Lumbar osteopathic manipulative treatment can improve KOA symptoms: short-term efficacy observation and mechanism analysis.

Background: Manipulative treatment can effectively improve knee pain and function, but no previous studies have shown that lumbar osteopathic manipulative treatment can improve knee symptoms. To explore the influence of lumbar manipulation on KOA and analyze its principlerelationship between coronal position of lumbar spine and KOA. Methods: Patients were divided into OMT group and DT group according to treatment. WOMAC scores were compared between the two groups, and X-ray examinations before and after treatment were performed in OMT group to analyze the imaging changes. Results: Both OMT group and DT group showed significant improvement in WOMAC score after treatment, and the improvement in OMT group was better than that in DT group. After OMT treatment, cTMI(P = 0.034), mL-SOD (P < 0.001), mΔL-KOD (P = 0.001), LL (P = 0.036), and FTA(P = 0.026) were significantly changed. Conclusion: Compared with drug therapy, lumbar manipulation can better improve WOMAC scores in KOA patients. It relives symptoms by loosening muscles and correcting small joint disorders to improve local knee alignment.

Anatomical Variation Types of the Deep Femoral Vein and Its Tributaries.

BACKGROUND: The deep femoral vein generally has individual differences in origin, course, tributary, caliber, and quantity. However, systematic research on deep femoral vein variations is still insufficient. Given this, this study employed anatomical observation to reveal the types and ratios of variations in the deep femoral vein and its tributaries. METHOD: This study selected 63 gross specimens of intact lower extremities and dissected their 126 lower limbs layer by layer to explore variations in the deep femoral vein and its tributaries. RESULT: A total of 15 lower limbs exhibit variations in the deep femoral vein and its tributaries, of which 93% were unilateral. No correlation is found between the mutations and gender. They can be generally classified into three types: variations in the small saphenous vein branch of the deep femoral vein (7.14%); variations in the popliteal vein branch of the deep femoral vein (3.96%); and multiple deep femoral vein variations (0.79%). CONCLUSION: Variations in the deep femoral vein and its tributaries are not rare and can achieve a variation rate of 11.9%. Moreover, 93% of the variations involve tributaries of the deep femoral vein, among which 60% occur in the small saphenous vein branch, and approximately 30% are related to the popliteal vein branch. The variation diversity can lay a theoretical foundation for clinical diagnosis and treatment.

Vascular eczema and link with intestinal disease.

Mr J worked as a long-distance driver and warehouse manager. He was diagnosed with Crohn's disease after retirement and developed dermatitis of the lower limbs as a consequence. Dermatitis and venous disease led to the appearance of leg ulcers. A friend recommended the local Leg Club to Mr J when he noticed that his leg wounds were not healing. Mr J has become a member since then and often visits the clinic with his wife and daughter.

Retroperitoneal and lower extremities muscle bleeding in acquired haemophilia A (AHA): Risk factors and implications in disability and survival.

AIM: To assess risk factors of retroperitoneal and lower extremity musculoskeletal bleed in acquired haemophilia (AHA) and perform an objective assessment of disability and influence on survival. METHODS: We included 49 patients with AHA from November 2017 to May 2023. The occurrence of any retroperitoneal or/and lower extremities bleeding manifestation was investigated. On clinical follow-up, we search for compressive femoral neuropathy and quadriceps amyotrophy. The lower extremity functional scale (LEFS) was carried out one year after the last bleeding event in all AHA patients. RESULTS: A 61.2% of patients in our AHA cohort presented with any retroperitoneal and/or lower extremities musculoskeletal manifestation. Those patients had higher percentage of major bleeding EACH2/ISTH criteria (90% vs. 57%, p = .01), needs of blood transfusions (86% vs. 57% of patients, p = .03), and haemostatic by-pass products (90% vs. 63%, p = .02). Hypertension (HR 2.6, 95% CI 1.1-5.9, p = .02), presence of autoimmune disease (HR 13, 95% CI 1.7-99, p = .01), and inhibitor level > 20 BU (HR 2.6 95% CI 1.0-6.8, p = .04) significantly predicted retroperitoneal/lower extremities clinical manifestations. Most frequent sequelae were quad atrophy (30.6%) and femoral nerve palsy (20.4%). Quad atrophy and LEFS scores under 50 were associated with increased mortality (HR 3, 95% CI 1.1-8.6 and HR 12, 95% CI 3.3-45, respectively). CONCLUSION: AHA with retroperitoneal/lower extremities bleeding involvement is of greater severity and shows high disability and worst survival outcomes. Quadriceps atrophy and LEFS scale scoring under 50 predicted mortality in our AHA patients.

Kinematic Analysis of Pelvic and Lower Limb Joints during Stand-to-sit Movement in Individuals with Chronic Low Back Pain: A cross-sectional study.

Objectives: It is crucial to investigate the daily functions commonly utilized by individuals with low back pain (LBP) due to their implications for recurrence and chronicity. Stand-to-sit (StTS) task is one of the more repetitive functions in human daily life. This study aims to evaluate pelvic and lower limb joint kinematics during the StTS task in individuals with Non-Specific Chronic Low Back Pain (NSCLBP) compared to a healthy control group. Methods: Pelvic and lower limb joint kinematic data in all three planes were recorded from 20 individuals with LBP and 20 healthy individuals using a Qualisys motion capture system during the StTS task. A Functional Data Analysis statistical approach was employed to compare the kinematic data between the two groups. Results: In the initial phase of the movement, we observed a greater anterior pelvic tilt (P=0.028) and an altered pelvic frontal plane motion pattern (P=0.029) in the LBP compared to the healthy group. The only significant differences between the lower limb joint kinematics of the two groups were a less hip external rotation position (P=0.025) and a more knee adduction pattern (P=0.002) on the right side in the LBP subjects compared to the healthy group. Conclusion: Considering a few differences noted between the two groups across various joints and planes evaluated, it appears that the kinematic pattern of the lower limbs does not significantly differ between the NSCLBP and healthy groups during the StTS task in most comparisons. However, distinct kinematic patterns have been observed in the pelvic region, particularly in the sagittal and frontal planes, between the two groups.

[Research progress of pelvic acetabular fractures combined venous thromboembolic disease].

Pelvic acetabular fractures(PAFs) are one of the most common types of pelvic fractures, mostly high-energy injuries, with complex pelvic acetabular structure and limited surgical methods. The trauma of the acetabular fracture itself and the need for long-term bed rest after surgery cause particularly complicated clinical complications. Venous thromboembolism (VTE) is one of its high incidence and serious complications. This review mainly focuses on VTE after PAFs, and describes the epidemiology, risk factors and prevention measures of VTE, aiming to help improve the prognosis and avoid the occurrence of serious complications.

Gait Reconstruction Strategy Using Botulinum Toxin Therapy Combined with Rehabilitation.

Numerous studies have established a robust body of evidence for botulinum toxin A (BoNT-A) therapy as a treatment for upper motor neuron syndrome. These studies demonstrated improvements in spasticity, range of joint motion, and pain reduction. However, there are few studies that have focused on improvement of paralysis or functional enhancement as the primary outcome. This paper discusses the multifaceted aspects of spasticity assessment, administration, and rehabilitation with the goal of optimising the effects of BoNT-A on lower-limb spasticity and achieving functional improvement and gait reconstruction. This paper extracts studies on BoNT-A and rehabilitation for the lower limbs and provides new knowledge obtained from them. From these discussion,, key points in a walking reconstruction strategy through the combined use of BoNT-A and rehabilitation include: (1) injection techniques based on the identification of appropriate muscles through proper evaluation; (2) combined with rehabilitation; (3) effective spasticity control; (4) improvement in ankle joint range of motion; (5) promotion of a forward gait pattern; (6) adjustment of orthotics; and (7) maintenance of the effects through frequent BoNT-A administration. Based on these key points, the degree of muscle fibrosis and preintervention walking speed may serve as indicators for treatment strategies. With the accumulation of recent studies, a study focusing on walking functions is needed. As a result, it is suggested that BoNT-A treatment for lower limb spasticity should be established not just as a treatment for spasticity but also as a therapeutic strategy in the field of neurorehabilitation aimed at improving walking function.

An articulated shape model to predict paediatric lower limb bone geometry using sparse landmarks.

Creating musculoskeletal models in a paediatric population currently involves either creating an image-based model from medical imaging data or a generic model using linear scaling. Image-based models provide a high level of accuracy but are time-consuming and costly to implement, on the other hand, linear scaling of an adult template musculoskeletal model is faster and common practice, but the output errors are significantly higher. An articulated shape model incorporates pose and shape to predict geometry for use in musculoskeletal models based on existing information from a population to provide both a fast and accurate method. From a population of 333 children aged 4-18 years old, we have developed an articulated shape model of paediatric lower limb bones to predict bone geometry from eight bone landmarks commonly used for motion capture. Bone surface root mean squared errors were found to be 2.63 ± 0.90 mm, 1.97 ± 0.61 mm, and 1.72 ± 0.51 mm for the pelvis, femur, and tibia/fibula, respectively. Linear scaling produced bone surface errors of 4.79 ± 1.39 mm, 4.38 ± 0.72 mm, and 4.39 ± 0.86 mm for the pelvis, femur, and tibia/fibula, respectively. Clinical bone measurement errors were low across all bones predicted using the articulated shape model, which outperformed linear scaling for all measurements. However, the model failed to accurately capture torsional measures (femoral anteversion and tibial torsion). Overall, the articulated shape model was shown to be a fast and accurate method to predict lower limb bone geometry in a paediatric population, superior to linear scaling.

Nutritional habits in patients with peripheral arterial disease: Adherence to the mediterranean diet. / Hábitos nutricionales en los pacientes con enfermedad arterial periférica: adherencia a la dieta mediterránea.

INTRODUCTION: Adherence to the Mediterranean diet (Dietmed) exerts protective effects on cardiovascular disease (CVD). In the Lower Extremity Peripheral Arterial Disease (PAD) there are fewer studies that analyze these data. OBJECTIVE: To determine adherence to Dietmed and dietary habits in patients with PAD, according to a history of CVD (coronary and/or cerebral ischaemic pathology) and according to the ankle-brachial index (ABI ≥ or <0,5). MATERIAL AND METHODS: Cross-sectional analytical study carried out in a tertiary hospital. The sample was collected consecutively. Sociodemographic and clinical history, ankle-brachial index (ABI) and a 14-point Dietmed adherence dietary questionnaire were included. The analysis of categorical variables was carried out using the Pearson's Chi-Square test, the T-Student's statistic test for independent samples was used for parametric variables and the U. Mann-Whitney test for non-parametric variables. RESULTS: Of the 97 patients, 87,6% had low adherence to Dietmed, with no differences according to the severity of PAD. However, when we analysed the data according to whether or not they had a history of CVD, we observed a high adherence to some items included in Dietmed, specifically, in the CVD group, the consumption of lean meat (95,5% vs 64%; P=.004). In addition, we observed a significant difference in the consumption in the group without a history of CVD (32% vs 9,1%; P=.033). CONCLUSION: In our population, patients with PAD, regardless of the stage of the disease and whether they had associated coronary or cerebral ischaemic pathology, had low adherence to Dietmed. Therefore, it is important to implement nutritional education programmes in patients with PAD in all stages, as well as in those patients who have already suffered a vascular event, so that they maintain adherence to healthy dietary habits in the long term.

Analysis of immune cells and risk factors related to lower limb deep vein thrombosis in patients with cerebral infarction.

To explore the characteristics of hematologic indicators and related risk factors of lower extremity deep vein thrombosis (LDVT) in patients with cerebral infarction. METHODS: This study retrospectively analyzed data from 174 patients with cerebral infarction admitted to The Rehabilitation Department of Shanghai Fifth Rehabilitation Hospital and Shanghai First People's Hospital from June 2022 to June 2023. Based on the results of lower limb venous color Doppler ultrasound examinations, patients were divided into two groups: the LDVT group (35 cases) and the non-LDVT group (139 cases). We compared the clinical data and hematologic indicators (D-dimer value, fibrinogen, white blood cells, platelets, uric acid, creatinine, etc.) of the two groups to identify the risk factors of cerebral infarction complicated with LDVT. RESULTS: Statistical analysis revealed that the D-dimer values of the LDVT group were significantly (P<0.05) higher than those of the non-LDVT group. The uric acid value of the LDVT group was significantly lower than that of the non-LDVT group, with statistical significance (P<0.05). The Brunnstrom staging in the LDVT group was significantly different from that in the non-LDVT group (P<0.05). Meanwhile, binary logistic regression analysis showed that LDVT complicated with cerebral infarction was associated with D-dimer level [OR=1.302, 95% CI (1.077, 1.575)], uric acid level [OR=0.995, 95% CI (0.990, 1.000)], and Brunnstrom staging [OR=3.005, 95% CI (1.312, 6.880)]. CONCLUSION: D-dimer value, uric acid value, and Brunnstrom stage I to II are closely related to the occurrence of LDVT in patients with cerebral infarction. High D-dimer value, low uric acid value, and Brunnstrom stage I to II are independent risk factors for LDVT in cerebral infarction. Early assessment of D-dimer value, uric acid value, and Brunnstrom stage of cerebral infarction should be considered in clinical practice.

Development of a Low-Cost Markerless Optical Motion Capture System for Gait Analysis and Anthropometric Parameter Quantification.

Technological advancements have expanded the range of methods for capturing human body motion, including solutions involving inertial sensors (IMUs) and optical alternatives. However, the rising complexity and costs associated with commercial solutions have prompted the exploration of more cost-effective alternatives. This paper presents a markerless optical motion capture system using a RealSense depth camera and intelligent computer vision algorithms. It facilitates precise posture assessment, the real-time calculation of joint angles, and acquisition of subject-specific anthropometric data for gait analysis. The proposed system stands out for its simplicity and affordability in comparison to complex commercial solutions. The gathered data are stored in comma-separated value (CSV) files, simplifying subsequent analysis and data mining. Preliminary tests, conducted in controlled laboratory environments and employing a commercial MEMS-IMU system as a reference, revealed a maximum relative error of 7.6% in anthropometric measurements, with a maximum absolute error of 4.67 cm at average height. Stride length measurements showed a maximum relative error of 11.2%. Static joint angle tests had a maximum average error of 10.2%, while dynamic joint angle tests showed a maximum average error of 9.06%. The proposed optical system offers sufficient accuracy for potential application in areas such as rehabilitation, sports analysis, and entertainment.

Effects of Bilateral or Unilateral Plyometric Training of Lower Limbs on the Bilateral Deficit During Explosive Efforts.

OBJECTIVES: Bilateral Deficit (BLD) occurs when the force generated by both limbs together is smaller than the sum of the forces developed separately by the two limbs. BLD may be modulated by physical training. Here, were investigated the effects of unilateral or bilateral plyometric training on BLD and neuromuscular activation during lower limb explosive extensions. METHODS: Fourteen young males were randomized into the unilateral (UL_) or bilateral (BL_) training group. Plyometric training (20 sessions, 2 days/week) was performed on a sled ergometer, and consisted of UL or BL consecutive, plyometric lower limb extensions (3-to-5 sets; 8-to-10 repetitions). Before and after training, maximal explosive efforts with both lower limbs or with each limb separately were assessed. Electromyography of representative lower limb muscles was measured. RESULTS: BL_training significantly and largely decreased BLD (p=0.003, effect size=1.63). This was accompanied by the reversion from deficit to facilitation of the electromyography amplitude of knee extensors during bilateral efforts (p=0.007). Conversely, UL_training had negligible effects on BLD (p=0.781). Also, both groups showed similar improvements in their maximal explosive power generated after training. CONCLUSIONS: Bilateral plyometric training can mitigate BLD, and should be considered for training protocols focused on improving bilateral lower limb motor performance.

Endovascular Management of Acute Lower Limb Ischemia Linked to Cocaine Abuse: A Case Report.

Cocaine abuse is a public health concern with well-documented cardiovascular complications. However, acute limb ischemia remains a rare and underreported consequence. We present a case of a 36-year-old man with acute right lower limb ischemia following heavy cocaine use, successfully managed with systemic heparin and intra-arterial nitroglycerin. The case highlights considering cocaine as a potential cause of acute limb ischemia and the efficacy of endovascular therapy. Further case reports with this diagnosis and their management are crucial for establishing the best strategies and improving outcomes in these scenarios.

Accuracy of EMG linear envelope in identifying the peak of muscular activity during walking.

BACKGROUND: The linear-envelope peak (LEP) of surface EMG signal is widely used in gait analysis to characterize muscular activity, especially in clinics. RESEARCH QUESTION: This study is designed to evaluate LEP accuracy in identifying muscular activation and assessing activation timing during walking. METHODS: Surface EMG signals from gastrocnemius lateralis (GL) and tibialis anterior (TA) were analyzed in 100 strides per subject (31 healthy subjects) during ground walking. Signals were full-wave rectified and low-pass filtered (cut-off frequency=5 Hz) to extract the linear envelope. LEP accuracy in identifying muscle activations and the associated error in peak detection were assessed by direct comparison with a reference method based on wavelet transform. LEP accuracy in identifying the timing of higher signalenergy levels was also assessed, increasing the reference-algorithm selectivity. RESULTS: The detection error (percentage number of times when LEP falls outside the correspondent reference activation interval) is close to zero. Detection error increases up to 70% for intervals including only signal energy higher than 90% of energy peak. Mean absolute error (MAE, the absolute value of the distance between LEP timing and the correspondent actual timing of the sEMG-signal peak computed by reference algorithm) is 54.1±20.0 ms. Detection error and MAE are significantly higher (p<0.05) in TA data compared to GL signals. Differences among MAE values detected adopting different values for LE cut-off frequency are not statistically significant. SIGNIFICANCE: LEP was found to be accurate in identifying the number of muscle activations during walking. However, the use of LEP to assess the timing of highest sEMG-signal energy (signal peak) should be considered carefully. Indeed, it could introduce a relevant inaccuracy in muscle-activation identification and peak-timing quantification. The type of muscle to analyze could also influence LEP performances, while the cut-off frequency chosen for envelope extraction appears to have a limited impact.

Dynamic comparison the lower extremities length in students education in higher institutions.

OBJECTIVE: Aim: Dynamic comparison of the lower limbs length, depending on the type of sport, followed by the construction of a mathematical model for predicting sports abilities. PATIENTS AND METHODS: Materials and Methods: The comparison of the lower limbs length in dynamics was carried out on 132 students of higher education institutions of Bukovyna. While the primary study was carried out during September-October 2021, next study of these same students was conducted in September-October 2022. The main group consists of 92 (69.7%) students, the control group - 40 (30.30%) students aged 16 to 18 years. All students underwent an anthropometric study (determination of the length of the lower limbs) according to the method of P.P. Shaparenka. The comparesment of anthropometric parameters in the main group depending on the type of sport used the Kruskel-Wallis test (non-parametric analysis of variance) in order to identify a reliable difference in the average indicators of the respondents depending on the type of sport (the median of the distribution was considered as a measure of central tendency). In order to establish which pairs of age groups had a statistical difference in the medians, the Conover-Iman test was used. A paired t-test (t-test of paired samples) was performed to compare the length of the respondents' lower limbs during the first measurement and again one year later. Statistical analysis of the obtained data was performed using the licensed RStudio program. RESULTS: Results: The distribution of the length of the right lower limb of the respondents of the main group by measurement shows that the average value of the length of the right lower limb has changed: a significant difference in the length of the right lower limb was found between the first (M = 88.812, SD = 5.287) and the second (M = 89.377, SD = 5.347) measurements; t (68) = -5.223, p < 0.001. The distribution of the length of the left lower limb shows that the average value of the length of the left lower limb has changed also: a significant difference in the length of the left lower limb was found between the first (M = 88.667, SD = 5.266) and the second (M = 89.435, SD = 5.309) measurements; t (68) = -8.289, p < 0.001. CONCLUSION: Conclusions: In order to dynamically compare the length of the lower limbs for comprehensive control and selection of promising students in football, volleyball, handball and basketball, a mathematical model was derived for predicting the length of the lower limbs, in corresponding sports: right lower limb y = 0.506 x and left y = 0.507x, where y - is the length of the left lower limb, x - is the height. The coefficient of determination is 99.8%. A significant predictor for the length of both lower limbs is the height.

Randomized comparative study of negative pressure wound therapy versus compression dressing on split-thickness skin grafts of the lower limbs in an elderly population.

INTRODUCTION: Failure to adequately secure the skin graft to the lower limbs recipient bed can result in loss of the graft. Our objective was to compare the healing of split-thickness skin grafts three weeks postoperatively, using either negative pressure wound therapy (NPWT) or conventional compression bandaging. METHODS: In this multicenter randomized controlled study, patients with tissue loss ranging from 50 cm2 to 600 cm2 on the lower limbs and treated with split-thickness skin grafts were included in three French hospitals. A digital photographic evaluation was performed at 3 weeks. RESULTS: During 9 years, 70 patients were included in the study and allocated to a treatment group. The grafted area was similar in both groups. Loss of graft was significantly reduced in the NPWT group with 14.6 cm2 compared to 29 cm2 in the control group (p = 0.0003). The hospital stay was also significantly reduced in the NPWT group, at 4 days versus 6.5 days in the control group (p = 0.0284). In the NPWT group, 60% reported pain compared to 22.9% in the control group (p = 0.0048). CONCLUSIONS: The use of NPWT dressings improves skin graft take by reducing necrosis, improving the graft's adherence to the recipient site, and reducing hospital length-of-stay.

Evaluación antropométrica biomédica y diseño mecánico conceptual de un sistema robótico para la rehabilitación pasiva de miembros inferiores en pacientes post-accidente cerebrovascular / Biomedical anthropometric evaluation and conceptual mechanical design of robotic system for lower limbs passive-rehabilitation on post-stroke patients

RESUMEN Antecedentes: El accidente cerebrovascular (ACV) es una de las principales causas de discapacidad permanente, ya que puede provocar lesiones cerebrales graves con secuelas físicas significativas, limitando la capacidad de realizar actividades diarias. Objetivo: Esta investigación tuvo como objetivo diseñar un sistema robótico de movimiento pasivo-continuo para la rehabilitación de miembros inferiores en pacientes adultos con ACV, mejorando así las probabilidades de recuperación de su movilidad de marcha. Metodología: Se llevó a cabo el modelado y simulación del sistema robótico mediante Diseño Asistido por Computadora (CAD), utilizando el software de ingeniería Autodesk Inventor Professional 2023. Resultados: Se obtuvieron las posiciones iniciales y finales del sistema robótico, así como la simulación de movimiento pasivo-continuo. Conclusiones: La toma de medidas precisas de un paciente maximiza la posibilidad de implementar un prototipo funcional que contribuya en el proceso de rehabilitación.

ABSTRACT Background: Cerebrovascular accident (CVA) is one of the main causes of permanent disability, as it can cause serious brain injuries with significant physical consequences, limiting the ability to perform daily activities. Objective: This research aimed to design a robotic system of passive-continuous movement for the rehabilitation of lower limbs in adult patients with stroke, thus improving the chances of recovery of their walking mobility. Methodology: Modeling and simulation of the robotic system using Computer Aided Design (CAD), using the engineering software Autodesk Inventor Professional 2023. Results: The initial and final positions of the robotic system were obtained, as well as the simulation of passive-continuous movement. Conclusions: Taking precise measurements of a patient maximizes the possibility of implementing a functional prototype that contributes to the rehabilitation process.

Effectiveness of Extracorporeal Shock Wave Therapy in Treatment of Spasticity of Different Aetiologies: A Systematic Review and Meta-Analysis.

Background: Spasticity is a motor disorder characterised by exaggerated movements of the tendons and accompanied by hyperreflexia and hypertonia. Extracorporeal shock wave therapy (ESWT) is used as a treatment for spasticity, although more evidence is needed on the effectiveness of this therapy in the treatment of spasticity. Therefore, the aim of this study was to assess the effectiveness ESWT in the treatment of upper and lower limbs spasticity in both children and adults through different aetiologies. Methods: A systematic search was performed in different databases from inception to December 2023. Random-effects meta-analysis was used to estimate the efficacy of ESWT on spasticity using the Modified Ashworth Scale. Results: Sixteen studies were included in the systematic review and meta-analysis. The effect of ESWT on spasticity measured with the Modified Ashworth Scale shows a significant decrease in spasticity in the upper limbs and in the lower limbs in adults with chronic stroke and in children with cerebral palsy, is more effective immediately after application, and maintains its effect up to 12 weeks post treatment. Conclusions: These findings are important for clinical practice since they show evidence that ESWT is effective in reducing spasticity in both children and adults.

Repetitive temporal interference stimulation improves jump performance but not the postural stability in young healthy males: a randomized controlled trial.

BACKGROUND: Temporal interference (TI) stimulation, an innovative non-invasive brain stimulation technique, has the potential to activate neurons in deep brain regions. The objective of this study was to evaluate the effects of repetitive TI stimulation targeting the lower limb motor control area (i.e., the M1 leg area) on lower limb motor function in healthy individuals, which could provide evidence for further translational application of non-invasive deep brain stimulation. METHODS: In this randomized, double-blinded, parallel-controlled trial, 46 healthy male adults were randomly divided into the TI or sham group. The TI group received 2 mA (peak-to-peak) TI stimulation targeting the M1 leg area with a 20 Hz frequency difference (2 kHz and 2.02 kHz). Stimulation parameters of the sham group were consistent with those of the TI group but the current input lasted only 1 min (30 s ramp-up and ramp-down). Both groups received stimulation twice daily for five consecutive days. The vertical jump test (countermovement jump [CMJ], squat jump [SJ], and continuous jump [CJ]) and Y-balance test were performed before and after the total intervention session. Two-way repeated measures ANOVA (group × time) was performed to evaluate the effects of TI stimulation on lower limb motor function. RESULTS: Forty participants completed all scheduled study visits. Two-way repeated measures ANOVA showed significant group × time interaction effects for CMJ height (F = 8.858, p = 0.005) and SJ height (F = 6.523, p = 0.015). The interaction effect of the average CJ height of the first 15 s was marginally significant (F = 3.550, p = 0.067). However, there was no significant interaction effect on the Y balance (p > 0.05). Further within-group comparisons showed a significant post-intervention increase in the height of the CMJ (p = 0.004), SJ (p = 0.010) and the average CJ height of the first 15 s (p = 0.004) in the TI group. CONCLUSION: Repetitive TI stimulation targeting the lower limb motor control area effectively increased vertical jump height in healthy adult males but had no significant effect on dynamic postural stability.

Novel Angiogenesis Role of GLP-1(32-36) to Rescue Diabetic Ischemic Lower Limbs via GLP-1R-Dependent Glycolysis in Mice.

BACKGROUND: Restoring the capacity of endothelial progenitor cells (EPCs) to promote angiogenesis is the major therapeutic strategy of diabetic peripheral artery disease. The aim of this study was to investigate the effects of GLP-1 (glucagon-like peptide 1; 32-36)-an end product of GLP-1-on angiogenesis of EPCs and T1DM (type 1 diabetes) mice, as well as its interaction with the classical GLP-1R (GLP-1 receptor) pathway and its effect on mitochondrial metabolism. METHODS: In in vivo experiments, we conducted streptozocin-induced type 1 diabetic mice as a murine model of unilateral hind limb ischemia to examine the therapeutic potential of GLP-1(32-36) on angiogenesis. We also generated Glp1r-/- mice to detect whether GLP-1R is required for angiogenic function of GLP-1(32-36). In in vitro experiments, EPCs isolated from the mouse bone marrow and human umbilical cord blood samples were used to detect GLP-1(32-36)-mediated angiogenic capability under high glucose treatment. RESULTS: We demonstrated that GLP-1(32-36) did not affect insulin secretion but could significantly rescue angiogenic function and blood perfusion in ischemic limb of streptozocin-induced T1DM mice, a function similar to its parental GLP-1. We also found that GLP-1(32-36) promotes angiogenesis in EPCs exposed to high glucose. Specifically, GLP-1(32-36) has a causal role in improving fragile mitochondrial function and metabolism via the GLP-1R-mediated pathway. We further demonstrated that GLP-1(32-36) rescued diabetic ischemic lower limbs by activating the GLP-1R-dependent eNOS (endothelial NO synthase)/cGMP/PKG (protein kinase G) pathway. CONCLUSIONS: Our study provides a novel mechanism with which GLP-1(32-36) acts in modulating metabolic reprogramming toward glycolytic flux in partnership with GLP-1R for improved angiogenesis in high glucose-exposed EPCs and T1DM murine models. We propose that GLP-1(32-36) could be used as a monotherapy or add-on therapy with existing treatments for peripheral artery disease. REGISTRATION: URL: www.ebi.ac.uk/metabolights/; Unique identifier: MTBLS9543.