凝视手机对青年女性行走时足底压力及下肢表面肌电的影响

目的:探讨凝视手机对青年女性行走时足底压力及下肢表面肌电的影响。方法:运用Footscan高频足底压力测试系统和BTS FREEEMG300型号的32导无线表面肌电系统对16名青年女性正常行走与凝视手机行走进行测量,比较两种状态步行过程中步长、跨步长、步宽,足底各区域压力峰值、接触面积、冲量、足着地过程时相及均方根振幅等指标的变化。结果:青年女性凝视手机行走改变了正常行走步态特征,主要表现在步长变短、步宽变小(P<0.05)、前掌接触阶段和整足接触阶段所占支撑期的百分比增加(P<0.05);低头凝视手机行走时足底第3跖骨、第4跖骨和足跟外侧区域的峰值压力高,与地面接触面积大(P<0.05));与正常行走相比,凝视手机行走足底第3跖骨、第2跖骨、第1跖骨所受冲量较大(P<0.05);凝视手机行走步态周期不同时相的下肢各肌肉参与程度较低。结论:凝视手机行走使用了更为谨慎的步态;凝视手机行走容易导致足底出现疲劳和损伤;凝视手机行走时神经肌肉的控制程度减弱。     

术前下肢肌肉锻炼对改善闭合性胫骨干骨折预后的影响及患者腓肠肌平均肌电值变化

目的 探索术前下肢肌肉锻炼对改善闭合性胫骨干骨折预后的效果并同时基于可穿戴式表面肌电技术(sEMG)监测患者平均肌电值(AEMG)变化。方法 前瞻性选择2021年5月—2023年1月因胫骨干骨折于惠州市中心人民医院行髓内钉内固定手术治疗的60例患者作为研究对象。随机分为研究组(n=30)和对照组(n=30)。研究组男性22例,女性8例;年龄38～59岁,平均45.8岁;对照组患者男性21例,女性9例;年龄40～58岁,平均44.9岁。道路交通伤35例,重物砸伤17例,高处坠落伤8例。两组患者在入院后均接受可穿戴式sEMG测量术前术后小腿肌群等长收缩时腓肠肌的AEMG,研究组患者进行术前踝泵运动,对照组不进行术前锻炼。对比两组患者术前,术后1、3、7 d VAS;术后住院期间下肢静脉血栓形成风险;远期功能恢复情况,包括完全负重活动时间、膝关节伸屈活动度(ROM)、踝关节伸-跖屈ROM、Johner-Wruhs评分、胫骨对位情况及两侧胫骨长度差;同时根据患者的可穿戴式sEMG的记录情况,记录骨折后(术前)1、3、5 d,以及术后1、3d、1周、1、3、6个月时腓肠肌的AEMG水平。结果 随...     

模拟长航时飞行对骨盆周围肌肉肌电活动和下背部主观疼痛等级的影响

目的 研究模拟长航时飞行对受试者骨盆周围肌肉肌电活动和下背部主观疼痛等级的影响,探讨肌肉功能失衡是否为引起下背痛的原因,为改善相关肌肉功能预防和治疗长航时飞行引发的下背痛问题提供理论依据.方法 16名男性受试者分为2组,对照组8人,未经历过下背痛;背痛组8人,有或曾经有过3个月以上下背痛史.受试者完成4h模拟长航时飞行...     

Examining the Degree of Pain Reduction Using a Multielement Exercise Model with a Conventional Training Shoe Versus an Ultraflexible Training Shoe for Treating Plantar Fasciitis

Abstract

Plantar fasciitis is a common injury to the plantar aponeurosis, manifesting as pain surrounding its proximal insertion at the medial calcaneal tubercle. Pain is typically worse in the morning when getting out of bed, and may subside after the tissue is sufficiently warmed up. For running-based athletes and individuals who spend prolonged periods of time on their feet at work, plantar fasciitis may become recalcitrant to conservative treatments such as ice, rest, and anti-inflammatory medication. Exercise-based therapies have received only limited attention in the literature for this common problem, yet they are becoming increasingly validated for pain relief and positive tissue remodeling at other sites of similar soft-tissue overuse injury. This study reports on pain outcomes in individuals experiencing chronic plantar fasciitis whiles wearing a shoe with an ultraflexible midsole (Nike Free 5.0) (FREE) versus a conventional training (CON) shoe in a 12-week multielement exercise regimen, and after a 6-month follow-up. Adults with ≥ 6-month history of painful heel pain were recruited and randomly assigned to wear 1 of the 2 shoes. All subjects completed the same exercise protocol. A visual analogue scale item tracked peak pain in the preceding 24 hours taken at baseline, 6- and 12-week points, and at the 6-month follow-up. Twenty-one subjects completed the program (9 FREE; 12 CON). Both groups reported significant improvements in pain by the 6-month follow-up, and the FREE group reported an overall reduced level of pain throughout the study as a result of lower mean pain scores at the midpoint and post-test compared with the CON group. The exercise regimen employed in this study appears to reduce pain associated with chronic plantar fasciitis, and in doing so, the Nike 5.0 shoe may result in reductions in pain earlier than conventional running shoes.     

Comparison of regional lower limb glucose metabolism in older adults during walking

Glucose metabolism in lower limb muscles during walking has an important role in gait efficiency and endurance. The purpose of this study was to identify differences in muscle activity during walking between healthy young and older adults using positron emission tomography (PET) and [¹⁸F]fluorodeoxyglucose (FDG). Ten healthy young men (24 ± 2 years) and 10 healthy older men (76 ± 2 years) participated in this study. An FDG PET assessment of each subject was conducted after 50 min of treadmill walking. The images of glucose metabolism in 18 regions of interest were estimated from the standardized uptake value (SUV). The older adults showed a significantly higher FDG uptake in the semitendinosus, biceps femoris, iliacus, gluteus minimus, gluteus medius, and gluteus maximus muscles than the young adults: FDG uptake ratios of SUV in the old to SUV in the young were 3.02, 3.19, 1.66, 1.64, 3.68, and 3.05, respectively. During walking, the FDG uptake in older adults was higher in hamstrings and deep layer hip muscles than that in young adults. These results suggest that intervention to facilitate efficient muscle activity during walking should be practiced to improve gait endurance in older adults with impaired walking patterns.     

正常成人主肺动脉的HRCT测量及其意义

目的：探讨通过正常成人主肺动脉的ＨＲＣＴ测量诊断肺动脉高压与否的可能性。方法：连续测量２００例正常成人主肺动脉直径（外径）并计算其与同一层面降主动脉直径（外径）的比值,另外采用相同方法测量１１例６０～７８岁一组已经ＣＴ与彩色Ｄｏｐｐｌｅｒ证实的ＣＯＰＤ患者主肺动脉直径及与降主动脉直径的比值并与正常组比较。结果：正常成人不同年龄,不同性别主肺动脉直径不同并有随年龄增长而增大的趋势（Ｐ＜０．０５）,但其比值与年龄有关（Ｐ＜０．０５）与性别无关（Ｐ＞０．０５）,其比值与ＣＯＰＤ患者的比值比较存在显著差异（Ｐ＜０．０１）。结论：正常成人不同年龄组主肺动脉与降主动脉的比值可作为判断肺动脉高压与否的简单、敏感的指标     

Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review

The purpose of this study was to present a systematic overview of published reports on the incidence and associated potential risk factors of lower extremity running injuries in long distance runners. An electronic database search was conducted using the PubMed-Medline database. Two observers independently assessed the quality of the studies and a best evidence synthesis was used to summarise the results. The incidence of lower extremity running injuries ranged from 19.4% to 79.3%. The predominant site of these injuries was the knee. There was strong evidence that a long training distance per week in male runners and a history of previous injuries were risk factors for injuries, and that an increase in training distance per week was a protective factor for knee injuries.     

能谱CT最佳单能量图提高下肢动脉造影成像质量研究

目的 探讨能谱CT最佳单能量图对提高下肢动脉造影成像质量的应用价值.方法 前瞻性连续选取符合纳入标准的34例下肢动脉硬化闭塞症(LEAOD)患者,其中17例为研究组,接受宝石CT能谱模式扫描检查;另17例为对照组,接受64排螺旋CT扫描检查.通过计算获得研究组扫描图像中最佳单能量图,分别测量两组图像中髂总动脉、股浅动脉、腘动脉及胫前动脉中段平面CT值及背景噪声(BN)值,计算出相应对比噪声比(CNR),以此对图像质量进行客观评价;同时2名资深影像诊断医师采用双盲法对两组图像质量作5分制主观评分.结果 客观评价显示,研究组最佳单能量图能量水平集中在58～67 KeV,图像中髂总动脉、股浅动脉、腘动脉及胫前动脉CT值及CNR均明显高于对照组,其中CT值分别提高17.6％,12.2％,12.3％,35.2％,差异有统计学意义(t=2.818,1.636,1.119,2.907,P＜0.01):CNR分别提高44.3％,40.8％,59.5％,105.8％,差异有统计学意义(t=3.729,4.686,4.294,5.213,P＜0.01).主观评价显示,研究组、对照组图像质量评分在医师1分别为82分,69分,医师2分别为81分,68分,两组差异均有统计学意义(P＜0.01);2名医师对图像质量评估一致性较好(K=0.85).结论 下肢动脉CTA检查中,宝石能谱CT最佳单能量图显示狭窄段血管、远端小血管及去除硬化伪影能力较64排螺旋CT有明显提高,对下肢动脉腔内成形术术前和术后评估具有重要临床意义.     

The effects of increased forward trunk lean during stair ascent on hip adduction and internal rotation in asymptomatic females

BackgroundIncreased hip adduction and internal rotation can lead to excessive patellofemoral joint stress and contribute to patellofemoral pain development. The gluteus maximus acts as a hip extensor, abductor, and external rotator. Improving hip extensor use by increasing one’s forward trunk lean in the sagittal plane may improve frontal and transverse plane hip kinematics during stair ascent.Research questionDoes increasing forward trunk lean during stair ascent affect peak hip adduction and internal rotation?MethodsTwenty asymptomatic females performed five stair ascent trials (96 steps/min) on an instrumented stair using their self-selected and forward trunk lean postures. Three-dimensional kinematics (200 Hz) and kinetics (2000 Hz) were recorded during the stance phase of stair ascent. Biomechanical dependent variables were calculated during the stance phase of stair ascent and included peak forward trunk lean, hip flexion, hip adduction, hip internal rotation angles, and the average hip extensor moment.ResultsDuring the forward trunk lean condition, decreases were observed for peak hip adduction (MD = 2.8˚; 95% CI = 1.9, 3.8; p < 0.001) and peak hip internal rotation (MD = 1.1˚; 95% CI = 0.1, 2.2; p = 0.04). In contrast, increases were observed during the forward trunk lean condition for the peak forward trunk lean angle (MD = −34.7˚; 95% CI = −39.1, −30.3; p < 0.001), average hip extensor moment (MD = −0.5 N·m/kg; 95% CI = −0.5, −0.4; p < 0.001), and stance time duration (MD = −0.02 s; 95% CI = −0.04, 0.00; p = 0.017).SignificanceIncreasing forward trunk lean and hip extensor use during stair ascent decreased peak hip adduction and internal rotation in asymptomatic females. Future studies should examine the effects of increasing forward trunk lean on hip kinematics, self-reported pain, and function in individuals with patellofemoral pain.     

Number of knee and ankle injuries is associated with poor physical but not mental health

The knee and ankle are among the most commonly injured joints in the body. Long-term strength and neuromuscular control deficits are common following these injuries, yielding lifelong disability and poor quality of life. However, it is unknown how the number of injuries sustained influences quality of life.

Objectives: Determine the association between the number of ankle or knee injuries sustained and physical and mental quality of life.

Methods: A total of 806 ankle-injured (age:45.2 ± 15.3 yrs; body mass index [BMI]:28.6 ± 7.4 kg/m²), 658 knee-injured (age:49.3 ± 16.1 yrs; BMI:28.4 ± 7.4 kg/m²), and 996 uninjured (age:43.4 ± 16.1 yrs; BMI:26.9 ± 6.5 kg/m²) adults completed the SF-8 survey to determine the physical (PCS) and mental (MCS) contributions to quality of life. Respondents were categorized by injury history (ankle, knee, none) and number of injuries (0, 1, 2, or 3 or more [3+]) to the same joint. Backward linear regression models were used to determine the association between quality of life, age, and injury history separately for SF-8 PCS and MCS, as well as ankle versus knee injury.

Results: Reporting 1, 2, or 3+ ankle injuries along with age predicted SF-8 PCS (P < 0.001). Further, 1 or 2 ankle injuries and age (P < 0.001) predicted SF-8 MCS. Reporting 1, 2, or 3+ knee injuries along with age significantly predicted SF-8 PCS (P < 0.001). Age, but not knee injury history, significantly predicted SF-8 MCS (P < 0.001).

Conclusion: Current age and history of sustaining at least one injury negatively impact physical quality of life following either a knee or ankle injury. However, mental quality of life was predicted most consistently by age. Efforts to reduce injuries should be employed to improve quality of life, but more research is needed to determine what other factors contribute to quality of life across the lifespan.     

MEBO联合激光治疗下肢静脉曲张性溃疡

目的：探索下肢静脉曲张诱发下肢皮肤溃疡的治疗方法。方法：局部采用湿润烧伤膏（MEBO）包扎方法，共60例。结果：MEBO＋激光治愈55例，MEBO＋激光＋皮片移植治愈5例，治愈率100％。结论：MEBO联合激光治疗下肢静脉曲张诱发溃疡安全易行，疗效满意。     

彩色多普勒超声联合D-二聚体对周围型下肢深静脉血栓筛查的价值

目的探讨彩色多普勒超声(CDUL)联合D-二聚体检测对周围型下肢深静脉血栓的筛查价值。方法对1821例下肢深静脉血栓的高危患者行下肢深静脉CDUL检查及D-二聚体的检测。分别计算CDUL、血浆D-二聚体浓度水平检测以及二者联合对高危人群中周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值以及Kappa值。结果CDUL诊断周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值为95.8%、94.5%、88.2%、98.1%、0.881。血浆D-二聚体浓度检测诊断周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值为85.2%、95.6%、89.3%、93.8%、0.818。二者联合诊断周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值为98.0%、100.0%、100.0%、99.1%、0.986。CDUL联合D-二聚体检测与单独行D-二聚体检测及CDUL检查的差异均有统计学意义(均P<0.05)。结论CDUL检查联合血清D-二聚体检测对筛查周围型下肢深静脉血栓有较高的诊断准确率,具有较高的临床价值。     

Walking, vigorous physical activity, and markers of hemostasis and inflammation in healthy men and women

The impact of walking on cardiovascular health, as compared with vigorous physical activity, remains controversial. We performed a cross-sectional analysis including 185 healthy participants drawn from the Whitehall II epidemiological cohort to examine whether there is an independent association between walking and markers of hemostasis and inflammation after controlling for vigorous physical activity. Blood was drawn for the assessment of von Willebrand factor antigen (vWF), fibrinogen, interleukin (IL)-6, IL-1 receptor antagonist (IL-1ra), and tumor necrosis factor-alpha (TNF-alpha). Self-reported levels and types of physical activity were recorded, including time spent walking per week and frequency of participation in vigorous physical activity. Multiple linear regression analyses, adjusted for age, body mass index, blood pressure, gender, smoking, alcohol, grade of employment, and frequency of vigorous physical activity revealed that time spent walking was inversely related to vWF (beta=-0.13, P=0.086), fibrinogen (beta=-0.16, P=0.016), IL-6 (beta=-0.12, P=0.087), and TNF-alpha (beta=-0.16, P=0.039). In addition, vigorous activity was inversely associated with hemostatic markers but not with inflammatory cytokines. Regular walking is associated with lower levels of hemostatic and inflammatory markers independently of vigorous physical activity in healthy men and women.