一种骨科患者下肢多功能防护架的研制及应用

目的：研究一种骨科患者下肢多功能防护架的研制及应用。方法：该下肢多功能防护架，包括布朗氏架，在布朗氏架上安装有烧伤架。本试验选取2013年1-10月本院住院的下肢骨折329例和膝关节术后强直患者66例，前者分为试验组169例和对照组160例，后者分为试验组34例和对照组32例。试验组采用新型下肢多功能防护架治疗，对照组则单纯采取常规治疗措施。比较各组的治疗效果。结果：下肢骨折试验组24 h内消肿止痛评分达I、II级130例（77%），对照组仅有39例（24%），试验组显著优于对照组（P〈0.05）；膝关节强直术后试验组达Ⅰ、Ⅱ级28例（82%），对照组仅有12例（37%），试验组显著优于对照组（P〈0.05）。结论：新型下肢多功能防护架的应用效果较好，值得在临床上推广和应用。     

下肢多功能分体式皮布结合垫的制作及临床应用

根据血液动力学原理,通过多次实践、改进,2008年研制出抬高下肢的下肢多功能分体式皮布结合垫,该结合垫既能有效抬高制动患肢,又确保患肢放于功能位.在3年内临床应用于430例患者,患者足背动脉良好,患肢肿胀明显减轻,未出现下肢静脉血栓及足跟部压疮现象.下肢多功能分体式皮布结合垫设计合理、取材容易、制作简单、经济实用、使用操作方便,值得临床推广应用.     

Interfacing a haptic robotic system with complex virtual environments to treat impaired upper extremity motor function in children with cerebral palsy

Objective: To investigate the ability of the New Jersey Institute of Technology Robot Assisted Virtual Rehabilitation (NJIT-RAVR) system training to elicit changes in upper extremity (UE) function in children with hemiplegia secondary to cerebral palsy.

Methods: Nine children (mean age 9 years, three males) participated in three pilots. Subjects trained 1 hour, 3 days a week for 3 weeks. Two groups performed this protocol as their only intervention. The third group also performed 5–6 hours of constraint-induced movement therapy.

Results: All subjects participated in a short programme of nine, 60-minute training sessions without adverse effects. As a group, subjects demonstrated statistically significant improvements in Melbourne Assessment of Unilateral Upper Limb Function Test, a composite of three timed UE tasks and several measurements of reaching kinematics. Several subjects demonstrated clinically significant improvements in active shoulder abduction and flexion as well as forearm supination.

Conclusion: Three small pilots of NJIT-RAVR training demonstrated measurable benefit with no complications, warranting further examination.     

INTERSESSION RELIABILITY FOR H-REFLEX MEASUREMENTS ARISING FROM THE SOLEUS,PERONEAL, AND TIBIALIS ANTERIOR MUSCULATURE

The Hoffmann reflex (H-reflex) has been widely used throughout neuroscience research, as it allows for the assessment of alpha motoneuron excit ability arising from a specific motoneuron pool. Recently, a protocol has been developed allowing for the simultaneous examination of the soleus, peroneal, and tibialis anterior motoneuron pools elicited from a single peripheral stimulus. In order for this protocol to be useful, the reliability of the measures must be established. The purpose of the current study was to determine the intersession reliability of the soleus, peroneal, and tibialis anterior H-reflexes and their corresponding M-waves elicited from a single stimulus to the sciatic nerve. Ten healthy neurologically sound individuals (age: 23 &#45 7 yrs; height: 175 &#45 12 cm; mass: 76 &#45 22 kg) volunteered to participate in this investi gation. To obtain the measurements, the sciatic nerve was stimulated just prior to its bifurcation into the tibial and common peroneal nerves in the popliteal fossa. A 1-ms square wave pulse was delivered in 0.2V increments until the maximum M wave was seen in each muscle. The maximum H-reflex and M-waves were collected from each muscle and their ratios calculated. Intersession reliability over 2 consecutive days was estimated using intraclass correlation coefficients (ICC [2,1]). Intersession reliability for the soleus Max H, Max M, and H:M ratio were 0.9953, 0.9514, and 0.9747, respectively. The peroneal reliability measurements were as follows: 0.9979 (Max H), 0.9924 (Max M), and 0.9664 (H:M ratio). Intersession reliability was 0.8591, 0.9968, and 0.7810 for the tibialis anterior Max H, Max M, and H:M ratio, respectively. These results indicate that the H-reflex measured from the soleus, peroneal, and tibialis anterior musculature elicited with a single peripheral stimulus to the sciatic nerve is reliable between sessions. This protocol allows the clinician/researcher to reliably investigate the alpha motoneuron excitability of multiple motoneuron pools about the ankle at a single point in time.