消炎利胆片治疗飞行员风湿寒性关节痛12例分析

消炎利胆片治疗飞行员风湿寒性关节痛１２例分析宋明超刘登琨杜密关键词（ＫＥＹＷＯＲＤＳ）风湿性关节痛（Ｒｈｅｕｍａｔｉｃａｒｔｈｒａｌｇｉａ）健康状况（Ｈｅａｌｔｈｓｔａｔｕｓ）中国图书资料分类法分类号Ｒ５９３．２１我们用中药消炎利胆片治疗患风湿寒性关...     

运动疗法治疗膝骨关节炎的研究进展

膝骨关节炎是一种以膝关节关节软骨的变性、破坏及骨质增生为特征的慢性关节疾病,临床主要表现为关节疼痛、肿胀、活动受限、肌肉萎缩以及关节畸形,膝骨关节炎发病率高,且治愈困难。运动疗法因适用范围广、不良反应少、疗效显著,国外很早就应用于膝骨关节炎的治疗中,国内运动治疗膝骨关节炎的起步较晚,但近年来仍取得了长足的发展,本文就近年来国内外关于运动疗法治疗膝骨关节炎的进展作一综述。     

膝骨关节炎患者平衡功能下降的影响因素分析

目的 明确膝骨关节炎(knee osteoarthritis,KOA)患者平衡功能下降的主要影响因素.方法 对89例KOA患者进行人口统计学基本信息采集、视觉模拟疼痛评分(visual analogue pain scale,VAS)、患膝关节的影像学分级、稳定极限测试(limits of stability,LOS)及双下肢的反应性测试、位置觉测试和等速肌力测试.结果 以年龄为控制因素,经Pearson偏相关分析发现患膝的VAS评分、反应时间、整体反应时间、复位误差平均值和60°峰力矩与LOS总分密切相关(P<0.05);经多元线性回归分析发现,患膝的复位误差平均值、60°伸肌峰力矩和反应时间是LOS总分的主要影响因素(P<0.01).结论 超重、膝关节疼痛、KOA病程、膝关节影像学分级不是导致KOA患者平衡功能下降的主要影响因素,而因膝关节疼痛导致的下肢肌力下降、本体感觉减退和患膝关节对新刺激做出知觉反应能力的减慢是导致KOA患者平衡功能较之无KOA者更差的疾病自身特征性主要影响因素.     

中西医结合治疗老年膝骨关节炎76例

膝骨关节炎是老年人常见病,不但治疗棘手,而且容易复发。2010年以来,我们采用中西医结合治疗老年膝骨关节炎76例,疗效满意。现分析报告如下。     

针刀联合药物注射治疗膝骨关节炎96例

膝骨关节炎较常见,多表现为膝关节疼痛、肿胀、僵硬及活动受限[1]。2002年以来,我们采用针刀联合药物注射治疗膝骨关节炎96例,疗效满意。现分析报告如下。     

南沙岛礁风湿寒性关节痛的流行病学调查

风湿寒性关节痛(简称风关痛)是寒区的高发病,但在温区也并非少见。我们对守卫在南沙岛礁上的182名指战员进行了风关痛的流行病学调查。182人中首次上礁73人,第2次上礁61人,第3次上礁48人,每次上礁时间多为3～6个月;年龄18～40岁,平均24.8岁;均为     

Characteristics of clinical measurements between biomechanical responders and non-responders to a shoe designed for knee osteoarthritis

PurposeThe purpose of this study was to investigate the characteristics of biomechanical and clinical measurements in relation to the knee adduction moment when wearing a standard shoe and a shoe design for individuals with knee osteoarthritis (Flex-OA).MethodsKinematic and kinetic data were collected from thirty-two healthy individuals (64 knees) using a ten camera motion analysis system and four force plates. Subjects performed 5 walking trials under the two conditions and the magnitude of individuals’ biomechanical responses where explored in relation to the clinical assessment of the Foot Posture Index, hip rotation range, strength of hip rotators, and active ankle-foot motion, all of which have been described as possible compensation mechanisms in knee osteoarthritis.ResultsSignificant reductions in the first peak of the knee adduction moment (KAM) during stance phase (9.3%) were recorded (p < 0.0001). However, despite this difference, 22 of 64 knees showed either no change or an increased KAM, indicating a non-response or negative-response to the Flex-OA shoe. Significant differences were observed between the responder and non-responder subgroups in the hip rotation range ratio (p = 0.044) and the hip rotators strength ratio (p = 0.028).ConclusionSignificant differences were seen in clinical assessments of hip rotation range and hip rotator strength between responders and non-responders using a cut-off of 0.02 Nm/kg change in the KAM.     

Effects of Taichi exercise on knee and ankle proprioception among individuals with knee osteoarthritis

ABSTRACT

The study aimed to investigate the effects of 24 weeks Taichi intervention on knee and ankle proprioception amongst individuals with knee osteoarthritis (KOA). Ninety-two patients with KOA were included in the current study, involving 52 participants in the intervention group and 40 participants in the control group. The intervention group performed Taichi exercise for 24 weeks, the control group accepted the health education lectures. The main outcome of this study was the proprioception of the knee and ankle which was measured by an electric-driven movable frame. Between- and within-group differences were evaluated through the repeated-measurement ANOVA. For the Taichi group, the differences in the changes in ankle proprioception were significant on ankle plantarflexion (p = 0.03), ankle dorsiflexion (p = 0.043), ankle varus (p = 0.019) and knee flexion (p = 0.01) between the baseline and post-test measures. Twenty-four weeks Taichi exercise may improve the ankle and knee proprioception of patients with KOA.     

Effects of strength exercise on the knee and ankle proprioception of individuals with knee osteoarthritis

This study aims to investigate the effects of 8-week strength exercise on knee and ankle proprioception of individuals with knee osteoarthritis (KOA). Forty participants were randomly divided into control and strength exercise groups. Strength exercise group underwent squat training of three times a week for 8 weeks, while control group received an education programme. Threshold for detection of passive movement of knee and ankle joint was tested using an electrically driven movable frame. Between- and within-group differences were evaluated through repeated-measurement analysis of variance. After intervention, passive motion sense in knee flexion of participants in strength exercise group significantly improved (p = 0.033, 95% confidence interval of mean difference: 0.019–1.478) with significant difference between groups. No significant differences of passive motion senses were found in knee extension and ankle between strength exercise and control groups. Eight-week squat training significantly improves the motion sense of knee flexion in patients with KOA.     

Knee contact forces are not altered in early knee osteoarthritis

ObjectiveThis study calculated knee contact forces (KCF) and its relations with knee external knee adduction moments (KAM) and/or flexion moments (KFM) during the stance phase of gait in patients with early osteoarthritis (OA), classified based on early joint degeneration on Magnetic Resonance Imaging (MRI). We aimed at assessing if altered KCF are already present in early structural degeneration.DesignThree-dimensional motion and ground reaction force data in 59 subjects with medial compartment knee OA (N = 23 established OA, N = 16 early OA, N = 20 controls) were used as input for a musculoskeletal model. KAM and KFM, and KCF were estimated using OpenSim software.ResultsNo significant differences were found between controls and subjects with early OA. In early OA patients, KAM significantly explained 69% of the variance associated with the first peaks KCF but only KFM contributed to the second peaks KCF. The multiple correlation, combining KAM and KFM, showed to be higher. However, only 20% of the variance of second peak KCF was explained by both moments in established OA.ConclusionKCF are not increased in patients with early OA, suggesting that knee joint overload is more a consequence of further joint degeneration in more advanced stages of OA. Additionally, our results clearly show that KAM is not sufficient to predict joint loading at the end of the stance, where KFM contributes substantially to the loading, especially in early OA.     

Dynamic knee joint stiffness and contralateral knee joint loading during prolonged walking in patients with unilateral knee osteoarthritis

BackgroundLong duration walking, a commonly recommended treatment option for knee osteoarthritis (OA), may lead to increased knee joint loading.Research questionTo evaluate the effects of prolonged walking on dynamic knee joint stiffness and contralateral knee joint contact forces (KCFs) in individuals with unilateral symptomatic knee OA.MethodsTwenty-six older adults with knee OA completed a 45-minute bout of walking on a treadmill. Dynamic knee joint stiffness, estimated KCFs, measured ground reaction forces (GRFs), and simulated muscle forces were evaluated for both the symptomatic and asymptomatic limbs at 15-minute intervals using repeated measures, analysis of variance (ANOVA).ResultsDynamic knee joint stiffness during the early weight-acceptance phase of gait was significantly higher for the symptomatic limb throughout the 45-minute bout of walking. A significant increase in peak KCFs and simulated muscle forces were also observed during the weight-acceptance phase of gait for both limbs after 30 and 45 min of walking. Additionally, significantly elevated peak KCFs and muscle forces were observed during the late-stance phase of gait for the contralateral asymptomatic limb throughout the 45-minute bout of walking.SignificanceWalking durations of 30 min or greater lead to increased knee joint loading. Additionally, the elevated dynamic knee joint stiffness observed for the symptomatic knee during the weight acceptance phase of gait appears to be unrelated to the knee joint loading profile. Finally, the greater KCFs during the late-stance phase of gait observed for the asymptomatic limb are consistent with previously demonstrated risk factors for OA development and progression.     

TTM对结节性甲状腺病的诊断（附8例分析）

目的：探讨红外线热扫描技术（TTM）对早期结节性甲状腺疾病的临床诊断价值。方法：回顾性分析8例在健康体检人群中由TTM首先发现的结节性甲状腺疾病的热图像。结果：在没有任何临床症状体征的情况下,TTM能独立地早期发现甲状腺区异常热源,并在初步判断热源的良恶性方面表现出一定特征。结论：利用TTM技术为早期诊断结节性甲状腺疾病尤其是甲状腺癌打下基础,有进一步探索的价值。     

膝关节骨性关节炎关节镜诊断治疗

目的:探讨关节镜诊断和治疗膝关节骨性关节炎的临床应用价值。方法:回顾性分析42例(44膝)关节镜诊断和治疗膝关节骨性关节炎的临床特征及镜下发现结果:关节镜诊断膝关节骨性关节炎更准确,具有创伤小、恢复快、并发症少等优点,关节镜下分级与临床表现呈正相关,随访6月~2年3个月,优良率90.9%。结论:关节镜对膝关节骨性关节炎诊断和治疗提供了更全面的信息,有较为肯定的疗效,是治疗膝关节骨性关节炎较为理想的手术方式。     

Immediate effect of Masai Barefoot Technology shoes on knee joint moments in women with knee osteoarthritis

Footwear modification can beneficially alter knee loading in patients with knee osteoarthritis. This study evaluated the effect of Masai Barefoot Technology shoes on reductions in external knee moments in patients with knee osteoarthritis. Three-dimensional motion analysis was used to examine the effect of Masai Barefoot Technology versus control shoes on the knee adduction and flexion moments in 17 women (mean age, 63.6 years) with radiographically confirmed knee osteoarthritis. The lateral and anterior trunk lean values, knee flexion and adduction angles, and ground reaction force were also evaluated. The influence of the original walking pattern on the changes in knee moments with Masai Barefoot Technology shoes was evaluated. The knee flexion moment in early stance was significantly reduced while walking with the Masai Barefoot Technology shoes (0.25 ± 0.14 N m/kg m) as compared with walking with control shoes (0.30 ± 0.19 N m/kg m); whereas the knee adduction moment showed no changes. Masai Barefoot Technology shoes did not increase compensatory lateral and anterior trunk lean. The degree of knee flexion moment in the original walking pattern with control shoes was correlated directly with its reduction when wearing Masai Barefoot Technology shoes by multiple linear regression analysis (adjusted R² = 0.44, P < 0.01). Masai Barefoot Technology shoes reduced the knee flexion moment during walking without increasing the compensatory trunk lean and may therefore reduce external knee loading in women with knee osteoarthritis.     

Clinical gait evaluation of patients with knee osteoarthritis

Knee osteoarthritis (KOA) is the most common osteoarthritis in lower limbs, and gait measurement is important to evaluate walking function of KOA patients before and after treatment. The third generation Intelligent Device for Energy Expenditure and Activity (IDEEA3) is a portable gait analysis system to evaluate gaits. This study is to evaluate the accuracy and reliability of IDEEA3 for gait measurement of KOA patients. Meanwhile, gait differences between KOA patients and healthy subjects are examined. Twelve healthy volunteers were recruited for measurement comparison of gait cycle (GC), cadence, step length, velocity and step counts between a motion analysis system and a high-speed camera (GoPro Hero3). Twenty-three KOA patients were recruited for measurement comparison of former five parameters between GoPro Hero3 and IDEEA3. Paired t-test, Concordance Correlation Coefficient (CCC) and Intraclass Correlation Coefficient (ICC) were used for data analysis. All p-values of paired t-tests for GC, cadence, step length and velocity were greater than 0.05 while all CCC and ICC results were above 0.95. The measurements of GC, cadence, step length, velocity and step counts by motion analysis system are highly consistent with the measurements by GoPro Hero3. The measurements of former parameters by GoPro Hero3 are not statistically different from the measurements by IDEEA3. IDEEA3 can be effectively used for the measurement of GC, cadence, step length, velocity and step counts in KOA patients. The KOA patients walk with longer GC, lower cadence, shorter step length and slower speed compared with healthy subjects in natural speed with flat shoes.     

Accelerometer-based determination of gait variability in older adults with knee osteoarthritis

Knee osteoarthritis (KOA) can affect the spatiotemporal (ST) aspects of gait as well as the variability of select ST parameters based on standard linear measures of variability (e.g., standard deviation (SD) and coefficient of variation). Non-linear measures (e.g., fractal scaling index (FSI) and sample entropy) can be more sensitive to changes in gait variability, and have been used to quantify differences in the stride patterns of patients with Parkinson’s disease and the motion of ACL-deficient knees. However, the effect of KOA on the dynamic complexity of the stride pattern has not been investigated. Therefore, the purpose of this study was to investigate the effect of KOA on gait variability (linear and non-linear measures) in a group of older adults, and to compare these results to a healthy control group. Participants walked for 10 min with a tri-axial accelerometer placed at the lower back. Mean and SDs of stride time and step time as well as the FSI for the entire series of stride times were calculated for each participant. Participants with KOA had significantly greater mean stride time (p = 0.031) and step time (p = 0.024) than control group participants. While stride and step time variability (SD) were greater in the KOA group, the differences were not significant, nor was the difference in the FSI. Low statistical power (β = 0.40 and 0.30 for stride and step time SD, respectively) combined with the confounding effects of walking speed and heterogeneous KOA severity likely prevented significant differences from being found.