Clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version) / 中华创伤杂志

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

The effectiveness of virtual reality therapy in relieving upper limb hemiparesis after stroke:A meta-analysis of randomized and controlled trials / 中华物理医学与康复杂志

Objective To analyze the clinical efficacy of using virtual reality ( VR) to improve the upper limb function of hemiplegic persons. Methods A search was conducted in the PubMed, Cochrane Library, EM-BASE, CNKI and Wanfang Data as well as VIP for reports of randomized and controlled studies of using VR in train-ing upper limb function after stroke. A meta-analysis was then performed using version 5. 3 of the Review Manager software. Results Ninety studies involving 879 patients were found and analyzed. The data showed that VR was sig-nificantly more effective than conventional training in improving Fugl-Meyer assessment scores. It was not superior, however, in improving average Functional Independence Measure scores or performance in the box and blocks test. Conclusion VR is superior to conventional training in promoting the recovery of upper limb function after a stroke.

Curative effects of pulsed electromagnetic fields on postmenopausal osteoporosis / 生物医学工程学杂志

We investigated the effects and optimal treatment frequency of pulsed electromagnetic fields (PEMFs) on postmenopausal osteoporosis (PMO). A comparison was performed with the cyclical alendronate and a course of PEMFs in the treatment for postmenopausal osteoporosis on bone mineral density (BMD), pain intensity and balance function. There was no significant difference between the two groups on mean percentage changes from baseline of BMD within 24 weeks after random treatments (P > or = 0.05). However, at the ends of 48 weeks and 72 weeks, the BMD of the PEMFs group were significantly lower than that of the alendronate group (P < 0.05). No significant difference was detected between the two groups with regard to treatment effects on Visual Analogue Scale score, the Timed Up & Go Test and Berg Balance Scale score. Compared with cyclical alendronate, a course of PEMFs was as effective as alendronate in treating PMO for at least 24 weeks. So its optimal treatment frequency for PMO may be one course per six months.

Whole body vibration training improves limb motor dysfunction in stroke patients:lack of evidence / 中国组织工程研究

BACKGROUND:Whole body vibration training, a recently developed method of neuromuscular training, is a useful method to improve muscle strength and postural control in the elderly. Recently, researchers attempt to explore whether whole body vibration training can reduce motor dysfunction for stroke patients. OBJECTIVE:To summarize clinical progress in whole body vibration treatment on stroke patients with limb motor dysfunction, including muscle strength of the affected limbs, muscle tension, balance and gait. METHODPubMed, EBSCO, Medline database were searched for articles relate to whole body vibration training intervention for stroke patients with motor dysfunction published from January 2002 to June 2014. Final y, 34 articles were included in result analysis. RESULTS AND CONCLUSION:Whole body vibration training is feasible and safe for stroke patients has the feasibility and safety. For therapeutic efficacy, we focus on the muscle strength, muscle tone, balance, posture control ability, but there is no sufficient evidence to support that the whole body vibration training can improve the motor dysfunction. There is also no recognized standard on specific intervention protocols, such as vibration type, treatment frequency, treatment amplitude, treatment time. Many researchers aim to observe the clinical curative effect at present, but rarely explore the intervention mechanism of the whole body vibration. Further large-sample, multi-center randomized control ed experiments are required to test the validity.

Normal conduction values for the posterior antebrachial cutaneous nerve / 中华物理医学与康复杂志

Objective To determine normal reference values for conduction in the posterior antebrachial cutaneous nerve.Methods Antidromic sensory conduction examinations of the bilateral posterior antebrachial cutaneous nerve were conducted with fifty-eight healthy subjects.The onset latency,peak latency,peak-to-peak amplitude and conduction velocity of the sensory nerve action potentials (SNAPs) were recorded and the inter-side ratios of the peak-to-peak amplitudes were calculated.Results The observed means (and standard deviations) of the onset time,the peak latency,the amplitude and the conduction velocity were 1.96 (0.12) ms,2.48 (0.14) ms,7.39 (2.36) μV and 61.39 (3.69) m/s,respectively.The side-to-side amplitude ratio (smaller/larger) was 0.88 ± 0.09,and no significant difference was observed between the left and right side.The average peak latency and amplitude were significantly different for different age groups.There was no statistically significant difference among the age groups with regard to onset latency or conduction velocity.Conclusion Conduction in the posterior antebrachial cutaneous nerve is easy to study.The peak latency is prolonged and the amplitude decreases with age,suggesting that different normal reference values should be established for different age groups.

Ultrasound effects on chondrocyte apoptosis and the expressions of caspase-8 and caspase-3 / 中国组织工程研究

BACKGROUND:Ultrasound therapy can relieve pain and improve the movement function in patients with knee osteoarthritis, but there lacks of consistency in the literatures of ultrasound therapy. OBJECTIVE:To further identify the effectiveness of ultrasound therapy in the treatment of knee osteoarthritis. METHODS:Twenty-four rabbits were randomly divided into three groups:normal group, model group and ultrasound group. The rabbit in the normal group received no intervention;rabbits in the model group received anterior cruciate ligament transaction to establish the knee osteoarthritis model without any treatment;the rabbit in the ultrasound group received ultrasound therapy after modeling for 10 minutes once time, once per day, 0.3 W/cm2 , 1 MHz and treated for 10 times. Hematoxylin-eosin staining was conducted for histological observation of rabbit articular cartilage;western blot and reverse transcription PCR assessment were used to assess the expressions of caspases-3 and caspases-8 in rabbit articular cartilage, while Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to assess the ratio of chondrocytes apoptosis of rabbit knee articular cartilage. RESULTS AND CONCLUSION:The normal rabbit cartilage tissues and chondrocytes were neatly arranged in column;the middle cartilage layer of the model was thin;the chondrocytes were arranged disorderly and became less. After ultrasound therapy, the chondrocytes were rearranged neatly, and the number was increased. Compared with the normal group, the Mankin scores in the model group and ultrasound group were higher;the apoptotic rate of chondrocytes was higher in the model group and ultrasound group than in the normal group, and was also higher in the model group than in the ultrasound group. Compared with the normal group, the expressions of caspases-3 and caspases-8 were higher in the model group and the ultrasound group, while decreased after ultrasound therapy. The results indicate that ultrasound can improve the structure of cartilage tissues, decrease the expressions of caspases-3 and caspases-8 and reduce the apoptosis rate of chondrocytes. It is effective for the treatment of knee osteoarthritis with ultrasound therapy.

Exercise in the treatment of osteoporosis / 中国组织工程研究

BACKGROUND:Osteoporosis is a condition resulting in an increased risk of skeletal fractures due to a reduction in bone mass and degradation in bone microstructure. Treatment of osteoporosis usual y involves the application of pharmacological agents as the first choice. Pharmacotherapy alone is not sufficient for the comprehensive management of osteoporosis, as pharmacotherapy has no effect on increasing muscle strength, improving balance ability, and preventing fal s. Exercise, considered as an important non-pharmacologic therapy, plays a considerable role in the prevention of osteoporosis. The importance of therapeutic exercises in the treatment of osteoporosis has been recognized gradual y. OBJECTIVE:To discuss the effect of exercise in the treatment of osteoporosis combined with some of the latest research literatures. METHODS:Clinical reports and mechanism researches about effects of different types of exercise on bone strength especial y the treatment of osteoporosis were retrieved from CNKI database and Medline database with the key words of“osteoporosis, bone mineral density, bone strength, treatment, exercise, stress, tai chi, muscle, bone architecture”in both Chinese and English from January 2001 to February 2013. The repetitive researches and atypical reports were eliminated. RESULTS AND CONCLUSLON:Therapeutic exercises including aerobic exercise, resistance, impact movement, and vibration, which can safely increase bone strength and muscle strength, improve equilibrium function, and prevent fal s and fractures. For spinal deformity patients, appropriate orthotics can improve the security and promote exercise therapy. As with drug therapy, therapeutic exercises are also individualized. Exercise program should be selected under the insurance of good compliance and security. Exercises that involve high strain rates seem to be more effective than others. However, al these benefits are comparatively smal , and should be maintained by continuous exercises.

Static balance and the limits of stability in postmenopausal women and their relationship with bone mineral density / 中华物理医学与康复杂志

Objective To characterize the static balance and limits of stability (LOS) of postmenopausal women and evaluate the relationship between bone mineral density (BMD) and balance.Methods Sixty women more than 12 months past menopause and aged 50 to 60 years were included in the study.Group 1 (n =20) consisted of women with normal BMD,group 2 (n =20) women with osteopenia,and group 3 (n =20) women with osteoporosis.The static balance of all the participants was evaluated in upright postural situations for 60 s with the eyes open and with the eyes elosed.Their LOS was quantified using a force platform.Results There was no significant difference in static balance parameters or LOS among the 3 groups.The static balance parameters were not significantly different in either the eyes-open or eyes-closed situation in the osteoporosis and osteopenia groups.The medial and lateral LOS were greater than the anterior and posterior limits in all 3 groups.The anterior LOS was greater than the posterior limits among the women with osteopenia and normal density.Conclusion In postmenopausal women aged 50 to 60 years,BMD did not show any significant association with static balance or LOS.Postmenopausal women had better postural control in the mediolateral than in the anteroposterior direction.In postmenopausal women with osteoporosis,postural control in the anterior direction deteriorates from age 50 to 60.

The test-retest reliability of limits of stability measurement with healthy young adults / 中华物理医学与康复杂志

Objective To estimate the test-retest reliability of limits of stability (LOS) measurement in healthy young adults. MethodsTwenty-five healthy young adults participated this study.Their center of pressure (COP) displacements were recorded while they stood on a force platform.The subjects performed maximal voluntary sway maneuvers in the anterior,posterior,left and right directions in turn.The LOS in each direction was calculated using balance clinic software.Each subject underwent 3 consecutive,identical tests at 7 day intervals with the same investigator.The test-retest reliability of LOS was analyzed using the intraclass correlation coefficient (ICC).ResultsFor the first test the ICC values ( ICC1 ) of the LOS ranged from 0.790 to 0.857.For the mean LOS of the first two tests the ICC2 ranged from 0.906 to 0.937,and for the mean LOS of three tests the ICC3 ranged from 0.910 to 0.948. ConclusionThe LOS test is a reliable measurement with healthy young adults.In clinical practice,averaging two LOS tests is suggested in assessing balance and postural control with young adults.

Delayed diagnosed developmental dysplasia of the hip got remission effectively through Neurac technique / 中国组织工程研究

BACKGROUND: Joint instability may be a key agent contributing to the progress of developmental dysplasia of the hip (DDH). Neurac technique is a new modality focused on activating neuromuscular function and improving joint stability. Neurac technique may be helpful for delayed diagnosed DDH.OBJECTIVE: To observe the therapeutic efficacy of Neurac training on DDH patients.METHODS: A female patient of 23 years old with delayed diagnosed DDH received Neurac training for 14 days was retrospective analyzed.RESULTS AND CONCLUSION: The pain was relieved at 14 day after treatment. The Harris scoring showed that the hip function was improved. At 6 months follow-up, the results indicated that the remission was kept fine. Patient with delayed diagnosed DDH may get fine remission of pain and function through Neurac treatments. The effectiveness can last for a long time.

The update progress of physical treatment for osteoporosis / 生物医学工程学杂志

Treatments for osteoporosis have many varieties, and the role, characteristics of them are also different. This paper investigates from the perspective of physical therapy pulsed electromagnetic fields (PEMFs), shock wave, and low-intensity pulsed ultrasound (LIPUS) therapy. Then comprehensive analysis of their mechanism of action, clinical application of new advances for more reasonable choice for clinical treatment and further trend of research are discussed. Through the research and discussions, we find out the strengths, weaknesses, and the best method of treatment in order to achieve better therapeutic effect.

The effect of pulsed electromagnetic fields on the biomechanical properties of the femur in ovariectomized rats / 中华物理医学与康复杂志

Objective To observe the effect of pulsed electromagnetic fields (PEMFs) of different intensities on the biomechanical properties of the femur in ovariectomized rats so as to determine the intensity for the best therapeutic efficacy. Methods Fifty female Sprague-Dawley rats were randomly divided into (1) a sham-operated control group (no PEMF treatment) , (2) ovariectomized control group (no PEMF treatment) (3) ovariectomized group Ⅰ (PEMF treatment at 8 Hz and 0.77 mT intensity, 40 min daily for 30 days) (4) ovariectomized group Ⅱ (PEMF treatment at 8 Hz and 3.82 mT intensity, 40 min daily for 30 days) and (5) ovariectomized group Ⅲ( PEMF treatment at 8 Hz and 9.87 mT intensity, 40 min daily for 30 days). Except for the 10 rats of the sham-operated control group, all the others received a standard ovariectomy. Serum estradiol (E2) and the biomechanical properties of one femur (peak load, maximum displacement, maximum energy absorption, maximum stress, maximum strain and modulus of elasticity) were assessed after 30 days of PEMF treatment. Results In group Ⅱ the biomechanical properties of the femur were significantly better than in group Ⅰ or the ovariectomized control group. In groups Ⅰ and Ⅲ the biomechanical properties of the femur were not significantly better than in the sham-operated group. In group Ⅱ the biomechanical properties of the femur were significantly better than in groups Ⅰ or Ⅲ. Conclusion PEMFs at 3.82 mT can improve the biomechanical properties of the femur significantly.

Effect of osteophytes on bone mineral density of female lumbar spine / 生物医学工程学杂志

Previous case-control studies have shown various degrees of inverse correlation between osteoarthritis (OA) and osteoporosis (OP). The aim of this study was to examine the relationship between osteophytes at the cervical , lumbar vertebrae and knee, and the bone mineral density (BMD) of lumbar spine. We analyzed the data on 4091 female patients (aged 13 to 92 years). Osteophyte was defined by X ray examination. BMD of the lumbar spine (LS) was measured by dual energy X-ray absorptiometry (Lunar DPX). The association of osteophytes with BMD and osteophytes at different sites and different degrees were assessed by covariance analysis. Adjustments were made for age and body mass index. The relationship between osteophytes and BMD was analyzed by Binary Logistic Regression. BMD at each site was greater in the female with osteophytes (L4 BMD: P < 0.01, Mean BMD: P < 0.05); the relationship between osteophytes and osteoporosis and that between duration of osteophytes and osteoporosis were inversely correlated (P < 0.01). It confirms the existence of an inverse relationship between osteophytes and OP while a positive relationship is between age, body mass index and osteoporosis.

On correlation between body mass index and lumbar spine average bone mineral density: a study in male patients with osteopenia and those with osteoporosis / 生物医学工程学杂志

From among the patients who visited the Dept. of Rehabilitation of West China Hospital for arthalgia in the period from Aug. 2003 to Dec. 2005, we recruited 566 male patients who were over 40 years of age and did not have hyperostosis in the lumbar spine, and whose T scores were each less than--1. Their ages ranged from 40 to 93 years, and the average age was 62.93 +/- 13.50. The dual-energy X-ray absorptiometry from DMS Company in France was used to measure the bone density of the L2-4 anterior-posterior. The basic data about the subjects, containing the age, height, weight, diabetes mellitus, exercise and smoking or not, were recorded. Then the body mass index were calculated. In accordance to the T score, the subjects were separated into two groups: osteopenia group and osteoporosis group. In comparison of the basic data between groups, BMI of osteoporosis group was significantly higher than that of the osteopenia group, but the number of the subjects who exercised was smaller (P < 0.05). Multiple linear regression analysis revealed that in the case BMI increased by 1 kg/m2, BMD significantly decreased by 0.003 g/cm2 (P = 0.002), and the age negatively correlated with BMD (B = -0.001, P = 0.035). "Exercise or not" was positively related to BMD (B = 0.028, P = 0.000). "Smoking or not" and BMD were not significantly correlated (P = 0.837). In conclusion, increase of BMI, or we may say, increase of fat, would decrease the lumbar spine average BMD in the patients of osteoporosis or osteopenia. Some reports have pointed out that only by increasing BMI with increased amount of muscles, but not with increased amount of fat, would be beneficial to the prevention of osteoporosis. So we concluded that the muscle amount in the subjects should be taken into account when we probe into the relation between BMI and BMD.

Study on the relationship between body mass index and osteoporosis in males / 生物医学工程学杂志

There were 482 male patients with non-hyperostosis diagnosed by X-ray among 1207 males who visited West China Hospital because of pain and/or numbness in bone or/and in joints from August 2003 to December 2005; the base-line information in records included age, stature, body weight(calculated BMD, symptoms, co-morbidities, exercise frequency, and smoking. The bone mineral density of lumbar spine was determined and used to judge osteoporosis or non-osteoporosis. Comparison was made on the basic information between osteoporosis group and non-osteoporosis group by t test or chi2 test statistical analysis; the relationship of multiple factors with osteoporosis was analyzed by Logistic Regression. The results of comparison between osteoporosis group and non-osteoporosis group indicated, there were significant differences among BMI, exercise and smoking, but no significant differences were seen among age, complications of hypertension and diabetes mellitus. According to the results of multiple regression analysis, BMI and smoking are the risk factors of osteoporosis, yet exercise is the protection factors of osteoporosis; the risk of osteoporosis increases by 0.654 times in men with BMI scaling up by 1 kg/m2 (P = 0.004). Therefore, we conclude that BMI is a risk factor of osteoporosis in male, and it may be related to body fat distribution.

Effect of spinal stabilization training on the vertebral osteoporotic compression fracture: An individualized program / 中国组织工程研究

BACKGROUND: Surgery is a main method to reconstruct the stability of spine after compression fracture. But the reconstruction of spinal stability for patients undergoing conventional therapy remains unclear.OBJECTIVE: To explore whether spinal stability training is effective on improving pain and motor function of patients with vertebral osteoporotic fractures.METHODS: Patients with vertebral osteoporotic fractures were divided into two groups. The study group was treated with conventional treatments and individualized spinal stabilization training, while the control group received conventional treatments alone. All the subjects were evaluated before and after treatment by numeric pain rating scale (NPRS), 3-meter timed up and go (TUG) and Oswestry functional limitation index (OFLI). The results were compared between the two groups.RESULTS AND CONCLUSION: A total of 27 patients were included, including 16 patients in the study group and 11 in the control group. After 4-week treatment, TUG and OFLI in the study group decreased significantly compared with the control group (P < 0.05). But there was no statistical significance between the two groups in the level of NPRS and the amount of changes (P > 0.05). Symptoms and function of both groups were improved after treatments. Individualized spinal stability training is effective to restore the motor function and may be helpful for reducing pain for patients with vertebral osteoporotic fractures combined with conventional treatments.

Effect of body mass index on bone mass of lumbar spine of male patients with ostealgia and arthralgia but without osteoporosis / 生物医学工程学杂志

For the purpose of identifying the effect of body mass index on bone mineral density, an investigation was made in regard to the relationship between body mass index (BMI), bone mineral density (BMD) and bone mineral content (BMC) of lumbar vertebrals of men without osteoporosis. 838 male patients were diagnosed and treated in West China Hospital of Sichuan University because of ostealgia and arthralgia from Aug. 2003 to Dec. 2005. They were examined by dual-energy X-ray absorptiometry, their L2-L4 bone mineral density being < -2.5SD. Then they were graded by body mass index (Kg/m2) [1st group BMI > or =23, 454 cases (Group A BMI > or = 29, 46 cases; Group B 25 < or = BMI < 28.9, 201 cases; Group C 23 < or = BMI < 24, 9193 cases); 2nd group 18.5 < BMI < 22.9, 311 cases; 3rd group BMI < or = 18.5, 68 cases]. The relationships between BMI and BMD of lumbar spine were analyzed using SPSS 13.0. The results revealed their positions in series: (1) Among Groups 1-3, BMD, average BMD and aBMC of L2-L4 being 3rd group > 2nd group > 1st group, the differencs are statistically significant (P < 0.05 or P < 0.01); BMC, aBMC of L3 and L4 and aBMC of L2 being 3rd group > 2nd group > 2nd group, the differences are significant (P < 0.01); besides BMC of L2 and T-score,the differencs among three groups are not statistically significant (P > 0.05); (2) Among the 1st group, BMD and average BMD of L2-L4 being Group C > Group B > Group A,the differencs are significant (P < 0.05 or P < 0.01); BMC, aBMC of L and I being Group C > Group B > Group A,the differences among the three groups are significant (P < 0.05 or P < 0.01); BMC, aBMC of L3 and L4 and aBMC of L2 being Group C > Group B > Group A, the differences are significant, besides BMC of L2 and T-score,the differences among three groups are not significant (P > 0.05), (3) BMI correlated negatively (P < 0.01, r = -0.189) to the average BMD of lumbar spine. The average BMD of lumbar spine decreases when BMI increases in males without osteoporosis. When obesity is more obvious, the decrease in average BMD of lumbar spine bone is more evidently decreased. The decrease of BMD, BMC and total BMC in L3 and L may be greater than that in L2.

Rehabilitation of Hemiplegic Patient with Bilateral Hemianopia:One Case Report / 中国康复理论与实践

@#Cerebrovascular diseases can lead to hemiplegia,hemiparaesthesia and hemianopia.However,patients with poor eyesight resulting from bilateral cerebral infarction are rare.The authors reported here the rehabilitation assessment and treatment of one case with hemiplegia and poor eyesight resulting from bilateral cerebral infarction.According to the poor eyesight of the patient,a rehabilitation program which was different from common program was designed,and the patient can walk independently and achieve basic activities of daily living independence underlying the treatment of the new rehabilitation program.The attention should be paid on the variant rehabilitation treatment process depending on variant condition of patients.

An investigation of functional characteristics of traumatic brain injuries occurred in earthquake / 中华物理医学与康复杂志

Objective To investigate the functional characters of traumatic brain injuries occurred in wenehuan earthquake.Methods Thirty-eight cases with brain injury,occurred in Wenchuan earthquake,hospitalized in intensive care unit and brain surgery wards of Wenchuan China Hospital were enrolled in the study.Glasglow coma scale(GCS)was used to assess the severity of brain injury,mini-mental state examination(M MSE)was used to assess the cognitive function,the modified Ashworth scale was applied to aSSeSS the muscle tone,the Bobath balance scale was applied to assess the sitting and standing balance.the modified Barthel index Was applied to evaluate the activities of daily living(ADL).Resuits Mean age of the patients was 46 years,ratio of male to female was 1.9:1.Twenty-seven(71.1%)patients suffered mild brain injury,4(10.5%)patients moderate brain injury and 7(18.4%)patients severe brain injury.In non-comatose patients,some patients suffered motor control disorder as hemiplegia,aphasia,cognitive disorder,Rom limitation,muscle tone disorder,muscle weakness,sitting balance disorder and standing balance disorder respectively.Thirty-six(94.7%)patients couldn't take care of themselves independently.Conclusion The function disorder of traumatic brain injuries occurred in earthquake had some particular characteristics.it's necessary to establish a rehabilitation system for the effectire rehabilitation management and treatment according tO the patients'characteristics.