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1.
背景:步态分析在人体运动系统和神经系统疾病的病因分析,诊断,功能、疗效与残疾评定中是重要的评价手段,其中肌肉活动是影响步行动力的基础因素.目的:分析人体自然行走过程中下肢前后肌群的表面肌电变化,分析对应于步态周期不同时相前后肌群的表面肌电特征和机制.方法:采用德国zebris FDM 步态分析系统(6 m)配套的同步肌电仪采集7例健康人正常步态过程中下肢胫骨前肌和腓肠肌外侧表面肌电信号,利用Matlab软件进行消噪和归一化,得到完整步态周期不同时相对应的表面肌电信号图,观察其峰值变化.采用芬兰ME6000肌电仪测试15 m自由行走人体左右侧下肢胫骨前肌和腓肠肌外侧表面肌电信号,提取时域和频域特征参数.结果与结论:下肢胫骨前肌和腓肠肌外侧表面肌电信号在一个完整步态周期中呈特征性变化,即胫骨前肌表面肌电的峰值发生在后跟着地处,而腓肠肌外侧其峰值发生在中后支撑相处.进一步分析发现,人体在自由行走时其下肢肌肉优势侧与非优势侧差异有显著性意义(P<0.05),且不同肌肉其差异趋势不同.  相似文献   

2.
目的:探讨一种便携式步态分析系统在时空参数、多关节角度值的信度。方法:选取30例健康青年,由2名评估者进行便携式步态分析,记录步频、步幅、步速、步长等时空参数和行走时矢状面、水平面和冠状面各关节活动角度的最大值,采用相关系数进行重测信度和测量者间信度的比较,评估其测量信度。结果:时空参数、矢状面最大角度值组内相关系数(ICC)均0.75,信度良好;水平面、冠状面最大角度值ICC无显著性差异或信度差。结论:该便携式步态分析系统分析时空参数、矢状面最大角度值信度良好,可良好地反映步行功能,有较好的评估价值;水平面及冠状面关节角度值信度较低,应用时需谨慎。  相似文献   

3.
目的研究智能假肢具有对不同路况适应性的必要性和实现这种功能的关键技术。方法通过人体在不同路况下步行时的步态分析实验数据和所建立的下肢运动的动力学模型 ,得到膝关节力矩函数 ,在自行研制的智能膝上假肢系统中进行实验验证。提出根据大腿肌电信号特征进行路况辨识的智能假肢方法 ,并对上、下坡时部分肌肉肌电信号进行检测。结果在不同路况下 ,膝关节力矩有较大变化 ;上、下坡时部分肌肉肌电信号有明显不同。结论根据肌电信号特征进行路况辨识是可行的 ,所研究的智能假肢系统能实现对小腿运动规律和踝关节运动轨迹的控制 ,达到比较理想的结果。  相似文献   

4.
目的:观察健康人在步行过程中下肢运动学、动力学、地面反作用力以及表面肌电信号的重测信度。方法:采用VICON (NEXUS 1.8.5)三维步态分析系统及NORAXON无线表面肌电图测试13名健康人步行过程中下肢运动学、动力学、地面反作用力以及表面肌电信号的重测信度。采用组内相关系数(ICC)及测量标准误(SEM)比较两次测试结果的相对信度与绝对信度。结果:步行过程中步速、下肢运动学、动力学、地面反作用力以及表面肌电信号均具有良好的重测信度ICC 0.78~0.96,运动学参数测量标准误SEM%为4.18~15.6,动力学参数SEM%为3.31~21.82,地面反作用力SEM%为1.70~16.67,表面肌电信号SEM%为8.00~11.11。结论:三维步态分析系统结合表面肌电图可用于评估步行时下肢运动学、动力学、地面反作用力以及表面肌电信号,且具有良好的重测信度。  相似文献   

5.
背景:近年来兴起的三维运动解析技术,可获得多项行走过程中的生物力学参数,代表了目前步态生物力学研究的先进水平.目前该技术在国外开展较多,而国内则较少.国内有限的研究主要集中在对偏瘫患侧下肢矢状面上运动的分析.目的:对偏瘫患者步行运动进行三维立体运动学分析,与正常步态对比,分析脑卒中偏瘫步态的运动学变化特征.方法:运用三维运动解析系统,对10例首发缺血性脑卒中偏瘫患者进行步态分析,以10例健康者作为对照.检测健康对照组步行过程中的基本时空参数、步态周期参数与骨盆三维运动角度参数,并对其运动过程中的对称性进行分析.检测两组下肢髋、膝、踝关节的三维运动学角度参数,对比两组下肢关节运动在矢状面、横断面与冠状面上的变化特征.结果与结论:偏瘫步态表现出下肢运动膝关节屈曲受限,膝关节活动度减小.髋关节内收、旋内不足,外展与旋外角度增大.提示三维运动解析系统测试可测定偏瘫患者步行功能,定量评价偏瘫患者下肢关节运动变化,从而进行相应针对性的稳定性与协调性训练.  相似文献   

6.
正常青年人自然步态下肢肌的表面肌电图分析   总被引:2,自引:0,他引:2  
背景:肌肉的生物电活动是人体的能动部分,可反映人体运动的功能。目的:观察和分析正常青年人在自然步态中下肢肌肉的表面肌电活动。方法:采用美国NORAXON公司生产的TELEMYO2400RG2表面肌电图仪对30例正常青年人在平地自然行走时,其双下肢股直肌、胫前肌、股二头肌和腓肠肌内侧进行测试,分析在正常步态中受试肌群表面肌电信号的变化规律。结果与结论:正常青年人平地自然步行中,其双下肢股直肌、胫前肌、股二头肌和腓肠肌内侧的肌电随步态周期呈活动与静止周期性变化,左右侧同名肌肉交替活动;平均肌电振幅、平均肌电积分、平均频率、中位频率值最大的是腓肠肌内侧,其余由大到小依次是胫前肌,股二头肌,股直肌,右左腿分布规律一致;右侧腓肠肌内侧平均肌电振幅、平均频率、中位频率值均明显低于左侧(P<0.05);受试肌的时域、频域值波动在一定范围。提示正常青年人自然步态中下肢肌群肌电活动呈节律性和右左侧交替活动;在受试肌中腓肠肌内侧的肌电活动最强;腓肠肌内侧的肌电活动存在着优势侧与非优势侧的轻度差别;下肢肌肌电活动的时域、频域值在一定范围波动。  相似文献   

7.
表面肌电信号的分析和特征提取   总被引:1,自引:0,他引:1  
背景:表面肌电信号的检测与分析对临床诊断人体功能状况以及患者康复具有重要意义.目的:对表面肌电信号的采集、信号处理、特征分析和特征值提取方面进行分析.方法;在人体屈伸肘部的过程中,选取人体上肢4块肌肉(肱三头肌,肘肌,肱二头肌,肱桡肌)分别检测表面肌电信号,对表面肌电信号进行陷波和带通滤波等预处理(优化).在此基础上分析表面肌电信号的特征,并应用不同的特征值提取方法对优化后的表面肌电信号进行了特征提取.结果与结论:时域方法最早应用于肌电信号分析,易提取、方法简单;频域方法提取的特征值较稳定,使得频域方法成为肌电信号处理技术的主流;以小波变换为代表的时-频分析方法因结合了时域、频域两方法的特性,在肌电信号分析方面颇有潜力.  相似文献   

8.
目的:探讨脑卒中偏瘫步态的时空参数与骨盆的运动学变化特征,从而为其康复治疗提供有价值的依据。方法:运用三维运动解析系统,对符合纳入标准的10例缺血性脑卒中偏瘫步态者进行步态分析,与其基本情况相匹配的健康者10例作为对照。评价两组间在时-空参数、步态周期方面的差异及偏瘫步态者骨盆运动在矢状面、横断面与冠状面上的运动变化特征。结果:脑卒中偏瘫步态者步行速度减慢,步频降低,步宽加大,步长缩短,且健侧步长缩短更为明显。患侧双支撑期在步态周期中所占的比例增加,单支撑期所占的比例减少。健侧支撑期、双支撑期在步态周期中所占的比例增加,摆动期所占的比例减少,健侧在步行中起代偿作用。偏瘫步态骨盆运动表现为骨盆横断面上的旋转度增加和矢状面上倾斜度的增加。结论:三维运动解析系统测试可定量评价与分析偏瘫患者步行功能,定量评价偏瘫患者骨盆运动变化,从而有益于治疗计划的制定。  相似文献   

9.
不同路况下的人体步态微机检测   总被引:1,自引:0,他引:1  
张瑞红  王人成 《现代康复》2000,4(5):664-665
步态分析是下肢康复评价中的一个重要方面,步态检测是步态分析的前提,中介绍了一种基于普通摄像机的人体步态微机检测系统,给出了不同路况下步态检测实验结果。并提出了应注意的问题。  相似文献   

10.
低成本实现人体运动图像实时检测   总被引:10,自引:0,他引:10  
王人成  黄昌华 《现代康复》2000,4(5):662-663
概述了人体运动检测技术的研究与进展;介绍了一种利用图像动态采集与自动识别跟踪技术实现运动图像在线检测分析方法;采用该方法的人体运动图像分析系统硬件造用通用产品,成本低、性能可靠、维护与升级容易。这种系统可以用于步态分析、假肢性能评定等方面。  相似文献   

11.
Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.  相似文献   

12.
Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.  相似文献   

13.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

14.
目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4%(55/72)]明显高于成功组[31.7%(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3%(42/72)]高于成功组[38.1% (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9% (28/72)]高于成功组[23.8%(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大<6 cm、胎头位于坐骨棘上及宫口开大8~10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1%(44/72)]高于成功组[38.9%(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2%(52/72)]明显高于成功组[34.1 %(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.  相似文献   

15.
ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.  相似文献   

16.
The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

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18.
目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

19.
Ranganath C  Heller AS  Wilding EL 《NeuroImage》2007,35(4):1663-1673
Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.  相似文献   

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