运动疗法结合阻滞疗法治疗膝关节骨性关节炎

目的：探讨运动疗法结合阻滞疗法对于缓解膝关节骨性关节炎（OA）的疼痛症状及改善其运动功能的效果。方法：40例膝关节OA患者，给予系统功能锻炼。同时进行关节腔内注射透明质酸钠2m1，配合1％利多卡因、强的松龙25mg及VitB12 0．5mg的混合液进行关节周围的痛点阻滞。每周1次。治疗前后采用视觉类比测试法（VAS）及关节活动功能评分。结果：治疗4周后。与治疗前比较，40例患者膝关节VAS和膝关节功能评分均显著下降（P〈0．01），治疗有效率达96．8％，且无不良反应发生。结论：应用运动疔法结合阻滞疗法治疗膝关节OA疗效显著，能有效改善患者膝关节运动功能，提高生存质量。     

A Meta-analysis of Clinical Effects of Low-level Laser Therapy on Temporomandibular Joint Pain

[Purpose] Temporomandibular joint (TMJ) pain is a symptom of TMJ disease. Low-level laser therapy (LLLT) is often used in the clinical treatment of TMJ pain. The aim of this study was to review the effective parameters of LLLT for TMJ pain. [Methods] This study was a systematic review in which electronic databases were searched for the period of January 2005 to January 2010. We selected reports of randomized controlled trials and calculated the effect size (ES) of the pain relief to evaluate the effect of LLLT. [Results] Seven reports are found to meet the inclusion criteria and discussed. Based on the calculation results, the pooled ES was –0.6, indicating a moderate effect of pain relief. In addition, the dosages and treatments with wavelengths of 780 and 830 nm can cause moderate and large pain relief effects. [Conclusion] Use of LLLT on the masticatory muscle or joint capsule for TMJ pain had a moderate analgesic effect. The optimal parameters for LLLT to treat TMJ pain have not been confirmed. However, our results can be a vital clinical reference for clinical physicians in treatment of patients with TMJ pain.Key words: Temporomandibular joint pain, Low-level laser therapy, Analgesic effect     

Unnecessary Dental Treatment of Headache Patients for Temporomandibular Joint Disorders

SYNOPSIS
The charts of 100 consecutive headache clinic patients were reviewed retrospectively to determine the frequency of prior dental treatment for TMJ disorders. Twenty had been treated, but only 4 satisfied our diagnostic criteria for the TMJ pain-dysfunction syndrome. The other 16 satisfied conventional criteria for other headache diagnoses, and none of them had improved with dental treatment. Increased patient awareness of the TMJ syndrome, inappropriate referral by physicians and incorrect diagnosis by dentists all probably led to the unnecessary dental treatment.     

Effect of Treatment Table Height on Shoulder Muscles during Ultrasound Therapy Work

[Purpose] The purpose of this study was to propose a table height that can reduce shoulder muscle fatigue by analyzing and comparing median frequencies of shoulder muscles at different table heights when performing therapeutic ultrasounds work. [Subjects and Methods] The subjects were 63 healthy male adults who were equally and randomly assigned to a standard height group (SHG), a high height group (HHG), and a low height group (LHG). The standard table height was set at the level of the elbow joint when the subjects flexed their elbow while in a sitting position. High height and low height were set 10 cm higher and 10 cm lower, respectively, than the standard height. Muscle fatigue of the upper trapezius, middle deltoid, rhomboid, and infraspinatus of the subjects was measured during ultrasound treatment work at each table height. [Results] Median frequencies of the upper trapezius, middle deltoid, rhomboid, and infraspinatus muscles were significantly lower in the HHG than in to the LHG. [Conclusion] When therapeutic ultrasound is performed using a table that has a height lower than that of the elbow joint, the median frequency of the shoulder muscle increases, hence decreasing muscle fatigue. This way, musculoskeletal pain as a result of performing therapeutic ultrasound can be prevented.Key words: Therapeutic ultrasound, Work environment, Table height     

物理疗法及手法治疗对颞下颌关节紊乱的疗效

目的观察物理疗法及手法治疗对颞下颌关节紊乱(TMD)的疗效。方法TMD患者90 例随机分为药物组(n=30)、理疗组(n=30)、理疗+手法组(n=30)。治疗前及治疗4 周后采用疼痛视觉模拟评分(VAS)、最大张口度、关节弹响程度进行评定。结果治疗后,各组疼痛均明显改善(P<0.01),理疗组还伴有最大张口度明显改善(P<0.01),理疗+手法组患者最大张口度、关节弹响程度显著改善(P<0.001)。治疗后三项评定从优到差顺序均为理疗+手法组、理疗组、药物组。结论理疗结合手法治疗可更有效改善TMD患者关节疼痛、张口受限及关节弹响。     

运动疗法对膝关节骨性关节炎的治疗作用

目的:观察物理因子配合运动疗法治疗膝关节骨性关节炎(OA)的临床效果。方法:72例膝关节OA患者随机分为2组各36例,均给予短波治疗。观察组患者增加膝关节等长收缩训练、渐进抗阻训练等。治疗前后采用疼痛目测类比法(VAS)和膝关节功能评分评定膝关节疼痛程度及功能。结果:治疗1个月后,2组VAS评分明显低于治疗前(P0.05,0.01),且观察组明显低于对照组(P0.05);膝关节功能评分,观察组较治疗前及对照组有明显提高(P0.05)。结论:膝关节OA患者在治疗中增加运动疗法能明显提高临床治疗效果,促进膝关节功能恢复。     

Shear Wave Elastography in the Evaluation of Temporomandibular Joint Disorders

We aimed at verifying the usefulness of shear wave elastography in determining the temporomandibular disc stiffness in patients with a temporomandibular disorders (TMDs). The study included 37 patients with confirmed TMDs and 208 healthy volunteers. Patients presented with significantly greater stiffness of the intermediate zone of the disc (region of interest [ROI] 1) and significantly lower stiffness of its anteriorly displaced portion (ROI 3). A receiver operating characteristics analysis indicated that a decrease in the stiffness in ROI 3 less than 8.667 KPa provided 100% sensitivity, 97.3% specificity, 100% positive predictive value (PPV) and 99.5% negative predictive value (NPV) in distinguishing between patients with TMDs and without. Whereas an increase in ROI 1 stiffness to at least 54.33 KPa provided high specificity and NPV, both the sensitivity and the PPV of this predictor equaled zero. Findings suggest that a decrease in anteriorly dislocated disc stiffness less than 8.667 kPa can accurately identify patients with TMDs.     

Effects of a Home Exercise Program on the Self-report Disability Index and Gait Parameters in Patients with Lumbar Spinal Stenosis

[Purpose] The present study was performed to identify the effect of a home exercise program on the self-reported disability index and gait parameters in patients with lumbar spinal stenosis (LSS). [Methods] Fifteen patients with LSS were enrolled in this study and were trained in a 4-week home exercise program (40 min/day). All patients were evaluated with three self-reported disability indices (Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Spinal Stenosis Scale), and gait parameters were assessed using a GAITRite system before and after the home exercise program. [Results] Patients with LSS showed significant decreases in the self-reported questionnaire scores and pain intensity after the home exercise program. However, the gait parameters did not significantly change. [Conclusion] These findings suggest that home exercise programs can improve self-reported questionnaire scores and decrease pain in patients with LSS.Key words: Lumbar spinal stenosis, Home exercise, Self-reported questionnaires     

颞下颌关节紊乱病的MRI表现与疼痛关系的研究

[目的]研究颞下颌关节紊乱病(TMD)的MRI表现与颞下颌关节疼痛的关系,探讨MRI在TMD诊断和治疗中的价值.[方法]对30例具有疼痛主诉的TMD患者的60侧颞下颌关节(TMJ)行开、闭口冠状位和矢状位T1加权、T2加权和质子加权扫描.[结果]MRI观察到37个疼痛关节中,发现关节盘移位34个(91.9%),关节盘变形33个(89.2%),关节渗液31个(83.8%);23个非疼痛关节中,关节盘移位12个(52.2%),关节盘变形3个(13%),关节渗液1个(4.5%).经统计学分析,疼痛与关节盘移位、变形和关节渗液的出现有关系(P＜0.01).[结论]MRI能清楚显示TMJ关节盘及周围组织变化,能反映TMJ的变化与疼痛的关系,在TMD的诊断和治疗方面均具有重要价值.     

Characteristics of Upper Quadrant Posture of Young Women with Temporomandibular Disorders

[Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk.Key words: Posture, Temporomandibular disorders, Ultrasound-based three-dimensional motion analyser     

两种不同咬合板治疗颞下颌关节紊乱病的临床效果

目的探讨两种不同咬合板治疗颞下颌关节紊乱病的临床效果。方法选取鹤壁市人民医院2017年1月至2018年4月收治的颞下颌关节紊乱病患者42例,按随机数字表法分为A、B 2组:A组21例予以稳定性咬合板治疗,B组21例予以Twin-block咬合板治疗。比较2组治疗效果、不同时间点疼痛、关节弹响及张口度变化情况。结果 2组治疗1、3、6个月后VAS评分较治疗前均显著降低,且A组较同时间点B组降低更为明显,差异均有统计学意义（均P<0.05）;2组治疗1、3、6个月后张口度均较同组治疗前显著增大,且A组较同时间点B组增大更为明显,差异均有统计学意义（均P<0.05）;2组治疗1、3、6个月后关节弹响声均较同组治疗前显著降低,且B组较同时间点A组降低更为明显,差异均有统计学意义（均P<0.05）。结论对颞下颌关节紊乱病患者采用稳定性咬合板和Twin-block咬合板治疗均有较好的治疗效果,稳定性咬合板在缓解关节疼痛和张口受限方面优于Twin-block咬合板,但Twin-block咬合板在改善关节弹响方面效果更显著。     

Evaluation of the Effectiveness of an Aerobic Exercise Program and the Personality Characteristics of Patients with Fibromyalgia Syndrome: A Pilot Study

[Purpose] The aim of this study was to assess the effectiveness of a 6-week aerobic exercise program on pain, physical function, and psychological status, and to evaluate the personality characteristics of fibromyalgia syndrome (FMS) patients. [Subjects and Methods] Fourteen women with FMS were enrolled. They were trained for a 6-week home-based aerobic exercise program. The Fibromyalgia Impact Questionnaire, the Beck Depression Inventory, the visual analog scale of pain and sleep quality were measured at baseline and at the end of week 6. The personality profiles were evaluated using the Minnesota Multiphasic Personality Inventory (MMPI). [Results] After the exercise program, significant improvements were determined in pain, sleep quality, physical function, depression and FMS symptoms compared to baseline. In addition, the hysteria item (71.21±8.84) of the MMPI was significantly higher in FMS. [Conclusion] Our findings indicate that home-based aerobic exercise may be a useful treatment in the management of FMS. Personality characteristics should be considered during the planning process of the treatment of FMS. Personality is a filter between life events and psychological responses. It is defined to be the integration of effective and behavioral patterns. Long-term studies involving larger clinical samples are needed to define the role of personality characteristics in FMS.Key words: Fibromyalgia syndrome, Aerobic exercise, Personality characteristics     

Effects of a Community-based Fall Prevention Exercise Program on Activity Participation

This study was conducted to identify the effects of a fall-prevention exercise program on the participation and static balance of elderly persons in daily life roles. [Subjects] Ten participants over 65 years of age (75.29±2.93) who were healthy community-dwellers (two men and eight women) were recruited. [Methods] The participants exercised three times a week for eight weeks. The exercise program was based on the fitness and mobility exercise (FAME) protocol. The outcome measures were changes in activity participation level and the fall index. [Results] After the exercise, the activity participation level significantly increased, and the fall index significantly decreased. [Conclusion] A fall prevention exercise program can have a positive effect on participation and static balance in older adults.Key words: Exercise, Fall, Participation     

Effect of Stomatognathic Alignment Exercise on Temporomandibular Joint Function and Swallowing Function of Stroke Patients with Limited Mouth Opening

[Purpose] This study investigated the effects of stomatognathic alignment exercise on temporomandibular joint function and swallowing function of stroke patients presenting limited mouth opening. [Subjects] Fourteen subjects with post-stroke hemiparesis presenting limited mouth opening were randomly assigned to either the experimental group or the control group, with 7 subjects in each group. [Methods] Subjects in the experimental group participated in a stomatognathic alignment exercise program that consisted of mobility exercises of the TMJ and neck and postural correction. Main outcome measures were neck mobility, the active maximum range of mouth opening, the craniomandibular index (CMI), and the Mann assessment of swallowing ability (MASA) score. [Results] The changes in the values of the range of mouth opening, CMI, MASA, and all the parameters of neck mobility were significantly different between the groups. Furthermore, post-test values appeared to be significantly different for the range of mouth opening, the craniomandibular index, and the MASA scores between the groups (p>0.05). [Conclusion] Stomatognathic alignment exercise may improve TMJ function and swallowing function of patients with post-stroke hemiparesis.Key words: Exercise therapy, Stroke, Temporomandibular joint     

McKenzie法结合运动疗法及腰椎牵引治疗腰椎间盘突出症

目的：探讨McKenzie法结合运动疗法及牵引治疗腰椎间盘突出症的临床疗效及其力学效应。方法：90例确诊患有该病的患者随机分为2组各45例,A组采用McKenzie法结合运动疗法及牵引,B组采用中医推拿配合中频电疗及牵引治疗。治疗前后均使用日本矫形外科学会（JOA）下背痛评分标准评分,并进行疗效评价。结果：治疗前2组患者JOA下背痛评分差异无统计学意义;治疗20d后2组JOA评分与治疗前比较均有提高（P〈0．01）,2组间比较,A组明显高于B组（P＜0．05）。临床疗效比较,A组痊愈率及总有效率均明显高于B组（P〈0．05）。结论：McKenzie法结合运动疗法及腰椎牵引治疗腰椎间盘突出症能显著提高康复疗效。     

旋磁穴位疗法对颞下颌关节紊乱病患者疼痛及Fricton指数的影响

目的探讨旋磁对颞下颌关节紊乱病患者的疼痛指数及Fricton指数的影响。方法采集解放军总医院门诊确诊为颞下颌关节紊乱病(TMD)、符合入选标准的患者65例,随机分为两组：观察组(35例)采用XZC-A型旋转磁疗仪在患侧的下关、听宫、颊车、翳风及阿是穴进行治疗,10 min/穴/次,2次/d,10 d为1个疗程。对照组(30例)采用超短波治疗,15～20 min/次,1次/d,10 d为1个疗程。治疗1个疗程前、后分别对患者进行视觉模拟评分法(VAS)疼痛评分和Fricton指数评定。结果1个疗程治疗后,两组患者的VAS疼痛评分及Fricton指数均下降(P<0-05),其中观察组效果优于对照组(P<0-05)。结论旋磁穴位疗法能有效缓解TMD患者的疼痛和颞下颌关节功能障碍等临床症状。     

聚焦超声治疗外阴上皮内非瘤样病变的有效性研究

目的评价超声治疗外阴上皮内非瘤样病变的临床疗效。方法根据随机化数字表按2：1的比例，将经病理确诊的90例外阴上皮内非瘤样病变患者随机分为超声治疗组（60例）和光谱治疗对照组（30例），于治疗后6个月评价两组的近期疗效和复发率。结果超声治疗组临床治愈29例，显效25例，好转6例，复发5例；光谱治疗组临床治愈1例，显效6例，好转19例，无效4例，复发21例。超声治疗组疗效优秀于对照组（Z=6.191．P=0.000），且复发率更低（X^2=-37.02，P=0.000），差异均有统计学意义。结论超声是目前治疗外阴上皮内非瘤样病变的一种有效方法。     

The Effects of a Balance Exercise Program for Enhancement of Gait Function on Temporal and Spatial Gait Parameters in Young People with Intellectual Disabilities

[Purpose] The aim of the study was to assess the effect of an 8-week balance exercise program for enhancement of gait function on temporal and spatial parameters of school aged children with intellectual disabilities. [Subjects] Forty young people with intellectual disabilities were assigned either to the balance exercise program for enhancement of gait function group (BG group, n=19) or the control group (n=21). [Methods] The BG group attended an 8-week balance exercise program for enhancement of gait function consisting of two sessions a week. Gait was assessed using temporal and spatial parameters. [Results] The balance exercise program resulted in significant improvements in participant performance in temporal and spatial parameters. [Conclusion] A balance exercise program for enhancement of gait function can be an effective intervention for improving functional outcomes and can be recommended as an alternative mode of physical activity programming for improving balance and gait.Key words: Balance exercise, Gait, Intellectual disability     

Influence of ROM Exercise on the Joint Components during Immobilization

[Purpose] The aim of this study was to clarify the effects of the ROM exercise on joint components according to histopathological analysis. [Subjects and Methods] In total, twenty-six 9-week-old adult male Wistar rats were used in this study. The rats were randomly divided into three groups, the immobilization group (n=10), exercise group (n=10), and control group (n=6). The immobilization group and exercise group were anaesthetized and operated on under sterile conditions. The right knee joints in the immobilization group and exercise group were immobilized with external fixation at 120 degrees of flexion. Range of motion exercise was started from the day after immobilization. ROM exercise was performed in the exercise group once a day for 3 minutes, 6 days a week, for 2 weeks. [Result] The joint capsule in the immobilization group and exercise group showed narrowing of the collagen bundles in interstitial spaces but was less dense in the control group. In the immobilized group, a hyperplastic reaction was associated with infiltration into the articular cavity and adhesion to the surface of the articular cartilage. Conversely, in the exercise group, hyperplasia of tissue was localized to the synovial membrane. [Conclusion] This finding may suggest that ROM exercise induces some changes within the joint components and tissue metabolism.Key words: Joint immobilization, Contracture, ROM exercise