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Context

Fatigue is one of the most prevalent symptoms among hemodialysis (HD) patients. To design effective treatments, it is crucial to understand the diurnal pattern of fatigue in this population.

Objectives

The objectives of this study were to assess diurnal changes in fatigue in patients undergoing hemodialysis and their relation with depressive symptoms and to explore whether fatigue may become a classically conditioned response to the hospital environment.

Methods

A prospective, observational study was conducted in 51 HD patients. Subjects repeatedly rated their current fatigue on three different days during one week of hemodialysis treatment to capture changes in momentary fatigue. First, on an HD treatment day, fatigue was measured one hour before and immediately before dialysis, as well as immediately after dialysis and again at 22:00 pm Second, on the postdialysis day and on the seventh weekday (when patients had not received treatment on the previous day), fatigue was measured at the same moments in time as the two measurements before dialysis on the treatment day. Beck Depression Inventory-II and Fatigue Severity Scale were administered to evaluate depressive mood and fatigue severity in daily life.

Results

Fatigue increased as a result of hemodialysis treatment over the entire sample. However, diurnal fatigue patterns differed significantly between individuals high and low in depressive symptoms, with the former being fatigued more constantly throughout the day, and the latter experiencing increases in fatigue due to treatment. Pretreatment fatigue experienced in the hospital environment followed a pattern consistent with the development of a classically conditioned response.

Conclusion

Diurnal fatigue patterns during hemodialysis treatment are associated with depressive symptoms, and classical conditioning may play a role in the experience of pretreatment fatigue.  相似文献   

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Background

Shoulder muscle imbalance is a potential shoulder injury risk factor in athletes performing overhead sports. While normative functional peak strength of concentric external to concentric internal shoulder muscle fatigue data is available, comparisons of functional eccentric external to concentric internal shoulder rotator muscle fatigue resistance, which impacts muscle imbalance throughout the duration of play, have not been studied in this population.

Objectives

To assess fatigue resistance of the internal and external shoulder rotator muscles in female tennis players.

Methods

Fifteen female collegiate tennis players were tested bilaterally for shoulder concentric internal and eccentric external peak torque production throughout 20 maximal repetitions on a Kin-Com isokinetic dynamometer. Twelve t - tests were conducted to evaluate for differences in peak torque, relative fatigue ratios, and functional peak torque ratios between extremities and mode of activation during the first, as well as, last five repetitions that were conducted.

Results

Non-dominant concentric internal and eccentric external peak torque production significantly decreased throughout the twenty repetitions. Neither dominant concentric internal peak torque decrements and eccentric peak torque decrements were not significantly different across the twenty contractions.These changes in peak torque upon subsequent repetitions resulted in relative fatigue ratios of dominant eccentric external rotation that were significantly greater than non-dominant eccentric external rotation. Relative fatigue ratios of dominant concentric internal rotation did not differ from non-dominant concentric internal rotation.

Conclusions

The data suggest that eccentrically activated external shoulder rotator muscles could possibly adapt to overhead activities by becoming more fatigue resistant.  相似文献   

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目的探讨高脂肪食物的摄入和运动对骨骼肌的脂类及糖类代谢的影响特点。方法采用44只体重在60~80g的Wistar雄性小鼠为实验对象,将它们分为标准食物的对照组(N),食高脂肪食物组(F),非运动组(S)和运动组(T)四组。每组各11只小鼠,饲养五周,然后将解剖取出副睾丸脂肪组织,肝藏,比目鱼肌,外侧包括的肌肉,肌腱和血液。进行血液性状,脂肪分辨力,糖原含量,酶的活性进行测定。结果高脂肪食物的摄入和耐力运动训练对ep-itrochlearis肌肉中肌糖原的影响具有显著性(P<0·05,P<0·001)高脂肪食物和耐力训练对副睾丸脂肪组织的脂肪分解表现出显著性差异(P<0·001,P<0·001)。摄入高脂肪食物和耐力训练对epitrochlearis肌肉中氧化酶cs的活性也具有显著性影响(P<0·05,P<0·001);对脂肪酶氧化酶3-HAD活性的影响非常显著(P<0·001)。结论高脂肪食物摄入虽然使骨骼肌肉内糖原含量降低,但可使氧化酶的活性增强,运动训练可使脂肪酸氧化酶的活性显著提高。  相似文献   

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目的探讨强化腹内外斜肌训练对脑卒中偏瘫患者坐位平衡的影响。方法偏瘫患者60例分为治疗组和对照组各30例,对照组按常规治疗,治疗组除常规治疗外,增加腹内外斜肌强化训练。两组治疗前及治疗后1个月分别进行Fugl-Meyer平衡功能评定、肌力评定。结果治疗组治疗后Fugl-Meyer平衡功能评定、腹内外斜肌肌力评定均明显高于对照组(P<0.01)。结论强化腹内外斜肌有助于偏瘫患者坐位平衡功能的恢复。  相似文献   

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不同方位超声束对正常人横纹肌纤维成像影响的实验研究   总被引:1,自引:0,他引:1  
本文描述了不同方位超声束对正常人横纹肌纤维成像影响的实验研究,通过离体正常人横纹肌不同方位超声扫描,结果显示:超声束垂直肌纤维长轴,其声像图表现为高回声;超声束平行于肌纤维长轴,其声像图表现为低回声;造成其声像图不同表现的原因是由于超声束与肌纤维入射角θ大小不同所致。  相似文献   

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Biopsies from vastus lateralis muscle of male patients suffering from chronic ethanol abuse were studied with regard to histochemical reactions of ATP-ase and NADH-diaphorase; enzymatic activities of triosephosphate dehydrogenase (TPD), lactate dehydrogenase (LD), and cytochrome c oxidase (cytox); content of ATP, creatine phosphate, and glycogen; and volume fractions of fat, mitochondria, and fibrillar and extrafibrillar space. The results were compared with those from controls without known abuse of ethanol. The relative numbers of fibers were the same in the two groups, but the size of the fast-twitch-glycolytic (white) fibers was diminished in the alcoholic group. The activities of TPD and LD were diminished in skeletal muscle of the alcoholics. This is most probably caused by the reduced amount of fast-twitch-glycolytic tissue, as there was a good correlation between this amount and the activity of the two enzymes. The activity of cytox was slightly lower in muscle of the alcoholics than in that of the controls. The volume fraction of mitochondria was lower in the alcoholic group than in the control group. Volume fractions of fat and fibrillar and extrafibrillar space were equal in the two groups. No significant differences were found in the amount of glycogen and ATP in the muscle of the two groups. However, the content of creatine phosphate is higher in the alcoholic group than in the control group.  相似文献   

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BackgroundPrevious studies have shown that performing the Nordic hamstring exercise (NHE) with different board slope angles can affect hamstring activation. However, changes in muscle length with different board slopes can alter joint angles leading to the moment arm (MA) at the knee changing during the NHE.PurposeThis study aimed to investigate the influence of changing muscle length on hamstring electromyographic activity during an isometric NHE, while maintaining an equal moment arm.Study DesignA crossover study designMethodsSixteen male volunteers performed two types of conventional NHE, one with knees on the floor (NHE) and one with the legs placed upon an incline slope of a lower leg board (NHEB). To compare between the conventional and inclined NHE, the moment arm at the knee was calculated to be equal by an examiner holding the lower legs at points marked at 77% and 94% of the length of the lower leg. The four sub-groups comprised of: 1) NHE-77%, 2) NHE-94%, 3) NHEB-77%, and 4) NHEB-94%. The hamstring EMG activity was measured at the biceps femoris long head (BFlh) and at the semitendinosus (ST) and related compensatory muscles. The RMS data were normalized as a percentage of the maximum isometric values (normalized EMG [nEMG]). Significant main effects findings were followed up with Tukey’s post-hoc test using SPSS software and statistical significance was set at the p < 0.05 level.ResultsThe BFlh EMG activity values for NHE-77% were significantly higher than those for NHE-94% (p= 0.036) and NHEB-77% (p < 0.001), respectively, while ST during NHE-77% was significantly higher only in NHEB-77% (p < 0.001). In addition, NHEB-94% was significantly greater than NHEB-77% for both BFlh (p < 0.001) and ST (p < 0.001).ConclusionThese results indicate that hamstring electromyographic activity is decreased when the hamstring muscle is lengthened during the Nordic hamstring exercise.Level of Evidence3  相似文献   

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Electrical low-frequency stimulation (LFS) of spinal afferents induces long-term depression (LTD) of nociceptive processing in rodents. LTD and its parameters in man are largely unknown. This study addresses the hypothesis that LTD of spinal nociception and pain in man depends on LFS frequency (0.5, 1, 2 Hz), number of electrical pulses (300, 600, 1200), intensity (relating to pain threshold IP: 1 × IP, 2 × IP, 4 × IP), and on LFS repetition. One hundred and twenty electrophysiological and psychophysical experiments were performed in 29 healthy volunteers. Painful electrical test stimulation (0.125 Hz) and conditioning LFS were applied to right hand dorsum by a concentric electrode. Somatosensory evoked cortical potentials (SEP) were recorded and volunteers rated stimulus intensity. LFS with 0.5, 1, and 2 Hz induced significant reduction of SEP and pain ratings as compared to Control group. Effect on SEP amplitude after 1 Hz LFS preponderated that of 2 Hz stimulation. LTD of SEP and pain perception was induced by noxious LFS with 300–1200 pulses. SEP suppression augmented with increasing number of pulses. LFS with intensities 2 × IP and 4 × IP evoked sustained depression of SEP and pain perception in comparison to Control and 1 × IP LFS. Established LTD after single LFS was amplified by an additional second LFS. Hence this study provides electrophysiological and psychophysical evidence for LTD of spinal nociceptive processing and pain perception in man and indicates appropriate LFS parameters 1 Hz, 1200 pulses and 4 × IP for future studies on human LTD.  相似文献   

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目的研究及观察电刺激生物反馈疗法对盆底功能障碍患者盆底肌力及血清相关指标的影响。方法选取60例盆底功能障碍患者,将其随机分为对照组(盆底肌肉锻炼)30例和观察组(盆底肌肉锻炼联合电刺激生物反馈疗法)30例。比较2组患者治疗前和治疗后1、3及6个月时的盆底Ⅰ类、Ⅱ类纤维肌力及疲劳度、血清RLX、NO及ET-1水平。结果观察组治疗后1、3及6个月时盆底Ⅰ类、Ⅱ类纤维肌力及疲劳度均好于对照组,血清NO高于对照组,血清RLX及ET-1均低于对照组,差异均有统计学意义(P0.05)。结论电刺激生物反馈疗法对盆底功能障碍患者盆底肌力及血清相关指标的影响较大,有助于患者病情的改善。  相似文献   

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目的 探讨骨骼肌急性损伤后24 h内介入运动和按摩对肌卫星细胞激活关键因子胰岛素样生长因子(IGF)-1,以及肌卫星细胞增殖通路丝裂原活化蛋白激酶(MAPK)/丝裂原活化蛋白激酶激酶(MEK)/细胞外调节蛋白激酶(ERK)1/2的影响。 方法 40只SPF级成年雄性Sprague-Dawley大鼠随机分为对照组(A组, n = 8)、模型组(B组, n = 8)、按摩组(C组, n = 8)、跑台运动组(D组, n = 8)和按摩联合跑台运动组(E组, n = 8)。A组不做任何处理,B、C、D、E组用改良打击器制备大鼠腓肠肌急性损伤模型;B组不予任何干预,自然恢复;C组于造模后24 h内介入按摩;D组在造模后24 h内介入跑台运动训练;E组在造模成功后24 h内介入跑台运动和按摩。造模24 h,取动物腓肠肌,HE染色观察其形态;逆转录聚合酶链反应(RT-PCR)检测成肌分化抗原(MyoD1)和肌细胞生成素(MyoG) mRNA,Western blotting检测IGF-1、p-MAPK、p-MEK和p-ERK1/2的表达量。 结果 C组、D组和E组MyoD1 mRNA表达量均高于B组,C组最高;C组、D组和E组MyoG mRNA表达量均低于B组,E组最高(P < 0.05);C组、D组、E组p-MAPK、p-MEK、p-EPK1/2表达量均高于B组( P < 0.05),D组最高( P < 0.05);C组IGF-1较B组升高( P < 0.05),D组较B组降低( P < 0.05)。 结论 在骨骼肌急性损伤后24 h内介入跑台运动和按摩,能各有侧重地通过不同途径激活肌卫星细胞。  相似文献   

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目的:比较不同针灸方法对带状疱疹后遗神经痛发生率的影响。方法:带状疱疹189例随机分为5组。A、B、C、D 4组均给予围针刺阿是穴、电针夹脊、支沟、后溪等穴,B组加用铺棉灸疗法,C组加用火针疗法,先行火针治疗,再进行基础针刺,D组加用叩刺拔罐疗法;E组采用西药盐酸伐昔洛韦胶囊口服治疗,比较各组治疗后随访第30、60、90天带状疱疹后遗神经痛的发生率。结果:5组均治疗10d后,随访30、60和90d各A、B、C、D组后遗神经痛的发生率差异无统计学意义,随访30及60d时A、B、C、D组后遗神经痛发生率明显低于E组(P<0.05)。结论:针灸治疗带状疱疹可显著减少后遗神经痛的发生率,值得临床推广应用。  相似文献   

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目的研究多种消毒方法对义齿石膏模型的消毒效果及尺寸精度的影响。方法50个模型试件共分6组,以清水冲洗作为对照组。每组中的各种不同方法(时间)均设5个试件。分别采用2%戊二醛喷涂后静置20min、2%戊二醛浸泡(20、30、60min)、含氯消毒液消毒喷涂后静置20min,含氯消毒液消毒浸泡(20、30、60min)、紫外线箱照射法及清水冲洗法,对临床污染了细菌的超硬石膏模型进行消毒。在处理前后对模型采样及测量尺寸精度的变化。结果各组的消毒方式对细菌灭活均有效,总有效率达93.3%。喷涂法、紫外线照射法杀菌率达80%,浸泡法杀菌率达100%。2%戊二醛、含氯消毒液(喷涂后静置20min或浸泡20、30min)和紫外线照射消毒处理前后各测量值的形变率均〈0.2%,但是含氯消毒液浸泡消毒60min后,形变率〉0.2%,而且其模型线性长度的测量值与对照组比较有统计学意义(P〈0.05)。结论2%戊二醛、含氯消毒液30min内(喷涂或浸泡)消毒及紫外线照射消毒,不影响修复体制作的精度,可试用于临床。  相似文献   

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Purpose.?To compare the acute effects of functional electrical stimulation (FES) with 15 and 50 Hertz (Hz) frequencies on muscle strength in patients with heart failure with healthy individuals.

Methods.?Twenty-two 61.6?±?1.0 y-old male volunteers were studied: 10 patients with heart failure (functional class II-III) and 12 healthy controls. The isometric muscle peak torque (IMPT) of the quadriceps femoral muscle was measured through a Biodex dynamometer in maximum voluntary contraction (MVC), and under FES of 50?Hz and 15?Hz, which was applied with a 0.4?ms pulse width, 10-s contraction time, 50- s resting time and maximum tolerable intensity.

Results.?The IMPT differed in MVC, 50?Hz and 15?Hz FES both in patients (201.9?±?14, 55.6?±?13 and 42.1?±?12 Newton-metre, respectively; p?<?0.001) and in controls (179.3?±?9, 62.4?±?8 and 52.3?±?7 Newton-metre, respectively; p?<?0.001). There were no differences between the groups. In patients and controls, respectively, the 50?Hz FES corresponded to 27% versus 35% and the 15?Hz to 21% versus 29% of the IMPT generated at the MVC (p?<?0.001).

Discussion.?This result can be attributed to the fact that muscle strength is proportional to the stimulation frequency and to the number of recruited motor units. Thus, the higher the frequency, the greater the motor recruiting, producing increased muscle strength.

Conclusion.?The IMPT generated by acute 50?Hz application of FES is higher than the one generated by 15?Hz, but it is lower than MVC in controls and patients with heart failure.  相似文献   

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【目的】探讨腹腔镜下卵巢囊肿剥离中不同止血方式对卵巢功能影响。【方法】卵巢子宫内膜囊肿患者66例,均行腹腔镜下囊肿剥除术,并将其分成两组:镜下缝合组36例、电凝组30例,观察两组术前、术后6个月性激素雌二醇(E2)、卵泡刺激素(FS H )、黄体生成激素(L H )水平及窦状卵泡数、卵巢功能正常例数及卵巢储备功能下降例数。【结果】术前两组卵巢功能正常率和卵巢储备功能下降率比较差异无统计学意义( P >0.05);术后缝合组卵巢功能正常率83.33%(30/36)显著高于电凝组53.33%(16/30)( P <0.05),而卵巢储备功能下降率16.67%(6/36)显著低于电凝组46.67%(14/30)( P<0.05)。缝合组E2、窦状卵泡数分别为(198.4±24.90)pmol/L、(7.13±2.25)个显著高于电凝组(153.40±16.8)pmo/L、(5.8±0.9)个( P<0.05),而FSH和FSH/LH分别为(10.56±4.56)U/L、2.35±1.26显著低于电凝组(13.72±2.81)U/L、(2.82±0.88)U/L ( P <0.05)。【结论】腹腔镜下卵巢保守性手术中,正确的镜下缝合止血与传统电凝术相比,对卵巢组织损伤更小,可更好地保留其功能。  相似文献   

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