Symbol of Professionalism

Theorigin[3] ofthenurses’scapisuncertain[4 ] .DuringtheMiddleAgesheadswerekeptcompletelycoveredforprotectionandcleanliness.Manybelievethiswasthebeginningofthetradition[5] andmanybelievetheideacamefromthehabitswornbytheCatholicsistersofSt .VincentdePaul,foundersofmanyhospitalsduringthelate 1 9thcentury .WhenFlorenceNightingalestartedhertrainingschoolin 1 86 0 ,shebeganwearingacapofherowndistinctive[6 ] capdesign[7] .Sincethattime ,eachnursingschoolandteachinghospitalhasitsowndistinc tiveca…     

法令条例著录格式

[标引项顺序号] 发布单位,文号.法令条例名称[文献类型标志].发布日期.如：[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].19900907.[2]中华人民共和国国务院.出版管理条例[S].20011215.[3]国家科委,新闻出版署,第12号令.科学技术期刊期刊管理办法[S].19910701.     

法令条例著录格式

正[标引项顺序号]发布单位,文号.法令条例名称[文献类型标志].发布日期.如:[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].1990-09-07.[2]中华人民共和国国务院.出版管理条例[S].2001-12-15.殙[3]国家科委,新闻出版署,第12号令.科学技术期刊管理办法[S].1991-07-01.     

前列腺淋巴瘤临床病理学特征

累及前列腺的淋巴瘤通常分为原发性和继发性两个类型,其中继发性病例占多数,而前列腺原发性淋巴瘤非常少见.由于发病较少,前列腺淋巴瘤在诊断和治疗上经验有限,往往容易造成混乱,笔者结合相关文献从临床和病理学方面对前列腺淋巴瘤进行简要综述. 到目前为止英文文献报道累及前列腺的淋巴瘤超过165 例[1] ,大宗报道比较少见[2-5] ,多数为个例报道[6-10] .在英文文献中前列腺原发性淋巴瘤的患者分别来自日本,印度[6] ,巴西[7] ,西班牙[8] ,波兰[9] ,法国[10] ,俄罗斯[11] ,美国[12] 等国家和地区.来自中国大陆地区诊断明确的原发性病例报道不足10 例,除一项2 例的研究[13] 之外,其余均为个例报道[14] .     

法令条例著录格式

正[标引项顺序号]发布单位,文号.法令条例名称[文献类型标志].发布日期.如:[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].1990-09-07.[2]中华人民共和国国务院.出版管理条例[S].2001-12-15.殙[3]国家科委,新闻出版署,第12号令.科学技术期刊期刊管理办法[S].1991-07-01.     

文后参考文献著录规则

正论文集【格式】[序号]主要责任者.题名[文献类型标志].出版地:出版者,出版年.【举例】[1]辛希孟.信息技术与信息服务国际研讨会论文集:A集[C].北京:中国社会科学出版社,1994.学位论文【格式】[序号]主要责任者.题名[文献类型标志].出版地:保存者,出版年.【举例】[1]张志祥.间断动力系统的随机扰动及其在守恒律方程中的应用[D].北京:北京大学数学学院,1998.研究报告【格式】[序号]主要责任者     

法令条例著录格式

正[标引项顺序号]发布单位,文号.法令条例名称[文献类型标志].发布日期.如:[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].1990-09-07.[2]中华人民共和国国务院.出版管理条例[S].2001-12-15.[3]国家科委,新闻出版署,第12号令.科学技术期刊期刊管理办法[S].1991-07-01.     

法令条例著录格式

正[标引项顺序号]发布单位,文号.法令条例名称[文献类型标志].发布日期.如:[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].1990-09-07.[2]中华人民共和国国务院.出版管理条例[S].2001-12-15.[3]国家科委,新闻出版署,第12号令.科学技术期刊期刊管理办法[S].1991-07-01.     

法令条例著录格式

正[标引项顺序号]发布单位,文号.法令条例名称[文献类型标志].发布日期.如:[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].1990-09-07.[2]中华人民共和国国务院.出版管理条例[S].2001-12-15.[3]国家科委,新闻出版署,第12号令.科学技术期刊期刊管理办法[S].1991-07-01.     

法令条例著录格式

正[标引项顺序号]发布单位,文号.法令条例名称[文献类型标志].发布日期.如:[1]全国人民代表大会常务委员会.中华人民共和国著作权法[S].1990-09-07.[2]中华人民共和国国务院.出版管理条例[S].2001-12-15.[3]国家科委,新闻出版署,第12号令.科学技术期刊期刊管理办法[S].1991-07-01.     

Proprioception

Although definitions of proprioception may vary, its importance in preventing and rehabilitating athletic injuries remains constant. Proprioception plays a significant role in the afferent-efferent neuromuscular control arc. This control arc is disrupted with joint and soft tissue injury. Restoring proprioception after injury allows the body to maintain stability and orientation during static and dynamic activities. By focusing on aspects of neuromuscular function, such as dynamic joint stability, practitioners can design and study interventions to maximize sport and daily life neuromuscular function. Further research is necessary to elucidate how proprioceptive deficits can be remedied or compensated to improve function and prevent reinjury.     

Implementation of a strength training program for a 5-year-old child with poor body awareness and developmental coordination disorder

BACKGROUND AND PURPOSE: This case report describes how a strength (muscle force-generating capacity) training program was associated with changes in muscle strength, motor function, and proprioceptive position sense in a young child with poor body awareness and a diagnosis of developmental coordination disorder. CASE DESCRIPTION: Assessment of a prekindergarten child referred for physical therapy because of behaviors compatible with poor body awareness revealed muscle weakness, poor performance on the Bruininks-Oseretsky Test of Motor Proficiency, and poor proprioception. Physical therapy testing done when the child was 5 years of age contributed to a pediatrician-assigned diagnosis of developmental coordination disorder. A 12-week strength training program was initiated. OUTCOMES: Improvements were noted in muscle strength, gross motor function, and proprioception. DISCUSSION: Research indicates that muscles provide information about joint position. Evidence suggests that muscle strength gains seen in children are the result of neuromuscular learning and neural adaptations; therefore, a structured strength training program may have contributed to proprioceptive changes in this child.     

Effects of localization and intensity of experimental muscle pain on ankle joint proprioception.

Accurate proprioceptive input is a prerequisite for balance control and coordination of movement. The present study investigated whether experimental muscle pain induced in healthy human subjects disturbed movement sense (detection of movement) or position sense (recognition of a reference position). Muscle pain was produced by infusion of 6% hypertonic saline simultaneously in m. tibialis anterior (TA) and m. soleus (experiment 1), by infusion of 6% hypertonic saline in TA (experiment 2) and by infusion of 9% hypertonic saline in TA (experiment 3). Control measurements were done with infusions of 0.9% isotonic saline. All infusions of 6% and 9% saline produced pain intensities significantly higher than the corresponding control infusions. Only infusion of 6% saline in two muscles (visual analogue scale=4-5) produced an elevation in movement detection thresholds which was significantly higher, compared with before infusion. No other significant changes in movement and position sense were found during the painful or control infusions. Pain of relatively high intensity in two antagonist muscles is necessary to disturb the movement detection threshold. The ability to recognize a reference position is not disturbed by experimentally induced muscle pain. Whether the disturbed movement sense is caused by sensitivity changes in muscle spindle afferents or altered processing of proprioceptive input cannot be answered. The present findings indicate that human ankle proprioception is rather robust to muscle pain.     

本体感觉神经肌肉促进技术对膝骨关节炎患者本体感觉及平衡能力的影响

目的 探讨本体感觉神经肌肉促进（PNF）技术训练对膝骨关节炎（KOA）患者膝关节本体感觉及平衡能力的影响。 方法 选取符合入组标准的KOA患者40例,按随机数字表法分为实验组和对照组,每组20例。实验组接受PNF技术锻炼,包括等张组合、节律性稳定和动态逆转技术;对照组接受规范的患侧股四头肌肌力训练。采用膝关节再成角试验评估本体感觉,采用单腿站立测试（OLS）和5次坐立试验（FTSST）评估患者的平衡能力。 结果 实验组治疗前后的膝关节30°、60°、110°主动成角误差与被动成角误差差异有统计学意义（P<0.05）,对照组治疗前后的膝关节各角度主动成角误差与被动成角误差差异无统计学意义（P>0.05）。治疗后,实验组的膝关节各角度主动成角误差及被动成角误差明显小于对照组治疗后（P<0.05）。实验组治疗后的OLS与FTSST时间亦明显优于组内治疗前（P<0.05）;但对照组治疗后的OLS时间与治疗前相比,差异无统计学意义（P>0.05）,而FTSST时间明显短于组内治疗前（P<0.05）。实验组治疗后的OLS与FTSST时间明显优于对照组治疗后（P<0.05）。 结论 PNF技术可显著改善KOA患者膝关节本体感觉及平衡能力。     

The effects of static friction and backlash on extended physiological proprioception control of a powered prosthesis

In general, externally powered prostheses do not provide proprioceptive feedback and thus require the user to rely on cognitively expensive visual feedback to effectively control the prosthesis. Applying the concept of extended physiological proprioception (EPP) to externally powered prostheses provides direct feedback to the user's proprioceptive system regarding the position, velocity, and forces applied to the prosthesis. However, electric elbows with EPP controllers developed at the Northwestern University Prosthetics Research Laboratory have exhibited unexplained "jerky" behavior in both clinical fittings and bench-top operation. In addition, the development of limit cycles, a specific type of constant-amplitude oscillation, had been observed in bench-top use of these elbows. Backlash and static friction within the EPP system were found to be primarily responsible for the development of limit cycles. Reducing static friction and backlash improved the system's performance. These results suggest that to most effectively implement EPP, prosthesis manufacturers should design prosthetic components that minimize static friction and backlash.     

Neuromuscular training improves knee proprioception in athletes with a history of anterior cruciate ligament reconstruction: A randomized controlled trial

BackgroundAthletes exhibit deficits in knee proprioception following anterior cruciate ligament reconstruction. Neuromuscular training programs improve knee proprioception in uninjured athletes; however, the effects on knee proprioception in athletes who have undergone anterior cruciate ligament reconstruction is not well understood. The purpose of this study was to examine the effects of a neuromuscular training program on knee proprioception in athletes who have returned to sport following anterior cruciate ligament reconstruction.MethodsTwenty-four male athletes, who had undergone anterior cruciate ligament reconstruction within the previous 6–12 months and returned to sport, participated in this randomized controlled trial. Athletes were randomly allocated to an experimental group (n = 12) that took part in an 8-week neuromuscular training program or a control group (n = 12) that simply continued their typical training routine. Knee position sense was assessed at baseline and after the 8-week period (post-testing). One-way analysis of covariance, with baseline performance included as a covariate, was used to compare knee position sense errors for the reconstructed limbs of the experimental and control groups at the post-testing time point.FindingsKnee position sense errors decreased by 51.7% for the experimental group and only 4.4% for the control group over the 8-week period. As a result, the experimental group demonstrated lower knee position sense errors, compared to the control group, at the post-testing time point (P < .001).InterpretationAthletes with a history of anterior cruciate ligament reconstruction may benefit from participation in a neuromuscular training program, even after completing post-operative rehabilitation.     

Evaluation of shoulder proprioception following muscle fatigue

OBJECTIVE: To investigate the effect of shoulder muscle fatigue on glenohumeral proprioception. DESIGN: A repeated proprioception test was performed. BACKGROUND: The role of conditioning and fatigue in sport injuries remains controversial. It has been hypothesized that proprioceptive information plays an important role in joint stabilization and that muscle fatigue may alter proprioceptive ability. However, the effect of shoulder muscle fatigue on glenohumeral proprioception is still controversial. METHODS: Eleven normal subjects (mean age 27.3 years) participated in this study. Proprioception tests (on the dominant shoulder) were performed in which proprioception of the active reproduced and passive reproduced shoulder position was measured using an isokinetic dynamometer and a proprioception testing apparatus, respectively. The speed of active repositioning was at 2 deg/s and passive repositioning was at 0.5 deg/s. The mean value of maximum voluntary contraction and the number of repetitions for muscle fatigue were recorded. Post-fatigue proprioception test was started within 3 min after muscle fatigue. RESULTS: There was no significant difference of shoulder proprioception between pre- and post-fatigue determinations of passive repositioning in shoulder internal rotation, passive repositioning in external rotation and active repositioning in internal rotation. There was a significant difference between pre- and post-fatigue determination of active repositioning in external shoulder rotation (mean degrees: 2.57 (SD 1.02) vs. 4.96 (SD 1.73), P<0.05). CONCLUSION: Shoulder proprioception in active repositioning in external rotation was major affected by muscle mechanoreceptors in the presence of muscle fatigue. RELEVANCE: This study revealed that the shoulder proprioception after muscle fatigue in active repositioning in shoulder external rotation was affected more sensitively by the muscle mechanoreceptors than the joint mechanoreceptors. Increasing resistance of muscle fatigue would increase the shoulder proprioceptive ability.     

Effects of active fatiguing movement versus passive repetitive movement on knee proprioception

Background

Proprioception can be affected by many factors such as age, gender, injury, disease, exercise, and fatigue. To date, the mechanisms or pathways by which fatigue influences proprioception have not been elucidated. Generally, it is accepted that local muscular effects occurred during fatigue state may negatively affect proprioception. Research has indicated that metabolic acidosis resulting from active muscle activities, along with tissue stretching and joint laxity resulting from repetitive joint movements, are likely related to proprioceptive deterioration. So far, little direct evidence or research supports these statements. The purpose of this study was to examine the effects of fatigue exercises (repetitive active movement) and repetitive passive movements on knee proprioception.

Methods

A quasi-experimental design with repeated measure on proprioception following two forms of knee joint movement (repetitive active/passive movement in 120°/s with 60 repetitions over a 10°–100° range) was conducted. Fifteen healthy volunteers underwent two forms of movement intervention in two consecutive days in a counter-balanced manner. Knee joint repositioning errors were measured before and after the movement intervention.

Findings

Study results showed a statistically significant increase in absolute repositioning error following repetitive active movement, but a decrease following repetitive passive movement intervention.

Interpretation

This study concluded that a repetitive passive movement protocol was capable of improving knee joint position sense. Meanwhile, the negative effect from the muscle receptors following the repetitive active movement overwhelmed the positive effect from the repetitive passive movement intervention. It supports the clinical utilization of repetitive passive movement to promote proprioception. This utilization can be implemented for proprioceptive training in sports activities, plus injury prevention and rehabilitation.     

Neuromuscular changes in football players with previous hamstring injury

BackgroundImpact of prior injury on myoelectrical activity of the hamstrings during isokinetic eccentric contractions has received increased literature attention. This cross-sectional study aimed to assess neuromuscular adaptations, namely proprioception, core stability, muscle strength, extensibility and activity, in football players with history of hamstring strain injury.MethodsSeventeen players, 10 with history of hamstring injury and 7 without prior injury underwent isokinetic strength testing, eccentric knee extension at 30 and 120°/s. Myoelectrical activity of bicep femoris and medial hamstrings was calculated at 30, 50 and 100 ms after onset of contraction. Functional tests included core stability, muscle strength, and knee proprioception tests.FindingDifferences were observed between Hamstring Group injured and uninjured and Control Group dominant limbs in the bicep femoris activity at almost all times in both velocities (p < 0.05). Joint position sense error was higher in the injured side compared to uninjured and control dominant limb; additionally there were also differences between injured and uninjured limb in the triple-hop test.InterpretationPreviously injured side showed deficits in bicep femoris myoelectrical activity after onset of contraction during eccentric testing, proprioceptive deficits, and functional asymmetry.     

Aging of the somatosensory system: a translational perspective

Balance in the elderly population is a major concern given the often catastrophic and disabling consequences of fall-related injuries. Structural and functional declines of the somatosensory system occur with aging and potentially contribute to postural instability in older adults. The objectives of this article are: (1) to discuss the evidence regarding age-related anatomical and physiological changes that occur in the peripheral proprioceptive and cutaneous systems, (2) to relate the basic science research to the current evidence regarding clinical changes associated with normal aging, and (3) to review the evidence regarding age-related proprioceptive and cutaneous clinical changes and relate it to research examining balance performance in older adults. The article is organized by an examination of the receptors responsible for activating afferent pathways (muscle spindle, golgi tendon organ, and articular and cutaneous receptors) and the corresponding sensory afferent fibers and neurons. It integrates basic science laboratory findings with clinical evidence suggesting that advanced aging results in a decline in cutaneous sensation and proprioception. The potential relationship between postural instability and sensory impairments in older adults also is discussed. Current laboratory and clinical evidence suggests that aging results in: (1) diverse and nonuniform declines in the morphology and physiological function of the various sensory structures examined, (2) preferential loss of distal large myelinated sensory fibers and receptors, and (3) impaired distal lower-extremity proprioception, vibration and discriminative touch, and balance. These findings provide foundational knowledge that emphasizes the importance of using reliable and valid sensory testing protocols for older adults and the need for further research that clarifies the relationship between sensory impairment and balance.