• 【霍奇金淋巴瘤幸存者中与癌症相关的疲劳和肌肉质量。】 复制标题 收藏 收藏
    DOI:10.1177/1534735417712009 复制DOI
    作者列表:de Lima FD,Bottaro M,de Oliveira Valeriano R,Cruz L,Battaglini CL,Vieira CA,de Oliveira RJ
    BACKGROUND & AIMS: :The purpose of this study was to compare fatigue, strength, body composition, muscle thickness, and muscle quality between Hodgkin's lymphoma survivors (HLS) and apparently healthy subjects matched by age, gender, and physical activity levels (CON). Twelve HLS (32.16 ± 8.06) and 36 CON (32.42 ± 7.64) were enrolled in the study. Fatigue was assessed using the 20-item Multidimensional Fatigue Inventory, muscle strength using an isokinetic dynamometer, body composition using dual-energy X-ray absorptiometry, and thickness and muscle quality using B-mode ultrasound. Differences between HLS and CON were analyzed using independent samples t tests. No significant differences were observed between groups for any demographic characteristics: age ( P = .922), weight ( P = .943), height ( P = .511), body mass index ( P = .796), fat mass ( P = .688), fat-free mass ( P = .520), and percent body fat ( P = .446). No significant differences were observed for strength (peak torque; P = .552), relative peak torque ( P = .200), muscle thickness ( P > .05) and muscle quality ( P > .05). However, self-perceived fatigue was significantly higher in HLS than in CON ( P = .009). It appears that when HLS are matched by age and physical activity levels to CON, no significant difference in body composition, muscle thickness, muscle quality, or strength is observed. Self-perceived fatigue, as predicted, is higher in HLS, which may have implications and should be considered when prescribing exercise training to this cancer population.
    背景与目标: :本研究的目的是比较霍奇金淋巴瘤幸存者(HLS)与显然健康的受试者之间的疲劳,强度,身体成分,肌肉厚度和肌肉质量,并根据年龄,性别和身体活动水平(CON)进行比较。十二项HLS(32.16±8.06)和36 CON(32.42±7.64)被纳入研究。使用20个项目的多维疲劳清单评估疲劳,使用等速测功机评估肌肉强度,使用双能X射线吸收法评估身体成分,并使用B型超声评估厚度和肌肉质量。使用独立样本t检验分析了HLS和CON之间的差异。两组之间在任何人口统计学特征上均未观察到显着差异:年龄(P = .922),体重(P = .943),身高(P = .511),体重指数(P = .796),脂肪质量(P = .688),不含脂肪的质量(P = .520)和体内脂肪百分比(P = .446)。强度(峰值扭矩; P = .552),相对峰值扭矩(P = .200),肌肉厚度(P> .05)和肌肉质量(P> .05)没有明显差异。但是,HLS的自我感觉疲劳明显高于CON(P = .009)。看起来,当HLS通过年龄和身体活动水平与CON相匹配时,在身体组成,肌肉厚度,肌肉质量或强度上均未观察到显着差异。正如预期的那样,HLS中的自我感觉疲劳较高,这可能会产生影响,因此在对此人群进行运动训练时应考虑这一点。
  • 【月经量大出血的青春期女性的铁缺乏和疲劳。】 复制标题 收藏 收藏
    DOI:10.1111/hae.12046 复制DOI
    作者列表:Wang W,Bourgeois T,Klima J,Berlan ED,Fischer AN,O'Brien SH
    BACKGROUND & AIMS: :Iron deficiency and fatigue are common problems in adolescent females. Heavy menstrual bleeding (HMB) is associated with both iron deficiency and fatigue. The aim of this study was to define baseline ferritin values and fatigue symptoms in a population of young females with excessive menstrual blood loss, as compared to healthy controls. The study population included 11 to 17-year-old menstruating females presenting to an Adolescent Gynaecology Clinic, Menorrhagia Clinic or Sports Medicine clinic. To evaluate the degree and effects of menstrual blood loss, we utilized the Ruta Menorrhagia Severity Score. We investigated the symptoms of fatigue using the Fatigue Severity Scale. We evaluated possible predictors of ferritin level (age, body mass index, fatigue scores and Menorrhagia Severity Score) using generalized linear models. A total of 48 adolescents with HMB and 102 healthy adolescents completed the study. Iron deficiency and elevated fatigue scores were common findings in young women with HMB. Both fatigue severity scores and menorrhagia severity scores were significantly higher in young women with HMB as compared to healthy controls. In adolescents with HMB, 87.5% had ferritin levels ≤40 ng mL(-1), and 29.2% had ferritin levels ≤15 ng mL(-1). Our generalized linear models did not identify any significant univariate relationships between ferritin levels and patient age, body mass index, fatigue score or menorrhagia score. Iron deficiency and symptoms of fatigue are common findings in young women with HMB. Fatigue severity scores are significantly higher in young women with HMB as compared to healthy controls.
    背景与目标: :铁缺乏和疲劳是青春期女性的常见问题。严重的月经出血(HMB)与铁缺乏和疲劳有关。这项研究的目的是确定与健康对照组相比,月经失血过多的年轻女性人群的基线铁蛋白值和疲劳症状。研究人群包括就诊于青春期妇科诊所,月经过多诊所或运动医学诊所的11至17岁的月经女性。为了评估月经失血的程度和影响,我们使用了Ruta Menorrhagia严重度评分。我们使用疲劳严重程度量表调查了疲劳症状。我们使用广义线性模型评估了铁蛋白水平的可能预测因子(年龄,体重指数,疲劳评分和月经过多程度)。共有48名HMB青少年和102名健康青少年完成了这项研究。缺铁和疲劳评分升高是HMB年轻女性的常见发现。与健康对照组相比,HMB年轻女性的疲劳严重程度评分和月经过多严重程度评分均显着更高。在HMB青少年中,铁蛋白水平≤40 ng mL(-1)占87.5%,铁蛋白水平≤15 ng mL(-1)占29.2%。我们的广义线性模型未发现铁蛋白水平与患者年龄,体重指数,疲劳评分或月经过多评分之间存在任何显着的单变量关系。铁缺乏症和疲劳症状是HMB年轻女性的常见发现。与健康对照组相比,HMB年轻女性的疲劳严重程度评分明显更高。
  • 【在疲劳加载之前和之后保留ERA直接覆盖义齿的附件。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Gamborena JI,Hazelton LR,NaBadalung D,Brudvik J
    BACKGROUND & AIMS: :This in vitro study investigated the retention of the four different color-coded ERA attachments prior to and after various levels of fatigue loading (at baseline, at 500 cycles, and after every 500 cycles up to 5,500 cycles). Samples were placed in the Instron testing machine for determination of initial retentive values and then cycled in a specially designed fatigue machine and retested. The results of this study demonstrated that although there are four different retentive elements supplied by the manufacturer of the ERA system, there were only two significantly different groups; (1) the white attachments and (2) the orange, blue, and gray attachments (P < .05). After 500 cycles, there was a loss in retention of 60% for the white, 60% for the orange, 56% for the blue, and 54% for the gray. After 1,500 cycles there was no difference in retentive values for any of the four colored attachments (P < .05). Microscopic examination of worn specimens supported the findings of the fatigue testing.
    背景与目标: :这项体外研究调查了在不同水平的疲劳负荷之前和之后(在基线,500次循环以及每500次循环后最多5500次循环),四种不同颜色编码的ERA附件的保留情况。将样品放入Instron测试机中以确定初始保持值,然后在专门设计的疲劳机中循环并重新测试。这项研究的结果表明,尽管ERA系统的制造商提供了四种不同的保持元件,但只有两个显着不同的组; (1)白色附件,以及(2)橙色,蓝色和灰色附件(P <.05)。 500次循环后,白色的保留率降低了60%,橙色的保留率降低了60%,蓝色的保留率降低了56%,灰色的保留率降低了54%。在1,500个循环之后,四个彩色附件中的任何一个的保持力值均无差异(P <.05)。磨损样品的显微镜检查支持了疲劳测试的结果。
  • 【肾移植后严重疲劳:一种高度流行的致残多因素症状。】 复制标题 收藏 收藏
    DOI:10.1111/tri.12166 复制DOI
    作者列表:Goedendorp MM,Hoitsma AJ,Bloot L,Bleijenberg G,Knoop H
    BACKGROUND & AIMS: :Fatigue is a common symptom of patients with chronic kidney disease, but seldom investigated after transplantation. We determined the prevalence, impact and related factors of severe fatigue in kidney transplant recipients (KTRs). Medical records and questionnaires were used to assess kidney function, donor characteristics, fatigue (Checklist Individual Strength), functional impairments (Sickness Impact Profile), work status, body mass index (BMI), pain, depressive symptoms, social support and sleeping problems in 180 participating KTRs. KTRs were compared with sex- and age-matched population-based controls. KTRs were significantly more often severely fatigued (39%) compared to matched controls (22%; P = 0.001). Severely fatigued KTRs had significantly more functional impairments than nonseverely fatigued recipients (effect size ≥ 0.7) P < 0.001, and less often a paid job (27% vs. 48%, P = 0.005). Univariate analysis showed that severely fatigued KTRs received more often a kidney from a deceased donor, had a higher BMI, more pain, discrepancy in social support, depressive symptoms and sleeping problems. In a multivariate analysis (n = 151) the latter two associations remained significant. Severe fatigue is a highly prevalent and disabling symptom in KTRs. Moreover, severe fatigue after kidney transplantation is more strongly related to behavioural and psychosocial factors than specific transplantation-related factors. Findings have implications for fatigue management.
    背景与目标: :疲劳是慢性肾脏疾病患者的常见症状,但很少在移植后进行检查。我们确定了肾移植受者(KTR)中严重疲劳的患病率,影响和相关因素。病历和问卷用于评估肾功能,供体特征,疲劳(清单个人力量),功能障碍(疾病影响概况),工作状态,体重指数(BMI),疼痛,抑郁症状,社会支持和睡眠问题。 180个参与的KTR。将KTR与性别和年龄相匹配的基于人群的对照进行了比较。与匹配的对照组(22%; P = 0.001)相比,KTR严重疲劳(39%)的频率明显更高。严重疲劳的KTR比非严重疲劳的接受者具有更大的功能障碍(效应量≥0.7)P <0.001,而有酬工作的频率更低(27%比48%,P = 0.005)。单因素分析表明,严重疲劳的KTR经常从死者的肾脏获得肾脏,BMI更高,疼痛更多,社会支持差异,抑郁症状和睡眠问题。在多变量分析(n = 151)中,后两个关联仍然显着。严重疲劳是KTR的高度普遍和致残的症状。此外,与特定的移植相关因素相比,肾移植后的严重疲劳与行为和社会心理因素的相关性更高。研究结果对疲劳管理有影响。
  • 【高强度运动(足球)的能量学,尤其涉及疲劳。】 复制标题 收藏 收藏
    DOI:10.1080/026404197367263 复制DOI
    作者列表:Reilly T
    BACKGROUND & AIMS: :Soccer entails intermittent exercise with bouts of short, intense activity punctuating longer periods of low-level, moderate-intensity exercise. High levels of blood lactate may sometimes be observed during a match but the active recovery periods at submaximal exercise levels allow for its removal on a continual basis. While anaerobic efforts are evident in activity with the ball and shadowing fast-moving opponents, the largest strain is placed on aerobic metabolism. On average, competitive soccer corresponds to an energy expenditure of about 75% maximal aerobic power. The energy expenditure varies with playing position, being highest among midfield players. Muscle glycogen levels can be reduced towards the end of a game, the level of reduction being reflected in a decrease in work rate. Blood glucose levels are generally well-maintained, although body temperature may rise by 2 degrees C even in temperate conditions. The distance covered by players tends to under-reflect the energy expended. Unorthodox modes of motion-running backwards and sideways, accelerating, decelerating and changing direction-accentuate the metabolic loading. These are compounded by the extra requirements for energy associated with dribbling the ball and contesting possession. The overall energy expended is extreme when players are required to play extra-time in tournaments. Training, nutritional and tactical strategies may be used to reduce the effects of fatigue that may occur late in the game.
    背景与目标: :足球需要间歇性运动,短而激烈的运动可以打断较长时间的低水平,中等强度的运动。有时在比赛中会观察到高水平的血乳酸,但是在低于最大运动水平的活跃恢复期可以连续去除乳酸。厌氧运动明显表现在对球和阴影快速移动的对手的活动中,但最大的压力在于有氧代谢。平均而言,竞技足球对应的能量消耗约为最大有氧能力的75%。能量消耗随比赛位置而变化,在中场球员中最高。肌肉糖原水平可以在比赛快结束时降低,降低水平反映在工作效率的降低上。血糖水平通常保持良好,尽管即使在温和条件下,体温也会升高2摄氏度。玩家所覆盖的距离往往不足以反映所消耗的能量。向后和向侧面运动,加速,减速和改变方向的非正统运动模式会加重新陈代谢负荷。与运球和比赛拥有权相关的额外能量需求进一步加剧了这些问题。当要求球员在比赛中加班时,总的精力消耗是极端的。训练,营养和战术策略可用于减少比赛后期可能出现的疲劳影响。
  • 6 Management of cancer-related fatigue. 复制标题 收藏 收藏

    【癌症相关疲劳的管理。】 复制标题 收藏 收藏
    DOI:10.1188/08.CJON.S2.21-25 复制DOI
    作者列表:Barsevick AM,Newhall T,Brown S
    BACKGROUND & AIMS: :Guidelines for the management of cancer-related fatigue (CRF) emphasize evidence-based strategies for reducing this common symptom in patients with cancer. Exercise has the largest body of data supporting its benefits in reducing CRF. Patient education and counseling also are considered integral to effective CRF management. Additional interventions can be pharmacologic or nonpharmacologic, although a combination of approaches may be employed. Several factors known to be associated with CRF may be particularly amenable to treatment.
    背景与目标: :癌症相关疲劳(CRF)的管理指南强调了以证据为基础的策略,以减少癌症患者的这种常见症状。锻炼具有最大的数据量,支持其减少CRF的益处。病人的教育和咨询也被认为是有效的CRF管理不可或缺的部分。尽管可以采用多种方法,但是其他干预措施可以是药物治疗的,也可以是非药物治疗的。已知与CRF相关的几种因素可能特别适合治疗。
  • 【接受癌症治疗的患者的情绪障碍,睡眠障碍,疲劳和疼痛的影响。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2354.2012.01372.x 复制DOI
    作者列表:Cheng KK,Yeung RM
    BACKGROUND & AIMS: :This paper describes the prevalence of mood disturbance, sleep disturbance, fatigue and pain (MSFP), either alone or in combination in patients receiving cancer therapy, and determines its impact and whether it is a predictor for functional status and the impairment of quality of life (QoL). This is a cross-sectional study using secondary data from a sample of 214 patients being treated by chemotherapy or radiotherapy. In all, 87%, 68%, 66% and 38% of the patients reported MSFP respectively. Co-occurrence of any three and all of the four symptoms, were reported separately at rates of 29% and 31%. Patients with all four symptoms recorded significantly lower Karnofsky Performance Scale (KPS) scores (mean 77.7 ± 12.9) and QoL scores (mean subscales scores 9.0-17.6) than those with none or up to any three of the symptoms (P < 0.001). Regression of the KPS and QoL scores against the MSFP revealed an increase in the explained variance of 25%, 43%, 27%, 37% and 41% respectively for KPS, physical, emotional, functional and total QoL. The results suggest that MSFP are highly prevalent, whether alone or in combination, in patients receiving cancer therapy, and may negatively influence the patient's functional status and QoL during cancer therapy.
    背景与目标: :本文描述了接受癌症治疗的患者中单独或联合使用时情绪障碍,睡眠障碍,疲劳和疼痛(MSFP)的患病率,并确定其影响以及它是否是功能状态和质量下降的预测指标生活(QoL)。这是一项横断面研究,使用了来自214名正在接受化学疗法或放射疗法治疗的患者的样本的辅助数据。总计分别有87%,68%,66%和38%的患者报告了MSFP。分别报告了这三种症状和所有四种症状的并发发生率,分别为29%和31%。与没有或没有任何三种症状的患者相比,所有四种症状的患者记录的Karnofsky绩效量表(KPS)评分(平均77.7±12.9)和QoL评分(平均子评分为9.0-17.6)均显着降低(P <0.001)。 KPS和QoL得分相对于MSFP的回归显示,KPS,身体,情绪,功能和总QoL的解释方差分别增加了25%,43%,27%,37%和41%。结果表明,MSFP在接受癌症治疗的患者中非常普遍,无论是单独使用还是组合使用,都可能对癌症治疗期间的患者功能状态和QoL产生负面影响。
  • 【通过生物神经适应症增强上肢的虚拟康复能力:虚拟现实对感知的肌肉疲劳,游戏性能和用户体验的影响。】 复制标题 收藏 收藏
    DOI:10.1109/TNSRE.2020.2968869 复制DOI
    作者列表:Montoya MF,Munoz JE,Henao OA
    BACKGROUND & AIMS: :Virtual rehabilitation has been used during decades to provide a more personalized, controlled, and enjoyable experience on upper-limb motor rehabilitation. Since novel virtual reality (VR) technologies are now accessible and highly immersive, the challenge for a wide dissemination of virtual rehabilitation in clinical scenarios has shifted from the hardware robustness to the software intelligence. A sophisticated technique that provides physiological intelligence to novel human-computer interaction (HCI) applications is biocybernetic adaptation. The concept emerges from the electrophysiological computing field, and it proposes using body signals to detect human states (e.g. workload or fatigue) and modulate the virtual activity accordingly. This paper evaluates the effects of using biocybernetic adaptation in a virtual rehabilitation game that aims to encourage users to exert at a desirable intensity level while interacting with the virtual environment. The system relies on surface-electromyography (sEMG) signals to detect fatigue levels in real-time and adapt the game challenge dynamically. Perceived fatigue levels, game user experience, and game performance parameters are assessed after playing the game, considering two different visualization modalities: non-immersive (conventional flat screen) and immersive (VR headset). Results revealed how the biocybernetic system in the immersive condition not only produced lower levels of perceived fatigue compared with the non-immersive, but also, created a more enjoyable and positive experience in a controlled experiment with 24 healthy subjects. Moreover, participants in the immersive condition showed a better performance in the virtual game and higher usability levels scored by users compared with the non-immersive condition. To conclude, we highlight the importance of combining novel immersive approaches with physiologically aware systems to enhance the benefits of virtual rehabilitation therapies.
    背景与目标: :数十年来,虚拟康复已被用于为上肢运动康复提供更个性化,可控制和令人愉悦的体验。由于新型虚拟现实(VR)技术现在已经可以访问并且具有高度沉浸性,因此在临床场景中广泛传播虚拟康复的挑战已经从硬件的健壮性转变为软件的智能性。一种为复杂的人机交互技术提供生理智能的先进技术是生物计算机适应。该概念来自电生理计算领域,并且提出使用身体信号来检测人的状态(例如工作量或疲劳)并相应地调节虚拟活动。本文评估了在虚拟康复游戏中使用生物cybernetic适应的效果,该游戏旨在鼓励用户在与虚拟环境互动的同时以理想的强度进行锻炼。该系统依靠表面肌电图(sEMG)信号实时检测疲劳程度并动态适应游戏挑战。考虑到两种不同的可视化模式:非沉浸式(常规纯平屏幕)和沉浸式(VR头戴式耳机),在玩完游戏后评估感知的疲劳水平,游戏用户体验和游戏性能参数。结果表明,沉浸状态下的生物神经网络系统不仅比非沉浸状态下产生的疲劳感更低,而且在24名健康受试者的对照实验中创造了更加令人愉悦和积极的体验。而且,与非沉浸状态相比,沉浸状态的参与者在虚拟游戏中表现出更好的性能,并且用户获得了更高的可用性级别。总而言之,我们强调了将新颖的沉浸式方法与具有生理意识的系统相结合以增强虚拟康复疗法的益处的重要性。
  • 【成年患者接受NHS慢性疲劳综合症(CFS / ME)专业服务的经验:在英国进行的定性研究。】 复制标题 收藏 收藏
    DOI:10.1186/s12913-017-2337-6 复制DOI
    作者列表:Broughton J,Harris S,Beasant L,Crawley E,Collin SM
    BACKGROUND & AIMS: BACKGROUND:Few studies have explored patients' experiences of treatment for CFS/ME. This study aims to fill this gap by capturing the perspective of patients who have been treated by NHS specialist CFS/ME services in England. METHODS:Semi-structured interviews were conducted during the period June-September 2014 with 16 adults who were completing treatment at one of three outpatient NHS specialist CFS/ME services. Interviews were analysed thematically using constant comparison techniques, with particular attention paid to contrasting views. RESULTS:Three themes were identified: 'Journey to specialist services'; 'Things that help or hinder treatment'; and 'Support systems'. Within these themes nine sub-themes were identified. A wide range of factors was evident in forming participants' experiences, including personal characteristics such as perseverance and optimism, and service factors such as flexibility and positive, supportive relationships with clinicians. Participants described how specialist services played a unique role, which was related to the contested nature of the condition. Many participants had experienced a lack of validation and medical and social support before attending a specialist service. Patients' experiences of life before referral, and the concerns that they expressed about being discharged, highlighted the hardship and obstacles which people living with CFS/ME continue to experience in our society. CONCLUSIONS:The experiences of CFS/ME patients in our study showed that NHS specialist CFS/ME services played a vital role in patients' journeys towards an improved quality of life. This improvement came about through a process which included validation of patients' experiences, acceptance of change, practical advice and support, and therapeutic outcomes.
    背景与目标: 背景:很少有研究探讨患者对CFS / ME的治疗经验。这项研究旨在通过捕获英国NHS专家CFS / ME服务所治疗患者的观点来填补这一空白。
    方法:在2014年6月至9月期间,对三名门诊NHS专家CFS / ME服务之一中完成治疗的16名成年人进行了半结构式访谈。访谈采用恒定比较技术进行主题分析,尤其要注意对比观点。
    结果:确定了三个主题:“专业服务之旅”; “有助于或阻碍治疗的事情”;和“支持系统”。在这些主题中,确定了9个子主题。形成参与者体验的因素很明显,包括毅力和乐观情绪等个人特征,以及灵活性和与临床医生之间的积极支持关系等服务因素。参与者描述了专家服务如何发挥独特作用,这与疾病的争议性质有关。许多参与者在参加专科服务之前经历了缺乏验证以及医疗和社会支持的经历。患者转诊前的生活经历以及他们对出院的担忧,凸显了CFS / ME患者在我们社会中继续经历的艰辛和障碍。
    结论:本研究中CFS / ME患者的经验表明,NHS专家CFS / ME服务在患者改善生活质量的旅程中起着至关重要的作用。这种改善是通过一个过程来实现的,该过程包括验证患者的经历,接受变更,实用的建议和支持以及治疗效果。
  • 【健康受试者的背部和臀部伸肌疲劳:Sorensen测试的两个变体的任务依赖性效应。】 复制标题 收藏 收藏
    DOI:10.1007/s00586-008-0782-y 复制DOI
    作者列表:Champagne A,Descarreaux M,Lafond D
    BACKGROUND & AIMS: :Paraspinal muscle fatigability during various trunk extension tests has been widely investigated by electromyography (EMG), and its task-dependency is established recently. Hip extensor muscle fatigability during the Sorensen test has been reported. The aim of the present experiments was to evaluate the task-dependency of back and hip extensor muscle fatigue during two variants of the Sorensen test. We hypothesized that the rate of muscular fatigue of the hip and back extensor muscles varies according to the test position. Twenty healthy young males with no history of low back pain volunteered to participate in this cross-sectional study. They were asked to perform two body weight-dependent isometric back extension tests (S1 = Sorensen test; S2 = modified Sorensen on a 45 degrees Roman chair). Surface EMG activity of the paraspinal muscles (T10 and L5 levels) and hip extensor muscles (gluteus maximus; biceps femoris) was recorded, and muscular fatigue was assessed through power spectral analysis of the EMG data by calculating the rate of median power frequency change. We observed hip extensor muscle fatigue simultaneously with paraspinal muscle fatigue during both Sorensen variants. However, only L5 level EMG fatigue indices showed a task-dependency effect between S1 and S2. Hip extensor muscles appear to contribute to load sharing of the upper body mass during both Sorensen variants, but to a different extent because L5 level fatigue differs between the Sorensen variants. Our findings suggest that task-dependency has to be considered when EMG variables are compared between two types of lumbar muscle-fatiguing tasks.
    背景与目标: :肌电图(EMG)已广泛研究了各种躯干伸展测试过程中的椎旁肌疲劳性,并且最近确定了其任务依赖性。据报道,在Sorensen测试中,髋伸肌易疲劳。本实验的目的是评估Sorensen测试的两个变体中背部和臀部伸肌疲劳的任务相关性。我们假设髋部和后伸肌的肌肉疲劳率根据测试位置而变化。 20名没有下腰痛史的健康年轻男性自愿参加了这项横断面研究。他们被要求进行两项与体重有关的等距后伸测试(S1 = Sorensen测试; S2 =在45度罗马椅上的改良Sorensen)。记录椎旁肌(T10和L5水平)和臀部伸肌(臀大肌;股二头肌)的表面肌电活动,并通过计算肌电频率中位数变化率,通过肌电图数据的功率谱分析评估肌肉疲劳。我们在两个Sorensen变体中同时观察到了髋部伸肌疲劳和椎旁肌疲劳。但是,只有L5级EMG疲劳指数显示出S1和S2之间的任务依赖效应。髋关节伸肌似乎在两个Sorensen变体中都有助于上半身的负荷分配,但是由于L5级疲劳在Sorensen变体之间不同,因此程度不同。我们的发现表明,在两种类型的腰肌疲劳任务之间比较EMG变量时,必须考虑任务依赖性。
  • 【创伤后应激障碍,纤维肌痛,慢性疲劳综合症的常见病因和通过升高的一氧化氮/过氧亚硝酸盐引起的多种化学敏感性。】 复制标题 收藏 收藏
    DOI:10.1054/mehy.2001.1325 复制DOI
    作者列表:Pall ML
    BACKGROUND & AIMS: :Three types of overlap occur among the disease states chronic fatigue syndrome (CFS), fibromyalgia (FM), multiple chemical sensitivity (MCS) and posttraumatic stress disorder (PTSD). They share common symptoms. Many patients meet the criteria for diagnosis for two or more of these disorders and each disorder appears to be often induced by a relatively short-term stress which is followed by a chronic pathology, suggesting that the stress may act by inducing a self-perpetuating vicious cycle. Such a vicious cycle mechanism has been proposed to explain the etiology of CFS and MCS, based on elevated levels of nitric oxide and its potent oxidant product, peroxynitrite. Six positive feedback loops were proposed to act such that when peroxynitrite levels are elevated, they may remain elevated. The biochemistry involved is not highly tissue-specific, so that variation in symptoms may be explained by a variation in nitric oxide/peroxynitrite tissue distribution. The evidence for the same biochemical mechanism in the etiology of PTSD and FM is discussed here, and while less extensive than in the case of CFS and MCS, it is nevertheless suggestive. Evidence supporting the role of elevated nitric oxide/peroxynitrite in these four disease states is summarized, including induction of nitric oxide by common apparent inducers of these disease states, markers of elevated nitric oxide/peroxynitrite in patients and evidence for an inductive role of elevated nitric oxide in animal models. This theory appears to be the first to provide a mechanistic explanation for the multiple overlaps of these disease states and it also explains the origin of many of their common symptoms and similarity to both Gulf War syndrome and chronic sequelae of carbon monoxide toxicity. This theory suggests multiple studies that should be performed to further test this proposed mechanism. If this mechanism proves central to the etiology of these four conditions, it may also be involved in other conditions of currently obscure etiology and criteria are suggested for identifying such conditions.
    背景与目标: 疾病状态慢性疲劳综合症(CFS),纤维肌痛(FM),多种化学敏感性(MCS)和创伤后应激障碍(PTSD)之间发生三种类型的重叠。他们有共同的症状。许多患者符合两种或两种以上疾病的诊断标准,每种疾病似乎通常是由相对短期的压力所致,随后是慢性病理,这表明压力可能通过诱导自我延续的恶性行为而起作用。循环。有人提出了这种恶性循环机制来解释CFS和MCS的病因,原因是一氧化氮及其有效氧化剂过氧化亚硝酸盐的含量升高。提出了六个正反馈回路来起作用,使得当过亚硝酸盐水平升高时,它们可能仍保持升高状态。涉及的生物化学不是高度组织特异性的,因此症状的变化可以用一氧化氮/过亚硝酸盐组织分布的变化来解释。此处讨论了PTSD和FM病因学中相同的生化机制的证据,尽管不如CFS和MCS广泛,但仍具有启发性。总结了支持升高一氧化氮/过氧亚硝酸盐在这四种疾病状态中作用的证据,包括这些疾病状态的常见表观诱导剂对一氧化氮的诱导作用,患者中一氧化氮/过氧亚硝酸盐升高的标志物以及升高的一氧化氮的诱导作用的证据。动物模型中的氧化物。该理论似乎是第一个为这些疾病状态的多重重叠提供机械解释的理论,它还解释了它们许多常见症状的起源以及与海湾战争综合症和慢性一氧化碳毒性后遗症的相似性。该理论建议应进行多项研究,以进一步测试这种提议的机制。如果此机制证明对这四种情况的病因至关重要,则它也可能与目前尚不清楚的病因的其他情况有关,并提出了确定此类情况的标准。
  • 【纤维肌痛对直立倾斜的心血管反应与慢性疲劳综合征的反应不同。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Naschitz JE,Rozenbaum M,Rosner I,Sabo E,Priselac RM,Shaviv N,Ahdoot A,Ahdoot M,Gaitini L,Eldar S,Yeshurun D
    BACKGROUND & AIMS: OBJECTIVE:To compare the cardiovascular response during postural challenge of patients with fibromyalgia (FM) to those with chronic fatigue syndrome (CFS). METHODS:Age and sex matched patients were studied, 38 with FM, 30 with CFS, and 37 healthy subjects. Blood pressure (BP) and heart rate (HR) were recorded during 10 min of recumbence and 30 min of head-up tilt. Differences between successive BP values and the last recumbent BP, their average, and standard deviation (SD) were calculated. Time curves of BP differences were analyzed by computer and their outline ratios (OR) and fractal dimensions (FD) were measured. HR differences were determined similarly. Based on the latter measurements, each subject's discriminant score (DS) was computed. RESULTS:For patients and controls average DS values were: FM: -3.68 (SD 2.7), CFS: 3.72 (SD 5.02), and healthy controls: -4.62 (SD 2.24). DS values differed significantly between FM and CFS (p < 0.0001). Subgroups of FM patients with and without fatigue had comparable DS values. CONCLUSION:The DS confers numerical expression to the cardiovascular response during postural challenge. DS values in FM were significantly different from DS in CFS, suggesting that homeostatic responses in FM and CFS are dissimilar. This observation challenges the hypothesis that FM and CFS share a common derangement of the stress-response system.
    背景与目标: 目的:比较纤维肌痛(FM)和慢性疲劳综合征(CFS)的体位激发期间的心血管反应。
    方法:对年龄和性别相匹配的患者进行了研究,其中38例患有FM,30例患有CFS,以及37例健康受试者。在横卧10分钟和抬头倾斜30分钟期间记录血压(BP)和心率(HR)。计算了连续BP值与最后一个横卧BP之间的差,它们的平均值和标准差(SD)。用计算机分析血压差异的时间曲线,并测量其轮廓比(OR)和分形维数(FD)。 HR差异的确定方法相似。基于后面的测量,计算每个受试者的判别分数(DS)。
    结果:对于患者和对照组,平均DS值分别为:FM:-3.68(SD 2.7),CFS:3.72(SD 5.02)和健康对照组:-4.62(SD 2.24)。 FM和CFS之间的DS值差异显着(p <0.0001)。有疲劳和无疲劳的FM患者亚组的DS值相当。
    结论:DS将数字表达赋予姿势挑战期间的心血管反应。 FM中的DS值与CFS中的DS显着不同,这表明FM和CFS中的稳态响应不同。该观察结果挑战了以下假设:FM和CFS共享压力响应系统的常见偏差。
  • 【拉丁美洲人/农民工在报告疲劳和疼痛方面与性别有关的差异的横断面研究。】 复制标题 收藏 收藏
    DOI:10.1080/1059924X.2020.1713272 复制DOI
    作者列表:Ramos AK,Carvajal-Suarez M,Trinidad N,Michaud TL,Grimm B,LeVan T,Siahpush M
    BACKGROUND & AIMS: :Objectives: Migrant farmworkers face many hardships in both their working and living environments including dangerous and demanding tasks, long hours, and inadequate rest. This study sought to explore gender differences in the reporting of fatigue and pain and to identify predictors of fatigue and pain among migrant farmworkers in Nebraska (n = 241). Methods: Bivariate tests were used to assess associations among study variables. Linear and generalized linear mixed effect models were used to assess gender as a predictor of fatigue and pain respectively while controlling for covariates. Results: Females reported significantly higher levels of fatigue (M score = 15.5, SD = 6.1 compared to M score = 12.8, SD = 4.3) than their male counterparts. Females were also more likely to report pain (56.9% of females compared to 36.3% of males). Being female, pain, hours of sleep, and job demands were significant predictors of fatigue. Fatigue and job-related injury were the only significant predictors of pain. Conclusions: There are gender-related disparities in the reporting of fatigue and pain among Latino/a migrant farmworkers. Extra precautions need to be taken to protect worker health and safety and reduce fatigue, particularly for female workers. Implications for employers, supervisors, and healthcare providers are discussed.
    背景与目标: :目标:农民工在工作和生活环境中都面临许多困难,包括艰巨而艰巨的任务,长时间工作和休息不足。这项研究旨在探讨内在疲劳和痛苦报告中的性别差异,并确定内布拉斯加州外来务工人员中疲劳和痛苦的预测因素(n = 241)。方法:双变量检验用于评估研究变量之间的关联。线性和广义线性混合效应模型用于评估性别,分别作为疲劳和疼痛的预测指标,同时控制协变量。结果:女性报告的疲劳水平明显高于男性(M评分= 15.5,SD = 6.1,而M评分= 12.8,SD = 4.3)。女性也更容易报告疼痛(女性为56.9%,而男性为36.3%)。作为女性,疼痛,睡眠时间和工作需求是疲劳的重要预测指标。疲劳和与工作有关的伤害是疼痛的唯一重要预测指标。结论:在拉丁裔/移民农民工的疲劳和疼痛报告中,存在与性别相关的差异。需要采取额外的预防措施以保护工人的健康和安全并减少疲劳,特别是对于女性工人。讨论了对雇主,主管和医疗保健提供者的影响。
  • 【膝关节角度和疲劳对人的股内侧斜肌和外侧股肌的神经肌肉控制的影响。】 复制标题 收藏 收藏
    DOI:10.1007/s004210000326 复制DOI
    作者列表:Chan AY,Lee FL,Wong PK,Wong CY,Yeung SS
    BACKGROUND & AIMS: :The effects of different knee joint angles and fatigue on the neuromuscular control of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles were investigated in 17 (11 men, 6 women) young subjects. The electromyogram (EMG) activities and the force generation capacities were monitored before and after a fatigue protocol at three different knee joint angles, 90 degrees, 150 degrees, 175 degrees of knee extension, on three occasions. In response to randomly triggered light signals, the subjects performed three isometric maximal voluntary contraction (IMVC) that lasted for 4 to 8 s. This was then followed by the fatigue protocol which consisted of six bursts of contractions fixed at 30 s on and 10 s off. Immediately after the exercise to fatigue, the subjects performed another three IMVC in response to the light signals. Repeated measures ANOVA were performed to examine the effects of fatigue at these three positions on the electromechanical delay (EMD), median frequency (fmed), peak force (Fpeak) and root mean square (rms)-EMG:Fpeak quotient of VMO and VL. The results revealed a significant effect of the three knee joint angles on the EMD before the fatigue (P < 0.05). The fatigue protocol induced a significant decrease in Fpeak at all the three positions (P < 0.01). However, the fatigue induced a significant decrease of fmed at only 90 degrees and 150 degrees of knee extension (P < 0.01). This occurred in parallel with the lengthening of EMD at these two joint angles (P < 0.01 and P < 0.05). The effects of fatigue on the fmed and EMD were not significant between VMO and VL at all three angles. The insignificant difference in fmed and EMD between VMO and VL at the three knee positions before and after fatigue indicated that no preferential onset activation between VMO and VL had occurred.
    背景与目标: :在17名(11名男性,6名女性)年轻受试者中,研究了不同膝关节角度和疲劳程度对内侧斜肌(VMO)和外侧肌(VL)的神经肌肉控制的影响。在三个不同的膝关节角度(90度,150度,175度膝关节伸展)进行疲劳试验之前和之后,监测肌电图(EMG)活动和力量产生能力。响应随机触发的光信号,受试者进行了3个等距的最大自愿收缩(IMVC),持续了4到8 s。然后是疲劳方案,该方案由固定在30 s开和10 s关的六次收缩爆发组成。运动至疲劳后,受试者立即响应光信号进行了另外三个IMVC。重复测量ANOVA,以检查这三个位置的疲劳对机电延迟(EMD),中频(fmed),峰值力(Fpeak)和均方根(rms)-EMG的影响:VMO和VL的峰商。结果表明,疲劳前,三个膝关节角度对EMD的影响显着(P <0.05)。疲劳方案导致所有三个位置的Fpeak显着降低(P <0.01)。但是,疲劳仅在膝盖伸展90度和150度时导致fmed显着降低(P <0.01)。这与在两个关节角处的EMD延长同时发生(P <0.01和P <0.05)。 VMO和VL在所有三个角度上,疲劳对fmed和EMD的影响均不显着。疲劳前后三个膝盖位置的VMO和VL之间的fmed和EMD差异不显着,表明VMO和VL之间没有发生优先的发作激活。
  • 【一种用于研究多发性硬化症疲劳的无线人体测量系统。】 复制标题 收藏 收藏
    DOI:10.1088/0967-3334/33/12/2033 复制DOI
    作者列表:Yu F,Bilberg A,Stenager E,Rabotti C,Zhang B,Mischi M
    BACKGROUND & AIMS: :Fatigue is reported as the most common symptom by patients with multiple sclerosis (MS). The physiological and functional parameters related to fatigue in MS patients are currently not well established. A new wearable wireless body measurement system, named Fatigue Monitoring System (FAMOS), was developed to study fatigue in MS. It can continuously measure electrocardiogram, body-skin temperature, electromyogram and motions of feet. The goal of this study is to test the ability of distinguishing fatigued MS patients from healthy subjects by the use of FAMOS. This paper presents the realization of the measurement system including the design of both hardware and dedicated signal processing algorithms. Twenty-six participants including 17 MS patients with fatigue and 9 sex- and age-matched healthy controls were included in the study for continuous 24 h monitoring. The preliminary results show significant differences between fatigued MS patients and healthy controls. In conclusion, the FAMOS enables continuous data acquisition and estimation of multiple physiological and functional parameters. It provides a new, flexible and objective approach to study fatigue in MS, which can distinguish between fatigued MS patients and healthy controls. The usability and reliability of the FAMOS should however be further improved and validated through larger clinical trials.
    背景与目标: :疲劳被报告为多发性硬化症(MS)患者最常见的症状。与MS患者疲劳相关的生理和功能参数目前尚不明确。开发了一种新的可穿戴无线人体测量系统,称为疲劳监测系统(FAMOS),用于研究MS的疲劳状况。它可以连续测量心电图,皮肤温度,肌电图和脚的运动。这项研究的目的是通过使用FAMOS来测试将疲劳MS患者与健康受试者区分开的能力。本文介绍了测量系统的实现,包括硬件设计和专用信号处理算法。该研究包括26名参与者,包括17名MS疲劳患者以及9名性别和年龄匹配的健康对照者,以进行24小时连续监测。初步结果显示,疲劳的MS患者与健康对照者之间存在显着差异。总之,FAMOS支持连续数据采集以及多种生理和功能参数的估计。它提供了一种新的,灵活的,客观的方法来研究MS的疲劳,可以区分疲劳的MS患者和健康对照者。但是,FAMOS的可用性和可靠性应通过更大的临床试验得到进一步改善和验证。

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