STRENGTH AND FATIGUE MEASUREMENTS OF THE HIP FLEXOR AND HIP EXTENSOR MUSCLES: TEST-RETEST RELIABILITY AND LIMB DOMINANCE EFFECT

Background:Standardized testing of hip muscle strength and fatigue in the sagittal plane is important for assessing, treating and preventing a number of trunk and lower extremity pathologies. Furthermore, individuals displaying asymmetries of muscle strength between limbs are more likely to sustain an injury.Purpose:To evaluate the test-retest reliability of isometric strength and isokinetic fatigue measurements of the hip flexor and hip extensor muscles, and to examine whether there is a significant limb dominance effect on strength, fatigue and flexor-extensor ratios.Study design:Cross-sectional study.Methods:To evaluate reliability, 30 healthy individuals (33.2 + /- 13.1 years) were included. On a separate occasion, 24 healthy individuals (29.0 + /- 10.3 years) participated to assess between-limb differences. Reliability was established using intraclass correlation coefficients (ICCs), standard error of measurements (SEM) and minimal detectable change (MDC). Isometric strength (best peak torque of three maximal contractions; Nm/kg), isokinetic fatigue (total work of 20 consecutive maximal concentric flexor-extensor contractions at 120 °/s; Joule/kg), and flexor-extensor ratios, were recorded using a Biodex dynamometer.Results:Reliability was good-to-excellent (ICCs>0.83) and measurement errors were acceptable (SEM<13.6% and MDC%<37.8%). No significant between-limb differences in strength, fatigue and flexor-extensor ratios were detected.Conclusions:Isometric strength and isokinetic fatigue of the hip flexor and hip extensor muscles can be reliably assessed in healthy individuals using the Biodex dynamometer. Limb dominance did not significantly affect strength, fatigue or flexor-extensor ratios.Level of Evidence:2b     

TEST-RETEST RELIABILITY OF TWO CLINICAL TESTS FOR THE ASSESSMENT OF HIP ABDUCTOR ENDURANCE IN HEALTHY FEMALES

Background

Substantial deficits in performance of hip abductor in patients with common lower extremity injuries are reported in literature. Therefore, assessing hip abductor endurance might be of major importance for clinicians and researchers.

Purposes

The purpose of this study was to examine the test-retest reliability of two hip abductor endurance tests in healthy females. Learning effect, systematic difference in the rate of perceived exertion and relationship between endurance performance and some clinical characteristics of participants were also investigated.

Design

Observational study, with a test-retest design.

Methods

Thirty-six healthy females, aged 18-30 years, were recruited. In two identical assessment sessions, the participants performed an isometric hip abductor strength test and two different hip abductor endurance tests

Results

Isometric and dynamic endurance tests demonstrated good test-retest reliability (intraclass correlation coefficients (ICC) = 0.73 and 0.78, respectively). The standard errors of measurement (SEM) and the minimal detectable changes (MDC) were, respectively, 19.8 and 54.9 seconds for isometric endurance test and 21.2 and 58.7 repetitions for dynamic endurance test. Moderate correlation between both endurance tests (r = 0.60, p = 0.0001) and weak correlation between dynamic endurance test and strength (r = 0.44, p = 0.008) were found.

Conclusions

The results of the present study demonstrate good test-retest reliability of two non-instrumented clinical tests of hip abductor endurance in healthy females.

Level of evidence

2b     

THE RELIABILITY,MINIMAL DETECTABLE CHANGE AND CONSTRUCT VALIDITY OF A CLINICAL MEASUREMENT FOR IDENTIFYING POSTERIOR SHOULDER TIGHTNESS

Purpose/Background:

Posterior shoulder tightness (PST) has been implicated in the etiology of numerous shoulder disorders. Therefore, clinicians and researchers must have a reliable and valid method for quantifying PST. The purpose of this study was to investigate the interrater reliability, minimal detectable change at the 90% confidence interval (MDC₉₀) and construct validity of an inclinometric measurement designed to quantify PST.

Methods:

Two investigators each performed sidelying PST measurements on the non-dominant shoulder of 45 asymptomatic participants in a blinded repeated measures design. Upon completion of the PST measurements, one rater assessed active internal and external rotation for the validity component of the investigation.

Results:

Interrater reliability using an intraclass correlation coefficient (ICC) model 2,k was good (ICC 5 0.90). The MDC₉₀ indicated that a change of greater than or equal to 9 degrees would be required to be 90% certain that a change in the measurement would not be the result of inter-trial variability or measurement error. Construct validity was evaluated using active internal rotation for convergence and external rotation for discrimination. Construct validity was supported by a good to excellent relationship between PST and internal rotation (r 5 0.88) and by an inverse relationship between PST and external rotation (r 5 20.07).

Conclusion:

The sidelying procedure described in this investigation appears to be a reliable and valid means for quantifying PST when strict measurement protocols are adhered to. An advantage of this procedure lies in the ability to control scapular position to ensure motion is limited to the glenohumeral joint. Moreover, the use of inclinometry provides an absolute angle of tightness that may be used for intersubject comparison, documenting change, and to determine reference values. Clinicians and researchers should consider the MDC values presented when interpreting change values during subsequent measurement sessions.     

THE IMPACT OF SAGITTAL PLANE HIP POSITION ON ISOMETRIC FORCE OF HIP EXTERNAL ROTATOR AND INTERNAL ROTATOR MUSCLES IN HEALTHY YOUNG ADULTS

Purpose/Background:

Hip external rotator (ER) and internal rotator (IR) muscle weakness is theorized to be associated with lower extremity injury in athletes including knee ligament tears and patellofemoral pain. Previous studies investigating hip musculature strength have utilized various sagittal plane hip positions for testing. The relationship between results at these different positions is unknown.

Methods:

Eighty healthy, pain‐free young adults participated in the study: 40 female, mean age 22.90 (± 2.32) years, and 40 male, mean age 23.50 (± 2.15) years. Peak isometric torque of bilateral hip ER and IR were tested at 90° and 0° of hip flexion with an instrumented dynamometer. Peak muscle forces were calculated. Peak forces were normalized by body mass. Mean normalized force was calculated for dominant and non‐dominant limbs for ER and IR in both positions. Male and female data were analyzed separately with paired t‐tests (2‐tailed). Reference values for average muscle force and torque were calculated for dominant and non‐dominant limbs for both hip positions.

Results:

Hip IR normalized peak force was greater at 90° compared to 0° flexion position bilaterally in both genders (p < .01). Hip ER normalized peak force was greater at 90° compared to 0° flexion in dominant limbs of both genders and in non‐dominant limbs of males (p < .01). Non‐dominant hip ER normalized force in females was greater at 90° versus 0° flexion; however, it was not significant (p = .092). Post hoc analysis of normalized average force (average over 5‐second contraction) yielded similar results.

Conclusion:

Clinicians and researchers should use consistent positioning for testing of hip ER and IR strength. This will improve certainty of determining if a patient’s strength has changed or if differences between groups are present. Reference values reported will be useful in order to determine if weakness is present and to set goals, particularly in cases of bilateral involvement.

Level of Evidence:

2b     

THE RELATIONSHIP BETWEEN PASSIVE GLENOHUMERAL TOTAL ROTATION AND THE STRENGTH OF THE INTERNAL AND EXTERNAL ROTATOR MUSCLES,A PRELIMINARY STUDY

Background

There is little research on how the amount of shoulder joint range of motion, specifically glenohumeral rotation, may be related to the muscle strength of the rotator cuff muscles. A long held belief is that a joint with excessive range of motion needs sufficient muscular strength for stability. However, no studies have examined this concept.

Purpose

The purpose of this study was to see if total arc of glenohumeral joint rotation (External rotation [ER]+Internal rotation [IR]) could predict peak isometric muscle strength of the IR or ER muscles of the shoulder.

Study Design

Cross‐sectional study design

Methods

Fifty‐three participants (41 females, 12 males) participated in the study. Passive glenohumeral joint internal rotation and external rotation motion was measured for each participant with a standard goniometer. Isometric muscle force of the ER and IR muscles were tested using a handheld dynamometer in three positions: end range ER, neutral 0°, and end range IR. Data were analyzed using a non‐parametric tree based regression method (CART) and then cross‐validated.

Results

The results showed that those with an increased total arc of motion of glenohumeral rotation (greater than 165.0°) had less muscle isometric muscle strength in all tests positions than those with less glenohumeral rotation.

Conclusion

Decreased force of the ER and IR muscles of the shoulder was noted in those with increased total arc glenohumeral rotation ( > 165.0°), specifically those with increased glenohumeral internal rotation ( > 80.0°) when compared to those with glenohumeral rotation ( < 165.0°) and glenohumeral internal rotation ( < 80.0°). Future studies should include more males and attempt to develop strategies to assist those with larger excursions of shoulder rotation who may be at risk of developing shoulder problems.

Level of Evidence

Level 2     

RELIABILITY AND ACCURACY OF A GONIOMETER MOBILE DEVICE APPLICATION FOR VIDEO MEASUREMENT OF THE FUNCTIONAL MOVEMENT SCREEN DEEP SQUAT TEST

Background/Purpose

The squat is a fundamental movement of many athletic and daily activities. Methods to clinically assess the squat maneuver range from simple observation to the use of sophisticated equipment. The purpose of this study was to examine the reliability of Coach''s Eye (TechSmith Corp), a 2‐dimensional (2D) motion analysis mobile device application (app), for assessing maximal sagittal plane hip, knee, and ankle motion during a functional movement screen deep squat, and to compare range of motion values generated by it to those from a Vicon (Vicon Motion Systems Ltd) 3‐dimensional (3D) motion analysis system.

Methods

Twenty‐six healthy subjects performed three functional movement screen deep squats recorded simultaneously by both the app (on an iPad [Apple Inc]) and the 3D motion analysis system. Joint angle data were calculated with Vicon Nexus software (Vicon Motion Systems Ltd). The app video was analyzed frame by frame to determine, and freeze on the screen, the deepest position of the squat. With a capacitive stylus reference lines were then drawn on the iPad screen to determine joint angles. Procedures were repeated with approximately 48 hours between sessions.

Results

Test‐retest intrarater reliability (ICC_3,1) for the app at the hip, knee, and ankle was 0.98, 0.98, and 0.79, respectively. Minimum detectable change was hip 6°, knee 6°, and ankle 7°. Hip joint angles measured with the 2D app exceeded measurements obtained with the 3D motion analysis system by approximately 40°. Differences at the knee and ankle were of lower magnitude, with mean differences of 5° and 3°, respectively. Bland‐Altman analysis demonstrated a systematic bias in the hip range‐of‐motion measurement. No such bias was demonstrated at the knee or ankle.

Conclusions

The 2D app demonstrated excellent reliability and appeared to be a responsive means to assess for clinical change, with minimum detectable change values ranging from 6° to 7°. These results also suggest that the 2D app may be used as an alternative to a sophisticated 3D motion analysis system for assessing sagittal plane knee and ankle motion; however, it does not appear to be a comparable alternative for assessing hip motion.

Level of Evidence

3     

CHANGES IN HIP RANGE OF MOTION AND STRENGTH IN COLLEGIATE BASEBALL PITCHERS OVER THE COURSE OF A COMPETITIVE SEASON: A PILOT STUDY

Background

Adaptations in hip range of motion (ROM) and strength have been shown to influence performance and injury risk in overhead athletes. These adaptations in hip ROM and strength have not been examined longitudinally, and little is known regarding whether these changes are a result of pitching workload.

Hypothesis/Purpose

The authors hypothesized that hip rotation ROM and strength would change over the course of a season, and would be associated with pitching workload (number of pitches over the course of a season). The purpose of this exploratory, pilot study was twofold: 1) to examine changes in hip external rotation (ER) ROM, internal rotation (IR) ROM, isometric hip abduction and hip extension strength in pitchers occurring over the course of a competitive season, and 2) to determine the association between changes in hip ROM, strength, and pitching volume.

Study Design

Cohort (longitudinal) study

Methods

Bilateral hip rotation ROM and hip isometric strength was tested pre‐ and post‐season in fourteen collegiate baseball pitchers. Pearson correlations were calculated to determine the association between changes in hip ROM, strength, and pitching workload.

Results

Trail and lead hip ER, trail and lead hip total rotational ROM, and trail and lead hip abduction strength in all pitchers decreased from preseason to postseason (p < 0.01). However, these changes were not significantly associated with pitching workload (p > 0.05).

Conclusion

This study demonstrates that changes occur in hip ROM and strength in collegiate pitchers over the course of a season. These changes were not associated with pitching workload

Level of Evidence

3     

PATELLOFEMORAL PAIN SUBJECTS EXHIBIT DECREASED PASSIVE HIP RANGE OF MOTION COMPARED TO CONTROLS

Background:

Patellofemoral pain is a common condition without a clear mechanism for its presentation. Recently significant focus has been placed on the hip and its potential role in patellofemoral pain (PFP). The majority of the research has examined hip strength and neuromuscular control. Less attention has been given to hip mobility and its potential role in subjects with PFP.

Purpose/Aim:

The purpose of this study was to compare passive hip range of motion (ROM) of hip extension and hip internal and external rotation in subjects with PFP and healthy control subjects. The hypothesis was that subjects with PFP would present with less total hip ROM and greater asymmetry than controls.

Design:

Two groups, case controlled.

Setting:

Clinical research laboratory

Participants:

30 healthy subjects without pain, radicular symptoms or history of surgery in the low back or lower extremity joints and 30 subjects with a diagnosis of PFP.

Main Outcome Measures:

Passive hip extension, hip internal rotation (IR) and hip external rotation (ER). A digital inclinometer was used for measurements.

Results:

There was a statistically significant difference (p<0.001) in hip passive extension between the control group and the PFP group bilaterally. Mean hip extension for the control group was 6.8° bilaterally. For the PFP group, the mean hip extension was −4.0° on the left and −4.3° on the right. This corresponds to a difference of means between groups of 10.8° on the left and 11.1° on the right with a standard error of 2.1°. There was no statistically significant difference (p>0.05) in either hip IR or ER ROM or total rotation between or within groups.

Conclusions:

The results of this study indicate that a significant difference in hip extension exists in subjects with PFP compared to controls. These findings suggest that passive hip extension is a variable that should be included within the clinical examination of people with PFP. It may be valuable to consider hip mobility restrictions and their potential impact on assessment of strength and planned intervention in subjects with PFP.

Level of Evidence:

2b     

两种方法治疗腰椎间盘突出症的疗效比较

为探讨腰椎间盘突出症确实有效的治疗方法，进行不同治疗方法的比较研究。研究对象６８例，分成两组，Ⅰ组（硬膜外注药）３７例，男２１例，女１６１例；Ⅱ组（硬膜外注药加推拿复位法）３１例，男２５例，女６例。注射液配制：利多卡因５０￣１００ｍｇ，维生素Ｂ１２ ５００μｇ，强地松龙５０ｍｇ，加生理盐水稀释至２０ｍｌ。两组治疗结果经Ｘ＾２检验，Ｐ〈０．００５，差异非常显著。Ⅰ组虽有一定的疗效，但没有消除病因；Ⅱ     

CONCURRENT VALIDITY OF DIGITAL INCLINOMETER AND UNIVERSAL GONIOMETER IN ASSESSING PASSIVE HIP MOBILITY IN HEALTHY SUBJECTS

Background:

Hip range of motion is an important component in assessing clinical orthopedic conditions of the hip, low back and lower extremities. However it remains unclear as to what constitutes the best tool for clinical measurement. The purpose of this study was to investigate the concurrent validity of passive range of motion (ROM) measurements of hip extension and hip internal and external rotation using a digital inclinometer and goniometer.

Design:

Criterion Standard

Setting:

Clinical research laboratory

Participants:

30 healthy subjects without pain, radicular symptoms or history of surgery in the low back or hip regions.

Main Outcome Measures:

Passive hip range of motion for extension, hip internal rotation and hip external rotation. A digital inclinometer and universal goniometer were utilized as the tools for comparisons between measurements.

Results:

There was a statistically significant difference (p < 0.05) between the goniometer and digital inclinometer in measured hip ROM except for measurements of right hip external rotation (p > 0.05). The mean difference between the goniometer and digital inclinometer in left hip extension, internal rotation and external rotation were 3.5°, 4.5° and 5.0° respectively. The mean difference between the two devices in right hip extension, internal rotation and external rotation were 2.8°, 4.2° and 2.6° respectively. On average, the difference between the goniometer and digital inclinometer in extension was 3.2°, internal rotation was 4.5° and external rotation was 3.8°. The digital inclinometer had greater measurement during EXT and ER. Furthermore, there was no statistically significant difference (p > 0.05) in hip ROM between the left and right side for either goniometric or digital inclinometer measurements.

Conclusions:

This results of this study indicate that a significant difference exists between the two devices in all measurements with exception of right hip extension. The differences were noted to be between 3–5 degrees for all planes measured. These findings suggest that caution should be used if these two devices are to be used interchangeably to quantify passive hip range of motion in either clinical practice or when comparing studies that utilize different instruments.

Level of Evidence:

2b     

Intra and inter-rater reliability study of pelvic floor muscle dynamometric measurements

OBJECTIVE:

The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM) dynamometric measurements for maximum and average strengths, as well as endurance.

METHOD:

A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4±3.9) participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC) was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75.

RESULTS:

The intra and inter-raters'' analyses showed good reliability for maximum strength (ICC_intra-rater1=0.96, ICC_intra-rater2=0.95, and ICC_inter-rater=0.96), average strength (ICC_intra-rater1=0.96, ICC_intra-rater2=0.94, and ICC_inter-rater=0.97), and endurance (ICC_intra-rater1=0.88, ICC_intra-rater2=0.86, and ICC_inter-rater=0.92) dynamometric measurements.

CONCLUSIONS:

The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice.     

Intra- and inter-rater reliability of movement and palpation tests in patients with neck pain: A systematic review

Neck pain is common and often becomes chronic. Various clinical tests of the cervical spine are used to direct and evaluate treatment. This systematic review aimed to identify studies examining the intra- and/or interrater reliability of tests used in clinical examination of patients with neck pain. A database search up to April 2016 was conducted in PubMed, CINAHL, and AMED. The Quality Appraisal of Reliability Studies Checklist (QAREL) was used to assess risk of bias. Eleven studies were included, comprising tests of active and passive movement and pain evaluating participants with ongoing neck pain. One study was assessed with a low risk of bias, three with medium risk, while the rest were assessed with high risk of bias. The results showed differing reliabilities for the included tests ranging from poor to almost perfect. In conclusion, active movement and pain for pain or mobility overall presented acceptable to very good reliability (Kappa >0.40); while passive intervertebral tests had lower Kappa values, suggesting poor reliability. It may be a coincidence that the studies indicating very good reliability tended to be of higher quality (low to moderate risk of bias), while studies finding poor reliability tended to be of lower quality (high risk of bias). Regardless, the current recommendation from this review would suggest the clinical use of tests with acceptable reliability and avoiding the use of tests that have been shown to not be reliable. Finally, it is critical that all future reliability studies are of higher quality with low risk of bias.     

五行体感音乐对痉挛型脑性瘫痪患儿肌张力的影响

目的观察五行体感音乐对脑瘫患儿肌张力的影响。方法将90例痉挛型脑瘫患儿分为常规治疗组、聆听组(常规治疗+聆听五行角音)、体感音乐组(常规治疗+五行体感音乐),每组30例,每次30 min,每天1次,20 d为1个疗程,于1个疗程前后分别评估患儿双下肢肌张力。结果治疗前三组患儿年龄、性别、关节活动度、肌张力均无显著性差异(P>0.05)。治疗后,聆听组及体感音乐组肌张力较治疗前降低(P<0.05);体感音乐组下肢髋、膝、踝关节活动度较治疗前改善(P<0.05)。结论五行音乐聆听及体感音乐均可降低痉挛型脑瘫患儿下肢肌张力,五行体感音乐可有效改善下肢关节活动度。     

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。     

TOTAL ARC OF MOTION IN THE SIDELYING POSITION: EVIDENCE FOR A NEW METHOD TO ASSESS GLENOHUMERAL INTERNAL ROTATION DEFICIT IN OVERHEAD ATHLETES

Background

Total arc of motion (TA) measured in a supine position has been utilized as a method to detect the presence of glenohumeral internal rotation deficit (GIRD) in overhead athletes. A component of supine TA is supine internal rotation (IR) range of motion (ROM), which has many variables including the amount and location of manual stabilization. A sidelying position for gathering IR ROM has recently been proposed and, when combined with supine external rotation (ER) ROM, constitutes a new method of quantifying TA. This new sidelying TA method, however, has no normative values for overhead athletes.

Purpose

The purposes of this study were to develop normative values for sidelying TA in overhead athletes, determine any ROM difference between supine and sidelying TA, and examine side‐to‐side differences within the two TA methods. A secondary purpose of the study was to examine for any effect of gender or level of competition on the two TA methods.

Study Design

Cross‐sectional study.

Methods

Passive supine IR ROM, supine ER ROM, and sidelying IR ROM were gathered on bilateral shoulders of 176 collegiate and recreational overhead athletes (122 male [21.4 ± 4.7 years, 71.7 ± 2.7 inches, 25.3 ± 2.7 BMI] and 54 female [21.4 ± 5.4 years, 67.6 ± 3.0 inches, 22.5 ± 2.37 BMI]).

Results

Sidelying TA mean for the dominant shoulder was 159.6 °±15.0 °; the non‐dominant shoulder was 163.3 °±15.3 °. Sidelying TA for both shoulders (p < 0.0001) was 14 ° less than supine TA. Both TA methods exhibited a 4 ° dominant‐shoulder deficit (p < 0.0001). For the dominant and non‐dominant shoulder, respectively, there was no gender (p = 0.38, 0.54) or level of competition (p = 0.23, 0.39) effect on sidelying TA.

Conclusion

In overhead athletes, sidelying TA is a viable alternative to supine TA when examining for the presence of GIRD. Gender and level of competition does not significantly affect sidelying TA, so the mean of 160 ° on the dominant shoulder and 163 ° on the non‐dominant shoulder can be used by clinicians.

Level of Evidence

Level 3     

Blood flow velocity and vascular resistance during passive leg exercise in the critically ill patient

Passive range of motion exercise is a very common physical therapy treatment for patients admitted to an intensive care unit. However is the knowledge scarce regarding its impact on blood circulation in the extremities. The objective of this study was therefore to investigate the effect of passive range of motion on arterial peripheral leg blood flow velocity (BFV) and vascular resistance. A cross-sectional consecutive study of twelve patients admitted to an intensive care unit and twelve healthy age- and gender-matched controls was conducted. Passive range of motion was performed in one leg by a physical therapist. Blood flow velocities and resistance index in the common femoral artery (CFA), blood pressure and heart rate were measured before, directly after and at rest after passive range of motion. No changes were seen in BFV or resistance index in the patient group or the control group. No changes were found in blood pressure or heart rate in the patient group. In the control group, changes were found in systolic and mean blood pressure, with a higher pressure before passive range of motion. The controls had lower BFV and higher resistance index than the patients when comparing the groups. The conclusion of this study including twelve patients is that passive range of motion does not alter BFV or resistance index in the CFA in comatose and/or sedated critically ill patients.     

腰后关节紊乱症手法治疗机理的临床与实验研究

通过对５３例腰后关节紊乱症患者和临床分析，并根据产生腰痛的原因，将该症分为关节周围型和关节内型。通过对１０具尸体的１００支腰脊神经后内侧支显微解剖观察，证明后关节的神经支配主要来自后内侧支，该神经的行程及通道存在多处被挤压的因素，作者从神经解剖生理的角度探讨腰后关节紊乱的病机和手法治疗原理。     

直流电锌离子导入治疗类风湿性关节炎的对比观察

目前对类风湿性关节炎尚无特殊治疗方法，有的学者报告本病与关节液内的锌离子浓度降低有关，曾以口服硫酸锌进行治疗收到一定效果。本组采用直流电锌离子导入，经两个疗程观察与对照组相比较，收到较好的治疗效果，经统计学处理Ｐ＜０．０５，差异显著。     

The effect of music‐movement therapy on physical and psychological states of stroke patients

Aims and objectives. This study evaluated the effects of combined music‐movement therapy on physical and psychological functioning of hospitalised stroke patients. Background. Few studies have focused on music‐movement therapy’s effects on physical and psychological functioning of stroke patients. Design. A quasi‐experimental design with pre‐ and post‐tests was used. Methods. A convenience sample was used: patients hospitalised for stroke and within two weeks of the onset of stroke were randomised to either an experimental group (received music‐movement therapy in their wheelchairs for 60 minutes three times per week for 8 weeks) or control group (received only routine treatment). The effect of music‐movement therapy was assessed in terms of physical outcomes (range of motion, muscle strength and activities of daily living) and psychological outcomes (mood states, depression), measured in both groups pre‐ and post‐test. Results. The experimental group had significantly increased shoulder flexion and elbow joint flexion in physical function and improved mood state in psychological function, compared with the control group. Conclusions. Early rehabilitation of hospitalised stroke patients within two weeks of the onset of stroke was effective by using music‐movement therapy. It improved their mood state and increased shoulder flexion and elbow joint flexion. Relevance to clinical practice. The findings of this study suggest that rehabilitation for stroke patients should begin as early as possible, even during their hospitalisation. Nursing practice should incorporate the concept of combining music and movements to improve stroke patients’ physical and psychological states starting from the acute phase.