被动式多功能下肢康复训练器

由于疾病或运动损伤造成的下肢运动障碍的患者很多，患者的康复过程多数都要经过从被动运动训练到主动运动训练。目前用于下肢被动训练的器械大多都是只具有单一冠状面上运动功能的训练器，该类训练器仅适用于下肢骨科患者手术后的关节功能恢复训练。对于属于球铰关节的下肢关节来说，如果要保持或恢复基本运动功能，还应当做矢状面上的训练。以使患者下肢关节的运动功能得到保持和恢复。     

多模式下肢康复训练机器人的设计与实验分析

目的:为满足下肢运动功能障碍患者的康复需要,设计了一种具有多种模式的下肢康复训练机器人。方法:介绍了它的机械结构、系统的工作原理并对样机进行了实验分析。结果:该机器人具有对患者进行主动运动、被动运动、辅助运动和主被动运动等训练模式。可以实现单关节的分离运动和多关节的协同运动。给出了患者髋、膝、踝关节做被动运动训练时往复运动机构末端的位置跟踪情况。基于柔顺性控制的脚踏板末端轨迹跟踪情况,以及被动运动时的足底力和腿部肌肉压力变化情况。结论:通过样机实验,验证了该机器人的基本功能,经过进一步改进和完善,可为下肢运动功能障碍的患者提供有效的康复训练。     

实用新型多功能康复健身车的研制

本设计是一种集四肢全面运动、主动和被动运动于一体的实用新型功能锻炼装置（见图１）,现介绍如下。１结构 本车是由车架、手动轮、鞍座和脚踏４大部分组成（见图２）。手动轮参照肩关节旋转训练器设计,手动轮上有手摇把,带有旋转阻力调节旋钮,手摇把参照前臂内外旋训练器设计,脚踏参照固定脚踏车设计,脚踏可装下肢定向装置,鞍座有扶手杆及握力把手,手动轮与脚踏以链条传动,手动轮中轴带离合装置。２使用方法２．１踏车运动（１）下肢主动运动：锻炼者坐在鞍座上,双足放在脚踏上进行踏车运动。（２）下肢被动运动：下肢瘫痪者坐…     

多功能智能化早期手功能训练器的研发

目的 设计研发一种多功能智能化早期手功能训练器,提供一种既能多部位训练又能显示训练数据的装置,便于训练者能准确掌握训练结果,达到科学训练目的。方法 设计方法：将训练器设计成三大部分,即杠铃部分、手部按钮部分和显示器部分。训练方法包括：手指和大小鱼际功能的训练、手腕功能的训练和手臂功能的训练等。结果 该设计研发项目已获得成果转化和成果推广。结论 多功能智能化早期手功能训练器有很好的应用和推广前景。     

多功能电控训练椅的研制和在脊髓损伤患者康复训练中的应用

自行研制的多功能电控训练椅对76例脊髓损伤患者进行被动运动或抗阻运动,训练4周,目的是加强早期康复训练,防止肌肉萎缩及关节活动异常,促进下肢功能恢复。结果表明,患者在肌容积、肌力、关节活动度和心血管系统功能方面都有较明显的改善,该训练椅设计合理,结构简易,可普及临床和家庭。     

介绍呼吸功能康复训练器的应用

我们于1986年参考日本有关文献研制出一种呼吸功能康复训练器并应用临床为肺切除术后患者进行呼吸功能康复训练,收到了一定效果。现介绍如下:一、训练器的结构与使用方法1.结构:训练器由四部分组成。①呼吸口罩:     

人体上肢表面肌电反馈康复训练系统的研制

目的：研究临床康复训练中急需解决的肌肉疲劳的保护问题。方法：开发了一种采用功能电刺激方式和表面肌电反馈控制的康复训练系统。该系统由功能电刺激器、被动训练发生器、表面肌电信号放大器及管理控制软件4部分组成。管理控制软件控制表面肌电信号放大器、功能电刺激器和被动训练发生器3部分的协调运作。结果：该系统可以实时分析康复训练过程中采集到的表面肌电信号，并以此判定肌肉是否疲劳，亦可设定功能电刺激系统的刺激参数，通过控制电路控制训练发生器运动参数等功能。结论：该系统可以有效地防止主动训练过程中因肌肉过度疲劳而造成的损伤。     

应用CPM恢复下肢关节功能的护理体会

下肢关节功能恢复器（CPM）是以持续被动运动理论为基础，通过模拟人体自然运动，激发人的自然复原力，发挥组织代偿作用，进行下肢关节功能恢复训练的一种仪器。我院自2000年以来，应用CPM对下肢手术后患者进行康复训练，恢复其肢体及关节功能，收到满意效果。现将体会介绍如下。     

基于轮椅的多姿态下肢康复训练系统的设计与仿真模拟分析

摘要 目的：针对庞大的下肢康复训练设备的持续周期性训练给患者带来的不便,以及下肢功能障碍患者经常需要从轮椅转移到下肢康复训练设备中的风险问题,本文提出了一种新型的电动轮椅,可以实现姿态变换和下肢康复训练。 方法：结合下肢康复训练设备的功能性与传统电动轮椅的便捷性,将下肢康复训练功能整合到轮椅中。本文设计的新型轮椅结构,可实现轮椅的姿态变换功能,采用了新型的腿托结构,用于完成下肢的康复训练。利用SolidWorks软件进行了三维建模,并通过Motion模块对模型进行了运动仿真,获得相关运动学数据与理论运动轨迹。最后测试了设备的样机。 结果：多姿态下肢康复训练轮椅通过运动学仿真,证明可以实现坐-卧-站三种姿态间的变换,能够实现下肢的膝关节屈伸训练。姿态变换的人体实测轨迹与仿真理论轨迹相似,实测运动学参数与理论值一致。 结论：多姿态下肢康复训练设备基于轮椅平台设计,既可以实现轮椅的移动、站立和平躺,又能够帮助患者进行下肢康复训练,优化了轮椅的整体结构,满足设备的安全性与功能性要求。     

70例恶性肿瘤转移致下肢瘫痪患者的功能康复护理

目的：促进恶性肿瘤转移致下肢瘫痪患者下肢功能的恢复和改善。方法：将70例患者按肿瘤发生部位及转移病灶的不同,有针对性地制定不同的康复计划,分别实施下肢被动屈髋屈膝训练、踝被动背屈训练、腓肠肌拍打训练、双脚趾趾尖的抓握护理,以达到促进下肢功能康复的效果。结果：通过治疗及康复训练,70例患者下肢功能均有不同程度的恢复和改善,肌力均可恢复到3至5级,可在护士的协助下翻身、坐起、站立至行走。结论：恶性肿瘤转移致下肢瘫痪患者进行放化疗同时配合功能康复训练可使下肢功能得到不同程度的恢复。     

平衡功能障碍康复训练装置的有限元分析

背景:为了对平衡功能障碍患者进行有效的康复训练,课题组自行设计了一款康复训练装置。目的:对自行设计的平衡功能障碍康复训练装置进行强度和刚度分析。方法:利用有限元分析软件ANSYS的工作界面Workbench对康复训练装置进行了强度和刚度分析。分别模拟临床上平衡功能障碍康复训练时的5种不同工作状况,在相同约束条件下分别施加装置自重载荷和患者体质量载荷,得出在不同工况下的应力分布和变形大小。结果与结论:5种工况下,应力集中与变形突出的区域大致相同,其数值与角度成正相关关系且最大等效应力值均小于所用材料的屈服强度,说明该康复训练装置的强度满足设计要求,能够承受所加的负载;从最大应力值和变形来看,该装置的设计趋于保守,可通过结构优化减轻整体装置的质量;对于复杂模型,ANSYS最新工作界面Workbench比Classic界面效率更高。     

Whole‐body vibration exercise leads to alterations in muscle blood volume

Occupationally used high‐frequency vibration is supposed to have negative effects on blood flow and muscle strength. Conversely, low‐frequency vibration used as a training tool appears to increase muscle strength, but nothing is known about its effects on peripheral circulation. The aim of this investigation was to quantify alterations in muscle blood volume after whole muscle vibration – after exercising on the training device Galileo 2000 (Novotec GmbH, Pforzheim, Germany). Twenty healthy adults performed a 9‐min standing test. They stood with both feet on a platform, producing oscillating mechanical vibrations of 26 Hz. Alterations in muscle blood volume of the quadriceps and gastrocnemius muscles were assessed with power Doppler sonography and arterial blood flow of the popliteal artery with a Doppler ultrasound machine. Measurements were performed before and immediately after exercising. Power Doppler indices indicative of muscular blood circulation in the calf and thigh significantly increased after exercise. The mean blood flow velocity in the popliteal artery increased from 6·5 to 13·0 cm s^–1 and its resistive index was significantly reduced. The results indicate that low‐frequency vibration does not have the negative effects on peripheral circulation known from occupational high‐frequency vibration.     

主动训练对脑卒中患者肢体运动功能的影响

目的:探讨主动训练对脑卒中患者肢体运动功能的影响。方法:120例急性脑卒中患者随机分为主动组和对照组各60例,均进行常规神经内科药物治疗和康复训练,教育组同时进行主动训练。治疗前和治疗3个月后采用Brunnstorm评定患者肢体运动功能。结果:治疗3个月后,主动组肢体运动功能优于对照组(P<0.05)。结论:主动训练可以提高脑卒中患者对治疗的依从性,促进其肢体运动功能的恢复。     

A study on the effects of severe repetitive exercise on serum myoglobin, creatine kinase, transaminases and lactate dehydrogenase

Two groups of young men taking part in a 24-day training course involving increasingly severe exercise were studied. Serum myoglobin, creatine kinase, creatine kinase-MB, transaminases, lactate dehydrogenase, urea, creatinine, calcium and uric acid were estimated at intervals. During the first few days, increases in myoglobin and muscle enzymes correlated with the severity of the preceding exercise. Increases in myoglobin and muscle enzymes after the final most severe exercising were less than with the initial exercising, demonstrating the effect of physical training. The changes in myoglobin and the muscle enzymes correlated closely. Elevated myoglobin levels persisted for over 24 hours. There was no consistent correlation between changes in myoglobin and uric acid, both of which have been considered responsible for the renal failure which may occur with rhabdomyolysis.     

Skeletal status assessed by quantitative ultrasound at the hand phalanges in karate training males

The aim of the study was to assess the influence of regularly exercised karate on the skeletal status. The study comprised a group of 226 males (the mean age: 25.64 ± 12.3 years, range 7-61 years), exercising for 61.9 ± 68.4 months, with the mean frequency of 3.12 ± 1.4 times per week, and 502 controls, matched for age and body size. The skeletal status was assessed by quantitative ultrasound, using a DBM Sonic 1200 (IGEA, Italy) sonographic device, which measures amplitude-dependent speed of sound (Ad-SoS [m/s]) at hand phalanges. Ad-SoS, T-score, Z-score were significantly higher in the examined karatekas than in controls. Up to age 18, there had been no difference between the study subjects and controls, while afterwards, up to age 35, the difference increased to stabilize again after age 35. Longer duration, higher frequency and earlier start of physical training positively influenced the skeletal status. In conclusion, karate is a sport with a positive influence on the skeletal status with the most significant benefits occurring in adults. (E-mail: bognadr@poczta.onet.pl)     

Ergonomic evaluation of three new principles for mono‐incision in laparoscopic surgery

Several instruments exist for performing a simple laparoscopic procedure through one trocar‐incision. However, all of these instruments have well‐known image‐related disadvantages. In order to solve these problems three principles have been developed for which a new device was designed. The functionality of this device was evaluated with regard to four parameters: duration of task completion, number of errors, image‐stability and preference by users.

Although the differences between the three principles were small, the tests clearly showed that the problems surgeons experienced before have been significantly diminished by the new device. Time measurements showed a preference for principles 1 and 2 (1: manual zoom camera in combination with a standard grasping device; 2: laparoscope with an angle of 45° in combination with a standard grasping device), the surgeons expressing preference for principle 2. Furthermore, the new trocar system is the first device for mono‐incision in which two standard instruments (currently available on the market) are used simultaneously without enlarging the incision. Finally, each surgeon can work with the new device using the principle he/she is preferring.     

用于骨力生物学研究的加载装置

背景:关节软骨组织细胞对力学刺激产生反馈来维持它的形态和结构,进而适应环境.加载装置能提供研究关节软骨力生物学的合适的力学环境.目的:根据组织工程仿生的原理,建立一种用于软骨力学生物学研究的双频加载装置.方法:该力学环境采用双频加载方式实现,通过控制可调凸轮和压电陶瓷振幅和频率来实现低频-高幅载荷耦合高频-低幅载荷,同时使用有限元法对受载体进行力学分析.结果与结论:按照仿真的原理,研制出用于软骨力生物学研究的加载装置.在双频加载的条件下,软骨浅表层受到的力学载荷最大,其次是中间层,深层受到的力学应力最小;在高频10 Hz 和20 Hz 与低频1 Hz 和2 Hz 叠加时,软骨表现出不同的力学响应,但是二者引起的差异很小.该力学环境的构建可能有助于组织工程的发展和临床医学的应用,未来将采用生物学实验进行检验.     

Empowering: the experiences of exercise among heart transplantation patients in Taiwan

AIM: To explore the experiences of exercise among Taiwanese heart transplant patients on the basis of a grounded theory. BACKGROUND: Although studies conducted around the world have proven how important exercise is to heart transplant patients, little information was found about heart transplant patients' exercise experience. In addition, because of different cultural backgrounds, people in Taiwan do not care about 'regular exercise' as much as Americans and Europeans do. Therefore, it is very important to find ways so that they can value 'regular exercise.' METHODS: In-depth interviews were undertaken with a purposive sample of eight heart transplant patients. Data was analysed by repeated verification. RESULTS: Eight valid cases were separately and thoroughly interviewed while they were exercising at a sports medical centre. The results revealed that 'empowering the new heart' is the core reason for their exercise. During the exercise training process, every participant felt that his or her new heart was filled with power or energy. The 'hardness and endurance' in terms of feeling discomfort in the body was identified at the beginning of post-surgical exercise training. Throughout the process of empowerment, patients experienced the following five interactive behaviour categories: 'self-protection', 'sharing', 'being watched and cared for', 'being aware of the benefits', and 'strengthening the new heart'. CONCLUSIONS: Exercise can empower the new heart. After the exercise training, all patients felt that their new hearts were empowered with energy and vigour, and thus were willing to continue exercising. They even expanded their regimen to include folk therapies such as Tai Chi and breathing exercises.     

减重步行训练在儿童脑瘫康复中的应用

减重步行器是专门为恢复步行能力而设计的一种训练装置,近年来广泛应用于神经康复领域。文章综述近年来国内外一些学者在儿童脑瘫康复中进行减重步行训练的研究,介绍减重步行器的组成、工作原理、训练方法、训练参数、效果测定方法和功效。