中药内服外洗结合冲击波治疗足底筋膜炎的临床疗效

目的：观察自拟中药方内服外洗结合冲击波治疗足底筋膜炎的临床疗效。方法收集在我院门诊就诊的符合条件足底筋膜炎患者50例,采用自拟四物四藤汤内服外洗结合冲击波治疗,运用VAS评分法及疼痛减轻百分数评定治疗前与治疗后1周、2周、1月的疗效比较。结果治疗前后VAS评分比较（P＜0.05）,组间比较有统计学意义,且前两周效果更明显,总有效率为94.00％,患者满意度为96.00％。结论本治疗方法对足底筋膜炎是有明显疗效的,可以在临床上进一步推广验证。     

针灸联合瓜蒌桂枝汤对脑卒中后上肢屈肘痉挛状态及肌电积分值的影响

目的:探究针灸联合瓜蒌桂枝汤对脑卒中后上肢屈肘痉挛状态及肌电积分的影响。方法:选取2016年11月至2019年1月延安大学附属医院收治的脑卒中后上肢屈肘痉挛患者116例作为研究对象,按照就诊顺序编号随机分为对照组和观察组,每组58例。对照组常规康复训练并口服巴氯芬片,观察组在对照组基础上加用针灸联合瓜蒌桂枝汤治疗,均治疗4周。观察2组治疗前、完成治疗临床痉挛指数(CSI)、改良Barthel指数(MBI)、改良Ashworth量表(MAS)、简式Fugl-meyer运动量表(FMA)、肌电积分值、肌电F波、生命质量并比较;治疗后评估疗效。结果:治疗后2组CSI、MAS较治疗前显著下降,MBI、FMA较治疗前显著升高,差异有统计学意义(P0.05),治疗后观察组MBI、FMA显著高于对照组,CSI、MAS显著低于对照组,差异有统计学意义(P0.05)。治疗后2组肱二头肌、尺侧腕屈肌、三角肌较治疗前显著下降,肱三头肌则显著升高,差异有统计学意义(P0.05)。治疗后观察组肱三头肌显著高于对照组,余均显著低于对照组,差异有统计学意义(P0.05)。治疗后2组肌电F波波幅较治疗前显著下降,阈值较治疗前显著升高,差异有统计学意义(P0.05),治疗后观察组阈值显著高于对照组,波幅显著低于对照组,差异有统计学意义(P0.05)。治疗后2组精力影响、家庭角色、语言功能、活动能力、情绪影响、自理能力较治疗前显著升高,差异有统计学意义(P0.05),治疗后观察组以上指标显著高于对照组,差异有统计学意义(P0.05)。治疗后观察组治疗有效率显著高于对照组,差异有统计学意义(P0.05)。结论:针灸联合瓜蒌桂枝汤能通过改善脑卒中上肢屈肘痉挛肌电,促进血液循环,提高生命质量和疗效。     

The influence of dietary carbohydrate on performance of supramaximal intermittent exercise

Summary The relative contraction force producing a reduction in exercise hyperaemia was studied by superimposing handgrip contraction at different intensities on plantar flexion of low intensity. Ten active women served as subjects. Blood flow to the forearm ( _forearm) and calf ( _calf) was measured with mercury-in-rubber strain gauges by venous occlusion plethysmography immediately after 60 s of rhythmic plantar flexion at 10% of maximum voluntary contraction (MVC), which was expressed as P₁₀H₀, or combined plantar flexion and handgrip contraction. In the combined exercise, handgrip exercise at 30%, 50% or 70% MVC was added to plantar flexion during the last 30 s of exercise (P₁₀H₃₀, P₁₀H₅₀ and P₁₀H₇₀, respectively). The _forearm increases after P₁₀H₃₀, P₁₀H₅₀ and P₁₀ were significantly larger (P<0.01) than that after P₁₀H₀, and the difference between P₁₀H₃₀and P₁₀H₇₀ was also significant (P<0.01) Immediate post-exercise _calf after P₁₀H₀ increased by 7.4 (SEM 0.9) ml·100 ml^–1·min^–1. When handgrip contraction at 70% MVC was added, the _calf increase after exercise [4.5 (SEM 0.7) ml·100 ml^–1·min^–1] was significantly lower than after plantar flexion alone (P<0.05). However, no significant change was found in _calf when the forces of added handgrip contraction were 30% and 50% MVC, although the mean value of _calf increase was lower after P₁₀H₅₀ combined exercise. Calf vascular resistance calculated as / _calf ( mean blood pressure) tended to increase after P₁₀H₇₀ to a nonsignificant extent. Heart rate and oxygen uptake in these exercises increased when handgrip contraction at 30%, 50%, or 70% MVC was added to plantar flexion at 10% MVC. However, the increases were considerably lower than the maximal ones. Thus, a reduction of _calf occurred even when the cardiac demand from the muscle was below its maximum. In conclusion, post-exercise hyperaemia in the active limb working at low intensity was inhibited by superimposition of exercise of another limb at a high contraction force. The critical force producing attenuation of exercise hyperaemia after combined exercise of short duration was found to be higher than 50% MVC in the case of handgrip contraction plus plantar flexion.     

Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances

Magnetic resonance (MR) imaging has emerged as an important noninvasive diagnostic imaging technique for assessment of foot pathology. This modality, owing to its multiplanar imaging capability and inherent superiority in contrast, has been shown to be more accurate and sensitive for detection of plantar fascia pathology than any other imaging method. One of the most important and recognizable causes of heel pain is plantar fasciitis. With the exception of plantar fasciitis, there has been little emphasis on imaging other conditions that affect this important structure. The objective of this review is to demonstrate, from a perspective of MR imaging, the many different pathologic conditions that affect the plantar fascia. Included in this review will be a discussion of normal anatomy as well as entities such as acute plantar fasciitis, chronic plantar fasciitis, traumatic rupture, normal post-surgical changes, pathologic post-fasciotomy conditions, infection, and fibromatosis. Received: 25 January 2000 Revision requested: 21 March 2000 Revision received: 3 April 2000 Accepted: 6 April 2000     

膝关节屈曲挛缩对下肢力线影响的研究及其临床意义

目的：研究、分析膝关节屈曲挛缩对下肢力线的影响。方法：募集47例很少有膝关节不适主诉的自愿者作为本研究对象。其中男性12例，年龄29岁(25～35岁)，女性35例，年龄40岁(16～57岁)。对每例自愿者行左膝的单足站立位X线检查。分别在膝关节伸直位和不同角度的屈曲位同时作正、侧位X线摄片。以立位胫股角(femorotibial angle，FTA)作为本研究中下肢力线的参数。将膝关节伸直位时测得的立位FTA与相应的不同角度屈曲位时测得的立位FTA作比较分析，探讨立体FTA与膝关节屈曲角度之间的相关性。结果：膝关节屈曲位时的立位FTA总是小于相应的伸直位时的立位FTA。随着膝关节屈曲角度的逐渐增大，相应的立位FTA逐渐减小。膝关节屈曲位和伸直位时的立位FTA的差值(△FTA)与膝关节的屈曲角度之间存在着正相关关系。结论：临床常见的一些膝关节手术如胫骨高位截骨和关节置换等，在术前计划时应考虑到膝关节屈曲挛缩对下肢力线的影响，否则将导致截骨过度或截骨不足。     

Stretch-shortening cycle during plantar flexion in young and elderly women and men

The stretch-shortening cycle (SSC) is a combination of eccentric and concentric muscle actions. The purpose of the study was to compare the SSC of four different groups comprising a total of 29 women and 30 men, divided according to sex and age (i.e. 20–40 years and 70–85 years). A KIN-COM dynamometer was used for strength measurements of the plantar flexion of the right foot. An electromyogram (EMG) from the gastroenemius muscle was recorded simultaneously. Maximal voluntary concentric muscle actions at 120° · s^–1 and 240° · s^–1 with and without prior eccentric muscle actions were performed. Average torque values of the range of motion between 90° and 99° of the ankle joint were extracted. All four groups were significantly stronger at 120° · s^–1 than at 240° · s^–1 for pure concentric actions. The average torque values of the concentric phases in the SSC movement were significantly higher than the torque values for pure concentric actions in all four groups and at both velocities. The EMG was significantly lower or unchanged in the SSC movement compared to a pure concentric action in all groups. A larger percentage increase in torque with prior eccentric action was found in young women compared to young men at both velocities. Our results suggested that the enhanced performance was even more marked when a concentric action was preceded by an eccentric action in the young women than in the young men, probably due to better utilization of elastic forces, but we could not demonstrate any age-related differences in enhanced performance with SSC.     

Analysis of plantar pressure in diabetic type 2 subjects with and without neuropathy

Diabetes is a disorder of metabolism—the way our bodies use digested food for growth and energy. The most common form of diabetes is type 2 diabetes. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot. The purpose of this study was to examine the plantar pressure distribution in normal, diabetic type 2 with and without neuropathy subjects. Footscans were obtained using the F-Scan (Tekscan USA) in-shoe pressure measurement system. Various pedobarographic parameters such as the total plantar force, total contact area, peak pressures, percentage medial impulse (PMI), load and power ratio (PR, the ratio of high frequency power to the total power in an image) were evaluated. These parameters were subjected to ANOVA (analysis of variance) test with more than 95% confidence interval giving excellent P-values in all the categories.     

The value of postoperative prosthesis alignment and patellar height measurements on standard X-rays after Total Knee Arthroplasty: Does it relate to knee function after 5 years?

Background

The purpose of this retrospective cohort study was to investigate the influence of parameters of malalignment on knee function 5?years post TKA and, additionally, to explore alterations in patellar height after TKA.