Objective To discuss the surgical procedures and curative effect of stiff 2-5 metacarpophalangeal (MP) joints after crash injury in hand. Methods Between January 2006 and June 2009, 7 cases of stiff 2-5 MP joints were treated by releasing the stiff MP joints and reconstructing the function of lumbrical muscle in one stage. There were 6 males and 1 female with an average age of 32 years (range, 18-56 years). All injuries were caused by crash. Six cases suffered from multiple metacarpal fracture or complex dislocation of MP joint and 1 case suffered from complete amputation at level of middle palm of hand. The interval from initial wound heal ing to hospital ization was 3 to 15 months. Before operation, the X-ray films showed fracture healed and the results of nipping paper test were positive. All hands were treated with physical therapy for 1 month. After the plaster external fixation for 6 weeks, the physical therapy and function training were given. Results All wounds healed by first intention. The patients had no joint instabil ity and extensor tendon side-sl ipping with normal finger function. Six patients were followed up from 6 months to 3 years. The extension and flexion of MP joint were 0° and 67-90°, respectively. The average grip strength of injured dominant hand reached 86.70% of normal side and non-dominant hand reached 66.70% of normal side. The average injured dominant tip pinch strength reached 83.52% of normal side and non-dominant tip pinch strength reached 61.30% of normal side. Based on total active motion (TAM) system of Chinese Medical Association for Hand Surgery, the results were excellent in 4 cases, good in 1 case, and fair in 1 case; the excellent and good rate was 83.33%. Conclusion In patients with stiff MP joint and lumbrical muscle defect, releasing stiff MP joint and reconstructing lumbrical function in one stage can recover the function of MP joint and achieve good outcome. Physical therapy plays an important role before operation.
Exoskeleton nursing robot is a typical human-machine co-drive system. To full play the subjective control and action orientation of human, it is necessary to comprehensively analyze exoskeleton wearer’s surface electromyography (EMG) in the process of moving patients, especially identifying the spatial distribution and internal relationship of the EMG information. Aiming at the location of electrodes and internal relation between EMG channels, the complex muscle system at the upper limb was abstracted as a muscle functional network. Firstly, the correlation characteristics were analyzed among EMG channels of the upper limb using the mutual information method, so that the muscle function network was established. Secondly, by calculating the characteristic index of network node, the features of muscle function network were analyzed for different movements. Finally, the node contraction method was applied to determine the key muscle group that reflected the intention of wearer’s movement, and the characteristics of muscle function network were analyzed in each stage of moving patients. Experimental results showed that the location of the myoelectric collection could be determined quickly and efficiently, and also various stages of the moving process could effectively be distinguished using the muscle functional network with the key muscle groups. This study provides new ideas and methods to decode the relationship between neural controls of upper limb and physical motion.
ObjectiveTo systematically review the dose-effect relationship between resistance exercise intervention and lower extremity muscle strength and function enhancement in the aging. MethodsEBSCO, PubMed, Web of Science, CNKI, VIP, and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the effects of resistance exercise on muscle strength and function of the lower extremities in older adults from inception to July 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. A network meta-analysis was then performed by using RevMan 5.4 and Stata 15.0 software. ResultsA total of 32 RCTs with a total sample size of 1 594 individuals were included. The results of network meta-analysis showed that the elements of resistance exercise prescription: intensity 50%-70% 1RM, period 8-12 weeks, frequency 3-4 times/week, duration 30-45 min, and intervals 1.1-2 min were superior to other doses. ConclusionThe optimal dose of resistance exercise for improving lower extremity muscle strength and function in older adults is moderate exercise intensity (50%-70% 1RM) for 8-12 weeks, 3-4 times per week, 30-45 min per exercise, and 1.1-2 min interval between sets.
Objective To investigate the mediating effect of phase angle between muscle strength and muscle function in maintenance hemodialysis (MHD) patients, aiming to provide a reference basis for clinical improvement of muscle strength and muscle function in MHD patients. Methods Random sampling was used to collect patients undergoing outpatient MHD in the Wenjiang Hemodialysis Room of the Department of Nephrology, West China Hospital, Sichuan University between September and December 2023 as the subjects of this study. Muscle strength was assessed by handgrip strength, muscle function was assessed by Short Physical Performance Battery (SPPB), and phase angle was measured by bioelectrical impedance analysis. The mediating effect of phase angle between muscle strength and muscle function was analyzed. Results A total of 239 MHD patients were included, including 125 males (52.3%) and 114 females (47.7%). The mean phase angle of MHD patients was (5.77±1.17)°, 89 patients (37.2%) showed decreased muscle strength, and 109 patients (45.6%) showed muscle hypoplasia. Spearman’s correlation analyses showed that phase angle was significantly and positively correlated with both handgrip strength and SPPB in MHD patients (P<0.001). The results of mediation effect analysis showed that handgrip strength was able to positively predict phase angle (β=0.535, P<0.001); handgrip strength was able to positively predict SPPB (β=0.481, P<0.001); phase angle was able to positively predict SPPB (β=0.296, P<0.001); and when both handgrip strength and phase angle entered in the regression equation, both handgrip strength (β=0.392, P<0.001) and phase angle (β=0.165, P<0.05) could positively predict SPPB. Phase angle in MHD patients partially mediated the association between muscle strength and muscle function, with the mediating effect accounting for 32.5% of the total effect. Conclusions There is a close relationship between phase angle, muscle strength and muscle function in MHD patients, and muscle strength can affect muscle function directly or indirectly through phase angle. Medical professionals should pay attention to the muscle function of MHD patients and further improve their muscle function by improving their phase angle and muscle strength.