基于CiteSpace的太极拳预防人群跌倒的可视化分析

目的探讨太极拳预防人群跌倒领域的研究热点与研究前沿,为该领域研究人员提供借鉴和参考。方法运用CiteSpace 5.3 R4和Excel 2013软件对CNKI中1994年1月—2019年1月太极拳预防人群跌倒研究领域的高频关键词、主题聚类和时区图进行可视化分析。结果老年女性群体是主要的研究对象,也是需要重点防控的对象;太极拳、平衡能力、老年女性、跌倒、帕金森、本体感觉、广场舞、脑卒中、肌力和骨密度是本研究领域的研究热点;帕金森、脑卒中等与老年人跌倒相关的高发疾病是本领域的研究前沿。结论太极拳预防人群跌倒领域以疾病为中心的研究模式初步形成,但研究力度有待加强,未来研究者可进一步从疾病、生活方式和心理状态多方面探讨太极拳对老年人跌倒的干预作用,以更好地发挥太极拳运动的社会经济学效应。     

Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

Objective We conducted a study to develop an assessment sheet for fall prediction in stroke inpatients that is handy and reliable to help ward staff to devise a fall prevention strategy for each inpatient immediately upon admission. Methods The study consisted of three steps: (1) developing a data sampling form to record variables related to risk of falls in stroke inpatients and conducting a follow-up survey for stroke inpatients from their admission to discharge by using the form; (2) carrying out analyses of characteristics of the present subjects and selecting variables showing a high hazard ratio (HR) for falls using the Cox regression analysis; (3) developing an assessment sheet for fall prediction involving variables giving the integral coefficient for each variable in accordance with the HR determined in the second step. Results and discussion (1) Subjects of the present survey were 704 inpatients from 17 hospitals including 270 fallers. (2) We selected seven variables as predictors of the first fall: central paralysis, history of previous falls, use of psychotropic medicines, visual impairment, urinary incontinence, mode of locomotion and cognitive impairment. (3) We made 960 trial models in combination with possible coefficients for each variable, and among them we finally selected the most suitable model giving coefficient number 1 to each variable except mode of locomotion, which was given 1 or 2. The area under the ROC curve of the selected model was 0.73, and sensitivity and specificity were 0.70 and 0.69, respectively (4/5 at the cut-off point). Scores calculated from the assessment sheets of the present subjects by adding coefficients of each variable showed normal distribution and a significantly higher mean score in fallers (4.94 ± 1.29) than in non-fallers (3.65 ± 1.58) (P = 0.001). The value of the Barthel Index as the index of ADL of each subject was indicated to be in proportion to the assessment score of each subject. Conclusion We developed an assessment sheet for fall prediction in stroke inpatients that was shown to be available and valid to screen inpatients with risk of falls immediately upon admission.     

残甲的后徙再造

目的创建一种通过组织后徙易位再造伤指甲床的方法。方法将残存甲床组织后徙易位，再造甲结构19例22指。结果13例16指满意成活;4例4指甲畸形成活;1例1指疤痕愈合f1例1指因骨髓炎截指。结论后徙术能最大限度地维持创伤指长度．利于闭合创口，恢复甲外观和功能。     

Temporal masking of auditory evoked brainstem responses in human newborns and adults

Temporal masking effects on brainstem evoked responses (BERs) were studied in normal human newborns and adults. Forward masking prolonged the latencies of the newborn BERs significantly longer than adult BERs. The effect of backward masking on BER latencies for both newborns and adults was small, suggesting that either backward masking effects for these stimuli are mediated by structures rostral to the brainstem or that backward masking does not affect the latency of the BER. Increasing the duration of the forward masker prolonged BER latencies more for newborns than adults. Increasing the intensity of the masker prolonged BER latencies for both newborns and adults, however, there were no significant age-intensity interactions.     

Japanese orthopedists’ interests in prevention of fractures in the elderly from falls

The aim of the present study was to survey the interest of Japanese orthopedists in preventing fractures in the elderly, and investigate their awareness with regard to main prevention strategies such as medications and hip protectors. From the list of 20,899 members of the Japanese Orthopedic Association, we randomly selected a sample of 2035 people. Each orthopedist was sent an anonymous survey consisting of 12 questions during July to August 2001. At that time, risedronate, raloxifene, and parathyroid hormone had not been approved for clinical use in Japan, and even alendronate had just been approved. Of the survey forms sent, 1011 responses were received, for a response rate of 50%. Analysis of these responses showed a very high interest in osteoporosis, fractures in the elderly from falls, and the prevention of such fractures. This interest was associated with physician age, with those above the age of 50 years being 2.3 times more likely to have an interest in each of these than physicians below that age. The respondents considered the most promising measure for the prevention of fractures in the elderly from falls to be fall prevention, followed by exercise and osteoporosis medications. The medication considered to be effective as a monotherapy by the overwhelming number of respondents was bisphosphonates, followed by vitamin D₃ and calcitonin. Combination agents cited were vitamin D₃, bisphosphonates, and calcitonin, in that order. Forty-two percent of respondents had some knowledge of hip protectors, but confidence in them as a means to prevent fractures was still low. The practical information from our survey should serve as a starting point for comparison to periods when new bisphosphonates or hip protectors become commonly available to Japanese orthopedists. The overall results indicate that Japanese orthopedists are very positive toward fracture prevention.     

Joint acceleration during gait in relation to age

Forty-four male and female subjects with no history of falling and whose ages ranged from 10 to 68 years participated in a series of experiments to assess movement at the joints during gait while walking in a straight line, in pivot turns and in turns of 0.33 and 0.66 m diameter. Acceleration at the joints in the forward and side-to-side direction was measured by dual-axis accelerometers placed at the ankles, knees, hips, shoulders, and on the head. Eye movement was assessed from electrodes placed on the sides of the eyes. The results of the experiments showed that for people whose age was above 40 years, significant increases in the forward-back and side-to-side movements occurred at all joints and progressively increased with age. By age 60, adverse movement of the joints as much as quadrupled in many subjects when compared to people whose age was 20–30 years. The increase in joint acceleration occurred equally in the front-back and side-to-side planes. The mechanism of the increased joint movement may be due to tendon laxness, peripheral neuropathy or loss of central control of gait due to age. Accelerometry may be a much more sensitive technique to analyze abnormalities in gait than standard video or observational gait analysis. Results are given as mean (SD) unless otherwise stated.     

Effects of combined sensory and muscular training on balance in Japanese older adults

BACKGROUND: Adequate levels of physical balance and muscular strength are necessary to live independently in old age. The effects of an exercise training program targeting the sensory and muscle systems on balance and strength in a group of older adults were determined in this study. METHODS: Static balance (one-leg balance with eyes closed), dynamic balance (limits of stability [endpoint excursion [EPE], maximum excursion [MXE]]), and strength (chair stand) were assessed before and after the intervention. Volunteers were divided randomly into a training group (TR, n = 15, 76 +/- 4 years) and a control group (CN, n = 14, 76 +/- 7 years). TR performed 12-week (2 days/week, 60 min/day) supervised training while standing on the floor (first 4 weeks) and progressing to standing on foam pads of different compliances. Exercises included movements that challenged the sensory and muscle systems. RESULTS: After 12 weeks of training, the TR demonstrated significant improvements in static balance (82%); EPE backward (72%), right (32%), and left (33%); MXE backward (74%), right (31%), and left (18%); and lower body muscle strength (20%) with no significant changes in CN. CONCLUSION: These results indicate that this training program is very effective in improving balance and lower body strength in older adults.     

A pilot study of visual backward masking performance among affected versus unaffected offspring of parents with bipolar disorder

BACKGROUND: Cognitive dysfunction is evident in some euthymic patients with established bipolar disorder (BD), including deficits in visual backward masking (VBM) tasks which map to a specific neural pathway. A high-risk paradigm would clarify the temporal relation of cognitive dysfunction to clinical course. METHOD: We compared euthymic offspring (age range: 18-32 years) of lithium-responsive bipolar parents with and without a previous lifetime history of psychiatric illness to healthy comparison subjects with a negative family history, on a VBM task that requires target location. RESULTS: High-risk offspring with no lifetime psychiatric history performed the VBM task at levels of healthy controls. High-risk offspring with a previous history of a mood disorder, in complete remission, made significantly more errors at short target-mask intervals than control or never ill offspring. These higher error rates were not a consequence of faster response times. CONCLUSIONS: There is preliminary evidence of specific cognitive dysfunction early in the course of illness in affected offspring of parents with lithium responsive BD. VBM is ideal for future longitudinal studies addressing whether cognitive dysfunction in BD is a trait marker or a consequence of illness manifestation.     

Hip fractures among older people: do marital status and type of residence matter?

This study analysed the extent to which civil status and type of residence affect the risk of elderly people sustaining a hip fracture. The study population consisted of all residents, aged 65 years or older, living in Stockholm County in Sweden between the years 1993 and 1995 (about 250,000 in total). Cases of hip fractures in the County's outpatient register (1993-1995) were linked to national registers, enabling injured people to be attributed a marital status (during year of injury), and also a size of dwelling and form of residential entitlement (in 1990). Gender-specific injury rates for three age groups were computed, as were age-standardized odds ratios (ORs) by gender for each variable of interest. As expected, hip fractures were found to rise with age among both men and women, and the risk of women sustaining such injuries was higher than that of men for all age groups. The proportion of injured men and women was higher among the unmarried than the married, and the majority of the injured were in rented accommodation (in all three age groups). The age-standardized ORs showed that the risk of hip fracture was substantially affected by civil (marital) status, but form of residential entitlement and size of dwelling did not affect the risk to any remarkable extent. The study demonstrates that being unmarried increases the risk of hip fracture among older men and women. This suggests that elderly unpartnered people may have a different daily-life pattern and may be in poorer health, both of which may be associated with a diminished social network.     

四联合理强化回授教育在精神病院长期住院患者跌倒预防中的应用研究

目的 探讨精神病院长期住院患者采用四联合理强化回授教育在跌倒预防中的应用价值，以指导临床干预措施的拟定，降低患者跌倒发生风险。方法 选择2021年7月至2022年10月在精神病院长期住院患者84例，使用随机数表法分为2组，各42例。对照组采用常规健康教育，观察组采用四联合理强化回授教育，比较两组跌倒预防知识技能掌握、跌倒风险及跌倒发生情况。结果 干预后，两组跌倒技能管理、跌倒管理知识评分均比干预前高，且观察组比对照组高（P＜0.05）；干预后，两组Morse跌倒危险因素评估（MFS）评分均比干预前低，且观察组比对照组低（P＜0.05）；观察组跌倒发生率3.33%（1/30）比对照组26.67%（8/30）低，有统计学差异（P＜0.05）。结论 精神病院长期住院患者实施四联合理强化回授教育可使其有效掌握跌倒预防知识技能，将患者跌倒风险降低，减少跌倒的发生。