BACKGROUND: An epidemic outbreak of poliomyelitis occurred in Pizhou City, Jangsu Province, 15 years ago. It is important to appraise the daily living and function of those survived children.OBJECTIVE: To investigate the physical status of the survived children and propose appropriate suggestions on rehabilitation.DESIGN: Case-based cross-sectional study based on patients.SETTING: Department of Rehabilitative Medicine of First Hospital Affiliated to Nanjing Medical University.PARTICIPANTS: Totally 545 patients with poliomyelitis sequela, which was onset in 1989, were found in Qizhou, and 333 of them were randomly selected from the local"New Hope" nursing house and its surrounding areas.All patients were assayed in one week.METHODS: The survey included 333 polio victims in the nursing house or from the surrounding areas. The study was conducted by five research groups, with two physiatrists and one therapist in each group. Assessment included muscle strength, joint rang of motion, limb deformities, activities of daily living, previous surgical interventions and orthosis. The distance was measured from the anterior superior iliac to medial malleolus and from nave to the medial malleolus, respectively. Anatomic length and functional length were also measured.MAIN OUTCOME MEASURES: Major outcomes included the forms,shapes, or functions of foot, pelvic, hip, knee and ankle joints.RESULTS: According to intention-to-treat analyses, 333 patients with poliomyelitis sequela entered the final analysis. Most of them aged from 15 to 17 years old, which accounted for 97%. Totally 135 patients(40.5% )walked independently and 148 (44.4%) walked with-orthsis and/or crutches. The discrepancy was between 0. 5 cm to 13.0 cm. Patients with paraplegia were 112(33.6% ), which was lesser than those with monoplegia (211, 65.8% ). There were 3 cases with quadriplegia and 2 cases with upper limb involvement. Another 46 sufferers had already underwent the scoliosis prthomorphia. There were 254 subjects with orthosis, including 110 knee ankle feet orthosis for both legs and 131 knee ankle feet orthosis for one leg,with 62 at left and 79 at right. Only three ankle-foot orthosis were employed.CONCLUSION: Besides the factor of muscle strength, limb teratism is the key factor that causes walking disorders. Physical functions maybe improved through surgical intervention, orthosis modification, and rehabilitation training. Every child who received survey required further rehabilitative therapy. A multi-disciplinary team is essential to achieve a better outcome.

Objective To observe the effects of dorsiflexion ankle foot orthotics (d-AFO) on pelvic control of hemiplegic patients by analyzing the time-space gait parameters and 3D pelvic motion parameters.Methods Fifteen hemiplegic patients (14 male and 1 female) were enrolled in this study.The time-space gait parameters and pelvic 3D motion parameters were collecte with a Motion Analysis System while the patients were asked to walk under 3 conditions:wearing d-AFO (5°dorsiflexion),f-AFO (0°dorsiflexion) or barefoot.Results It was found that,while wearing d-AFO,the velocity,the paralyzed step length and the nonparalyzed step length were significantly increased,and the step width was significantly decreased when compared with those while walking barefoot (P ＜ 0.05).Comparison between wearing d-AFO and f-AFO showed that the sagittal and coronal plane inclinations,but not the transverse rotation of pelvis were significantly decreased when wearing the d-AFO (P ＜ 0.05).Conclusions d-AFO can significantly improve pelvis control and increase gait stability in hemiplegic patients.

Objective To explore the effect of bio-resonance on walking efficiency in healthy youths. Methods Ten young male participants were involved in this study (age 16 ± 2 years, height 1.73 ±:0. 1 m and weight 56. 1 ± 7 kg). The time-space data were collected using a motion analysis system, and oxygen cost was meas-ured with a Cosmed K4b2 portable gas analysis system. Walking at a self-selected, comfortable walking frequency was recorded through three dimensional gait analysis. Each participant walked at 100% , 80% and 120% of their comfortable walking frequency. Results The average 100% , 80% and 120% comfortable walking frequencies were 107.60 ± 1.78, 85.80 ± 7.45 and 128.60 ±10.46 steps/min, respectively. Oxygen consumption at the three frequencies was significantly different (P≤0.01), and the oxygen costs were 0. 140 ± 0.011, 0. 193 ± 0. 049 and 0. 192 ± 0. 035 ml/m/kg, respectively. Above or below the self-selected pace, oxygen cost increased significantly (P ≤0.05). Conclusion There is an inherited bio-resonance in human walking, and walking with this natural rhythm is reflected in the lowest oxygen cost. Any change from the natural walking rhythm may result in increased en-ergy expenditure and decreased efficiency.

Objective To explore the effectiveness of the timed up and go test (TUGT) and the maximum walking speed test (MWST) in evaluating stroke patients' motor function.Methods Twenty-two stroke patients were assessed using the TUGT and MWST,and the temporal-spatial parameters of their gait were also assessed.The correlations among the TUGT times,walking speed and the gait parameters were quantified using Pearson correlation coefficients.Results The TUGT time was (18.57±7.41) s,significantly correlated with step length and velocity (P＜0.05).Walking speed showed a significant positive correlation with step length,velocity and step length (P＜ 0.05).The TUGT times were negatively correlated with walking speed (r=-0.712,P=0.000).Conclusion The MWST and TUGT both can assess stroke patients' motor function effectively.

Objective To observe the therapeutic effects of muscle energy technique combined with joint mobilization on frozen shoulder.Methods Thirty-six patients with frozen shoulder were randomly assigned to:group A (treated with muscle energy technique plus joint mobilization),group B (treated with passive stretching with joint mobilization),and group C (treated with joint mobilization merely),and each had 12 patients.All the patients were treated accordingly for 3 times a week,totally for 4 weeks.The American Shoulder and Elbow Surgeons evaluation system (ASES) was adopted to evaluate clinical effects before and at the end of treatment.Results After 4 weeks of treatment,all patients' ASES scores were improved significantly (P ＜ 0.05).The improvement in the shoulder score index and shoulder range of motion were to a significantly better extent in group A than in the other two groups.Conclusion Muscle energy technique plus joint mobilization could effectively relieve pain increase the shoulder ROM and improve performance in activities of daily living in patients suffering from frozen shoulder.

Objective To explore the best vibration frequency for activating human muscles.Methods Nineteen healthy college students accepted vibration stimulation at frequencies between 10 and 50 Hz.Surface electromyograms (sEMG) were recorded.The subjects were sitting,standing,squatting (knee flexion 30°) and recumbent.Their left anterior tibial muscles and the medial heads of the gastrocnemius were targeted as test muscles.The vibration stimulation point was on the surface of the left distal tibia.The sEMG characteristics of the calf muscles were analyzed under vibration stimulation at different frequencies. ResultsThe leg muscles were activated significantly at all vibration frequencies,but the sEMG values of the anterior tibialis were significantly different at different frequencies,except for among 30 Hz,40 Hz and 50 Hz in any position.The gastrocnemius sEMG values were not significantly different at different frequencies. ConclusionVibration at 30 to 50Hz may be the normal human muscle activation frequency.

In the presence of silver ion, Mn2+ could be electro-oxidized to potassium hypermanganate in phosphoric acid solution, which could effectively react with pyrocatechol in acid solution and luminol in sodium hydroxide solution to produce chemiluminescence. On the basis of this, a novel indirect approach for the detection of Mn2+ was established. The effect of silver ions on the electrochemical oxidation of Mn2+was studied. when 1. 5 ×10-5 mol/L Ag+ and 0. 01 mol/L phosphoric acid solution were used in the process of electrochemical oxidation, the CL intensity could be up to the maximum value after the above solution was electrolyzed for 2 min. The relation of CL intensity and Mn2+concentration in the solutions at different pH and the selectivity were also investigated. when the pyrocatechol was used as luminescent reagent in the acidic medium, the CL intensity was linearly to the Mn2+concentration in the range of 1. 82×10-7-7. 27×10-5 mol/L with excellent selectivity. Common ions had little interferences in the determination of Mn2+. The method was successfully applied to the determination of Mn2+ in surface water and drinking water with satisfactory results.

Objective To explore the resonant frequencies of human spinal motor neurons.Methods Twenty healthy college students were recruited as the subjects.Each was put in a supine position and administered vibratory stimulation at 20 Hz,30 Hz,40 Hz,50 Hz and 60 Hz on the left distal fibula just above the lateral malleolus for 5 minutes.M-waves and F-waves were recorded before each intervention.F-waves were also recorded immediately after each intervention.Results The F-wave amplitude and the F/Mmax ratio after the 30 Hz stimulation were significantly larger than those at baseline and after stimulation at 50 or 60 Hz.However,20 Hz,30 Hz and 40 Hz stimulation produced no significantly different F-wave amplitudes or F/Mmax.Conclusion Human spinal motor neurons may have a resonant frequency around 30 Hz.

Objective To study the effects of dynamic,support-inducing exercise on the support,balance and gait ability of patients with moderate-to-severe hemiplegia after stroke.Methods Fourteen stroke patients were randomly assigned to an experimental or a control group (7 cases to each).The patients in the experimental group received both dynamic,support-inducing exercise and routine exercises,while the patients in the control group received routine exercises only.Before training and after 40 and 60 days of training,their functional capacity was evaluated with the Chinese stroke scale (CSS) for neurological deficits,Berg's balance scale (BBS) and using functional ambulation categories (FACs).Results Before training there was no inter-group difference in average CSS or BBS scores or in FACs.For the experimental group there were significant intra-group differences compared with 0th day in all three items at both time points.At days 40 and 60 there were also significant intra-group differences in BBS scores and FACs in the control group,and CSS scores improved significantly only in the experimental group.At day 40 there were significant inter-group differences in average CSS,BBS and FAC results.However,by day 60 a significant difference persisted only in average CSS scores.Conclusions Dynamic,support-inducing exercise can improve support,balance and gait in patients with moderate-to-severe hemiplegia after stroke.

Objective:To investigate the effect of whole body vibration (WBV) on balance and walking ability after a stroke.Methods:Thirty stroke survivors were randomly divided into a control group ( n=15) and an experimental group ( n=15). Both groups received 30 minutes of routine rehabilitation training twice a day, 6 days a week for 2 weeks. The experimental group was additionally provided with 14 minutes of 10Hz WBV with an amplitude of 4mm every day during the 2 weeks. Before and after the intervention, balance was quantified using the front-behind inclination angle (F-BIA), the left-right inclination angle (L-RIA) and the single-leg stance time of the hemiplegic side (SSTHS). Walking efficiency was quantified using the 10 metre walk test (10MWT) and the 3 metre timed up-and-go test (3TUG). Results:There was a significant improvement in all of the measurements in both groups after the intervention, but the improvements in average L-RIA, SSTHS, 10 MWT and 3TUG results in the experimental group were significantly greater than those in the control group.Conclusions:Supplementing routine therapy with WBV can improve balance and walking ability after a stroke more effectively than routine therapy alone.