Robust features of knee osteoarthritis in joint moments are independent of reference frame selection

Background

Changes in lower-limb joint moments are important outcome measures for treatment and prevention of knee osteoarthritis. However, it is known that both the magnitude and amplitude of joint moments are affected by the choice of anatomical reference frame. The purpose of this study was to identify features of joint moment waveforms that, regardless of the choice of reference frame, are different for subjects with knee osteoarthritis as compared to asymptomatic control subjects.

Methods

External joint moments during the stance phase of gait were calculated for 44 subjects with moderate knee osteoarthritis and 44 asymptomatic subjects. Moments were then expressed using four anatomical reference frames: Joint Coordinate System, Plane of Progression, Proximal, and Distal. Principal component analysis was used to extract features of the moment waveforms that differed between control and osteoarthritis groups across all reference frames.

Findings

Principal component analysis revealed that, regardless of the choice of reference frame, subjects with knee osteoarthritis exhibited significantly decreased overall hip adduction moment magnitudes, increased overall knee adduction moment magnitudes, decreased knee internal rotation moment amplitudes, and increased early-stance ankle adduction magnitudes.

Interpretation

The four robust features identified in this study are sensitive to the effect of knee osteoarthritis, but independent of changes in the anatomical reference frame. These features can be solely attributed to the pathogenesis of the disease, and not to the artifact of reference frame selection.     

80例乳腺癌女性患者术后1年患肢并发症的纵向研究及对策

目的 探讨乳腺癌患者术后1年期间患肢并发症的状况及变化规律。方法 选取80例乳腺癌术后患者,测量患者术后3个月、6个月、12个月的患肢并发症的发生状况,进行统计描述。结果 80例乳腺癌患者术后1年期间,患肢并发症中,除患肢淋巴水肿发生率升高外,患肢疼痛、感觉异常、患肢肌力下降及条索状结构的发生率均呈下降趋势,发生率在3个时点的差异有统计学意义（P<0.05）。结论 乳腺癌患者术后上肢功能康复效果总体并不理想,虽除淋巴水肿以外,其余并发症发生率均呈下降趋势,但直至术后1年均未能完全恢复,而术后淋巴水肿是上肢功能恢复中唯一会随着时间进展而增加发生率的并发症。提示需加强乳腺癌患者术后患肢功能及其并发症的管理,并且时间应维持在1年以上。     

全膝关节置换术前应用双下肢全长摄影对不同体位下肢负重轴线的影响

目的 探讨全膝关节置换术前应用双下肢全长摄影对不同体位下肢负重轴线的影响.方法 选择在我院接受全膝关节置换术患者138例,均拍摄两组双下肢全长正位片,一组以骨盆正中,下肢呈中立位为标准,另一组以膑骨正中,胫骨覆盖腓骨小头内1/3为标准方案.比较两种体位下的股骨胫骨机械轴夹角等数据,并评估两者图像质量.术后随访,比较术前...     

渐进式康复操对乳腺癌改良根治术后生存质量的作用

【】 目的 探讨渐进式康复操对乳腺癌患者术后生存质量的临床效果。方法 将362例乳腺癌根治术患者随机分为康复组和对照组,对照组给予常规护理,康复组术后实施渐进式康复操训练。术后调查患者上肢水肿、皮下积液、上肢功能、生活质量以及满意度评价康复操的锻炼效果。结果 康复组术后没有上肢水肿的并发症发生。另外,康复组患者患肢功能,生活质量以及满意度明显高于对照组,有统计学差异。结论 渐进式康复操可明显改善乳腺癌患者术后的上肢功能,改善患者术后生活质量,值得在临床护理实践中广泛推广与开展。     

Sonography of the Pronator Teres: Normal and Pathologic Appearances

The pronator teres muscle is rarely examined during a routine sonographic examination of the elbow joint. Nevertheless, it can be affected by a variety of conditions, including trauma and tumors, and can be implicated in compression of the median nerve. This pictorial essay first illustrates the anatomy and biomechanics of the pronator teres. Then we present the sonographic technique for examination, normal sonographic appearance, and anatomic variations of the pronator teres and adjacent structures as well as sonography of their main disorders. Normal and pathologic sonographic appearances are correlated with magnetic resonance imaging and radiographic results.     

虚拟现实技术在脑卒中患者偏瘫上肢功能康复中的应用

目的:初步观察虚拟厨房上肢康复训练结合常规作业治疗对脑卒中恢复期患者偏瘫上肢功能康复的临床疗效.方法:将33例脑卒中恢复期偏瘫上肢功能障碍的患者随机分为治疗组(16例)和对照组(17例).对照组接受常规作业治疗每次40min,每日1次,每周5次,共3周.治疗组接受常规作业治疗和虚拟厨房上肢康复训练各20min,每次共40min,每日1次,每周5次,共3周.其余康复治疗如运动疗法和日常生活活动训练等两组均相同.两组患者分别于治疗前、治疗后予以FMA上肢部分(FMA-UE)、MAS上肢部分(MAS-UE)和MBI评定,比较两组的疗效.结果:两组患者治疗后FMA-UE、MAS-UE及MBI的评分均较治疗前提高,治疗前、后各量表的评分差异具有显著性(P＜ 0.05);与对照组相比,治疗组患者FMA-UE、MBI的评分提高幅度更大(P＜0.05).结论:虚拟厨房上肢康复训练结合常规康复作业治疗能更好地改善脑卒中恢复期患者偏瘫上肢的运动功能,更有效地提高患者日常生活活动能力.     

ePTFE血管移植修复创伤性四肢干动脉缺损的临床研究

【目的】总结应用膨胀泡沫聚四氟乙烯（ePTFE）血管移植修复创伤性四肢干动脉缺损的方法和疗效，探讨血管吻合口感染的预防途径。【方法】采用Lire Green公司的ePTFE血管移植通过肌瓣包裹、转位覆盖及旁路迂回等方式修复四肢千动脉缺损40例。【结果】血管移植术后全部通畅，无吻合口感染。随访6个月、1年、2年，血管通畅率分别为100％、96．9％、89．3％。无截肢病例。【结论】ePTFE血管移植修复创伤性四肢主干动脉缺损是一种简便可行的手术方式．既能解决自体血管来源困难有限、口径小等难题，又能达到自体静脉移植同样的疗效。     

自制踝足矫形带对痉挛型偏瘫脑性瘫痪足下垂患儿下肢运动功能的疗效

目的观察自制自制踝足矫形带对痉挛型偏瘫脑瘫足下垂患儿下肢运动功能的疗效。方法 24例痉挛型偏瘫脑瘫足下垂患儿随机分为观察组和对照组各12例。两组患儿均行常规康复训练,对照组行步态训练,观察组佩戴自制踝足矫形带行步态训练,共12周。治疗前后分别采用腓肠肌改良Ashworth量表(MAS)、踝关节主动背屈活动度(ROM)和粗大运动功能测量(GMFM-88)D区(站立)、E区(走跑跳)进行评定。结果治疗后,两组MAS评分明显降低(P0.01),观察组低于对照组(P0.05);两组ROM、GMFM-88的D区和E区评分均明显高于治疗前(P0.01),观察组高于对照组(P0.05)。结论佩戴自制踝足矫形带行步态训练能进一步降低痉挛型偏瘫脑瘫患儿患侧的腓肠肌张力,增加踝关节活动度,提高下肢运动功能。