上肢康复机器人主动康复训练控制策略

近年来,脑卒中和交通事故造成上肢损伤的人数逐年上升,医疗领域对康复器械的需求越来越大。为满足实际需求,开发以气动人工肌肉为驱动器的4自由度（肩关节外收/内展（被动）、前驱/后伸、肘关节屈曲、腕关节屈曲）可穿戴上肢康复机器人。首先设计上肢康复机器人的结构,并采用气动人工肌肉作为肘关节与腕关节的驱动器。然后针对该上肢康复机器人,研究主动康复训练控制策略,设计两种控制策略。通过穿戴实验验证控制策略的有效性和实际应用价值。     

Physiological responses in different intensities of resistance exercise – Critical load and the effects of aging process

Aim was to identify critical load (CL) in young and elderly apparently healthy male cohorts. To contrast the metabolic, cardiovascular and perceptual responses on CL according to age. We evaluated 12 young (23 ± 3 years) and 10 elderly (70 ± 2 years) apparently healthy active males, who underwent: (1) 1 repetition maximum (1RM) test on a 45° Leg Press; (2) on different days, three high-intensity resistance exercise constant load tests (60%, 75% and 90% 1RM) until fatigue (Tlim). Absolute values of both the CL asymptote and curvature constant (kg) were significantly lower in elderly subjects (P < 0.05). In contrast, elderly subjects demonstrated a significantly higher number of repetitions at CL when compared with young subjects (P < 0.05). As expected, oxygen uptake (VO₂) and heart rate (HR) during maximal aerobic exercise testing were significantly reduced in older subjects. However, percent-predicted aerobic capacity were higher in older subjects (P < 0.05). In addition, blood lactate ([La^?]) corrected to Tlim and rating of perceived exertion values were greater in younger subjects at all intensities (P < 0.05). These findings, despite reduced force production in older subjects, endurance-related parameters are well preserved according to age-adjusted percent-predicted values in apparently healthy males.     

Combined effects of exposure to hypoxia and cool on walking economy and muscle oxygenation profiles at tibialis anterior

We investigated combined effects of ambient temperature (23°C or 13°C) and fraction of inspired oxygen (21%O₂ or 13%O₂) on energy cost of walking (C_w: J·kg^?1·km^?1) and economical speed (ES). Eighteen healthy young adults (11 males, seven females) walked at seven speeds from 0.67 to 1.67 m s^?1 (four min per stage). Environmental conditions were set; thermoneutral (N: 23°C) with normoxia (N: 21%O₂) = NN; 23°C (N) with hypoxia (H: 13%O₂) = NH; cool (C: 13°C) with 21%O₂ (N) = CN, and 13°C (C) with 13%O₂ (H) = CH. Muscle deoxygenation (HHb) and tissue O₂ saturation (StO₂) were measured at tibialis anterior. We found a significantly slower ES in NH (1.289 ± 0.091 m s^?1) and CH (1.275 ± 0.099 m s^?1) than in NN (1.334 ± 0.112 m s^?1) and CN (1.332 ± 0.104 m s^?1). Changes in HHb and StO₂ were related to the ES. These results suggested that the combined effects (exposure to hypoxia and cool) is nearly equal to exposure to hypoxia and cool individually. Specifically, acute moderate hypoxia slowed the ES by approx. 4%, but acute cool environment did not affect the ES. Further, HHb and StO₂ may partly account for an individual ES.     

我国男生引体向上“零”分探因:基于三角互证的研究策略

我国多数男生引体向上得"零"分,使上肢力量测评出现"地板效应"。采用量化研究和质性研究两种范式提高研究效度。量化研究对学生体质与健康调研数据和监测数据进行方差分析、多重比较和回归分析,结果表明：（1）每5~10年,男生的握力、体重、身高、BMI、引体向上均值差异显著;（2）年龄、握力、体重、身高、BMI分别显著预测引体向上成绩,体重和握力是影响我国男生引体向上成绩的主要影响因素。质性研究结果表明,引体向上"零"分主要有四个方面的原因：体重增长难挡,力量增长受限,个体认知偏差,社会支持薄弱。结论：我国男生引体向上"零"分的首要原因是体重增长较快,其次,主要肌群绝对力量和耐力增长不足,男生对引体向上的认知有偏差,学校、家长、社会支持较弱;借助政策控制体重、发展肌力、完善测评标准、促进男生积极练习引体向上十分重要。     

Specific tackling situations affect the biomechanical demands experienced by rugby union players

Tackling in Rugby Union is an open skill which can involve high-speed collisions and is the match event associated with the greatest proportion of injuries. This study aimed to analyse the biomechanics of rugby tackling under three conditions: from a stationary position, with dominant and non-dominant shoulder, and moving forward, with dominant shoulder. A specially devised contact simulator, a 50-kg punch bag instrumented with pressure sensors, was translated towards the tackler (n = 15) to evaluate the effect of laterality and tackling approach on the external loads absorbed by the tackler, on head and trunk motion, and on trunk muscle activities. Peak impact force was substantially higher in the stationary dominant (2.84 ± 0.74 kN) than in the stationary non-dominant condition (2.44 ± 0.64 kN), but lower than in the moving condition (3.40 ± 0.86 kN). Muscle activation started on average 300 ms before impact, with higher activation for impact-side trapezius and non-impact-side erector spinae and gluteus maximus muscles. Players’ technique for non-dominant-side tackles was less compliant with current coaching recommendations in terms of cervical motion (more neck flexion and lateral bending in the stationary non-dominant condition) and players could benefit from specific coaching focus on non-dominant-side tackles.     

The influence of race length on arterial compliance following an ultra-endurance marathon

There is inconclusive evidence concerning the effects of routine participation in ultra-endurance events on cardiovascular disease (CVD) risk. Arterial compliance is a reliable, non-invasive, and effective tool for evaluating CVD risk. The purpose of this research was to examine if race length influences acute changes in arterial compliance following an ultra-marathon event. A total of 46 ultra-marathon runners were recruited including 21 participants (39.8?±?8.3?years, 6 females) in the 80-km event and 25 participants (43.7?±?9.8?years, 3 female) in the 195-km event. Arterial compliance was measured via radial applanation tonometry (CR-2000, HDI) for diastolic pulse contour analysis before and following the race. Significant between-group differences were found for changes in large arterial compliance with a decrease (increase in stiffness) following the 195-km event and an increase following the 80-kilometre event (p?<?.05). Longer race lengths are associated with greater reductions in large arterial compliance following recreational ultra-marathon running. Assessment of arterial compliance might be a useful prognostic tool to assess the long-term risk of CVD among ultra-marathon runners.     

Tribute to Dr Jacques Rogge: muscle activity and fatigue during hiking in Olympic dinghy sailing

‘A tribute to Dr J. Rogge’ aims to systematically review muscle activity and muscle fatigue during sustained submaximal quasi-isometric knee extension exercise (hiking) related to Olympic dinghy sailing as a tribute to Dr Rogge’s merits in the world of sports. Dr Jacques Rogge is not only the former President of the International Olympic Committee, he was also an orthopaedic surgeon and a keen sailor, competing at three Olympic Games. In 1972, in fulfilment of the requirements for the degree of Master in Sports Medicine, he was the first who studied a sailors’ muscle activity by means of invasive needle electromyography (EMG) during a specific sailing technique (hiking) on a self-constructed sailing ergometer. Hiking is a bilateral and multi-joint submaximal quasi-isometric movement which dinghy sailors use to optimize boat speed and to prevent the boat from capsizing. Large stresses are generated in the anterior muscles that cross the knee and hip joint, mainly employing the quadriceps at an intensity of 30–40% maximal voluntary contraction (MVC), sometimes exceeding 100% MVC. Better sailing level is partially determined by a lower rate of neuromuscular fatigue during hiking and for ≈60% predicted by a higher maximal isometric quadriceps strength. Although useful in exercise testing, prediction of hiking endurance capacity based on the changes in surface EMG in thigh and trunk muscles during a hiking maintenance task is not reliable. This could probably be explained by the varying exercise intensity and joint angles, and the great number of muscles and joints involved in hiking.

Highlights

• Dr Jacques Rogge, former president of the International Olympic Committee and Olympic Finn sailor, was the first to study muscle activity during sailing using invasive needle EMG to obtain his Master degree in Sports Medicine at the Ghent University.

• Hiking is a critical bilateral and multi-joint movement during dinghy racing, accounting for >60% of the total upwind leg time. Hiking generates large stresses in the anterior muscles that cross the knee and hip joint.

• Hiking is considered as a quasi-isometric bilateral knee extension exercise. Muscle activity measurements during sailing, recorded by means of EMG, show a mean contraction intensity of 30-40% maximal voluntary contraction with peaks exceeding 100%.

• Hiking performance is strongly related to the development of neuromuscular fatigue in the quadriceps muscle. Since maximal strength is an important determinant of neuromuscular fatigue during hiking, combined strength and endurance training should be incorporated in the training program of dinghy sailors.

     

Resting MAPK expression in chronically trained endurance runners

Purpose: There is a paucity of research investigating the expression of mitogen-activated protein kinases (MAPK) in chronically trained (CT) athletes. Thus, it is unclear how MAPK may contribute to performance and muscle adaptation in CT subjects. The purpose of this study was to determine MAPK total protein, and phosphorylated expression of extracellular signal-regulated kinases 1 and 2 (ERK1/2), c-Jun N-terminal kinase (JNK), and p38-MAPK (p38) between untrained, and chronically trained runners. Methods: Tissue samples were analysed from sedentary (SED; n?=?5) controls and chronically trained runners (CT; n?=?5). Resting muscle biopsy samples were analysed for total-MAPK – and ratio of phosphorylated/total (p-MAPK) – ERK1/2, JNK, and p38-MAPK via western blotting. Mann–Whitney U tests and effect sizes were utilized to determine differences in total MAPK protein content and phosphorylation status between SED and CT subjects. Results: There was no difference in total-MAPK expression between SED and CT (p?>?.05). p-p38-MAPK tended to be greater for CT compared to SED (p?=?.07). There were moderate effect sizes of decreased pERK/total-ERK (d?=??0.69) and increased pJNK/total-JNK (d?=?0.54) in CT compared to SED. There was a positive correlation between p-p38-MAPK/total-MAPK and the percentage of type I fibres (r?=?0.73, p?=?.016). Conclusion: Contrary to previous studies, chronic endurance training does not greatly influence total MAPK protein expression in chronically trained runners. However, resting phosphorylation of p38-MAPK may contribute to enhanced oxidative metabolism at chronically trained levels. These alterations are likely involved in the different physiological adaptations that occur following long-term training or at highly competitive levels.     

The dynamic control ratio at the equilibrium point (DCRe): introducing relative and absolute reliability scores

Analytical methods to assess thigh muscle balance need to provide reliable data to allow meaningful interpretation. However, reproducibility of the dynamic control ratio at the equilibrium point has not been evaluated yet. Therefore, the aim of this study was to compare relative and absolute reliability indices of its angle and moment values with conventional and functional hamstring–quadriceps ratios. Furthermore, effects of familiarisation and angular velocity on reproducibility were analysed. A number of 33 male volunteers participated in 3 identical test sessions. Peak moments (PMs) were determined unilaterally during maximum concentric and eccentric knee flexion (prone) and extension (supine position) at 0.53, 1.57 and 2.62 rad · s^–1. A repeated measure, ANOVA, confirmed systematic bias. Intra-class correlation coefficients and standard errors of measurement indicated relative and absolute reliability. Correlation coefficients were averaged over respective factors and tested for significant differences. All balance scores showed comparable low-to-moderate relative (<0.8–0.9) and good absolute reliability (<10%). Relative reproducibility of dynamic control equilibrium parameters augmented with increasing angular velocity, but not with familiarisation. At 2.62 rad · s^–1, high (moment: 0.906) to moderate (angle: 0.833) relative reliability scores with accordingly high absolute indices (4.9% and 6.4%) became apparent. Thus, the dynamic control equilibrium is an equivalent method for the reliable assessment of thigh muscle balance.