Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, ...Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, and carries an increased risk of morbidity and mortality. The aim of this study was to assess the knowledge of patients and their carers about obliterative arteriopathy of the lower limbs at Conakry University Hospital. Material and Methods: We conducted a descriptive cross-sectional study lasting 3 months, from March 12 to June 12, 2022 in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). Following free and informed consent, they were interviewed on the basis of a pre-established questionnaire. Socio-demographic data (age, gender, level of education) were collected, and knowledge of obliterative arterial disease of the lower limbs. Results: The study involved 159 people, comprising 106 patients (66.66%) and 53 accompanying persons (33.34%) in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). The 60 to 79 age group was the most represented (44.7%), with an average age of 55.4 ± 15.9 years and extremes of 20 to 84 years. Half (47.8%) had not attended school, and almost all (96.4%) of those who had attended school had a low level of education (primary and secondary). Almost all of them (91.2%) had never heard of AOMI. Only 5% identified at least one risk factor, diabetes, hypertension and smoking. Amputation was the most frequently identified complication. About 98% did not know that AOMI is associated with myocardial infarction and stroke, and 93.7% did not know of any complications. Almost all the participants (99.4%) had poor knowledge of the following complications. Conclusion: Obliterative arterial disease of the lower limbs could be prevented or delayed by screening and controlling risk factors. Our results show a huge deficit in knowledge of this pathology, including risk factors, preventive measures, clinical signs and complications among patients and their relatives. A study conducted outside the hospital environment would provide a better understanding of the extent to which the general population is unaware of this disease.展开更多
Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the ...Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> An open fracture is an injury in which the fracture site and/or hematom...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and lead</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of January 2015 to the 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">40 </span><span style="font-family:Verdana;">years. There were 147 (75.4%) males and 48 (24.6%) females giving a sex-ratio</span><span style="font-family:Verdana;"> of 3.1:1. The most common cause was road traffic crashes 142 (72.8%). In 98 cases (50.3%)</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the left side was more involved. The tibia was the most common long bone affected in 75 (38.5%) cases. Comminuted fracture was the most common fracture pattern encountered in 126 cases (64.6%). A total of 76 (39%) fractures were graded Gustilo-Anderson IIIA. External fixator was used in 112 cases (57.1%) and internal fixator in 86 cases (42.9%). We recorded 127 (65.1%) cases of wound infection and 143 (73.3%) cases of limb shortening as the most common complications. Other complications include</span><span style="font-family:Verdana;">: </span><span style="font-family:Verdana;">20 cases (17.1%) of mal-union, 27 cases (22.5%) of delayed union, 18 cases (15.1%) of non-union and 50 cases (38.5%) chronic osteomyelitis. We recorded a mortality of 2.1%. Gustilo IIIB and IIIC were associated to chronic osteomyelitis (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.02). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Open fractures of long bones of the lower limb affect the active age group of the population and road traffic crashes</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">are the most common causes. It tends to affect the left side and the tibia being the most fractured long bone. A reasonable proportion of these fractures subsequently get infected. Comminuted fracture is the common fracture pattern.</span>展开更多
Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with st...Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.展开更多
Rehabilitation of lower limb amputation in developing countries is quite challenging.Though there are basic to highly advanced prostheses available in India,the set-up is still facing difficulties in developing countr...Rehabilitation of lower limb amputation in developing countries is quite challenging.Though there are basic to highly advanced prostheses available in India,the set-up is still facing difficulties in developing countries.Prosthetic management is difficult due to lack of availability of prostheses and reduced affordability among low income populations.In this review we highlighted the lower limb amputation and prosthetic rehabilitation status in India.Currently,India is advancing well in the rehabilitation field,but further studies are required to provide more evidence and recommendation.展开更多
Introduction: Inequality in the length of the lower limbs has an impact on the stability and function of the musculoskeletal system because of the imbalance it causes in our bodies. Several treatment modalities were u...Introduction: Inequality in the length of the lower limbs has an impact on the stability and function of the musculoskeletal system because of the imbalance it causes in our bodies. Several treatment modalities were used by practitioners. The aim of this study was to evaluate the anatomical and functional results of length equalisation of the lower limbs using internal osteosynthesis in the Orthopaedic and Traumatological Surgery Department of the Amirou Boubacar Diallo National Hospital in Niamey. Patients and method: This was a retrospective, prospective study of 22 patients from January 2010 to November 2015, a period of 5 years. The patients concerned were aged at least 18 years and had undergone a femoral shortening osteotomy not exceeding 5 cm on the contralateral healthy limb with a screw plate as the internal osteosynthesis device. Results: The average age of our patients was 24.18 years (18 to 48 years). The etiologies of these length inequalities were: vascular 54.55% (n = 12), post-traumatic 27.27% (n = 6), post-infectious 13.64% (n = 3) and neuromuscular 4.54% (n = 1). The mean length inequality of our patients was 4.93 cm, with extremes ranging from 4 to 8 cm. At an average follow-up of 6.5 months (6 to 24 months), our functional results were satisfactory overall. Discussion: Despite the significant nature of our initial inequalities, which were moderate and severe, we ended up with slight inequalities or even total correction for some of our patients. Conclusion: Inequality in the length of the lower limbs is a handicap that requires appropriate management.展开更多
BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ...BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.展开更多
No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest res...No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest research indicates that when combined with local injections of botulinum toxin type A,it is more effective on post-stroke muscle spasticity than local injections of botulinum toxin type A alone.We designed a prospective,single-center,non-randomized,controlled clinical trial to investigate the safety and effica cy of different frequencies of repetitive transcranial magnetic stimulation combined with local injections of botulinum toxin type A in treating post-stroke lower limb muscle spasticity to determine an optimal therapeutic regimen.This trial will enroll 150 patients with post-stroke muscle spasticity admitted to the Department of Rehabilitation Medicine at the First Affiliated Hos pital of China Medical Unive rsity.All enrolled patients will undergo ro utine rehabilitation training and will be divided into five groups in-30 per group) according to the particular area of cerebral infa rction and treatment methods.G roup A:Patients with massive cerebral infarction will be given local injections of botulinum toxin type A and low-frequency(1 Hz)repetitive transcranial magnetic stimulation on the contralate ral side;G roup B:Patients with non-massive cerebral infarction will be given local injections of botulinum toxin type A and high-frequency(10-20 Hz) re petitive transcranial magnetic stimulation on the affected side;G roup C:Patients with massive/non-massive cerebral infarction will be given local injections of botulinum toxin type A;G roup D:Patients with massive cerebral infarction will be given low-frequency(1 Hz) repetitive transcranial magnetic stimulation on the contralate ral side;and G roup E:Patients with non-massive cerebral infa rction will be given high-frequency(10-20 Hz) repetitive transcranial magnetic stimulation on the affected side.The primary outcome measure of this trial is a modified Ashwo rth scale score from 1 day before treatment to 12 months after treatment.Secondary outcome measures include Fugl-M eyer Assessment of Lower Extremity,Visual Analogue Scale,modified Barthel index,and Berg Balance Scale scores for the same time as specified for primary outcome measures.The safety indicator is the incidence of adverse events at 3-12 months after treatment.We hope to draw a definite conclusion on whether there are diffe rences in the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation combined with botulinum toxin type A injections in the treatment of patients with post-stroke lower limb spasticity under strict grouping and standardized operation,thereby screening out the optimal therapeutic regimen.The study protocol was approved by the Medical Ethics Committee of the First Affiliated Hospital of China Medical University(approval No.[2021] 2021-333-3) on August 19,2021.The trial was registe red with the Chinese Clinical Trial Registry(Registration No.ChiCTR2100052180) on October 21,2021.The protocol version is 1.1.展开更多
BACKGROUND We explored the genotype-phenotype correlation of the novel deletion 16p13.2p12.3 in an 8-year-old child with progressive total ophthalmoplegia,cervical dyskinesia,and lower limb weakness by comparing the p...BACKGROUND We explored the genotype-phenotype correlation of the novel deletion 16p13.2p12.3 in an 8-year-old child with progressive total ophthalmoplegia,cervical dyskinesia,and lower limb weakness by comparing the patient’s clinical features with previously reported data on adjacent copy number variation(CNV)regions.CASE SUMMARY Specifically,we first performed whole-exome sequencing,CNV-sequencing,and mitochondrial genome sequencing on the patient and his parents,then applied“MitoExome”(the entire mitochondrial genome and exons of nuclear genes encoding the mitochondrial proteome)analysis to screen for genetic mitochondrial diseases.We identified a de novo 7.23 Mb deletion,covering 16p13.2p12.3,by both whole-exome sequencing and CNV sequencing.We also detected 16p13.11 in the deleted region,which is the recurrent distinct region associated with neurodevelopmental disorder.However,the patient only displayed features of progressive total ophthalmoplegia,cervical dyskinesia,and weakness in his lower limbs without neurodevelopmental disorder.The“MitoExome”sequencing was negative.Brain magnetic resonance imaging revealed non-specific sporadic changes in the occipital parietal lobe and basal ganglia.CONCLUSION Taken together,these results indicated that 16p13.2p12.3 deletion causes a syndrome with the phenotype of early-onset total ophthalmoplegia.The“MitoExome”analysis is powerful for the differential diagnosis of mitochondrial diseases.We report a novel copy number variant in this case,but further confirmation is required.展开更多
At present,the incidence rate of arteriosclerosis obliterans(LEASO)of the lower extremities is significantly increased by aging and lifestyle changes.It is of great importance to predict the LEASO effectively and accu...At present,the incidence rate of arteriosclerosis obliterans(LEASO)of the lower extremities is significantly increased by aging and lifestyle changes.It is of great importance to predict the LEASO effectively and accurately by analyzing the imaging data of the lower extremities⑴.At this stage,China has entered the era of big data and artificial intelligence.Medical institutions at all levels can produce a large number of lower limb vascular image data every day.Using big data deep learning technology to intelligently analyze a large number of image data,and then carry out auxiliary diagnosis,so as to improve the diagnosis and treatment effect of LEASO is the focus of clinical research.展开更多
In this study,a humanoid prototype of 2-DOF(degrees of freedom)lower limb exoskeleton is introduced to evaluate the wearable comfortable effect between person and exoskeleton.To improve the detection accuracy of the h...In this study,a humanoid prototype of 2-DOF(degrees of freedom)lower limb exoskeleton is introduced to evaluate the wearable comfortable effect between person and exoskeleton.To improve the detection accuracy of the humanrobot interaction torque,a BPNN(backpropagation neural networks)is proposed to estimate this interaction force and to compensate for the measurement error of the 3D-force/torque sensor.Meanwhile,the backstepping controller is designed to realize the exoskeleton's passive position control,which means that the person passively adapts to the exoskeleton.On the other hand,a variable admittance controller is used to implement the exoskeleton's active followup control,which means that the person's motion is motivated by his/her intention and the exoskeleton control tries best to improve the human-robot wearable comfortable performance.To improve the wearable comfortable effect,serval regular gait tasks with different admittance parameters and step frequencies are statistically performed to obtain the optimal admittance control parameters.Finally,the BPNN compensation algorithm and two controllers are verified by the experimental exoskeleton prototype with human-robot cooperative motion.展开更多
OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fractur...OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.展开更多
Recently,the Muscle-Computer Interface(MCI)has been extensively popular for employing Electromyography(EMG)signals to help the development of various assistive devices.However,few studies have focused on ankle foot mo...Recently,the Muscle-Computer Interface(MCI)has been extensively popular for employing Electromyography(EMG)signals to help the development of various assistive devices.However,few studies have focused on ankle foot movement classification considering EMG signals at limb position.This work proposes a new framework considering two EMG signals at a lower-limb position to classify the ankle movement characteristics based on normal walking cycles.For this purpose,we introduce a human anklefoot movement classification method using a two-dimensional-convolutional neural network(2D-CNN)with low-cost EMG sensors based on lowerlimb motion.The time-domain signals of EMG obtained from two sensors belonging to Dorsiflexion,Neutral-position,and Plantarflexion are firstly converted into time-frequency spectrograms by short-time Fourier transform.Afterward,the spectrograms of the three ankle-foot movement types are used as input to the 2D-CNN such that the EMG foot movement types are finally classified.For the evaluation phase,the proposed method is investigated using the healthy volunteer for 5-fold cross-validation,and the accuracy is used as a standard evaluation.The results demonstrate that our approach provides an average accuracy of 99.34%.This exhibits the usefulness of 2D-CNN with low-cost EMG sensors in terms of ankle-foot movement classification at limb position,which offers feasibility for walking.However,the obtained EMG signal is not directly considered at the ankle position.展开更多
Functional electrical stimulation is a method of repairing a dysfunctional limb in a stroke patient by using low-intensity electrical stimulation.Currently,it is widely used in smart medical treatment for limb rehabil...Functional electrical stimulation is a method of repairing a dysfunctional limb in a stroke patient by using low-intensity electrical stimulation.Currently,it is widely used in smart medical treatment for limb rehabilitation in stroke patients.In this paper,the development of FES systems is sorted out and analyzed in a time order.Then,the progress of functional electrical stimulation in the field of rehabilitation is reviewed in details in two aspects,i.e.,system development and algorithm progress.In the system aspect,the development of the first FES control and stimulation system,the core of the lower limb-based neuroprosthesis system and the system based on brain-computer interface are introduced.The algorithm optimization for control strategy is introduced in the algorithm.Asynchronous stimulation to prolong the function time of the lower limbs and a method to improve the robustness of knee joint modeling using neural networks.Representative applications in each of these aspects have been investigated and analyzed.展开更多
BACKGROUND Left cardiac myxoma(CM)is the most common benign tumor of primary cardiac tumors,but because of its special position caused by pathological physiology change,caused by the complications of the heavier,the s...BACKGROUND Left cardiac myxoma(CM)is the most common benign tumor of primary cardiac tumors,but because of its special position caused by pathological physiology change,caused by the complications of the heavier,the surface is often accompanied by blood clots,once fall out,it causes peripheral vascular embolization,such as acute lower limb artery embo-lization,harmfulness is large,high morbidity,and easy to occur repeatedly.CASE SUMMARY A 67-year-old male patient suddenly appeared numbness and weakness of the left lower limb and could not walk without obvious incentive.The patient was finally diagnosed as left CM complicated with acute lower limb arterial embolism after completing cardiac ultrasound,computer tomography angiography,and histopathological analysis,such as hematoxylin-eosin stain staining,immunohistochemistry and special staining including alcian blue staining and periodic acid schiff staining.Arterial thrombosis was removed successfully by femoral artery thrombectomy,postoperative numbness and weakness of the patient’s left lower limb disappeared,skin temperature became warm,and dorsal foot artery pulsation was accessible.The patient was readmitted to the hospital 8 mo after discharge for left atrial mass resection,and was diagnosed as CM by postoperative histopathological examination.CONCLUSION Although CM is rare,it may be considered as the source of embolism in patients with acute limb ischemia.Repeated loss of thrombus on the tumor and its surface may lead to repeated embolism of peripheral vessels.Cardiac ultrasound is helpful for early diagnosis.Here,we use this case report to highlight left CM as an important cause of acute limb ischemia and to report our experience in the diagnosis and treatment of lower limb arterial embolism caused by CM detachment.展开更多
Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. How...Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.展开更多
Background: Vacuum-assisted dressing is a noninvasive closure system of the wound, which makes localized and controlled negative pressure. Its mechanical tension reduces edema, stimulates granulation tissue formation ...Background: Vacuum-assisted dressing is a noninvasive closure system of the wound, which makes localized and controlled negative pressure. Its mechanical tension reduces edema, stimulates granulation tissue formation and angiogenesis, and prepares the wound bed for closure. In this study, a patient has been presented, who suffered from serious lower extremity wounds due to arterial emboli, one of her wounds has been treated with vacuum-assisted dressing and the other with conventional dressing to evaluate the efficacy of vacuum-assisted dressing in acute ischemic wounds. Methods: A 65-year-old female patient was admitted to the emergency clinic, due to complaint of severe pain in her right lower extremity which suggested an acute arterial occlusion. She immediately underwent an embolectomy operation;however, a few days later, severe ischemia on the leg and foot became appearant. All of the necrosis was sharply debrided under sterile conditions in the operating room, and then lower leg wound was covered with vacuum-assisted dressing, also calcaneal wound was dressed with silver sulphadiazine. Results: Eighteen days after the first dressing with negative pressure, distal leg wound became ready for closure, whereas, enough granulation tissue over the calcaneal area developed merely thirty-four days later. Calcaneal wound closed spontaneously within fifty-three days. Conclusions: When dealing with this experience, using the negative pressure dressing in patient with severe lower limb wounds following arterial emboli, accelerates wound healing by means of developing the granulation tissue, and rapidly prepares the wound for closure, so it may reduce the risk of amputation.展开更多
Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in ou...Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion.展开更多
For the 2-Degree of Freedom(DOF)lower limb exoskeleton,to ensure the system robustness and dynamic performance,a linearextended-state-observer-based(LESO)robust sliding mode control is proposed to not only reduce the ...For the 2-Degree of Freedom(DOF)lower limb exoskeleton,to ensure the system robustness and dynamic performance,a linearextended-state-observer-based(LESO)robust sliding mode control is proposed to not only reduce the influence of parametric uncertainties,unmodeled dynamics,and external disturbance but also estimate the unmeasurable real-time joint angular velocity directly.Then,via Lyapunov technology,the stability of the corresponding LESO and controller is proven.The appropriate and reasonable simulation was carried out to verify the effectiveness of the proposed LESO and exoskeleton controller.展开更多
文摘Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, and carries an increased risk of morbidity and mortality. The aim of this study was to assess the knowledge of patients and their carers about obliterative arteriopathy of the lower limbs at Conakry University Hospital. Material and Methods: We conducted a descriptive cross-sectional study lasting 3 months, from March 12 to June 12, 2022 in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). Following free and informed consent, they were interviewed on the basis of a pre-established questionnaire. Socio-demographic data (age, gender, level of education) were collected, and knowledge of obliterative arterial disease of the lower limbs. Results: The study involved 159 people, comprising 106 patients (66.66%) and 53 accompanying persons (33.34%) in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). The 60 to 79 age group was the most represented (44.7%), with an average age of 55.4 ± 15.9 years and extremes of 20 to 84 years. Half (47.8%) had not attended school, and almost all (96.4%) of those who had attended school had a low level of education (primary and secondary). Almost all of them (91.2%) had never heard of AOMI. Only 5% identified at least one risk factor, diabetes, hypertension and smoking. Amputation was the most frequently identified complication. About 98% did not know that AOMI is associated with myocardial infarction and stroke, and 93.7% did not know of any complications. Almost all the participants (99.4%) had poor knowledge of the following complications. Conclusion: Obliterative arterial disease of the lower limbs could be prevented or delayed by screening and controlling risk factors. Our results show a huge deficit in knowledge of this pathology, including risk factors, preventive measures, clinical signs and complications among patients and their relatives. A study conducted outside the hospital environment would provide a better understanding of the extent to which the general population is unaware of this disease.
文摘Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and lead</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of January 2015 to the 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">40 </span><span style="font-family:Verdana;">years. There were 147 (75.4%) males and 48 (24.6%) females giving a sex-ratio</span><span style="font-family:Verdana;"> of 3.1:1. The most common cause was road traffic crashes 142 (72.8%). In 98 cases (50.3%)</span></span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the left side was more involved. The tibia was the most common long bone affected in 75 (38.5%) cases. Comminuted fracture was the most common fracture pattern encountered in 126 cases (64.6%). A total of 76 (39%) fractures were graded Gustilo-Anderson IIIA. External fixator was used in 112 cases (57.1%) and internal fixator in 86 cases (42.9%). We recorded 127 (65.1%) cases of wound infection and 143 (73.3%) cases of limb shortening as the most common complications. Other complications include</span><span style="font-family:Verdana;">: </span><span style="font-family:Verdana;">20 cases (17.1%) of mal-union, 27 cases (22.5%) of delayed union, 18 cases (15.1%) of non-union and 50 cases (38.5%) chronic osteomyelitis. We recorded a mortality of 2.1%. Gustilo IIIB and IIIC were associated to chronic osteomyelitis (P</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.02). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Open fractures of long bones of the lower limb affect the active age group of the population and road traffic crashes</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">are the most common causes. It tends to affect the left side and the tibia being the most fractured long bone. A reasonable proportion of these fractures subsequently get infected. Comminuted fracture is the common fracture pattern.</span>
文摘Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.
文摘Rehabilitation of lower limb amputation in developing countries is quite challenging.Though there are basic to highly advanced prostheses available in India,the set-up is still facing difficulties in developing countries.Prosthetic management is difficult due to lack of availability of prostheses and reduced affordability among low income populations.In this review we highlighted the lower limb amputation and prosthetic rehabilitation status in India.Currently,India is advancing well in the rehabilitation field,but further studies are required to provide more evidence and recommendation.
文摘Introduction: Inequality in the length of the lower limbs has an impact on the stability and function of the musculoskeletal system because of the imbalance it causes in our bodies. Several treatment modalities were used by practitioners. The aim of this study was to evaluate the anatomical and functional results of length equalisation of the lower limbs using internal osteosynthesis in the Orthopaedic and Traumatological Surgery Department of the Amirou Boubacar Diallo National Hospital in Niamey. Patients and method: This was a retrospective, prospective study of 22 patients from January 2010 to November 2015, a period of 5 years. The patients concerned were aged at least 18 years and had undergone a femoral shortening osteotomy not exceeding 5 cm on the contralateral healthy limb with a screw plate as the internal osteosynthesis device. Results: The average age of our patients was 24.18 years (18 to 48 years). The etiologies of these length inequalities were: vascular 54.55% (n = 12), post-traumatic 27.27% (n = 6), post-infectious 13.64% (n = 3) and neuromuscular 4.54% (n = 1). The mean length inequality of our patients was 4.93 cm, with extremes ranging from 4 to 8 cm. At an average follow-up of 6.5 months (6 to 24 months), our functional results were satisfactory overall. Discussion: Despite the significant nature of our initial inequalities, which were moderate and severe, we ended up with slight inequalities or even total correction for some of our patients. Conclusion: Inequality in the length of the lower limbs is a handicap that requires appropriate management.
文摘BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.
文摘No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest research indicates that when combined with local injections of botulinum toxin type A,it is more effective on post-stroke muscle spasticity than local injections of botulinum toxin type A alone.We designed a prospective,single-center,non-randomized,controlled clinical trial to investigate the safety and effica cy of different frequencies of repetitive transcranial magnetic stimulation combined with local injections of botulinum toxin type A in treating post-stroke lower limb muscle spasticity to determine an optimal therapeutic regimen.This trial will enroll 150 patients with post-stroke muscle spasticity admitted to the Department of Rehabilitation Medicine at the First Affiliated Hos pital of China Medical Unive rsity.All enrolled patients will undergo ro utine rehabilitation training and will be divided into five groups in-30 per group) according to the particular area of cerebral infa rction and treatment methods.G roup A:Patients with massive cerebral infarction will be given local injections of botulinum toxin type A and low-frequency(1 Hz)repetitive transcranial magnetic stimulation on the contralate ral side;G roup B:Patients with non-massive cerebral infarction will be given local injections of botulinum toxin type A and high-frequency(10-20 Hz) re petitive transcranial magnetic stimulation on the affected side;G roup C:Patients with massive/non-massive cerebral infarction will be given local injections of botulinum toxin type A;G roup D:Patients with massive cerebral infarction will be given low-frequency(1 Hz) repetitive transcranial magnetic stimulation on the contralate ral side;and G roup E:Patients with non-massive cerebral infa rction will be given high-frequency(10-20 Hz) repetitive transcranial magnetic stimulation on the affected side.The primary outcome measure of this trial is a modified Ashwo rth scale score from 1 day before treatment to 12 months after treatment.Secondary outcome measures include Fugl-M eyer Assessment of Lower Extremity,Visual Analogue Scale,modified Barthel index,and Berg Balance Scale scores for the same time as specified for primary outcome measures.The safety indicator is the incidence of adverse events at 3-12 months after treatment.We hope to draw a definite conclusion on whether there are diffe rences in the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation combined with botulinum toxin type A injections in the treatment of patients with post-stroke lower limb spasticity under strict grouping and standardized operation,thereby screening out the optimal therapeutic regimen.The study protocol was approved by the Medical Ethics Committee of the First Affiliated Hospital of China Medical University(approval No.[2021] 2021-333-3) on August 19,2021.The trial was registe red with the Chinese Clinical Trial Registry(Registration No.ChiCTR2100052180) on October 21,2021.The protocol version is 1.1.
文摘BACKGROUND We explored the genotype-phenotype correlation of the novel deletion 16p13.2p12.3 in an 8-year-old child with progressive total ophthalmoplegia,cervical dyskinesia,and lower limb weakness by comparing the patient’s clinical features with previously reported data on adjacent copy number variation(CNV)regions.CASE SUMMARY Specifically,we first performed whole-exome sequencing,CNV-sequencing,and mitochondrial genome sequencing on the patient and his parents,then applied“MitoExome”(the entire mitochondrial genome and exons of nuclear genes encoding the mitochondrial proteome)analysis to screen for genetic mitochondrial diseases.We identified a de novo 7.23 Mb deletion,covering 16p13.2p12.3,by both whole-exome sequencing and CNV sequencing.We also detected 16p13.11 in the deleted region,which is the recurrent distinct region associated with neurodevelopmental disorder.However,the patient only displayed features of progressive total ophthalmoplegia,cervical dyskinesia,and weakness in his lower limbs without neurodevelopmental disorder.The“MitoExome”sequencing was negative.Brain magnetic resonance imaging revealed non-specific sporadic changes in the occipital parietal lobe and basal ganglia.CONCLUSION Taken together,these results indicated that 16p13.2p12.3 deletion causes a syndrome with the phenotype of early-onset total ophthalmoplegia.The“MitoExome”analysis is powerful for the differential diagnosis of mitochondrial diseases.We report a novel copy number variant in this case,but further confirmation is required.
基金Scientific research project of Sichuan Provincial Health Commission"auxiliary diagnosis of lower extremity arteriosclerosis obliterans based on deep learning of big data,"No.:18PJ488.
文摘At present,the incidence rate of arteriosclerosis obliterans(LEASO)of the lower extremities is significantly increased by aging and lifestyle changes.It is of great importance to predict the LEASO effectively and accurately by analyzing the imaging data of the lower extremities⑴.At this stage,China has entered the era of big data and artificial intelligence.Medical institutions at all levels can produce a large number of lower limb vascular image data every day.Using big data deep learning technology to intelligently analyze a large number of image data,and then carry out auxiliary diagnosis,so as to improve the diagnosis and treatment effect of LEASO is the focus of clinical research.
基金Supported by National Natural Science Foundation of China(Grant Nos.51775089,12072068,11872147)Sichuan Province Science and Technology Support Program of China(Grant Nos.2020YFG0137,2018JY0565).
文摘In this study,a humanoid prototype of 2-DOF(degrees of freedom)lower limb exoskeleton is introduced to evaluate the wearable comfortable effect between person and exoskeleton.To improve the detection accuracy of the humanrobot interaction torque,a BPNN(backpropagation neural networks)is proposed to estimate this interaction force and to compensate for the measurement error of the 3D-force/torque sensor.Meanwhile,the backstepping controller is designed to realize the exoskeleton's passive position control,which means that the person passively adapts to the exoskeleton.On the other hand,a variable admittance controller is used to implement the exoskeleton's active followup control,which means that the person's motion is motivated by his/her intention and the exoskeleton control tries best to improve the human-robot wearable comfortable performance.To improve the wearable comfortable effect,serval regular gait tasks with different admittance parameters and step frequencies are statistically performed to obtain the optimal admittance control parameters.Finally,the BPNN compensation algorithm and two controllers are verified by the experimental exoskeleton prototype with human-robot cooperative motion.
基金2012 Science and Technology Program of Shenzhen(Grant No.:201203283)
文摘OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.
基金This work was supported by Suranaree University of Technology(SUT),Thailand Science Research and Innovation(TSRI),and National Science Research and Innovation Fund(NSRF)(NRIIS no.42852).
文摘Recently,the Muscle-Computer Interface(MCI)has been extensively popular for employing Electromyography(EMG)signals to help the development of various assistive devices.However,few studies have focused on ankle foot movement classification considering EMG signals at limb position.This work proposes a new framework considering two EMG signals at a lower-limb position to classify the ankle movement characteristics based on normal walking cycles.For this purpose,we introduce a human anklefoot movement classification method using a two-dimensional-convolutional neural network(2D-CNN)with low-cost EMG sensors based on lowerlimb motion.The time-domain signals of EMG obtained from two sensors belonging to Dorsiflexion,Neutral-position,and Plantarflexion are firstly converted into time-frequency spectrograms by short-time Fourier transform.Afterward,the spectrograms of the three ankle-foot movement types are used as input to the 2D-CNN such that the EMG foot movement types are finally classified.For the evaluation phase,the proposed method is investigated using the healthy volunteer for 5-fold cross-validation,and the accuracy is used as a standard evaluation.The results demonstrate that our approach provides an average accuracy of 99.34%.This exhibits the usefulness of 2D-CNN with low-cost EMG sensors in terms of ankle-foot movement classification at limb position,which offers feasibility for walking.However,the obtained EMG signal is not directly considered at the ankle position.
基金This work has received funding from the European Union Horizon 2020 research and innovation programmer under the Marie Sklodowska-Curie grant agreement No.701697,Major Program of the National Social Science Fund of China(Grant No.17ZDA092)Basic Research Programs(Natural Science Foundation)of Jiangsu Province(BK20180794)+1 种基金333 High-Level Talent Cultivation Project of Jiangsu Province(BRA2018332)the PAPD fund.
文摘Functional electrical stimulation is a method of repairing a dysfunctional limb in a stroke patient by using low-intensity electrical stimulation.Currently,it is widely used in smart medical treatment for limb rehabilitation in stroke patients.In this paper,the development of FES systems is sorted out and analyzed in a time order.Then,the progress of functional electrical stimulation in the field of rehabilitation is reviewed in details in two aspects,i.e.,system development and algorithm progress.In the system aspect,the development of the first FES control and stimulation system,the core of the lower limb-based neuroprosthesis system and the system based on brain-computer interface are introduced.The algorithm optimization for control strategy is introduced in the algorithm.Asynchronous stimulation to prolong the function time of the lower limbs and a method to improve the robustness of knee joint modeling using neural networks.Representative applications in each of these aspects have been investigated and analyzed.
文摘BACKGROUND Left cardiac myxoma(CM)is the most common benign tumor of primary cardiac tumors,but because of its special position caused by pathological physiology change,caused by the complications of the heavier,the surface is often accompanied by blood clots,once fall out,it causes peripheral vascular embolization,such as acute lower limb artery embo-lization,harmfulness is large,high morbidity,and easy to occur repeatedly.CASE SUMMARY A 67-year-old male patient suddenly appeared numbness and weakness of the left lower limb and could not walk without obvious incentive.The patient was finally diagnosed as left CM complicated with acute lower limb arterial embolism after completing cardiac ultrasound,computer tomography angiography,and histopathological analysis,such as hematoxylin-eosin stain staining,immunohistochemistry and special staining including alcian blue staining and periodic acid schiff staining.Arterial thrombosis was removed successfully by femoral artery thrombectomy,postoperative numbness and weakness of the patient’s left lower limb disappeared,skin temperature became warm,and dorsal foot artery pulsation was accessible.The patient was readmitted to the hospital 8 mo after discharge for left atrial mass resection,and was diagnosed as CM by postoperative histopathological examination.CONCLUSION Although CM is rare,it may be considered as the source of embolism in patients with acute limb ischemia.Repeated loss of thrombus on the tumor and its surface may lead to repeated embolism of peripheral vessels.Cardiac ultrasound is helpful for early diagnosis.Here,we use this case report to highlight left CM as an important cause of acute limb ischemia and to report our experience in the diagnosis and treatment of lower limb arterial embolism caused by CM detachment.
文摘Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.
文摘Background: Vacuum-assisted dressing is a noninvasive closure system of the wound, which makes localized and controlled negative pressure. Its mechanical tension reduces edema, stimulates granulation tissue formation and angiogenesis, and prepares the wound bed for closure. In this study, a patient has been presented, who suffered from serious lower extremity wounds due to arterial emboli, one of her wounds has been treated with vacuum-assisted dressing and the other with conventional dressing to evaluate the efficacy of vacuum-assisted dressing in acute ischemic wounds. Methods: A 65-year-old female patient was admitted to the emergency clinic, due to complaint of severe pain in her right lower extremity which suggested an acute arterial occlusion. She immediately underwent an embolectomy operation;however, a few days later, severe ischemia on the leg and foot became appearant. All of the necrosis was sharply debrided under sterile conditions in the operating room, and then lower leg wound was covered with vacuum-assisted dressing, also calcaneal wound was dressed with silver sulphadiazine. Results: Eighteen days after the first dressing with negative pressure, distal leg wound became ready for closure, whereas, enough granulation tissue over the calcaneal area developed merely thirty-four days later. Calcaneal wound closed spontaneously within fifty-three days. Conclusions: When dealing with this experience, using the negative pressure dressing in patient with severe lower limb wounds following arterial emboli, accelerates wound healing by means of developing the granulation tissue, and rapidly prepares the wound for closure, so it may reduce the risk of amputation.
文摘Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion.
基金This work was supported by National Natural Science Foundation of China(No.51775089 and 11872147)Sichuan Science and Technology Program(No.2018JY0565 and 2020YFG0137).
文摘For the 2-Degree of Freedom(DOF)lower limb exoskeleton,to ensure the system robustness and dynamic performance,a linearextended-state-observer-based(LESO)robust sliding mode control is proposed to not only reduce the influence of parametric uncertainties,unmodeled dynamics,and external disturbance but also estimate the unmeasurable real-time joint angular velocity directly.Then,via Lyapunov technology,the stability of the corresponding LESO and controller is proven.The appropriate and reasonable simulation was carried out to verify the effectiveness of the proposed LESO and exoskeleton controller.
