镜像理论指导下的运动联合康复机器人对脑卒中患者手功能恢复的影响

目的 探讨镜像理论指导下的运动联合康复机器人对脑卒中患者手功能恢复的影响。方法 选取2020年1月—2022年1月广州医科大学附属第二医院收治的122例脑卒中手功能障碍患者作为研究对象。以随机数字表法分为对照组、研究组，每组61例。对照组患者给予康复机器人治疗，研究组患者在对照组患者基础上另给予镜像理论指导下的运动。两组患者持续治疗4周后评价疗效。对比两组患者治疗前后手最大握力、捏力及手指总主动活动情况，比较两组患者治疗前后腕关节等速肌力及手屈曲、背伸动作下屈指浅肌、伸指肌的积分肌电值情况，统计两组患者治疗前后上肢功能及日常生活活动功能变化。结果 研究组治疗前后的最大握力、捏力的差值高于对照组（P <0.05）。研究组手指总主动活动度优良率高于对照组（P <0.05）。研究组治疗前后的腕关节屈肌肌群手、腕关节伸肌肌群峰值力矩、最大总用功的差值高于对照组（P <0.05）。研究组治疗前后的手屈曲、手背伸动作下屈指浅肌、伸指肌的积分肌电值的差值高于对照组（P <0.05）。研究组治疗前后Fugl-Meyer运动功能量表、Barthel指数的差值高于对照组（P <...     

Efficacy of mirror therapy on lower limb motor recovery,balance and gait in subacute and chronic stroke: A systematic review

Objective

Mirror therapy (MT) has been proposed to be an effective therapeutic regimen for lower limb stroke rehabilitation. This review is the first to evaluate the efficacy of MT in subacute and chronic stroke for lower-limb motor functions, balance and gait focusing on particular stage of stroke with specific outcome measures.

Methods

According to PRISMA guidelines, all relevant sources were searched from 2005 to 2020 using “PIOD” framework. Search methods included electronic database, hand and citation searching. Screening and quality assessment was performed by two individual reviewers. Data was extracted and synthesised from 10 studies. Thematic analysis was considered, random-effect models were used and pooled analysis was performed using forest plots.

Results

For motor recovery, MT showed statistically significant effects compared to control group using Fugl-Meyer Assessment and Brunnstorm stages as outcome measures (SMD 0.59; 95% CI 0.29 to 0.88; p < 0.0001; I² = 0%). Statistical significant improvement was reported for balance in MT compared to control using Berg Balance Scale and Biodex in pooled analysis (SMD 0.47; 95% CI 0.04 to 0.90; p = 0.03; I² = 0%). When compared with electric stimulation and action-observation training MT showed no signifiant improvement for balance (SMD −0.21; 95% CI −0.91 to 0.50; p = 0.56; I² = 39%). For gait, MT showed statistical and clinical significant improvement compared to control group (SMD 1.13; 95% CI 0.27–2.00; p = 0.01; I² = 84%) and when compared to action-observation training and electrical stimulation, presented statistical improvement using 10-m walk test and Motion Capture system (SMD −0.65; 95% CI −1.15 to −0.15; p = 0.01; I² = 0%).

Conclusion

This review has shown that MT is effective in lower-limb motor recovery, balance and gait in subacute and chronic stroke in patients 18 years or above with no severe cognitive disorder, MMSE score ≥24 and FAC level ≥2. MT could be used for 30 min/day, 5 days/week for 4 weeks, as stand-alone for motor recovery and balance or as an adjunct with electric stimulation for gait for beneficial effects.

     

152例雄激素性脱发患者临床特征分析

分析雄激素脱发（AGA）患者的临床特征。方法 选取2019年12月-2023年2月于泰州市姜 堰区皮肤病防治院毛发病专病门诊就诊的152例AGA患者为研究对象，分析其临床特征及性别特异性。 结果 152例AGA患者中，男64例，女88例；年龄13~49岁，平均年龄（31.25±7.62）岁；有直系亲属家族 史48例（31.58%），其中男24例（37.50%），女24例（27.27%）；不同性别AGA患者直系亲属家族史占 比比较，差异无统计学意义（P ＞0.05）。152例AGA患者脱发程度以轻度脱发为主；不同性别AGA患者 脱发程度比较，差异无统计学意义（P ＞0.05）；152例AGA患者中湿热内蕴型最为常见（40.13%），其 次就是肝郁血瘀型（14.47%）和肝肾不足（12.50%）。152例AGA患者中＞20%的毛干直径变细、无毛 干的毛囊开口、毳毛比例增加占比最高，分别为89.47%、55.26%和51.32%。不同性别AGA患者皮肤（毛 发）镜征象比较，差异无统计学意义（P ＞0.05）。男性AGA患者湿热内蕴、肝肾不足占比高于女性AGA 患者，而肝郁血瘀占比低于女性AGA患者（P ＜0.05）。不同性别AGA患者洗发频率比较，差异无统 计学意义（P ＞0.05）；女性AGA患者有烫染发习惯占比高于男性（P ＜0.05）；男性AGA患者头皮油 性和头发油性占比均高于女性AGA患者（P ＜0.05）；女性患者平均睡眠时间＜8 h占比高于男性AGA患 者（P＜0.05）。结论 AGA患者年龄呈现年轻化趋势，病程短且以轻度脱发为主，与患者遗传、生活方式、 油脂分泌和睡眠时间等因素有关，且具有一定的性别特异性，毛发镜征象和中医辨证分型可指导临床诊疗工 作开展。     

基于折射补偿的水下结构光三维测量系统

针对结构光技术在水下三维测量中的应用,提出了一种基于折射补偿的水下结构光三维测量方法。考虑到水下三维测量时,由于光线在不同介质交界处发生折射,采用平面网格靶标对系统进行陆上标定的结果不能直接应用,必须进行折射补偿,补偿被测物体在CCD摄像机靶面上成像点的像素坐标,按所建立的水下三维测量模型进行测量。通过实验证明,本文的折射补偿方法有效地克服了折射对水下三维测量的影响,实现了水下结构光高精度三维测量。