Chinese Journal of Tissue Engineering Research ›› 2024, Vol. 28 ›› Issue (33): 5403-5412.doi: 10.12307/2024.674
Xu Yi, Deng Yubin
Received:
2023-09-18
Accepted:
2023-11-07
Online:
2024-11-28
Published:
2024-01-31
Contact:
Deng Yubin, PhD, Professor, Seventh Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University (Shenzhen), Shenzhen 518107, Guangdong Province, China
About author:
Xu Yi, MD, PhD, Associate chief physician, Seventh Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University (Shenzhen), Shenzhen 518107, Guangdong Province, China
Supported by:
CLC Number:
Xu Yi, Deng Yubin. Exoskeleton-assisted walking rehabilitation for spinal cord injury: CiteSpace analysis of research hotspots[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(33): 5403-5412.
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2.1.2 施引文献国家(地区)合作分析 如图2,表2所示,外骨骼机器人应用于脊髓损伤后患者步行功能研究可以看出,2014-2023 年,共有54个国家(地区)发表了该领域相关研究,合作图谱共得到54个节点,127条连线,各国间有良好合作关系。发文数量排名前5国家依次是:美国USA 158篇,中国PEOPLES R CHINA 77篇,意大利ITALY 50篇,日本JAPAN 47篇,加拿大 CANADA 43篇。中介中心性前5国家依次为:美国USA(0.42),英国ENGLAND(0.18),法国FRANCE(0.16),意大利 ITALY (0.14),瑞士SWITZERLAND(0.12)。美国的发文量及中介中心性均最高居于榜首,在此领域处于领军地位。可能由于欧美国家科学技术水平较高、起步较早、认可度高,故中介中心性也较高。中国近几年度发文量提升明显,但可能由于起步相对较晚,中介中心性仍偏低(0.05)。具体见图2。"
2.1.3 施引文献机构合作分析 如图3,表2所示,在过去近10年共有约240个机构涉及该领域研究,集中于各国大学,具有密切合作关系。发表文章数量排名前5位的机构依次为美国退伍军人事务部US Department of Veterans Affairs 31篇,美国退伍军人健康管理局Veterans Health Administration (VHA) 30篇,瑞士联邦理工学院 Swiss Federal Institutes of Technology Domain 26篇,美国西北大学 Northwestern University 20篇,西班牙国家最高科学研究委员会 Consejo Superior de Investigaciones Cientificas (CSIC)18篇 ;就中介中心性而言,排名前5位的机构依次是美国芝加哥Shirley Ryan康复中心(原芝加哥康复研究所)Shirley Ryan Ability Lab 0.08,西班牙国家最高科学研究委员会 Consejo Superior de Investigaciones Cientificas (CSIC) 0.07,意大利圣卢西亚基金会 IRCCS Santa Lucia 0.07,美国佐治亚理工学院Georgia Institute of Technology 0.05,美国西北大学 Northwestern University 0.04。与主要研究国家一致,该领域主要研究机构也以欧美国家为主,这些信息可为从事该领域研究专家后续进一步研究、深造、合作提供信息。"
2.1.4 高影响力施引文献作者合作与被引文献作者共被引分析 如表3所示,近 10年来多名施引文献作者参与该领域研究,其中4位作者发文量在10篇以上,分别是日本筑波大学Sankai Yoshiyuki教授(13篇)、Kadone Hideki教授(12篇),德国波鸿伯格曼谢尔大学Aach Mirko教授(10篇),中国四川电子科技大学Hong Cheng教授(10篇),但综合而言,作者中介中心性较低,被引用率不高;如表3所示,近 10年被引文献被引频次排序前 5 核心共被引作者依次为美国宾夕法尼亚MossRehab & Albert Einstein医疗中心ESQUENAZI A (167 次)、以色列Chaim Sheba医疗中心ZEILIG G(109次)、德国德累斯顿医学院MEHRHOLZ J (84 次)、加拿大哥伦比亚大学LOUIE DR (84次)、美国北卡罗来纳州Miller科学咨询机构MILLER LE (81次)。被引文献中介中心性排序前 5的核心共被引作者依次为美国宾夕法尼亚MossRehab & Albert Einstein医疗中心ESQUENAZI A(0.13),美国印第安纳大学HORNBY TG (0.13),瑞士苏黎世Hocoma医学GmbH的VENEMAN JF (0.12),美国科罗拉多州恩格尔伍德克雷格医院TEFERTILLER C (0.12),瑞士苏黎世联邦理工学院RIENER R (0.11)。其中被引文献共被引频次最多、中介中心性最高作者均为来自美国Pennsylvania大学MossRehab & Albert Einstein Medical Center的Alberto Esquenazi教授,他在脊髓损伤后EAW研究领域涉及的研究主题包括评估脊髓损伤患者使用 ReWalk? 外骨骼行走系统的安全性和耐受性,评估功能性步行测量,并将其与神经脊髓水平、年龄和受伤后持续时间等相关联;并长期致力于外骨骼机器人、肉毒毒素等手段应用于各类步行功能障碍患者的相关研究[11-16]。"
2.2 研究热点分析结果 2.2.1 被引核心文献共被引分析结果 文献共被引指1篇文献被≥2篇文献同时引用,可预测研究领域在一定时间范围内研究热点及趋势。图4可见2014-2023年间该领域的研究共涉及297篇共被引核心参考文献。共被引参考文献排名前5位的文献依次是:美国Virginia Tech大学MILLER团队[17]2016年在《Med Devices-Evid Res》发表文献,共被引次数(53次)最高,加拿大温哥华大学LOUIE团队[18]于2015年发表于《J Neuroeng Rehabil》的文献,共被引51次;丹麦Rigshospitalet脊髓损伤诊所BAUNSGAARD团队[19]2018年发表于《Spinal Cord》的文献,共被引45次;美国宾夕法尼亚MossRehab & Albert Einstein医疗中心ESQUENAZI团队[11]2012年发表于《Am J Phys Med Rehab》的文献,共被引41次;德国BG大学AACH 团队[20]2014年发表于《Spine J》的文献,共被引39次,频次前5位文献主要研究内容:脊髓损伤患者配备电动外骨骼设备真实环境中行走的安全性及优势;以及设备应用于胸椎及以下水平运动功能完全损伤的脊髓损伤患者辅助步行效果、影响因素及应用潜力等,具体见表4。"
最佳中介中心性(0.23)以美国退伍军人事务部Asselin PK团队在《JOVE-J VIS EXP》发表文献“Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton”获得,他们重点研究了脊髓损伤患者使用动力型外骨骼筛选标准与培训计划[21];其他高中介中心性被引参考文献尚包括英国格拉斯哥喀里多尼亚大学 MORAWIETZ团队[22]2013年发表于《ARCH PHYS MED》文献,中介中心性0.21;美国科罗拉多州恩格尔伍德克雷格医院TEFERTILLER团队 [23]2018年发表于《 TOP SPINAL CORD INJ》文献,中介中心性0.19;美国退伍军人事务部ASSELIN团队[24]2015年发表于《J REHABIL RES DEV》文献,中介中心性 0.17;以色列Chaim Sheba医疗中心ZEILIG团队[12]2012年发表于《J SPINAL CORD MED》文献,中介中心性 0.17 ,具体见表5。"
2.2.3 关键词共现分析结果 文献主要内容一般可被凝炼成关键词,故关键词共同出现次数越多则代表该领域在一定时间范围内研究主题热度越高,主要以中介中心性为衡量量化指标(0-1),数值越大影响力越大,若其≥0.1 说明中介中心性较高,如表7,图6,中介中心性排名前10的关键词依次是:body weight support (减重支持),Functional electrical stimulation (功能性电刺激),assistive technology(辅助技术),validity (有效性), recovery(恢复),rehabilitation(康复),ambulation(步行活动),stroke(脑卒中),adults(成人),gait(步态)。除去与主题相关的关键词——Spinal cord injury(脊髓损伤),walking(步行),rehabilitation(康复),共现出现频次前10的关键词尚包括Individuals (个人),gait(步态),Powered exoskeleton(动力外骨骼),people(人),recovery(恢复),stroke(脑卒中),design(设计)。"
2.2.4 关键词共现聚类分析结果 关键词聚类分析是将关联密切关键词汇聚成一类,并观察一定时间范围内研究领域形成的具体研究类团(聚类号),号数越小则类团包含关键词数量越多,轮廓值则表示类团内部关键词间紧密程度,一般认为> 0.7 时聚类较成功。进一步通过对上述关键词进行对数似然比(log-likelihood ratio,LLR)聚类分析,得到聚类图7。其中,聚类模块化Q 值Modularity为0.489 8(> 0.3,表示聚类结构显著),平均轮廓S 值Silhouette 值为0.775 2(一般认为S值> 0.5聚类即合理,S值> 0.7意味聚结果令人信服),提示聚类结构显著,同质性高。如图7,排名前10的聚类与相应轮廓值分别为#0 exoskeleton device(外骨骼设备,0.804 ),#1 adaptive control(适应性控制,0.745),#2 functional near-infrared spectroscopy(功能性近红外光谱成像技术 0.739),#3 reciprocating gait orthosis (往复式步态矫形器,0.7),#4 hybrid assistive limb (混合辅助肢体,0.762),#5 gait rehabilitation(步态康复,0.8),#6 functional electrical stimulation(功能性电刺激,0.819),#7 motion function(运动功能 0.811),#8 electrical stimulation(电刺激,0.694),#9 assisted gait(辅助步行,0.911)。将上述信息进一步进行聚类列表处理,自聚类Clusters-聚类列表Summary Table中白名单Whitelist获得关键词具体相关信息,具体见表8。由聚类结果及其所含关键词可知,脊髓损伤患者步态功能康复近年研究主要聚焦于外骨骼设备技术,作用机制以适应性控制为主,既往促进步行功能改善方法还包括往复式步态矫形器、混合辅助肢体、功能性电刺激等康复工程技术,目前研究倾向联合功能性近红外光谱成像等智能高端技术。"
(1) 2014-2018年热点: stroke(脑卒中),2014-2017时间段针对步态异常康复机器人设备更偏重对脑卒中类患者进行尝试与研究;mobility (行走能力)与system(系统)。 (2) 2016-2018年热点:研究强调提升患者步行能力及综合系统对待病患具体问题; functional electrical stimulation (功能性电刺激),2017-2018时间段内研究偏重功能性电刺激使用对脊髓损伤患者功效。 (3)2019-2020 研究热点:逐渐转向 locomotor training(步行训练)作为干预手段改善脊髓损伤患者步行功能。 (4) 2020-2023年热点:突变热点转变为quality of life (生活质量),exercise(运动训练)、body composition(身体结构)、legged locomotion(腿部运动)等,突变系数较高且至今仍保持较高发文量,应是该领域研究热点与前沿方向,其中,尤其以quality of life 突变系数最高,可见围绕脊髓损伤患者步态康复阶段各项评估内容中,患者生活质量的重要性日益受到关注。在功能恢复中,运动训练扮演着至关重要的角色。研究人员也致力于改善机体结构,以促进康复和功能恢复。 进一步对关键词聚类进行时间线图分析,可见#0 exoskeleton device(外骨骼设备)一直是脊髓损伤患者步行功能康复研究热点与重点,尤其近几年呈现热度持续增高趋势,也是后续被持续关注目标方向;#4 hybrid assistive limb (混合辅助肢体)、#7 motion function(运动功能)也是近年研究热点聚类;相反,#3 reciprocating gait orthosis (往复式步态矫形器),#6 FES(功能性电刺激)虽在早年关注度较高,但近年呈下降趋势,具体见图9。"
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Song Jiating, Chen Jianmin, Wang Kewen, Huang Lanying, Xu Senming, Gui Yuchang, Xu Jianwen.
Metabolomics analysis of serum and urine in patients with traumatic spinal cord injury #br#
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[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(在线): 1-6.
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