坐位和卧位持续性被动运动训练对下肢骨关节术后康复效果的促进作用

目的:探讨坐位和卧位持续性被动运动训练对下肢骨关节术后康复效果的促进作用.方法:回顾性分析本院2012年9月至2014年9月收治的151例下肢骨关节损伤患者的临床资料,均接受手术治疗,分为对照组(73例)和观察组(78例)分别给予传统术后康复训练和传统康复训练结合坐位和卧位持续性被动运动训练.结果:较之本组治疗前,两组的各关节屈曲和伸展活动度均出现提高的情况,P<0.05;治疗后观察组的各关节屈曲和伸展活动度均出现大于对照组,P<0.05.较之本组治疗前两组的6min的步行距离和10米的步行时间均出现改善的情况,步行距离增加,步行时间缩短,P<0.05;治疗后观察组的6min的步行距离和10米的步行时间均出现大于或者短于对照组,P<0.05.较之本组治疗前,两组的平衡能力评分均出现提高的情况,P<0.05;治疗后观察组的平衡能力评分大于对照组,P<0.05.结论:对下肢骨关节术后患者实施坐位和卧位持续性被动运动训练可以获得十分理想的效果,提高其运动功能和平衡能力等,促进患者的术后康复.     

手法治疗在青年股骨头缺血性坏死保髋术后的临床应用

目的研究关节松动牵拉手法在股骨头坏死保髋术后的临床疗效,寻求保髋术后理想的康复方法,提高保髋治疗效果。方法25例患者39髋纳入研究(青年股骨头坏死保髋术后,坏死灶已清除,术后1年以上,经X线检查股骨头内坏死已修复患者),给予关节松动牵拉手法治疗,15d为1个疗程,疗程间休息3～5d,连续治疗3个疗程;第1个疗程开始前1d和第3个疗程结束后第2d进行评分。观察25例患者39髋治疗前、后关节功能、痛疼程度、优良率,应用Harris评分标准分别对患者治疗前、后状况进行评价。结果治疗前、后患者疼痛指数、关节活动度评定得分间差别有显著性意义(P<0.01)。结论关节松动牵拉手法可改善股骨头坏死保髋术后患者的关节功能,加快肌力恢复,缩短康复疗程,提高保髋治疗效果及生存质量,可望延缓,甚至避免全髋人工关节置换。     

持续被动运动治疗膝关节功能障碍的疗效观察

目的　观察膝部骨折术后膝关节功能障碍患者运用持续被动运动的疗效。方法　将 3 6例膝部骨折术后膝关节功能障碍患者随机分为治疗组和对照组。治疗组以膝关节持续被动运动为主 ,辅以综合康复治疗 ;对照组只接受辅助的综合康复治疗。结果　所有病例治疗后膝关节活动范围、疼痛均较治疗前明显好转 ,差异有统计学意义 (P <0 .0 1)。治疗组膝关节活动范围大于对照组 ,差异有统计学意义 (P <0 .0 1)。结论　采用持续被动运动并辅以综合康复治疗是治疗膝部骨折术后膝关节功能障碍的有效方法。     

Sport science applied to basketball refereeing: a narrative review

ABSTRACT

Objectives: The present review provides a summary of basketball referees’ game activities, fitness assessment, cognitive function, and energy expenditure (EE) during official games.

Methods: Analyzing the literature on basketball referees. Literature review conducted using Pub Med, WOK, SCOPUS, and Google Scholar, with search criteria including the terms ‘referees’, ‘game officials’, ‘basketball’ and performance terms such as ‘physiological’, ‘physical demands’, ‘decision-making’, and ‘mental fatigue’.

Results: the relevant studies (n = 19) showed that referees cover ~5000 m during a game with mean heart rates (HR) of ~140 beats.min^?1 (>75% HR_max) and oxygen uptake (VO₂) of ~52 ml.min^?1.kg^?1 (~86.19% VO₂max). The YO-YO intermittent recovery test level 1 (YO-YO-IRT1) performance has revealed a direct validity to assess the intermittent aerobic activity as it was correlated to the on-field activity of the referees. The estimated referees' EE during a game exceeds 500 kcal (~5 kcal.kg-1.h^?1). The threshold of low intensity and high intensity could be considered as lower than 3.8 METs and higher than 9.8 METs, respectively. The physical abilities of referees decrease gradually with the chronological age. However, older referees (>32 years old) have a significantly better quality of officiating than young referees. The perceptual-cognitive demands of basketball refereeing are also discussed in the present review.

Conclusion: Basketball referees’ game-analysis showed an intermittent activity (~1:12 ratio of high-intensity effort/recovery). The YO-YO-IRT1 could be used as a specific fitness test to estimate their aerobic capacity. The referees’ EE showed a “moderate energy intensity“ when expressed by the metabolic equivalent (~5 METs). A specific training program should be prescribed for the referees, taking into consideration their age. The cognitive processes influencing basketball referees’ decisions should be studied in further researches.     

The dosimetric impact of respiratory breast movement and daily setup error on tangential whole breast irradiation using conventional wedge,field-in-field and irregular surface compensator techniques

To evaluate the dosimetric impact of respiratory breast motion and daily setup error on whole breast irradiation (WBI) using three irradiation techniques; conventional wedge (CW), field-in-field (FIF) and irregular surface compensator (ISC). WBI was planned for 16 breast cancer patients. The dose indices for evaluated clinical target volume (CTV_evl), lung, and body were evaluated. For the anterior-posterior (AP) respiratory motion and setup error of a single fraction, the isocenter was moved according to a sine function, and the dose indices were averaged over one period. Furthermore, the dose indices were weighted according to setup error frequencies that have a normal distribution to model systematic and random setup error for the entire treatment course. In all irradiation techniques, AP movement has a significant impact on dose distribution. CTV_evlD₉₅ (the minimum relative dose that covers 95 % volume) and V₉₅ (the relative volume receiving 95 % of the prescribed dose) were observed to significantly decrease from the original ISC plan when simulated for the entire treatment course. In contrast, the D₉₅, V₉₅ and dose homogeneity index did not significantly differ from those of the original plans for FIF and CW. With regard to lung dose, the effect of motion was very similar among all three techniques. The dosimetric impact of AP respiratory breast motion and setup error was largest for the ISC technique, and the second greatest effect was observed with the FIF technique. However, these variations are relatively small.     

A simulated passive intervertebral motion task: observations of performance in a cross-sectional study

Abstract

Introduction: Passive motion palpation is an integral component in examination, diagnosis or classification, and treatment of persons with mechanical disorders of the cervical spine. If the magnitude of force application during passive movement assessment is associated with greater palpatory accuracy has not been established.

Methods: This investigation used a novel mechanical model as a basis for assessing the palpatory force of students and clinicians. The model included multiple palpable resistance and displacement levels similar to that observed in humans. The ability of the subjects to discriminate the various levels of resistance and displacement offered by the model was concurrently measured.

Results: Large variability occurred in the amount of force applied by the subjects in completing the palpatory examination. The data indicated no major differences in palpatory accuracy across the student and clinician groups with different training and experience levels beyond basic competency. Those subjects applying less force in the palpatory exam demonstrated greater accuracy of palpatory assessment with one measure.

Discussion: The data indicate training and experience had minimal relationship to palpatory interpretation precision beyond the basic level and individual natural discriminatory ability may be a factor in accuracy of palpatory skill. The results demonstrate remarkable inconsistency in palpatory force among examiners and suggest that palpatory accuracy may be related to less force application.     

The influence of scapular depression on upper limb neurodynamic test responses

Abstract

Objectives

Upper limb neurodynamic testing (ULNT) can be used clinically to assist in identifying neural tissue involvement in patients with upper quarter pain and dysfunction. Consideration for scapular positioning is a crucial component of ULNT standardization, as variations in positioning may dramatically impact sensory and motor responses. This study aimed to determine if there was a meaningful difference in test outcomes when the ULNT was performed in alternative scapular positions.

Methods

This cross-sectional study included 40 asymptomatic individuals. Repeated ULNT testing was performed on the dominant limb with the scapula blocked in neutral (ULNTb) and in scapular depression (ULNTd). Sensory responses, muscle activity, and range of motion outcomes were compared between the two test variations.

Results

Pre-positioning in scapular depression (ULNTd) led to reduced elbow extension range of motion, provoked greater upper trapezius muscle activity and an earlier onset and broader area of sensory responses compared to ULNTb.

Discussion

During ULNTb, the limbs were taken further into range and elicited reduced muscle activation and more localized sensory response providing a less vigorous version of the test. This study demonstrates that scapular positioning has a meaningful impact on ULNT test outcomes in healthy, asymptomatic individuals. The ULNTd can be considered a more vigorous version that may be appropriate when the cervical motions commonly utilized for structural differentiation are limited or contraindicated.     

Mode of administration bias

Abstract

Limitation in cervical spine range of motion (ROM) is one criterion for diagnosis of cervicogenic headaches (CHs). The flexion–rotation test, when performed passively (FRT-P), has been shown to be a useful test in diagnosis of CH. Few investigations have examined the flexion-rotation test when performed actively (FRT-A) by the individual, and no studies have examined the FRT-A in a symptomatic population. The purpose of this study was to compare ROM during the FRT-A and FRT-P in patients with CH and asymptomatic individuals and to compare ROM between sides for these two versions of the test. Twelve patients with CH and 10 asymptomatic participants were included in the study. An eight-camera Motion Analysis system was used to measure head motion relative to the trunk during the FRT-P and the FRT-A. Cervical rotation ROM was measured in a position of full cervical flexion for both tests. No significant difference was observed between right and left sides for cervical rotation ROM during the FRT-P nor the FRT-A when performed by asymptomatic participants. In patients with CH, a significant difference was observed between sides for the FRT-P (P?=?0·014); however, the FRT-A failed to reveal bilateral descrepancy in rotation ROM.     

经会阴实时超声图像引导技术在前列腺癌放疗中应用

目的 经会阴实时超声图像引导(TPUS)技术实时监测前列腺各分次内运动幅度,以期为前列腺癌的精确放疗和大分割放疗提供参考。方法 应用TPUS技术采集70例前列腺癌患者1 588个分次运动数据。每次放疗前均采用CBCT纠正分次间误差,采用VMAT技术放疗。放疗过程中实时采集超声图像(1次/s),获取出束时间内的前列腺左右(x轴)、头脚(y轴)、腹背(z轴)方向上的位移范围,整合时间因素分析前列腺四维运动轨迹。结果 全部患者均顺利完成治疗及数据采集。单次有效监测时间的中位值为179 s (132~286 s)。95%的监测时间内前列腺在各方向上的运动范围分别为左侧2.22 mm、右侧2.17 mm、头侧2.08 mm、脚侧1.98 mm、腹侧2.44 mm及背侧2.97 mm。放疗过程中前列腺在x、y、z轴的位移幅度<1 mm的时间占总时间的百分比分别为83.07%、85.46%和78.27%,<3 mm的时间占97.70%、97.87%和96.45%。结论 TPUS技术是一种无创的实时追踪技术,可探测到放疗过程中前列腺的四维运动轨迹,在采用VMAT技术放疗时,前列腺整体位移幅度较小,95%时间内各个方向的位移范围在3 mm以内。     

体素内不相干运动成像应用于乳腺癌研究进展

体素内不相干运动（IVIM）成像利用双指数模型多b值DWI评价水分子扩散、微循环灌注,已应用于鉴别诊断乳腺良恶性病变及监测新辅助化疗效果,且IVIM参数可能与乳腺癌分子亚型及预后因子等相关。本文对IVIM应用于乳腺癌的研究进展进行综述。