<0.01);坐位体前屈均低于全国均值,20～44岁年龄段存在显著性差异(P<0.01);20～39岁年龄段闭眼单脚站立时间短于全国均值(P<0.01),45～59岁年龄段闭眼单脚站立时间长于全国均值,但差异无显著性意义(P>0.05);选择反应时所需时间均长于全国均值(P<0.05,0.01)。结论:体质综合指数落后的贵州省六盘水地区成年女性体质整体水平低于全国均值,主要影响因素为缺乏体育锻炼、饮食习惯、落后经济等。     

两种躯干运动模型在五种日常活动下的运动学差异的对比研究

目的:比较五种日常活动下,由胸节段、腰部全节段构成的简略躯干模型与由胸节段、上腰节段、下腰节段构成的细化躯干模型的运动学差异性。方法:使用NDI运动捕捉系统,采集26名健康的年轻志愿者在水平行走,上楼梯,躯干前屈,同侧拾取物体,对侧拾取物体五种活动下的胸节段,上腰节段,下腰节段和全腰节段的运动学参数。采用主成分分析的方法,分析三节段细化躯干模型和两节段简略躯干模型运动学参数的主成分的贡献率与载荷系数。结果:简略躯干模型中,全腰段的屈曲角度和侧弯角度显著高于胸节段,细化躯干模型中,下腰段的屈曲角度和侧弯角度显著高于其他节段。在水平行走和上楼梯活动中,细化模型中的腰部两节段的载荷系数符号相反。结论:躯干的运动主要是由腰部提供且主要是由下腰部分提供。在某些活动中,腰部节段间的运动出现了相互抵消的作用。因此,在进行躯干的运动分析时,需要对躯干进行细分成多节段,尤其要注意对腰部的细分。     

一种基于刚体的虚拟Marker人体步态测量

高精度、快速地采集人体运动数据是人体步态测量的关键技术。试验根据人体解剖特征和正常人体步态特性,将人体划分为12块刚体（左右上臂、前臂、大腿、小腿、脚和上躯干、骨盆）,总结人体运动捕捉测量中Marker点贴附的技术难点,并针对每个难点制定出相应的Marker点贴附及刚体的设计方案,同时制作与人体各部位形态匹配的12块刚体;使用NDI Optotrak Certus运动捕捉系统对3名志愿者进行步态试验,然后将三维捕捉系统所测数据导入Visual3D软件进行人体运动学仿真分析。结果表明使用基于人体多刚体的虚拟Marker方法后,步态测量试验的工作量大大减少（试验工作量减少了25%左右）,试验的稳定性能也较全部贴实体Marker时有所提高。     

闭孔神经和股神经的近远端运动传导

本文旨在通过电生理方法评价健康人的闭孔神经 (obturatornerve ,ON)及股神经 (femoralnerve ,FN)近端运动传导。资料与方法　健康成年志愿者 16例 ,男女各 8例 ,年龄 2 2～ 5 2岁 (平均 37 5岁 )。检测方法如下 :①刺激ON :受试者仰卧位 ,将双极体刺激电极放置在腹股沟韧带 (i     

基于人体坐立转换运动规律的三自由度站立康复机器人设计

目的:探究以何种方式设计站立康复辅具,降低因人机匹配度差导致的固化姿态形成几率。方法:选取30例成年健康男性受试者,捕捉其坐立转换时肩峰、大转子隆起处、外侧髂隆起处的运动轨迹和运动特征。提出了三自由度串联机械臂设计方案。结果:根据受试者的运动特征将坐立转换过程分成了四个阶段。根据不同受试者的人体参数,推荐了三条大转子轨迹,设计了三自由度站立康复机器人。结论:站立康复辅具应以大转子位置为辅助支撑点为佳,小腿的自由度不应被限制,配合控制躯干倾角,以保证与自然状态下的站立过程较高的相似度。站立康复辅具能够根据不同人体参数调整坐立转换的运动轨迹,避免人机融合性差导致错误的固化姿态。     

中年人群血浆一氧化氮在运动中及恢复期的变化及影响因素

目的:探讨中年人群单次极量运动中及恢复期血浆一氧化氮变化的情况及影响因素。方法:健康中年志愿者49例,分别于一次极量平板运动前,运动高峰期及运动终止30min的恢复期采集静脉血样本,采用硝酸还原酶法测定血浆一氧化氮的代谢产物硝酸盐及亚硝酸盐(NOx)的总和水平,比较3个时点的血浆NOx变化,分析其影响因素。结果:运动前的基线平均NOx浓度为44.42±23.34μmol/L,与血浆甘油三酯水平呈正相关,r=0.322,P=0.024。运动高峰期血浆NOx较运动前显著上升,平均为68.86±29.45μmol/L,(t=9.621,P=0.000),为运动前的1.86±0.95倍,并且倍数与运动时间及工作负荷呈正相关(r=0.307,P=0.032)。运动终止后50%志愿者血浆NOx维持在运动高峰期水平,为58.16±31.3μmol/L,约25%志愿者(A组)恢复期血浆NOx较高峰期明显升高,平均为119.12±36.87μmol/L(t=-15.78,P=0.000),而另有25%志愿者(B组)恢复期血浆NOx则降低至运动前水平,平均为37.51±24.98μmol/L(t=7.803,P=0.000),A、B两组比较,运动前的基线NOx,A组较B组高(t=2.136,P=0.04)。结论:健康中年人单次极量运动时血浆NOx显著升高,NOx增加的倍数与运动时间正相关,部分志愿者在运动终止30min的恢复期血浆NOx较运动高峰期明显降低而另一部分反而增高,提示两组之间存在内皮生成NO的功能差异。     

两种固定器固定脊柱骨折脱位的生物力学分析

背景:胸腰椎脊柱骨折脱位的治疗方法主要是通过手术以内、外固定器械进行复位固定.脊柱骨折脱位固定治疗是国内外学者们研究的重要课题.目的:从生物力学角度对临床应用治疗脊柱骨折脱位的椎弓根钉和钢板固定器进行定量分析,为临床提供力学参数.方法:在日本岛津电子万能试验机上对模拟L_1椎体骨折脱位以钢板固定和以椎弓根钉固定标本进行前屈、后伸、压缩、扭转实验,实验速度为5 mm/min,在扭转试验机上进行扭转实验,实验速度为0.05(°)/s.以统计分析和配对t检验方法处理实验数据.结果与结论:实验结果表明各组压缩实验结果差异无显著性意义(P>0.05).椎弓根钉固定组左、右扭转角度小于钢板固定组(P<0.05).椎弓根钉固定组前屈、后伸位移小于钢板固定组(P<0.05).提示骨折脱位后钢板内固定效果不如椎弓根固定,而锥弓根钉内固定有利于促进骨折愈合和复位,所以椎弓根钉固定是一种较好的内固定方法.     

Head eye co-ordination and gaze stability in subjects with persistent whiplash associated disorders

Symptoms of dizziness, unsteadiness and visual disturbances are frequent complaints in persons with persistent whiplash associated disorders. This study investigated eye, head co-ordination and gaze stability in subjects with persistent whiplash (n?=?20) and asymptomatic controls (n?=?20). Wireless motion sensors and electro-oculography were used to measure: head rotation during unconstrained head movement, head rotation during gaze stability and sequential head and eye movements. Ten control subjects participated in a repeatability study (two occasions one week apart). Between-day repeatability was acceptable (ICC?>?0.6) for most measures. The whiplash group had significantly less maximal eye angle to the left, range of head movement during the gaze stability task and decreased velocity of head movement in head eye co-ordination and gaze stability tasks compared to the control group (p??0.55) between both unrestrained neck movement and neck pain and head movement and velocity in the whiplash group. Deficits in gaze stability and head eye co-ordination may be related to disturbed reflex activity associated with decreased head range of motion and/or neck pain. Further research is required to explore the mechanisms behind these deficits, the nature of changes over time and the tests' ability to measure change in response to rehabilitation.     

In vivo motion analysis of forearm rotation utilizing magnetic resonance imaging.

OBJECTIVE: To analyse in vivo normal forearm rotation utilizing the image processing method on axial magnetic resonance imaging. DESIGN: Rotatory motion and translation of the radius and rotation of the ulna were analysed in vivo, utilizing features of the bone image; axial centre of gravity and axis of the bone. METHODS: Axial magnetic resonance images at the proximal, middle and distal portion of the right forearms of 20 healthy volunteers were examined in five rotational positions, maximum pronation, 45 degrees pronation, neutral, 45 degrees supination and maximum supination. The axis of forearm rotation, the rotation angle of the radius, the rotation of the radius around its axial centre of gravity, and the rotation of the ulna around its axial centre of gravity were calculated on these axial MR images. RESULTS: The radius rotates in a near-circular ellipse around its rotational centre located on a line through the radial head and the ulnar head from maximum supination to 45 degrees pronation. There was discrepancy between the calculated maximum rotational angle of the radius and the pronation-supination angle showed on the goniometer. This discrepancy was due to motion at the radiocarpal, midcarpal and carpometacarpal joints. The rotation of the ulna ranges within 6 degrees. At maximum pronation, there was palmar translation of the radius. CONCLUSIONS: The forearm rotation is not a simple rotatory motion but a complex motion with rotation and translation. The palmar translation of the radius at maximum pronation may be caused by incongruity of the distal radioulnar joint and contraction of the pronator quadratus muscle. RELEVANCE: To date there exist few methods for the accurate and non-invasive assessment for motion analysis of the forearm rotation. Such a technique utilizing magnetic resonance image characteristics is, however, helpful to reveal accurate self- and relative-rotatory motion of both radius and ulna as well as the translation movement on forearm rotation in normal forearm.     

Neck kinematics and sternocleidomastoid muscle activation during neck rotation in subjects with forward head posture

[Purpose] The present study investigated differences in the kinematics of the neck and activation of the sternocleidomastoid (SCM) muscle during neck rotation between subjects with and without forward head posture (FHP). [Subjects and Methods] Twenty-eight subjects participated in the study (14 with FHP, 14 without FHP). Subjects performed neck rotation in two directions, left and right. The kinematics of rotation-lateral flexion movement patterns were recorded using motion analysis. Activity in the bilateral SCM muscles was measured using surface electromyography. Differences in neck kinematics and activation of SCM between the groups were analyzed by independent t-tests. [Results] Maintaining FHP increased the rotation-lateral flexion ratio significantly in both directions. The FHP group had significantly faster onset time for lateral flexion movement in both directions during neck rotation. Regarding the electromyography of the SCM muscles during neck rotation in both directions, the activity values of subjects with FHP were greater than those of subjects without FHP for the contralateral SCM muscles. [Conclusion] FHP can induce changes in movement in the frontal plane and SCM muscle activation during neck rotation. Thus, clinicians should consider movement in the frontal plane as well as in the sagittal plane when assessing and treating patients with forward head posture.Key words: Axial rotation, Cervical movement, Forward head posture     

Variability of the helical axis during active cervical movements in people with chronic neck pain

BackgroundRecent work described parameters of the helical axis in asymptomatic people with potential for investigating kinematic changes in the cervical region. This approach could provide novel information on movement variability in people with neck pain, however this has never been investigated. This study aimed to investigate movement variability during active neck movements performed at different speeds in people with and without chronic neck pain.MethodsThis observational case-control study examined 18 participants with chronic neck pain of either idiopathic or traumatic origin and 18 gender-matched asymptomatic participants. Cervical kinematics were captured with 3D motion capture as people with and without chronic neck pain performed flexion-extension, bilateral lateral flexion and bilateral rotation at different speeds (natural, slow, and fast). The mean distance and mean angle parameters of the helical axis were extracted to describe 3D motion and quantify movement variability.FindingsA smaller mean distance was observed in those with neck pain compared to the asymptomatic participants during flexion-extension (P = 0.019) and rotation movements (P = 0.007). The neck pain group displayed smaller values for the mean angle during rotation movements with different speeds (P = 0.01). These findings indicate less variable movement for those with neck pain relative to the asymptomatic participants. No difference in the mean angle was observed between groups for flexion-extension and lateral flexion.InterpretationThe findings reiterate the importance of data derived from kinematic measures, and its potential for providing clinicians with further insight into the quality of active neck movements in people with chronic neck pain.     

解剖锁定钢板治疗肱骨近端骨折术后功能与影像学指标的相关性

目的探索解剖锁定钢板（ALP）治疗肱骨近端骨折（PHF）术后功能与影像学指标之间的相关性。方法回顾性分析2016年6月~2019年1月本院收治的120例PHF患者,根据患者的Neer分型将其分为二部分骨折组（n=28）、三部分骨折组（n=60）和四部分骨折组（n=32）。所有患者均采用ALP治疗,记录患者ALP的手术时间和术中出血量;术后1年,X线片检查患者颈干角丢失角度和肱骨头丢失高度,检查患肢肩关节的活动度,采用Constant-murley评分评估肩关节功能,视觉模拟评分评估术后疼痛程度,Pearson相关性分析PHF患者术后肩关节功能与颈干角丢失角度和肱骨头丢失高度之间的相关性。结果随着Neer分型增加,PHF患者术中出血量明显增加（P < 0.05）,术后颈干角丢失角度和肱骨头高度丢失明显增加（P < 0.05）,肩关节前屈、外旋、内旋角度明显下降（P < 0.05）,Constant评分明显降低（P < 0.05）,视觉模拟评分明显增加（P < 0.05）;Pearson相关性分析显示,PHF患者术后肩关节前屈、外旋、内旋、Constant评分与术后颈干角丢失角度和肱骨头高度呈显著的负相关关系（P < 0.05）。结论PHF患者ALP术后肩关节活动度和功能与颈干角、肱骨头高度变化具有显著的相关性。      

成人股骨上端部分参数测定

背景：在髋部骨折治疗中,内植物的设计和匹配对实现力学的传导及获得长期稳定具有熏要意义。然而由于人种的遗传,生活、工作环境等的影响,从而造成人种股骨参数各异。目的：测定重庆地区成年人股骨上端部分参数。方法：利用游标卡尺实体测量160例重庆地区股骨标本（左右各80例）的股骨头直径、股骨头长径、头颈轴长等5项相关参数,用浩辰CAD软件在影像资料上测量重庆地区成人股骨（男女各80例）上端内、外侧弧度及头颈轴线与股骨外侧皮质夹角。结果与结论：实体测量重庆地区股骨标本得出人股骨头直径为（45．26±3．17）mm;股骨头长径为（39．02±2．58）mm;头颈轴长为（93．23±5．43）mm;股骨颈最小上下颈为（31．28±2．18）mm;股骨颈最小前后径为（26．23±2．10）mm;测量成人股骨影像学资料得出的男性股骨上端内侧弧度为（0．267±0．024）TT;男性股骨上端外侧弧度为（0．219±0．019）TT;男性头颈轴线与股骨外侧皮质夹角为（130．92±2．31）°;女性股骨上端内侧弧度为（0．278±0．019）TT;女性股骨E端外侧弧度为（0．219±0．019）TT;女性头颈轴线与股骨外侧皮质夹角为（130．68±2．02）°。实体测量的股骨头直径、股骨头长径、股骨头颈轴长、股骨颈最小前后径和股骨颈最小上下径呈正相关,相关系数为0．246—0．588。软件测量的影像学数据中股骨上端内、外侧弧度无相关性（P〉0．05）;头颈轴线与股骨外侧皮质夹角和股骨上端内侧弧度呈负相关（r日：一0．446,ra=一0．509,P〈0．05）,而与股骨,卜端外侧弧度呈正相关（r=0．259,ra=0．311,P〈0．05）。测得的重庆地区成人股骨上端的部分参数为设计及改良出符合当地髋部骨折的内固定物提供参考依据。     

Measuring range of active cervical rotation in a position of full head flexion using the 3D Fastrak measurement system: an intra-tester reliability study

Most external assessments of cervical range of motion assess the upper and lower cervical regions simultaneously. This study investigated the within and between days reliability of the clinical method used to bias this movement to the upper cervical region, namely measuring rotation of the head and neck in a position of full cervical flexion. Measurements were made using the Fastrak measurement system and were conducted by one operator. Results indicated high levels of within and between days repeatability (range of ICC2,1 values: 0.85-0.95). The ranges of axial rotation to right and left, measured with the neck positioned in full flexion, were approximately 56% and 50%, respectively of total cervical rotation, which relates well to the proportional division of rotation in the upper and lower cervical regions. These results suggest that this method of measuring rotation would be appropriate for use in subject studies where movement dysfunction is present in the upper cervical region, such as those with cervicogenic headache.