The effect of complex dynamic lifting and lowering characteristics on trunk muscles recruitment

A better understanding of how the neuromuscular spinal system behaves during lifting and lowering could provide more insight about potential causes of occupational low back disorders (LBDs), and could help in the prevention and rehabilitation process of these disorders. The purpose of this study was to quantify trunk muscle activities under various whole-body free-dynamic symmetric and asymmetric complex lifting and lowering tasks. Eleven male subjects with no prior history of LBDs participated in the study. Electromyographic activities of ten trunk muscles were monitored while subjects either symmetrically or asymmetrically lifted and lowered a box under three different speeds and three weights. The results showed that all ten muscles were responsive to various experimental conditions with the erector spinae and internal oblique muscles showing the greatest response. Substantial electromyographic activities were observed in muscles that were on the contralateral side of the load. Lowering conditions yielded consistently lower muscular activities than their corresponding lifting conditions. These results show that it is essential to consider multiple trunk muscles in modeling efforts of quantifying spinal loading, as well as for back rehabilitation research purposes.     

生物反馈联合上肢任务导向性训练对脑卒中偏瘫患者上肢功能的影响

目的 探讨生物反馈联合上肢任务导向性训练对脑卒中偏瘫患者上肢功能的影响.方法 选取我院2017年3月至2019年12月收治的脑卒中偏瘫患者87例,随机分为观察组(44例)和对照组(43例).对照组行上肢任务导向性训练,观察组行生物反馈联合上肢任务导向性训练.采用Fugl-Meyer运动评分(FMA)评价患者上肢运动功能...     

前馈控制结合躯干训练对小儿脑瘫患儿运动发育恢复及随访的影响

目的 分析前馈控制结合躯干训练对小儿脑瘫运动发育及日常生活活动能力的影响,为临床治疗提供科学依据。方法 2015年12月-2016年12月选取40例小儿脑瘫患者随机分成训练组和对照组,每组各20例,对照组给予常规躯干控制训练,训练组在进行常规躯干训练前先进行前馈控制训练。在治疗8周和6个月、1年后两组患儿采用Berg平衡量表(BBS),粗大运动功能量表(GMFCS),Fugl-Meyer运动功能评定量表(FMA),改良Barthel指数(MBI)进行疗效分析。结果 治疗前两组患儿BBS、GMFCS、FMA及MBI评分比较组间差异均无统计学意义(P＞0.05),治疗8周后两组患儿上述各项指标与治疗前相比显著改善,且训练组的改善较明显,与对照组比较,差异均有统计学意义(t=2.124、2.393、2.283、3.048,P＜0.05)。6个月、1年后随访发现训练组的改善仍高于对照组(P＜0.05)。重复测量方差分析结果显示,两组患儿BBS,GMFCS,FMA及MBI评分的时间效应、组内效应与交互作用差异均有统计学意义(P＜0.05)。结论 前馈控制结合躯干训练可以明显改善小儿脑瘫运动功能及日常生活活动能力,长期随访发现效果仍显著。     

儿童悬吊训练系统对脑瘫儿童躯干控制及粗大运动功能的影响

目的 观察儿童悬吊训练系统对脑瘫儿童躯干控制及粗大运动功能的影响。方法 将纳入标准的40例痉挛型脑瘫儿童随机分成两组,对照组(n=20)采用常规康复训练治疗,观察组(n=20)在接受常规康复训练的同时联合应用儿童悬吊训练系统。两组儿童分别于治疗前后,采用Berg平衡量表(BBS)、20 cm宽步道10 m步行速度(MWS)对躯干控制能力及步行能力进行评估和比较分析,采用粗大运动功能评定量表(GMFM)对粗大运动功能进行评估和比较分析。结果 治疗后,两组儿童BBS评分、20 cm宽步道10 m MWS、GMFM评分与治疗前比较差异均有统计学意义(P均<0.05),且观察组评分明显高于对照组(P<0.05)。结论 儿童悬吊训练系统能有效提高痉挛型脑瘫儿童的躯干控制能力及粗大运动功能。     

男性受试者搬举MAWL和RWL时的劳动负荷评价

目的对手工搬举方程在我国应用的适合性进行研究,为我国制订手工搬举作业劳动负荷的标准提供依据。方法用表面肌电信号技术和Borg量表对男性受试者搬举最大可接受搬举重量(MAWL)和推荐搬举重量(RWL)时的劳动负荷进行了评价。结果受试者对称搬举MAWL时竖脊肌肌电幅度在50%~70%MVE(最大自主收缩时肌电幅度)范围内波动,对称搬举RWL时在41%~71%MVE范围内波动。在水平距离25 cm处,从地面到可触及高度,搬举RWL时竖脊肌肌电幅度比搬举MAWL时高7.51%。从指节到可触及高度,搬举RWL时竖脊肌肌电幅度比搬举MAWL时高13.08%。非对称搬举MAWL时的竖脊肌肌电幅度明显高于搬举RWL时,差异有统计学意义(P<0.01)。身体各部位搬举MAWL时的自我用力感受(RPE)评分都明显高于搬举RWL时的RPE。结论美国职业安全卫生研究所(NIOSH)搬举方程对于水平距离和不对称的校正是充分的,但对于高度的校正是不足的,尤其是对于过肩的搬举作业是不适合的,对于过肩搬举作业的推荐搬举重量限值还应降低。     

Cortical activation during robotic therapy for a severely affected arm in a chronic stroke patient: a case report

The use of robotic-aided therapy in a patient with residual damage from a previous stroke was an attempt to improve function in a moderate to severe hemiparetic arm. Cortical activities associated with motor recovery are not well documented and require investigation. A chronic stroke patient with a severely affected arm underwent a robotic-training program for 12 weeks. The robotic-aided therapy improved motor control and spasticity in the proximal upper-limb. An increased oxygenated hemoglobin level was observed at the motor-related area in the affected hemisphere. A 12-week robotic-aided training program used in a chronic stroke patient demonstrated elements of motor recovery, and was also associated with direct activation of the affected hemisphere.     

Exercise treatment for depression: efficacy and dose response

BACKGROUND: This study, conducted between 1998 and 2001 and analyzed in 2002 and 2003, was designed to test (1) whether exercise is an efficacious treatment for mild to moderate major depressive disorder (MDD), and (2) the dose-response relation of exercise and reduction in depressive symptoms. DESIGN: The study was a randomized 2x2 factorial design, plus placebo control. SETTING/PARTICIPANTS: All exercise was performed in a supervised laboratory setting with adults (n =80) aged 20 to 45 years diagnosed with mild to moderate MDD. INTERVENTION: Participants were randomized to one of four aerobic exercise treatment groups that varied total energy expenditure (7.0 kcal/kg/week or 17.5 kcal/kg/week) and frequency (3 days/week or 5 days/week) or to exercise placebo control (3 days/week flexibility exercise). The 17.5-kcal/kg/week dose is consistent with public health recommendations for physical activity and was termed "public health dose" (PHD). The 7.0-kcal/kg/week dose was termed "low dose" (LD). MAIN OUTCOME MEASURES: The primary outcome was the score on the 17-item Hamilton Rating Scale for Depression (HRSD(17)). RESULTS: The main effect of energy expenditure in reducing HRSD(17) scores at 12 weeks was significant. Adjusted mean HRSD(17) scores at 12 weeks were reduced 47% from baseline for PHD, compared with 30% for LD and 29% for control. There was no main effect of exercise frequency at 12 weeks. CONCLUSIONS: Aerobic exercise at a dose consistent with public health recommendations is an effective treatment for MDD of mild to moderate severity. A lower dose is comparable to placebo effect.     

基于脑电与肌电对中风偏瘫病人肌肉能力恢复研究的进展

现代医学认为,脑卒中是指脑局部血液循环障碍所致的神经功能缺损综合征。中医认为半身不遂、口舌歪斜、偏身麻木等症状是＂中风＂后的表现[1]。在中风之后,大脑的控制信号不能很好地到达手脚处的肌肉,使该部位的运动肌肉的电活动电位处于一种较低的水平,从而导致病人无法很好地控制手脚,造成基本生活的不便。利用EMG-EEG结合进行辅助治疗技术的发展将会给中风病人带来福音。本文将从肌电控制、脑电控制、肌电脑电结合三方面对此问题展开讨论。     

The Effects of Aerobic-Resistance Training and Broccoli Supplementation on Plasma Dectin-1 and Insulin Resistance in Males with Type 2 Diabetes

Background: This study aimed to evaluate the effects of a combination of aerobic-resistance training (CARET) and broccoli supplementation on dectin-1 levels and insulin resistance in men with type 2 diabetes mellitus (T2D). Methods: Forty-four males with T2D were randomly allocated to four groups (n = 11 each group): CARET + broccoli supplement (TS), CARET + placebo (TP), control + broccoli supplement (S), and control + placebo (CP). CARET was performed three days per week for 12 weeks. TS and S groups received 10 g of broccoli supplement per day for 12 weeks. All variables were assessed at baseline and 12 weeks. Results: Plasma dectin-1 levels were decreased in TS and TP groups compared with the CP group (p < 0.05). Cardiometabolic risk factors showed significant reductions in TP and TS groups compared to S and CP groups (p < 0.05). Conclusion: The combination of CARET and broccoli supplementation produced the largest improvements in insulin resistance and dectin-1 and other complications of T2D.     

The effects of static trunk flexion on oxygenation and electromyographic activity of erector spinae muscles

In the workplace, localized muscle fatigue can be a limiting factor for prolonged static work. It is important to study the etiology of fatigue in the muscle to prevent discomfort and potential muscle injury. The purpose of this study was to investigate the effect of sustained trunk flexion and loading on the erector spinae muscles (ESM) fatigue using electromyography (EMG) and muscle oxygenation (Mox) changes. Twelve healthy male volunteers, aged between 19 and 28 years (mean age 23 +/- 2.6), participated in this study. The subjects held a load (5, 10 and 15 kg) and no load in their hands whilst sustaining trunk flexion at 60 degrees and also in an upright standing posture for 30 seconds. Five minutes rest was given between the conditions, and each condition was randomly repeated three times. Surface EMG and near-infrared spectroscopy were recorded. Root mean square and median frequency (MF) of EMG, and Mox were calculated. The results showed a greater decrease in Mox with an increase in loads over time (P = 0.015). Using unloaded trunk flexion as a control to ascertain load effect resulted in a significant difference in Mox in the unloaded condition and in the 15 kg condition (P = 0.027). EMG results showed a significant decrease in the MF over time in trunk flexion while holding a load (P < 0.001). These results show objectively that trunk flexion while holding loads causes ESM fatigue.     

运动对2型糖尿病小鼠内皮祖细胞功能的影响

目的 探讨不同运动方式对2型糖尿病小鼠内皮祖细胞(EPCs)功能的影响,明确2型糖尿病小鼠预防心血管并发症的最佳运动方式。方法 8周龄雄性2型糖尿病小鼠随机分为4组:对照组、有氧运动组、抗阻运动组、联合运动组。对照组不作运动干预;有氧运动组进行无负重跑步运动;抗阻运动组进行尾部负重爬梯运动;联合运动组隔日交替进行有氧运动和抗阻运动。运动干预1 、2 、4 周时处死小鼠,体外分离培养骨髓源性EPCs并检测其增殖、粘附、迁移及血管生成能力。结果 组间比较:运动干预4周时,各运动组EPCs粘附、迁移及血管生成能力均强于对照组,以联合运动效果最优。组内比较:各运动组EPCs粘附、迁移和血管生成能力在运动干预第2周时强于第1周时,增殖能力在第4周时强于第1周时(均P<0.05)。结论 与有氧运动和抗阻运动相比,联合运动在预防2型糖尿病小鼠心血管并发症方面效果更佳,运动效果随着时间的延长而增强。     

自我效能理论在缺血性脑卒中偏瘫患者康复中的应用效果

目的：探讨以自我效能理论为核心的活动分析方法对缺血性脑卒中偏瘫患者康复中的应用效果。方法随机将缺血性脑卒中后偏瘫患者分为对照组和效能组各30例,对照组给予活动分析法康复训练10周。效能组在此基础上按照自我效能理论给予效能训练。两组在治疗前后均分别采用简式Fugl－Meyer量表（FMA）评定运动功能和平衡功能;用日常生活活动能力量表（Barthel指数）和活动分析法评价日常生活能力和活动能力,用一般自我效能感量表（GSES）评价自我效能水平。用SF－36量表作生命质量测评比较。结果治疗前两组患者FMA评分、Barthel评分、日常活动分析法评分及一般自我效能评分差异无统计学意义（P＞0.05）。治疗后两组各项指标评分均高于治疗前（P＜0.05）,效能组除日常生活活动能力的10项指标中有6项评分高于对照组（P均＜0.05）外,其他3项指标评分均高于对照组。结论效能训练可强化活动分析方法对缺血性脑卒中下肢瘫患者的治疗效果明显。     

脑卒中后便秘与认知功能的护理干预

目的探讨对脑卒中后便秘患者行认知功能护理干预的临床效果。 方法选择2014年2月至2016年5月中山市坦洲医院收治的106例脑卒中后便秘患者,将患者按照数字表法随机分为两组,对照组53例给予常规护理及行为干预;观察组53例在对照组基础上给予个性化认知功能护理干预,干预后第2疗程对比分析两组的临床效果。 结果观察组干预后第2疗程便秘症状评分(2.43±2.28)分显著低于对照组(3.97±2.20)分,差异具有统计学意义(t＝7.526,P<0.05)。观察组干预后第2疗程MMSE评分(28.57±2.63)分明显高于对照组的(27.49±2.98)分,差异具有统计学意义(t＝0.597,P<0.05)。观察组干预后第2疗程BI评分(91.76±13.49)分明显高于对照组的(80.61±14.34)分,差异具有统计学意义(t＝0.912,P<0.05)。 结论认知功能训练护理干预能够显著提高脑卒中后便秘患者认知功能和日常生活能力,还可以显著的改善患者便秘症状,值得临床应用推广。     

手-臂双侧强化训练对偏瘫脑瘫儿童上肢功能及日常活动能力的影响

目的探讨手-臂双侧强化训练对痉挛型偏瘫脑瘫儿童上肢功能障碍及日常生活运动能力的影响,为脑瘫患儿的康复治疗提供依据。方法选取60例偏瘫型脑瘫儿童随机分为三组:试验A组(20例)、试验B组(20例)和对照组(20例)。对照组采用常规性OT治疗,试验组采用手-臂双侧徒手强化训练(HABIT)治疗,试验A、B组训练时间分别为每日0.5h、每日1h。三组分别于治疗前及治疗后8周、12周采用上肢功能评定量表(QUEST)、Peabody精细运动发育量(Peabody-FM)、儿童残疾评定量表(PEDI)进行评定和对比分析。结果三组儿童治疗后12周QUEST分数、PeabodyFM分数、PEDI分数均优于治疗前(P<0.05),试验A、B组均优于对照组(P<0.05),试验B组均优于试验A组(P<0.05);试验A、B各组组内对比,治疗后不同时长各项评分均有提高,治疗12周时各项评分与治疗8周时各项评分比较差异无统计学意义(P>0.05)。结论 HABIT治疗痉挛型偏瘫脑瘫儿童上肢功能障碍可有效提高儿童患手-臂的结构与功能、双手协作表现、日常生活活动能力,并且每日1h的HABIT训练较每日0.5h训练效果好,8周的治疗时间改善效果最为显著。     

核心肌力训练对脑卒中后平衡和日常生活活动能力的影响

目的探讨核心肌力训练对脑卒中偏瘫患者平衡功能和日常生活活动能力(activities of daily living,ADL)的影响。方法研究对象为2013年5月—2014年2月住院治疗的脑卒中患者42例,采用随机数字表法将患者分为对照组和治疗组各21例。对照组进行常规偏瘫康复治疗,治疗组在常规治疗基础上增加核心肌力训练。治疗前、治疗4周后采用平衡测试仪评定患者重心移动轨迹长度及重心移动范围,应用改良巴氏指数(modified barthel index,MBI)评分对患者ADL进行评定。计量资料采用t检验,P0.05为差异有统计学意义。结果治疗4周后治疗组的重心移动轨迹及重心移动范围[(375.70±110.63)mm、(698.39±521.72)mm2]较对照组[(451.12±121.98)mm、(1 129.0±640.18)mm2]均显著减少(P0.05),MBI评分[(69.70±17.90)分]较对照组[(58.86±16.76)分]显著增加(P0.05)。结论核心肌力训练配合常规康复综合治疗更有效改善脑卒中偏瘫患者的平衡功能和ADL。     

重复性搬举作业所致背部肌肉疲劳的表面肌电信号分析

目的　应用表面肌电信号 (SEMG)技术对重复性搬举所致的竖脊肌疲劳进行评价。方法　通过对 13名自愿者 10 0次搬举 8kg负荷至腰部高度的EMG波幅分析和搬举前后 2次静态实验EMG信号快速傅立叶转换 (FFT)后的频谱变化分析对竖脊肌疲劳进行评估。结果　 10 0次动态搬举过程中 ,随着时间的延长 ,EMG平均波幅逐渐上升 ,T10右竖脊肌和L3左竖脊肌平均波幅的差异有显著性 (P <0 .0 5、P <0 .0 1) ;而T10左竖脊肌和L3右竖脊肌的差异无显著性 (P >0 .0 5 )。中频截距在T10右竖脊肌、T10左竖脊肌、L3右竖脊肌、L3左竖脊肌均有下降。T10右竖脊肌中频截距下降了2 .0 % ,与搬举前的差异无显著性 (P >0 .0 5 ) ,T10左竖脊肌、L3右竖脊肌和L3左竖脊肌分别下降了10 .9%、2 9.9%、2 7.9% ,与搬举前的差异均有显著性 (P <0 .0 5、P <0 .0 1)。 10 0次搬举后平均功率频率截距在L3左竖脊肌下降了 9% ,与搬举前比较 ,差异有显著性 (P <0 .0 5 ) ,其他部位下降不明显。结论　重复性的搬举可导致竖脊肌疲劳 ,L3部位比T10部位更容易疲劳 ;用中频截距的下降评价肌肉疲劳比用平均功率频率截距下降更敏感。     

Open-label use of placebos in the treatment of ADHD: a pilot study

Background This study examined short‐term efficacy, side effects and acceptability of a placebo treatment procedure designed to maintain children with attention deficit hyperactivity disorder (ADHD) on 50% of their usual stimulant dose. Methods An open‐label prospective crossover trial was conducted in 26 children with ADHD, ages 7–15 years, stable on stimulant therapy, followed at a community‐based developmental paediatrics ADHD clinic. Subjects were randomly assigned to one of two orders of experimental conditions: (1) baseline (100%) dose (1 week), then 50% dose (1 week), then 50% dose + placebo (1 week), or (2) baseline (100%), then 50% dose + placebo, then 50% dose. The inert nature of the placebo was fully disclosed to parent and child. Treatment was open‐label for child, parents and physician, but single blind for teachers. Main outcome measures included weekly IOWA Conners parent and teacher rating scales, the Pittsburgh side effects rating scale (PSERS) and the Clinical Global Impressions (CGI) scale. Results Parent IOWA showed ADHD behaviour tended to remain the same when the dose of stimulant medication was reduced with placebo but to deteriorate when the dose was reduced without placebo. There were no significant differences between conditions on the Teacher IOWA. PSERS scores were higher at baseline than on 50% dose. On the CGI, there was a significant difference (P = 0.004) between the 50% dose and the 50% + placebo conditions. Individual subject analysis showed that eight subjects met criteria for responder. Conclusions Results indicate that the open‐label placebo treatment was acceptable and efficacious in the short term for some children.     

基于体感互动的综合平衡训练在脑卒中偏瘫患者中的应用效果

目的探讨在脑卒中偏瘫患者中采用基于体感互动的综合平衡训练(体感互动技术)的临床效果。方法选择2018年7月1日-2019年12月31日沈阳市第二中医医院收治的76例脑卒中偏瘫患者,依据随机数字表法随机分为观察组和对照组各38例。观察组采用基于体感互动的综合平衡训练(体感互动技术),对照组采用常规康复训练。观察并比较两组的康复效果。结果康复训练后观察组平衡功能、神经功能、运动功能和上下肢肌力评分均优于对照组,差异均有统计学意义(P<0.05)。结论脑卒中偏瘫患者进行基于体感互动的综合平衡1川练有利于改善其肢体运动和平衡功能。     

Resistance weight training during caloric restriction enhances lean body weight maintenance

To assess the individual and combined effects of weight loss and weight training on body weight and body composition, 40 obese women were randomly assigned to one of four groups for an 8 wk weight-loss study. These groups were control (C); diet without exercise (DO); diet plus weight training (DPE); and weight training without diet (EO). Body weight decreased for DO (-4.47 kg) and DPE (-3.89 kg) compared with C (-0.38 kg) and EO (0.45 kg). Lean body weight (LBW) increased for EO (1.07 kg) compared with DO (-0.91 kg) and C (-0.31 kg) and for DPE (0.43 kg) compared with DO. Upper-arm muscle areas (determined by radiograph) increased for DPE (11.2 cm2) and EO (10.4 cm2) compared with C (2.7 cm2) and DO (2.1 cm2). It was concluded that weight training results in comparable gains in muscle area and strength for DPE and EO. Adding weight training exercise to a caloric restriction program results in maintenance of LBW compared with DO.     

循证法应用于环氧乙烷灭菌质量控制的探讨

目的探讨循证法应用于环氧乙烷灭菌(EO)质量控制的效果。方法通过利用循证法开展人员培训,并应用于EO灭菌器的安装及质控灭菌物品的洁净度、正确选用包装材料及控制灭菌过程的EO气体浓度、温湿度和过程追溯,并通过对灭菌器运行的每锅次进行物理监测、化学监测和生物监测,对无菌物品定期进行无菌试验,综合评判EO的灭菌效果。结果 72锅次4835件物品的灭菌合格率100.0%。结论应用循证法可做好环氧乙烷灭菌质量的控制。