1.A robotic brace for dynamic trunk support when evaluating seated trunk control after a spinal cord injury
Jiehong SHI ; Rongli WANG ; Ninghua WANG
Chinese Journal of Physical Medicine and Rehabilitation 2024;46(1):38-43
Objective:To explore the utility of a robotic trunk support brace (a RoboBDsys) in evaluating seated trunk control after a spinal cord injury (SCI).Methods:Twenty wheelchair-dependent SCI patients were tested for trunk resistance while seated and wearing the RoboBDsys. In the test they were required to maintain an upright seated position for 1 minute while external forces were applied from the left, right, anterior and posterior directions. The system generated eight observations of swings of the center of pressure (COP), their mean velocity and their standard deviations. Sway area, sway path (SP), mean sway frequency (MF) and mean sway amplitude (MA) were also recorded along with the maximum voluntary contraction torque (MVC). The trunk control test (TCT), the Tinetti Balance Scale (Tinetti), the modified Functional Reach Test (mFRT) and Spinal Cord Independence Measure III (SCIM-III) were also administerd and their results were correlated with the RoboBDsys resistance test results.Results:All twenty of the patients completed the resistance test in the left and right directions, but only 11 did it in the anterior and posterior directions. In the left and right-direction resistance tests the average center of pressure deviation, sway area and MVC showed some significant correlation with the TCT, Tinetti, mFRT and SCIM-III results (| r| ranging from 0.46 to 0.74). The average MVC in the anterior-direction correlated moderately with the TCT, mFRT and SCIM-III results (| r|=0.63 to 0.67), while that in the posterior-direction had moderate correlation with the TCT and mFRT results only (| r|=0.63 to 0.67). Conclusion:The Robotic Brace for Dynamic Trunk Support system can be effective in assessing reactive postural control and functional independence after a spinal cord injury.
2.Reliability and validity of the robotic brace for dynamic trunk support system for trunk control function assessment in patients with spinal cord injury
Jiehong SHI ; Rongli WANG ; Ninghua WANG
Chinese Journal of Rehabilitation Medicine 2023;38(12):1643-1650
Objective:To investigate the test-retest reliability and criterion validity of the Robotic Brace for Dynamic Trunk Support System(RoboBDsys)in evaluating seated trunk control function in patients with spinal cord in-jury(SCI). Method:From October to December,2022,20 patients with spinal cord injury who were unable to walk were recruited.All participants completed RoboBDsys trunk control test including static control test and dynam-ic control test on the seated platform.The evaluation indexes were the supporting torque regression slope exert-ed by the robot platform on the direction of x,y,α,and θ,recorded as Kx,Ky,Kθ,Kα;the average sup-porting torque recorded as Fx,Fy,Mθ,Mα in the static control test;and the the Range of Motion(ROM)of trunk in four directions in the dynamic control test.All the participants completed Trunk Control Test(TCT)as criterion assessment.The test interval was one week,intraclass correlation coefficient(ICC)values were calculated between two RoboBDsys trunk control test. Result:There were 13 participants completed two tests.In the static control test,the ICCs of four indexes were 0.418-0.742 between 2 tests;the ICCs of all indexes in dynamic control test were 0.633-0.848,which all showed moderate to high test-retest reliability.In regards of criterion validity,there was low to mod-erate correlation between Ky,Mθ,Mα in static control test and TCT(|r|=0.467-0.561,P<0.05);all indexes except right lateral flection ROM in dynamic control test showed moderate to high correlation with TCT(r=0.559-0.758,P<0.05). Conclusion:RoboBDsys is a reliable and valid tool for evaluating seated trunk control function in patients with SCI.
3.Efficacy and safety of high-dose esomeprazole–amoxicillin dual therapy for Helicobacter pylori rescue treatment: a multicenter, prospective, randomized, controlled trial
Hanxin BI ; Xingxing CHEN ; Yuxin CHEN ; Xin ZHAO ; Shasha WANG ; Jiehong WANG ; Ting LYU ; Shuang HAN ; Tao LIN ; Mingquan LI ; Donghong YUAN ; Junye LIU ; Yongquan SHI
Chinese Medical Journal 2022;135(14):1707-1715
Background::High-dose dual therapy (HDDT) with proton pump inhibitors (PPIs) and amoxicillin has attracted widespread attention due to its favorable efficacy in eradicating Helicobacter pylori ( H. pylori). This study aimed to compare the efficacy and safety of high-dose PPI–amoxicillin dual therapy and bismuth-containing quadruple therapy for H. pylori rescue treatment. Methods::This was a prospective, randomized, multicenter, non-inferiority trial. Patients recruited from eight centers who had failed previous treatment were randomly (1:1) allocated to two eradication groups: HDDT (esomeprazole 40 mg and amoxicillin 1000 mg three times daily; the HDDT group) and bismuth-containing quadruple therapy (esomeprazole 40 mg, bismuth potassium citrate 220 mg, and furazolidone 100 mg twice daily, combined with tetracycline 500 mg three times daily; the tetracycline, furazolidone, esomeprazole, and bismuth [TFEB] group) for 14 days. The primary endpoint was the H. pylori eradication rate. The secondary endpoints were adverse effects, symptom improvement rates, and patient compliance. Results::A total of 658 patients who met the criteria were enrolled in this study. The HDDT group achieved eradication rates of 75.4% (248/329), 81.0% (248/306), and 81.3% (248/305) asdetermined by the intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses, respectively. The eradication rates were similar to those in the TFEB group: 78.1% (257/329), 84.2% (257/305), and 85.1% (257/302). The lower 95% confidence interval boundary (–9.19% in the ITT analysis, –9.21% in the MITT analysis, and –9.73% in the PP analysis) was greater than the predefined non-inferiority margin of –10%, establishing a non-inferiority of the HDDT group vs. the TFEB group. The incidence of adverse events in the HDDT group was significantly lower than that in the TFEB group (11.1% vs. 26.8%, P < 0.001). Symptom improvement rates and patients’ compliance were similar between the two groups. Conclusions::Fourteen-day HDDT is non-inferior to bismuth-containing quadruple therapy, with fewer adverse effects and good treatment compliance, suggesting HDDT as an alternative for H. pylori rescue treatment in the local region. Trial registration::Clinicaltrials.gov, NCT04678492.