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Kuchtaruk A, Yu SSY, Iansavichene A, Davidson J, Wilson CA, Symonette C. Telerehabilitation Technology Used for Remote Wrist/Finger Range of Motion Evaluation: A Scoping Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5147. [PMID: 37621918 PMCID: PMC10445783 DOI: 10.1097/gox.0000000000005147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/12/2023] [Indexed: 08/26/2023]
Abstract
Background Monitoring finger/wrist range of motion (ROM) is an important component of routine hand therapy after surgery. Telerehabilitation is a field that may potentially address various barriers of in-person hand therapy appointments. Therefore, the purpose of this scoping review is to identify telerehabilitation technologies that can be feasibly used in a patient's home to objectively measure finger/wrist ROM. Methods Following PRISMA-ScR guidelines for scoping reviews, we systematically searched MEDLINE and Embase electronic databases using alternative word spellings for the following core concepts: "wrist/hand," "rehabilitation," and "telemedicine." Studies were imported into Covidence, and systematic two-level screening was done by two independent reviewers. Patient demographics and telerehabilitation information were extracted from the selected articles, and a narrative synthesis of the findings was done. Results There were 28 studies included in this review, of which the telerehabilitation strategies included smartphone angle measurement applications, smartphone photography, videoconference, and wearable or external sensors. Most studies measured wrist ROM with the most accurate technologies being wearable and external sensors. For finger ROM, the smartphone angle application and photography had higher accuracy than sensor systems. The telerehabilitation strategies that had the highest level of usability in a remote setting were smartphone photographs and estimation during virtual appointments. Conclusions Telerehabilitation can be used as a reliable substitute to in-person goniometer measurements, particularly the smartphone photography and motion sensor ROM measurement technologies. Future research should investigate how to improve the accuracy of motion sensor applications that are available on easy-to-access devices.
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Affiliation(s)
- Adrian Kuchtaruk
- From the Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | | | - Alla Iansavichene
- Library Services, London Health Sciences Centre, London, Ontario, Canada
| | - Jacob Davidson
- Department of Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Claire A. Wilson
- Department of Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Caitlin Symonette
- Department of Surgery, London Health Sciences Centre, London, Ontario, Canada
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MontJohnson A, Cronce A, Qiu Q, Patel J, Eriksson M, Merians A, Adamovich S, Fluet G. Laboratory-Based Examination of the Reliability and Validity of Kinematic Measures of Wrist and Finger Function Collected by a Telerehabilitation System in Persons with Chronic Stroke. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23052656. [PMID: 36904860 PMCID: PMC10007090 DOI: 10.3390/s23052656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/09/2023]
Abstract
We have developed the New Jersey Institute of Technology-Home Virtual Rehabilitation System (NJIT-HoVRS) to facilitate intensive, hand-focused rehabilitation in the home. We developed testing simulations with the goal of providing richer information for clinicians performing remote assessments. This paper presents the results of reliability testing examining differences between in-person and remote testing as well as discriminatory and convergent validity testing of a battery of six kinematic measures collected with NJIT-HoVRS. Two different groups of persons with upper extremity impairments due to chronic stroke participated in two separate experiments. Data Collection: All data collection sessions included six kinematic tests collected with the Leap Motion Controller. Measurements collected include hand opening range, wrist extension range, pronation-supination range, hand opening accuracy, wrist extension accuracy, and pronation-supination accuracy. The system usability was evaluated by therapists performing the reliability study using the System Usability Scale. When comparing the in-laboratory collection and the first remote collection, the intra-class correlation coefficients (ICC) for three of the six measurements were above 0.900 and the other three were between 0.500 and 0.900. Two of the first remote collection/second remote collection ICCs were above 0.900, and the other four were between 0.600 and 0.900. The 95% confidence intervals for these ICC were broad, suggesting that these preliminary analyses need to be confirmed by studies with larger samples. The therapist's SUS scores ranged from 70 to 90. The mean was 83.1 (SD = 6.4), which is consistent with industry adoption. There were statistically significant differences in the kinematic scores when comparing unimpaired and impaired UE for all six measures. Five of six impaired hand kinematic scores and five of six impaired/unimpaired hand difference scores demonstrated correlations between 0.400 and 0.700 with UEFMA scores. Reliability for all measures was acceptable for clinical practice. Discriminant and convergent validity testing suggest that scores on these tests may be meaningful and valid. Further testing in a remote setting is necessary to validate this process.
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Affiliation(s)
- Ashley MontJohnson
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07105, USA
- NeurotechR3 Inc., Warren, NJ 07059, USA
| | - Amanda Cronce
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07105, USA
- NeurotechR3 Inc., Warren, NJ 07059, USA
| | - Qinyin Qiu
- NeurotechR3 Inc., Warren, NJ 07059, USA
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | - Jigna Patel
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | | | - Alma Merians
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | - Sergei Adamovich
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07105, USA
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | - Gerard Fluet
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
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Gu F, Fan J, Wang Z, Liu X, Yang J, Zhu Q. Automatic range of motion measurement via smartphone images for telemedicine examination of the hand. Sci Prog 2023; 106:368504231152740. [PMID: 36721870 PMCID: PMC10450288 DOI: 10.1177/00368504231152740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Telemedicine support virtual consultations and evaluations in hand surgery for patients in remote areas during the COVID-19 era. However, traditional physical examination is challenging in telemedicine and it is inconvenient to manually measure the hand range of motion (ROM) from images or videos. Here, we propose an automatic method using the hand pose estimation technique, aiming to measure the hand ROM from smartphone images. METHODS Twenty-eight healthy volunteers participated in the study. An eight-hand gestures measurement protocol and the Google MediaPipe Hands were used to analyze images and calculate the ROM automatically. Manual goniometry was also performed according to the guideline of the American Medical Association. The correlation between the automatic and manual methods was analyzed by the intraclass correlation coefficient and Pearson correlation coefficient. The clinical acceptance was testified using Bland-Altman plots. RESULTS A total of 32 parameters of each hand were measured by both methods, and 1792 measurement results were compared. The mean difference between automatic and manual methods is -2.21 ± 9.29° in the angle measurement and 0.48 ± 0.48 cm in the distance measurement. The intraclass correlation coefficient of 75% of parameters was higher than 0.75, the Pearson correlation coefficient of 84% of parameters was over 0.6, and 40.6% of parameters reached well-accepted clinical agreements. CONCLUSIONS The proposed method provides a helpful protocol for automatic hand ROM measurement based on smartphone images and the MediaPipe Hands pose estimation technique. The automatic measurement is acceptable and comparable with existing methods, showing a possible application in the telemedicine examination of hand surgery.
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Affiliation(s)
- Fanbin Gu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingyuan Fan
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhaoyang Wang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Jiantao Yang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou, China
- Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
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Lv L, Yang J, Gu F, Fan J, Zhu Q, Liu X. Precision and accuracy of measuring finger motion with a depth camera: a cross-sectional study of healthy participants. J Hand Surg Eur Vol 2022; 48:453-458. [PMID: 36420794 DOI: 10.1177/17531934221138924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this cross-sectional study was to determine the precision and accuracy of the measurement of finger motion with a depth camera. Fifty-five healthy adult hands were included. Measurements were done with a depth camera and compared with traditional manual goniometer measurements. Repeated measuring showed that the overall repeatability and reproducibility of extension measured with the depth camera were within 3° and 4° and that of flexion were within 13° and 14°. Compared with traditional manual goniometry, biases of extension of all finger joints and flexion of metacarpophalangeal joints were less than 5°, and the average bias of flexion of proximal and distal interphalangeal joints was 29°. We conclude that the measurement of finger extension and flexion of the metacarpophalangeal joints with a depth camera was reliable, but improvement is required in the precision and accuracy of interphalangeal joint flexion.
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Affiliation(s)
- Lulu Lv
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiantao Yang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Fanbin Gu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingyuan Fan
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
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Lv L, Yang J, Gu F, Fan J, Zhu Q, Liu X. Validity and Reliability of a Depth Camera-Based Quantitative Measurement for Joint Motion of the Hand. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2022; 5:39-47. [PMID: 36704372 PMCID: PMC9870814 DOI: 10.1016/j.jhsg.2022.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/23/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose Quantitative measurement of hand motion is essential in evaluating hand function. This study aimed to investigate the validity and reliability of a novel depth camera-based contactless automatic measurement system to assess hand range of motion and its potential benefits in clinical applications. Methods Five hand gestures were designed to evaluate the hand range of motion using a depth camera-based measurement system. Seventy-one volunteers were enrolled in performing the designed hand gestures. Then, the hand range of motion was measured with the depth camera and manual procedures. System validity was evaluated based on 3 dimensions: repeatability, within-laboratory precision, and reproducibility. For system reliability, linear evaluation, the intraclass correlation coefficient, paired t -test and bias were employed to test the consistency and difference between the depth camera and manual procedures. Results When measuring phalangeal length, repeatability, within-laboratory precision, and reproducibility were 2.63%, 12.87%, and 27.15%, respectively. When measuring angles of hand motion, the mean repeatability and within-laboratory precision were 1.2° and 3.3° for extension of 5 digits, 2.7° and 10.2° for flexion of 4 fingers, and 3.1° and 5.3° for abduction of 4 metacarpophalangeal joints, respectively. For system reliability, the results showed excellent consistency (intraclass correlation coefficient = 0.823; P < .05) and good linearity with the manual procedures (r = 0.909-0.982, approximately; P < .001). Besides, 78.3% of the measurements were clinically acceptable. Conclusions Our depth camera-based evaluation system provides acceptable validity and reliability in measuring hand range of motion and offers potential benefits for clinical care and research in hand surgery. However, further studies are required before clinical application. Clinical relevance This study suggests a depth camera-based contactless automatic measurement system holds promise for assessing hand range of motion in hand function evaluation, diagnosis, and rehabilitation for medical staff. However, it is currently not adequate for all clinical applications.
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Affiliation(s)
- Lulu Lv
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiantao Yang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, Guangdong, China
| | - Fanbin Gu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jingyuan Fan
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, Guangdong, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, Guangdong, China,Corresponding author: Xiaolin Liu, MD, Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan Er Lu, Guangzhou, Guangdong 510080, China.
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Analysis of the Leap Motion Controller's Performance in Measuring Wrist Rehabilitation Tasks Using an Industrial Robot Arm Reference. SENSORS 2022; 22:s22134880. [PMID: 35808379 PMCID: PMC9269845 DOI: 10.3390/s22134880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/19/2022] [Accepted: 06/25/2022] [Indexed: 11/17/2022]
Abstract
The Leap Motion Controller (LMC) is a low-cost markerless optical sensor that performs measurements of various parameters of the hands that has been investigated for a wide range of different applications. Research attention still needs to focus on the evaluation of its precision and accuracy to fully understand its limitations and widen its range of applications. This paper presents the experimental validation of the LMC device to verify the feasibility of its use in assessing and tailoring wrist rehabilitation therapy for the treatment of physical disabilities through continuous exercises and integration with serious gaming environments. An experimental set up and analysis is proposed using an industrial robot as motion reference. The high repeatability of the selected robot is used for comparisons with the measurements obtained via a leap motion controller while performing the basic movements needed for rehabilitation exercises of the human wrist. Experimental tests are analyzed and discussed to demonstrate the feasibility of using the leap motion controller for wrist rehabilitation.
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吕 璐, 杨 建, 顾 凡, 范 景, 王 朝, 朱 庆, 刘 小. [Accuracy of key point matrix technology based contactless automatic measurement for joint motion of hand]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:540-547. [PMID: 35570626 PMCID: PMC9108647 DOI: 10.7507/1002-1892.202201078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To validate the use of key point matrix technology based contactless automatic measurement for evaluation of joint motion of hand. METHODS Thirty-three volunteers were enrolled to evaluate the extension and flexion of hand joints between May 2021 and November 2021. There were 20 males and 13 females, the age ranged from 16 to 70 years with an average of 30.2 years. The extension angles of 14 joints of 5 fingers (including hyperextension) and the flexion angles of 12 joints of 4 fingers (excluding thumb) of volunteers were measured by key point matrix technology and manual goniometer, respectively. Then 5 participants and repeated measurement experiment were employed to test the system repeatability and accuracy; 28 participants and paired measurement experiment were employed to test the system accuracy. RESULTS The average repeatability of finger joint motion measured by the key point matrix technology was 1.801° (extension) and 7.823° (flexion), respectively. Compared with manual measurement, the average differences of each finger joint measured by the key point matrix technology were 3.225° in extension and 14.145° in flexion, respectively. The key point matrix technology based contactless automatic evaluation system offered excellent consistency with the manual goniometers ( ICC=0.875). While most of the consistency with manual goniometer of individual joints were at moderate levels (median of ICC, 0.440). The correlation coefficients between the measurement results of the two methods were mainly positive in the extension of the joint ( P<0.05) and negative in the flexion of the joints ( P<0.05). CONCLUSION The key point matrix technology based contactless automatic evaluation provides sufficient measurement repeatability and accuracy in evaluation for the joint motion of hand.
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Affiliation(s)
- 璐璐 吕
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
| | - 建涛 杨
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
- 广东省周围神经组织工程技术研究中心(广州 510080)Guangdong Provincial Center for Peripheral Nerve Tissue Engineering and Technology Research, Guangzhou Guangdong, 510080, P. R. China
- 广东省软组织生物制造工程实验室(广州 510080)Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou Guangdong, 510080, P. R. China
| | - 凡彬 顾
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
| | - 景元 范
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
| | - 朝阳 王
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
| | - 庆棠 朱
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
- 广东省周围神经组织工程技术研究中心(广州 510080)Guangdong Provincial Center for Peripheral Nerve Tissue Engineering and Technology Research, Guangzhou Guangdong, 510080, P. R. China
- 广东省软组织生物制造工程实验室(广州 510080)Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou Guangdong, 510080, P. R. China
| | - 小林 刘
- 中山大学附属第一医院显微创伤手外科(广州 510080)Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510080, P. R. China
- 广东省周围神经组织工程技术研究中心(广州 510080)Guangdong Provincial Center for Peripheral Nerve Tissue Engineering and Technology Research, Guangzhou Guangdong, 510080, P. R. China
- 广东省软组织生物制造工程实验室(广州 510080)Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Guangzhou Guangdong, 510080, P. R. China
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