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1.
目的探讨躯干屈伸肌等长与等速向心收缩肌力测试结果的相关性。方法对50例健康受试者分别进行躯干肌屈曲、伸展等长收缩与等速向心收缩肌力测试,将二种方法测试的屈曲、伸展峰力矩(peak torque,PT)和屈曲、伸展峰力矩之比(F/E)进行相关与回归分析。结果躯干屈伸肌等长收缩、等速向心收缩肌力测试中PT值呈显著正相关(r伸=0.827,P=0.000<0.05,r屈=0.873,P=0.000<0.05);等长收缩和等速向心收缩肌力测试获得的屈曲、伸展PT值建立的回归方程式分别为y^=8.158+1.097x和y^=-12.375+0.781x,经检验成立并有统计学意义(P<0.05);而屈曲、伸展峰力矩之比(F/E)无相关性(r=0.18,P=0.208>0.05),二者差异有统计学意义(t=-7.588,P=0.000<0.05)。结论躯干屈伸肌等长收缩肌力测试能准确地反映躯干肌肌力的变化,并且用中立位等长收缩肌力测试的F/E比值反映躯干的稳定性更合理。  相似文献   

2.
<正> 人体躯干从直立位做屈曲运动是由上半身重量的力矩作用产生的,并旦为竖脊肌、臀大肌、臀中肌及腘绳肌的离心收缩所调节。当躯干屈曲到一定角度时,竖脊肌就会出现一个突发的电静息。Allen于1948年首次在健康人身上发现了这一现象。Floyd和Silver后来把其命名为屈曲-放松现象(Flexion-Relaxation Phenomenon,F-R现象)。  相似文献   

3.
目的:研究慢性腰痛(CLBP)患者在站立位矢状面屈伸运动时腰背肌功能状况的变化,揭示其改变的可能机制及临床意义。方法:慢性非特异性腰痛患者25例和健康人25例,在站立位进行躯干的屈曲伸展运动,运用表面肌电图(sEMG)仪和摄像系统同步采集记录双侧L2/3、L4/5水平最长肌、多裂肌在站立位、前屈运动、完全屈曲及回到直立位不同运动时相的sEMG值。结果:两组受试对象站立位时,最长肌及多裂肌均方根(RMS)值差异无显著性意义(P>0.05);前屈运动时,最长肌及多裂肌RMS值增大,完全屈曲时,最长肌及多裂肌RMS值减小,腰痛组在前屈运动和完全屈曲时,最长肌和多裂肌RMS值较健康对照组增大,差异具有显著性意义(P<0.05);由屈曲位回至直立位时,腰痛组最长肌和多裂肌的RMS值明显小于健康对照组,差异具有显著性意义(P<0.05);腰痛组最长肌和多裂肌的屈曲-放松比较健康对照组降低,差异具有显著性意义(P<0.05);运动时相对两组受试对象的最长肌和多裂肌RMS值影响均有显著性意义(P<0.05)。结论:在躯干屈伸运动中,健康人腰背肌存在屈曲-放松现象(FRP),腰痛患者腰背肌功能发生疼痛适应性改变,表现为屈曲-放松反应缺如和主动活动机能不足。  相似文献   

4.
目的:探讨慢性非特异性腰痛的潜在致病原因,为日后治疗慢性腰痛提供临床支持。方法:招募31例慢性非特异性腰痛患者,了解其疼痛程度(NRS)和Oswestry腰背功能障碍指数(ODI),同时收集在30°/s、60°/s和90°/s角速度下躯干屈伸肌群的峰力矩值(PT),并实时记录运动过程中双侧腹直肌和竖直肌的均方根值(RMS)。结果:NRS和ODI呈正相关关系(r=0.817,P=0.045)。30°/s(t=-3.256,P=0.003)、60°/s(t=-3.970,P=0.001)和90°/s(t=-2.722,P=0.011)时屈肌PT明显少于伸肌,比值分别为0.8∶1、0.72∶1、0.81∶1。躯干屈曲和伸展时,肌肉与速度均存在交互效应(P=0.001)。双侧竖直肌的RMS在躯干伸展时随着角速度的加快而出现显著下降:①左侧竖直肌,30°/s时的RMS明显大于90°/s(P=0.001),60°/s时的RMS明显大于90°/s(P=0.048);②右侧竖直肌,30°/s时的RMS明显大于90°/s(P=0.002),60°/s时的RMS明显大于90°/s(P=0.033)。结论:慢性非特异性腰痛患者躯干屈肌和伸肌PT的比值在低速30°/s和60°/s时与正常健康人相似。双侧竖直肌的肌电信号在躯干伸展时随着运动角速度的增加而出现下降趋势。  相似文献   

5.
目的:观察慢性下腰痛患者腰椎曲度与躯干肌肌力的变化,为慢性下腰痛的康复和预防提供依据。方法:选择2004-08/12第二军医大学长海医院康复医学科门诊接诊慢性下腰痛患者36例,均为女性;平均(44.2±3.9)岁;平均体质量(61.9±7.7)kg;平均身高(160.3±5.6)cm。对36例患者分别进行躯干肌屈伸等长收缩肌力测试和腰椎曲度测量,并根据腰椎曲度测量结果分为曲度正常组19例和曲度异常组16例,评价两组间等长收缩肌力测试的屈伸峰力矩及屈、伸峰力矩之比。结果:两组屈、伸峰力矩和屈、伸峰力矩之比值的比较:两组躯干肌等长收缩肌力测试中前屈峰力矩无显著差别(t=0.525,P=0.603>0.05),曲度异常组后伸峰力矩值显著小于曲度正常组[(86.50±10.30),(117.21±23.32)N·m,t=4.875,P=0.000<0.05],曲度异常组前屈和后伸峰力矩之比值显著大于曲度正常组(0.359±0.050,0.286±0.099,t=2.699,P=0.011<0.05)。结论:慢性下腰痛患者躯干肌后伸肌力的显著降低和腰椎曲度的降低可能存在着互为因果的密切关系,加强躯干肌后伸肌力训练和调整腰椎曲度的训练可能会促进慢性下腰痛的康复和预防慢性下腰痛的发生和发展。  相似文献   

6.
目的:观察慢性下腰痛患者腰椎曲度与躯干肌肌力的变化,为慢性下腰痛的康复和预防提供依据.方法:选择2004-08/12第二军医大学长海医院康复医学科门诊接诊慢性下腰痛患者36例,均为女性;平均(44.2&;#177;3.9)岁;平均体质量(61.9&;#177;7.7)kg;平均身高(160.3&;#177;5.6)cm.对36例患者分别进行躯干肌屈伸等长收缩肌力测试和腰椎曲度测量,并根据腰椎曲度测量结果分为曲度正常组19例和曲度异常组16例,评价两组间等长收缩肌力测试的屈伸峰力矩及屈、伸峰力矩之比.结果:两组屈、伸峰力矩和屈、伸峰力矩之比值的比较:两组躯干肌等长收缩肌力测试中前屈峰力矩无显著差别(t=0.525,P=0.603>0.05),曲度异常组后伸峰力矩值显著小于曲度正常组[(86.50&;#177;10.30),(117.21&;#177;23.32)N&;#183;m,t=4.875,P=0.000<0.05],曲度异常组前屈和后伸峰力矩之比值显著大于曲度正常组(0.359&;#177;0.050,0.286&;#177;0.009,t=2.699,P=0.011<0.05).结论:慢性下腰痛患者躯干肌后伸肌力的显著降低和腰椎曲度的降低可能存在着互为因果的密切关系,加强躯干肌后伸肌力训练和调整腰椎曲度的训练可能会促进慢性下腰痛的康复和预防慢性下腰痛的发生和发展.  相似文献   

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目的 观察单侧肘关节僵硬患者在执行腰部屈伸动作时对屈曲-放松现象的影响。 方法 选取20例单侧肘关节僵硬患者纳入观察组,选取相同数量健康成人纳入对照组。要求2组受试者在15 s内完成躯干前屈、保持最大屈曲及躯干伸展3个动作,每个动作均持续5 s。在运动过程中采用表面肌电(sEMG)技术记录2组受试者L3处两侧竖脊肌肌电值,取中间3 s均方根(RMS)平均值并计算2组受试者躯干屈曲/伸展比值以及保持最大屈曲时RMS值,对2组受试者上述sEMG数据进行统计学比较。 结果 单侧肘关节僵硬患者躯干屈曲/伸展比值及保持最大屈曲时RMS值均显著大于对照组水平,组间差异具有统计学意义(均P<0.05);另外僵硬侧屈曲/伸展比值亦显著大于对侧水平,差异具有统计学意义(均P<0.05)。 结论 单侧肘关节僵硬可明显影响患者腰部肌群神经肌肉控制功能,且对僵硬侧肌群的影响明显大于对侧肌群,故针对肘关节僵硬患者的康复干预应同时关注腰部肌肉功能训练,以预防腰痛发生。  相似文献   

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目的 应用表面电极肌电图(EMG)测量膝关节在不同角度做开放链最大等长伸膝时屈膝肌的共同兴奋能力,比较不同角度膝屈伸肌的共同兴奋水平。方法 12名健康在校大学生参与测试。每名受试者在Cybex测试仪上髋关节屈曲90°,单侧膝关节分别于屈膝10,60和90°时各做1组开放链的最大等长伸膝动作。使用表面电极EMG测量每次膝关节伸展时股四头肌与胭绳肌的电信号。在每次伸膝的同时用cy—bex测量股四头肌的最大伸膝力矩。结果所有角度下股四头肌的最大等长收缩均伴胭绳肌的共同兴奋。平均最大伸膝力矩出现在屈膝60°(P〈0.05)。结论膝关节在屈膝60°时可产生最大等长伸膝力矩,开放链的伸膝肌等长收缩伴有屈膝肌的共同兴奋。  相似文献   

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腰痛患者腰活动度、肌力与生活质量的相关回归分析   总被引:8,自引:3,他引:5  
目的:分析等长和等速运动对腰伸肌肌力的相关性,探讨影响腰痛患者生活质量的主要原因。方法:对20例腰痛患者进行髋关节和腰的活动性测量、腰伸肌等长、等速肌力测定和改良的Oswestry腰痛问卷评分,将结果进行相关和回归分析。结果:腰伸肌等长肌力峰值与慢速等速峰力矩和最大做功量显著性正相关,腰痛问卷得分与腰伸肌肌力、腰屈曲范围和双直腿抬高角度之差显著性负相关。腰痛问卷得分的69.0%可以用腰屈曲范围和腰伸肌肌力来预测。结论:腰伸肌等长肌力测定方法简单,可以作为评定腰痛患者肌力的方法。增加腰活动性和腰伸肌肌力的康复训练可以改善腰痛患者的生活质量。  相似文献   

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目的:研究不同角度对躯干肌等长收缩测试的影响,探讨躯干肌等长收缩测试的合理角度参数。方法:32例健康在校男性军人作为受试者,使用美国产BiodexⅡAP型等速测试系统进行躯干肌等长收缩测试,测定其最大平均力矩(MAT)、相对最大平均力矩(MAT/BW)、最大重复做功(MRW)、相对最大重复做功(MRW/BW)、总做功(TW)、平均功率(AP)和最大平均力矩屈伸比值(F/E)等指标,测试角度分别选用后伸15°位、中立0°位和前屈15°位,利用方差分析对结果进行统计学分析。结果:伸展测试时三组间上述所有指标的差异有显著性意义(P<0.05),屈曲测试时上述指标的差异无显著性意义(P>0.05);三组间F/E差异亦有显著性意义(P<0.05)。结论:在躯干肌等长收缩测试中,角度的选择对于伸展测试的结果影响是明显的,而对屈曲测试的结果影响并不明显;中立0°位可作为躯干肌等长收缩测试的推荐角度。  相似文献   

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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.
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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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.
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   

16.
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   

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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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