An operative position of foot stepping and knee bending in toe replantation for avulsed and fractured great toe / 中华显微外科杂志

Objective:To summarise the advantages and disadvantages of applying the method of retrograde replantation with an operative position of foot stepping and knee bending for replantation of rotational avulsed and fractured great toes.Methods:From January 2016 to June 2021, 11 rotational avulsed and fractured great toes were replanted with the method of retrograde replantation in an operative position of foot stepping and knee bending. Of the 11 patients, 10 were males and 1 was female, aged 18 to 50 years old with an average of 32 years old. Causes of injury: 5 of driving belt, 4 of machinery crush and 2 of car accident. Injury sites: 4 on left great toes and 7 on right great toes. All of the injuries were with fracture and exposure of proximal tendons of flexor and extensor. Seven patients had the follow-up reviews by outpatient clinic visiting, 2 over mobile phone and 2 via WeChat.Results:After surgery, 9 great toes completely survived and 2 great toes had necrosis. The survival rate of toe replantation was 81.8%(9/11). The operation time was 2 to 3 hours, with an average of 2.5 hours. Postoperative X-ray film showed that 8 to 12 weeks after the operation, the fracture and joint fusion were healed at first stage in the survived toes. All patients were entered in follow-up for 3 to 18 months with 10.5 months in average. The survived great toes were plump and the toenail grown well. At the final follow-up, the static TPD at the toes was 8-12 mm, with an average of 10 mm. There was no effect shown on either walking or running.Conclusion:The retrograde replantation method with an operative position of foot stepping and knee bending for great toe replantation has the characteristics of a good field of view and convenient in operation under microscope, a short operation time, and a high survival rate of replantation.

Effect of anodal transcranial direct current stimulation on full-effort stepping exercise performance / 体力科学

We investigated the effect of anodal transcranial direct current stimulation (anodal tDCS) on the performance of full-effort box stepping exercises in athletes and non-athletes. Twenty-one subjects (athletes: five men and six women, non-athletes: four men and six women) participated in this study. tDCS was applied through two electrodes placed on the vertex (anode) and the forehead (cathode). A 2-mA anodal stimulation was applied for 15 minutes, while sham stimulation was applied on different days with similar electrodes. Participants were asked to apply a maximal effort while stepping up and down a 10-cm tall box for 20 s following termination of the tDCS. The 20 s box stepping was repeated three times with 15 s of rest. The number of total steps was significantly increased following anodal tDCS compared to sham tDCS. The degree of increase in performance was more prominent in non-athletes than in athletes. In non-athletes, a differential pattern of fatigue in performance between stimulus conditions was observed. In contrast, this significant performance modulation between stimulus conditions was not detected in athletes. Our findings of improved stepping performance following anodal tDCS depended on the training level of the subject group; this implies modulation of descending command from CNS to active muscles by tDCS. It is suggested that the degree of neural modulation for controlling complex and full-effort leg movements due to tDCS is higher in non-athletes than in athletes.

The assessment of fukuda stepping test results in prognosis of benign paroxysmal postural vertigo / Avaliação dos resultados do teste da marcha de Fukuda no prognóstico da vertigem posicional paroxística benigna

Abstract Introduction Benign paroxysmal postural vertigo originating from the peripheral vestibular system is characterized by brief vertigo spells triggered by the sudden head motion. Usually, vestibular dysfunction in benign paroxysmal postural vertigo is unilateral. Fukuda stepping test which is helpful in the diagnosis of unilateral vestibular dysfunction, may also be valuable in the prediction of prognosis of benign paroxysmal postural vertigo. Objective The purpose of this study is to evaluate the relevance of Fukuda stepping test results with resistant and/or recurrent benign paroxysmal postural vertigo cases. Methods We evaluated 62 patients with unilateral, idiopathic benign paroxysmal postural vertigo of posterior and/or lateral canals. The Fukuda stepping test was performed prior to the Dix-Hallpike and head-roll tests. Two groups were created according to the Fukuda stepping test results. In Group 1 Fukuda stepping test results were positive with a deviation angle >45°, while in Group 2 the results were negative with no apparent deviation. Two groups were compared by the number of canalith repositioning manuevers performed and the frequency of recurrences. Results We found Fukuda stepping test to be invaluable in the diagnosis of benign paroxysmal postural vertigo since the ratio of Fukuda stepping test positivity and negativity were similar in benign paroxysmal postural vertigo patients. However, the need for multiple canalith repositioning manuevers was significantly higher in Group 1 (p= 0.0103). In addition, the recurrence frequency was found significantly lower in the Group 2 (p= 0.0441). Conclusion Although the sensitivity of Fukuda stepping test in detecting mild/moderate unilateral vestibular dysfunction is poor, it may be valuable in prediction of the prognosis of benign paroxysmal postural vertigo. We suggest that positive Fukuda stepping test results in benign paroxysmal postural vertigo patients indicate poor prognosis, the need for multipl canalith repositioning manuevers and the higher possibility of recurrences.

Resumo Introdução A vertigem posicional paroxística benigna com origem no sistema vestibular periférico é caracterizada por breves crises de vertigem desencadeadas pelo movimento súbito da cabeça. Geralmente, a disfunção vestibular na vertigem posicional paroxística benigna é unilateral. O teste da marcha de Fukuda, útil no diagnóstico de disfunção vestibular unilateral, também pode ser valioso para prever o prognóstico da vertigem posicional paroxística benigna. Objetivo Avaliar a relevância dos resultados do teste da marcha de Fukuda em casos de vertigem posicional paroxística benigna resistente e/ou recorrente. Método Avaliamos 62 pacientes com vertigem posicional paroxística benigna unilateral idiopática dos canais posterior e/ou lateral. O teste da marcha de Fukuda foi feito antes dos testes de Dix‐Hallpike e head‐roll (giro da cabeça). Dois grupos foram criados de acordo com os resultados do teste de Fukuda. No Grupo 1, os resultados do teste de Fukuda foram positivos com um ângulo de desvio > 45°, enquanto no Grupo 2 os resultados foram negativos sem desvio aparente. Dois grupos foram comparados pelo número de manobras de reposicionamento canalicular feitas e pela frequência de recorrências. Resultados Observamos que o teste de Fukuda é inestimável no diagnóstico de vertigem posicional paroxística benigna, pois a relação entre a positividade e a negatividade do teste de Fukuda foi semelhante nos pacientes com vertigem posicional paroxística benigna. No entanto, a necessidade de múltiplas manobras de reposicionamento canicular foi significantemente maior no Grupo 1 (p = 0,0103). Além disso, a frequência de recorrência encontrada foi significantemente menor no Grupo 2 (p = 0,0441). Conclusão Embora a sensibilidade do teste de Fukuda para detectar disfunção vestibular unilateral leve/moderada seja baixa, o teste pode ser valioso na previsão do prognóstico de vertigem posicional paroxística benigna. Sugerimos que os resultados positivos do teste da marcha de Fukuda em pacientes com vertigem posicional paroxística benigna indicam mau prognóstico, necessidade de múltiplas manobras de reposicionamento canicular e maior possibilidade de recorrências.

Effects of the Square-Stepping Exercise program on physical fitness and cognitive function in elderly / 体力科学

The purpose of this study was to examine the effects of a six-month Square-Stepping Exercise (SSE) program on physical fitness and cognitive function in elderly and the effects of differences in cognitive function levels before the program on cognitive function. Twenty-four elderly (≧75 years old, mean age: 80.7±3.8 years) participated in the SSE program (once a week, 90 minutes/session, for six months). Grip strength, single leg balance with eyes open, chair stand, figure-8 walking test, and cognitive function (Five Cog) were measured before and after the program. Physical function did not improve during the SSE program. Significant memory and language improvements in Five Cog were observed. There was no significant interaction between the pre cognitive function level and the pre results. In conclusion, the six-month SSE program is an effective exercise for improving memory and language in cognitive function of elderly women and prevented physical function decline. However, there was no difference in the improvement due to the pre cognitive function level.

Development of Stand-walking Simulator for Rehabilitation Training / 中国医疗器械杂志

A rehabilitation equipment is developed by mechanical and electronic engineering principle based on the need of rehabilitation training for patients with paraplegia. The device can prevent complications such as palsy bedsores and deep venous thrombosis. The device effectively reduces the labor intensity of the rehabilitation staff or family members to carry the patient's body, and promotes the physical and psychological rehabilitation progress of patients with lower limb paralysis.

Evaluation of Residual Stepping Ability in Monkeys with Spinal Cord Injury / 中国康复理论与实践

Objective:To evaluate the residual stepping ability in monkeys with spinal cord injury longitudinally. Methods:Four adult female monkeys were studied. Right hemisection of 10 mm spinal cord tissue was performed at the T7-9 segment. Gait tests of bipedal locomotion were performed before, and six weeks and twelve weeks after injury by VICON system. Gait cycle duration, amplitude of knee and ankle angles, and ratio of united parameters were obtained from successive stepping and were quantitative analyzed. Results:The coordination of bilateral hindlimbs was destroyed after spinal cord injury, and the right hindlimb showed obviously dragging. The gait cycle duration of the left hindlimb increased significantly (P < 0.001), and the amplitudes of knee and ankle angle significantly increased (P < 0.001) after spinal cord injury. The ratio of united parameters was not statistically different among all the time points (P > 0.05). The gait cycle duration of the left hindlimb was correlated with step length (r = 0.838, P = 0.001), step height (r = 0.726, P = 0.007) and amplitude of ankle angle (r = 0.766, P = 0.004), and the amplitude of ankle angle was correlated with step length (r = 0.627, P = 0.029). Conclusion:The gait pattern of monkey with spinal cord injury has been changed. The gait strategy of the uninjured side was adjusted compensatively after spinal cord injury to adapt the functional impairment of contralateral hindlimb.

Relationship of an osteoarthritis of the knee and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping / 体力科学

In this study, we investigated the relationship of an osteoarthritis of the knee (OA) and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping. The subjects were 29 middle-aged women (mean age 63.7±6.7 years). We categorized them into groups based on the following conditions: osteoarthritis of the knee (OA groups; n = 9), knee pain (KP groups; n = 7), and no pain (NP groups; n = 13). We measured the ground reaction force in a vertical direction when stepping on a platform. The evaluation variables were as follows: peak of ground reaction force at the early stance phase (F1), middle phase (F2), and late phase (F3). We calculated the bilateral difference of ground reaction force of the left and right leg and the affected side and the unaffected side ratio. The result of two way ANOVA, there was a significant difference between the leg in F1 and F3 and the group at F2. The result of comparison between the OA groups and the KP groups, there was no significant difference in the unaffected side and the affected side ratio, those in the OA groups tended to have a load on the unaffected side, while those in the KP groups had a load on the affected side. Therefore, it was suggested that there was the relationship of the OA and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping.

Evaluation of the protective effect of Paeonia emodi Wall on rat model of Parkinson’s disease induced by 6 hydroxy dopamine

Background: Generation of reactive oxygen species together with paucity of antioxidant defense is considered as an important cause for dopaminergic neuronal death. Review of literature indicates that none of the drugs so far studied for preventing the PD were found to be promising for use. Therefore, the present study was planned to evaluate the neuroprotective effect of Paeonia emodi Wall (PEW) in 6-hydroxy dopamine induced Parkinson’s disease (PD) model.Methods: The study was conducted on Wistar rats where Parkinson’s disease was induced by producing the striatal 6-hydroxy dopamine lesions. The test animals received ethanolic extract of PEW at dose of 200 and 300mg/kg for 28 days. Circling behavior, spontaneous locomotor activity, muscular coordination and akinesia were studied. Antioxidant levels were assessed by biochemical estimation and histopathology was carried out for dopaminergic neuronal loss.Results: PEW ethanolic extract showed significant dose dependent recovery in number of circlings, line crossing, muscular coordination and akinesia. A significant increase in MDA levels and decreased GSH level in PEW treated groups was observed in test groups as compared to control group (p<0.05). Normal architecture was retained only in PEW 300mg/Kg (p<0.05). L-Dopa did not showed effect on biochemical and histological parameters.Conclusions: The ethanolic extract of PEW showed neuroprotective activity against 6-hydroxy dopamine induced Parkinson’s disease in rats in both 200 and 300mg/kg doses. The protective action of PEW in PD can be because of its ability to reduce the oxidative stress.

Effects of different obstacle height and movement pattern on supported leg sway during lateral stepping over in healthy young adults: Analysis using a small triaxial accelerometer / 体力科学

<p>The purpose of this study was to determine sway characteristics of a supported leg during a lateral stepping over obstacle task with different obstacle height and movement patterns, using a small triaxial accelerometer. We examined 20 healthy young adults to assess their trochanter malleolar distance traveled during a lateral stepping over obstacle task with obstacle heights of 30%, 50%, and 70%. The lateral stepping over tasks revealed flexion and extension patterns. We directed the subjects to grasp a forward handrail, perform the lateral step, and subsequently step over to the side. We calculated synthetic acceleration (SA) from acceleration data measured using two small triaxial accelerometers and two web cameras. We calculated supporting leg sway; RMS phases of X-, Y-, and Z-axes; and SA data. The subjects showed increased RMS of Y-axis and SA according to the obstacle height for the flexion pattern; however, they did not show change in RMS of Y-axis and SA according to the obstacle height for the extension pattern. During lateral stepping over, the RMS of Y-axis and SA for the flexion pattern were higher than for the extension pattern. The findings for the flexion pattern suggest that the center of gravity shifts higher according to increased obstacle height; consequently, the supporting leg becomes unstable. The findings for the extension pattern suggest that the “screw-home” rotation effect of the supporting leg during movement can support lateral stepping over better than the flexion pattern.</p>

Effects of a Group Exercise Activity Managed by Elderly Volunteers on the Physical Function of Community-dwelling Older Women who Had Recently Completed an Exercise Program Led by Fitness Experts / 日本プライマリ・ケア連合学会誌

<p><b>Introduction: </b>The purpose of this study was to investigate the effects that a group exercise activity managed by elderly volunteers would have on the physical function of older women after they participated in a formal exercise program taught by fitness experts.</p><p><b>Methods: </b>Subjects were 47 community-dwelling older women who had completed a 3-month exercise program led by expert instructors in Kasama City, Ibaraki. After completing this exercise program, 28 subjects continued to participate in a group exercise activity led by elderly volunteers for approximately 11 months. The remaining 19 subjects did not join the group activities after the formal program. In both the initial, expert-led exercise program and the subsequent, volunteer-led group activity, subjects mainly engaged in the square-stepping exercise, which is a novel exercise for improving lower extremity physical function. In order to assess participants' physical function, we conducted five physical performance tests at both the baseline and follow-up; the former is the last day of the exercise program and the latter is approximately a year after the baseline.</p><p><b>Results: </b>Two-way ANOVA demonstrated a significant interaction in the timed up and go test (P=0.003). The performance of subjects who had participated in the volunteer-managed group activity improved between the baseline and follow-up tests (P=0.007).</p><p><b>Conclusion: </b>Participating in a group exercise activity managed by elderly volunteers can improve mobility skills of older women who had previously completed a formal exercise program led by expert instructors.</p>

Comparative evaluation of moderate dose inhalational corticosteroid (ICS) fluticasone with the combination of low dose fluticasone and montelukast in moderate persistent bronchial asthma.

Background: Use of inhaled corticosteroids (ICS) are recommended in all grades of persistent asthma and once the symptoms are stabilized, “stepping down" of steroids is recommended to minimize their unwanted effects with the addition of a second medication with a complimentary mechanism of action. Aims & Objective: In our study a comparison of moderate dose ICS Fluticasone in “stepping down” strategy with combination of low dose Fluticasone with once-daily montelukast were assessed. Materials and Methods: 50 patients with moderate persistent asthma were randomly assigned in study. Initially stabilized on fluticasone propionate (FP) 250 μg twice daily, for four weeks, there after patients were given the medication as per the protocol Group-I (n=25)- fluticasone 250μg BD; Group-II (n=25)- fluticasone125 μg BD + Montelukast 10 mg in night. Patients were then followed up for 12 weeks. The primary efficacy variables were changes in FEV1%, PEFR%, ACS (asthma control symptom) score and asthma quality of life (QOL) score. Results: Changes in lung function at the end of study in Group-I and Group-II respectively as compared to 0 week (baseline) values, FEV1% value (p <0.05, p <0.05), PEFR% value (p <0.01, p <0.05), ACS score (p <0.01, p <0.05), AQOL score (p <0.05, p <0.05). ICS fluticasone 250 μg BD and low dose fluticasone 125 μg BD + Montelukast 10 mg in night are equally efficacious in improving lung functions, asthma symptoms and QOL. Montelukast group was more expensive with fewer adverse events. Conclusion: Moderate dose fluticasone did not show any benefit over combination of low dose fluticasone and Montelukast 10mg in night. Montelukast 10 mg in combination with low dose fluticasone can be an alternative in moderate persistent asthma.

Home-based interventions for the children with mental retardation / 国际儿科学杂志

Home-based intervention is a essential for rehabilitation treatment for the children with mental retardation.This paper describes the methods of home-based intervention for children with mental retardation,which include Portage Project,parent-child interaction therapy,snoezelen therapy and Stepping Stones Triple P and reviews their current situations and curative effect in order to provide a reference for the application of these methods in China in the future.Each method has its own principle and advantages,and meanwhile it plays an active role in reducing disruptive behavior of children with mental retardation and optimizing parenting styles of parents.

The effect of bench-stepping exercise training on BMD, BMC and bone metabolism in menopausal women / 体力科学

Since the effect of the submaximal aerobic exercise on bone had been controversial, the aim of this study was to elucidate the effect of the bench step (BS), that seemed to deliver higher mechanical load on bone than any other aerobic exercises, on the total bone mineral content (BMC) and the bone metabolism of menopausal women. Sixteen menopausal women (65 ± 9 years old) as the exercise group (ExG) and 28 pre-menopausal women (43 ± 3 years old) as the control group (CG) were studied. ExG carried out BS training with the exercise intensity at lactate threshold (LT) for 21 weeks. In ExG, BMC was measured by dual energy X-ray absorptiometry (DXA) at one year before the intervention (A year before), pre-intervention (Pre) and post-intervention (Post). Serum osteocalcin (OC) as the marker of bone formation and serum type I collagen cross-linked N-telopeptide (NTx) as the marker of bone absorption at Pre, 11th week of the intervention and Post. In CG, BMC was measured annually without the intervention. In ExG, OC was not changed, but NTx was significantly decreased by intervention (<i>p</i><0.05). The decreased amount of annual change in BMC between a year before and Pre (T1) was significantly higher compared to that between Pre and Post (T2) (<i>p</i><0.01) and CG (<i>p</i><0.001). There was no significant difference between T2 and CG. In conclusion, BS with LT could prevent decreasing BMC in menopausal women, and maintain the same level of BMC in pre-menopausal women by suppressing the bone absorption.

Effects of static acceleration training with a whole-body vibration machine in community-dwelling older adults / 体力科学

The purpose of this study was to examine the effects of 9 weeks of resistance training, with and without static acceleration training (AT), on participants' lower-limb muscle strength, power, and physical function. Healthy participants (19 men and 28 women), aged 65-75 years, were assigned to a static AT group (AT, n = 31) or a non-AT control group (C, n = 16). The AT group and the C group trained three times/week for 9 weeks. The AT group performed unloaded static AT and low-intensity aerobic activity. The C group performed dynamic weight-bearing resistance training without whole-body vibration and the same aerobic activity as the AT group. We collected and analyzed data from 45 participants (AT = 30, C = 15) who completed pre- and post-tests. There was no significant Group × Time interaction on any measurements of lower-limb muscle strength, power, or physical function. Significant time effects were observed in the following tests:isokinetic knee extensor and flexor peak torque, 5-time sit-to-stand, usual gait speed, timed up and go, standing time from a long sitting position, and sit and reach. All of these 7 variables showed positive changes. These results suggest that static AT is a suitable training method having approximately the same efficiency as conventional, weight-bearing, dynamic resistance training for improving lower-limb muscle strength and power, mobility, and flexibility in community-dwelling Japanese older adults.

Development of infusion tele-control system based on LonWorks / 医疗卫生装备

This paper introduces some information of the infusion tele-control system based on LonWorks, including its system function, operation principle, software and hardware designs. With high reliability, low cost and convenient operation, this system has a bright future in the market and its application.

Development of multi-function hydraulic pressure diagnostic and therapeutic instrument / 医疗卫生装备

This paper introduces some information of the multi-function hydraulic pressure diagnostic and therapeutic instrument, which is applied to the diagnoses and treatments of oviduct, matrix, urethra, bladder and bile duct, including its system function, operation principle, software and hardware designs. Being reliable, cheap, convenient and multipurpose, the instrument has a bright future in the market.

Automatic Stepping in Patients with Progressive Basilar Artery Infarction

Automatic stepping is an involuntary disorder with cyclic alternating leg movements which causes patients to appear as if walking. We report automatic stepping in patients with progressive basilar artery territory infarcts. These movements consisted of spontaneous knee flexions and ankle dorsiflexions with intermittent hip flexions, and alternating leg movements without provocation. Intervals between the movements were various from 3 to 30 seconds. Serial diffusion- weighted MRI revealed that progressive lesions were mainly located in the pontine tegmental areas.

Biomechanics analysis of ascending and descending stairs / 中国康复理论与实践

@#ObjectiveTo analyze the biomechanics of ascending and descending stairs.MethodsThe moment of force of knee joint and contract strength of quadriceps muscles were analyzed by three dimensional motion analysis system and electromyograph (EMG) in three healthy men.ResultsFor the moment of force of knee joint, there were differences among different styles of ascending and descending stairs, but there were no differences in angles of knee joint flexion. The contract strength of quadriceps muscles during ascending stairs was stronger than that during descending stairs.Conclusion There are differences of knee joint moment and quadriceps muscles activities among 4 strategies during descending, and it is shown that quadriceps muscles' activities and knee joint moment became smaller during forward stepping, double stepping on one stair, side stepping, and 45°side stepping in sequence during descending stairs.

Application and Evaluation of Stepping DSA Technology in Lower Extremity Artey Disease / 医疗卫生装备

Objective To evaluate stepping DSA technology in lower extremity artey disease. Methods 12 cases performed with stepping DSA in lower extremity artery were examined with TOSHIBA Infinixi digital subtraction angiography system, of which, 8 ones were also examined with conventional DSA. Results Stepping DSA technology could decrease the dosage of contrast agent and the examination.

Cross-Sectional Change in Reaction Time and Stepping Ability Estimated from Skeletal and Chronological Age in Adolescent Soccer Players / 体力科学

The purpose of this study was to clarify the differences in reaction time, stepping frequency and stepping endurance estimated by chronological age compared to skeletal age. The participants were 76 well-trained soccer players aged from 9.7 to 14.8 years old. Height and weight were measured before training. Their skeletal ages were evaluated by RUS score of TW II method. RUS score was calculated for skeletal age by Murata's method. Reaction time, stepping frequency and endurance were measured by Talent-Diagnose-System (Werthner Sports Consulting, KEG, Co, Ltd.) . For chronological age, height increased linearly from 9 to 14. Height estimated by skeletal age increased slowly from 8 to 10, then increased drastically between the ages of 10 to 15. Significant change was shown between the ages of 12 and 13 (p<0.01) . Complex reaction time (CRT) estimated from chronological age developed linearly from 9 to 14 years of age. However for skeletal age, CRT at 10 was slower than at 8 and 9 years of age. Then it developed significantly between the ages of 10 and 11 (p<0.05) . On the other hand, stepping frequency and endurance did not show as remarkable a change with increasing age as reaction time. The results of this present study indicate that in adolescent soccer players, there are some differences between skeletal age and chronological age in cross-sectional change of reaction time. Moreover, skeletal age did not affect the development of stepping frequency and endurance.