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1.
Sensors (Basel) ; 21(19)2021 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-34640779

RESUMEN

Early and self-identification of locomotive degradation facilitates us with awareness and motivation to prevent further deterioration. We propose the usage of nine squat and four one-leg standing exercise features as input parameters to Machine Learning (ML) classifiers in order to perform lower limb skill assessment. The significance of this approach is that it does not demand manpower and infrastructure, unlike traditional methods. We base the output layer of the classifiers on the Short Test Battery Locomotive Syndrome (STBLS) test used to detect Locomotive Syndrome (LS) approved by the Japanese Orthopedic Association (JOA). We obtained three assessment scores by using this test, namely sit-stand, 2-stride, and Geriatric Locomotive Function Scale (GLFS-25). We tested two ML methods, namely an Artificial Neural Network (ANN) comprised of two hidden layers with six nodes per layer configured with Rectified-Linear-Unit (ReLU) activation function and a Random Forest (RF) regressor with number of estimators varied from 5 to 100. We could predict the stand-up and 2-stride scores of the STBLS test with correlation of 0.59 and 0.76 between the real and predicted data, respectively, by using the ANN. The best accuracies (R-squared values) obtained through the RF regressor were 0.86, 0.79, and 0.73 for stand-up, 2-stride, and GLFS-25 scores, respectively.


Asunto(s)
Locomoción , Aprendizaje Automático , Estudios de Factibilidad , Extremidad Inferior , Medición de Riesgo
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(5): 838-842, 2021 Oct 18.
Artículo en Chino | MEDLINE | ID: mdl-34650282

RESUMEN

OBJECTIVE: To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers. METHODS: The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared. RESULTS: A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen. CONCLUSION: In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.


Asunto(s)
Traumatismos en Atletas , Esquí , Traumatismos en Atletas/epidemiología , Humanos , Extremidad Inferior , Estudios Retrospectivos , Centros Traumatológicos
3.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(10): 1221-1226, 2021 Oct 15.
Artículo en Chino | MEDLINE | ID: mdl-34651472

RESUMEN

Lower limb alignment and soft tissue balance are important factors affecting patient satisfaction, clinical functional outcome, and prosthetic long-term survival rate after total knee arthroplasty (TKA). Robot-assisted TKA (rTKA) has the advantages of achieving precise osteotomy and soft tissue balance. However, rTKA under the guidance of classic mechanical alignment principles does not significantly improve the functional outcome after operation. The new TKA alignment principles, such as kinematic alignment (KA) and functional alignment (FA), can better consider the patient's own knee joint morphology and kinematic characteristics, which may help improve the clinical results of TKA. With the help of more objective and accurate soft tissue balance assessment tool such as pressure sensors, KA and FA have been proven to better achieve soft tissue balance. rTKA can achieve non-neutral alignment goals such as KA or FA more accurately and reproducibly. The use of these lower limb alignment and soft tissue balancing strategies will be expected to further increase the patients' satisfaction rate after rTKA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Osteoartritis de la Rodilla , Robótica , Fenómenos Biomecánicos , Humanos , Articulación de la Rodilla/cirugía , Extremidad Inferior , Osteoartritis de la Rodilla/cirugía
4.
BMC Res Notes ; 14(1): 356, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34507606

RESUMEN

OBJECTIVE: While there is evidence on the short-term effects of unilateral balance training (BT) on bipedal balance performance, less is known on the acute effects of unilateral BT on unilateral (i.e., ipsi- and contralateral) balance performance. Thus, the present study examined the acute effects of a single unilateral BT session conducted with the non-dominant, left leg or the dominant, right leg on ipsilateral (i.e. retention) and contralateral (i.e., inter-limb transfer) balance performance in healthy young adults (N = 28). RESULTS: Irrespective of practice condition, significant improvements (p < 0.001, d = 1.27) in balance performance following a single session of unilateral BT were observed for both legs. Further, significant performance differences at the pretest (p = 0.002, d = 0.44) to the detriment of the non-dominant, left leg diminished immediately and 30 min after the single unilateral BT session but occurred again 24 h following training (p = 0.030, d = 0.36). These findings indicate that a single session of unilateral BT is effective to reduced side-to-side differences in balance performance, but this impact is only temporary.


Asunto(s)
Pierna , Equilibrio Postural , Estado de Salud , Humanos , Extremidad Inferior , Adulto Joven
5.
Georgian Med News ; (316-317): 10-16, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34511436

RESUMEN

Aim - analyze the results of surgical treatment of patients with diabetes mellitus (DM) with chronic critical lower limb ischemia (CCLLI) against the background of the combined stenotic-occlusive lesions (SOL) of the femoral arterial segment (FAS) and popliteo-tibial arterial segment (PTAS), considering the data of the intraoperative debitometry (ID). The results of surgical treatment of 97 patients with diabetes mellitus with CCLLI caused by combined SOL of FAS and PTAS arteries after 1 month and 12 months of treatment were analyzed. All patients were treated at the Vascular Surgery Center of the Clinical Hospital "Feofania" of State Directorate for Affairs, Kiev, Ukraine during 2014 - 2018yrs. All patients underwent femoro-popliteal bypass grafting without intervention on arteries of PTAS.According to the obtained results of the ID, the patients were divided into groups: group 1 - 32 patients with a debit of the shunt (SD) greater than 60 ml/min, group 2 - 35 patients with SD 30-60 ml/min, group 3 - 30 patients with SD lesser than 30 ml/min. In case of the femoro-popliteal shunt (FPS) thrombosis, performed repeated surgery as a hybrid revascularization (HR) - thrombectomy from the shunt and endovascular balloon angioplasty of the arteries of PTAS. The primary patency of the arterial reconstruction zone of the patients from group 1 after 1 month was 93.75% (30 of 32), after 12 months - 78.13% (25 of 32); group 2 - after 1 month it was 82.8% (29 out of 35), after 12 months - 68.57% (24 out of 35); group 3 - after 1 month it was 46.66% (14 out of 30), after 12 months - 23.33% (7 out of 30). Thrombosis of the femoropopliteal shunt (FPS) within 12 months was diagnosed in 41 (42.27%) of 97 patients, within these patients 1 month after primary shunting in 26 (63.41%), and during the next 11 months in 15 (36.59 %)cases.With repeated intervention on thrombosis ofFPSin form ofHR, secondary patency within 12 months was 78.05% (32 of 41 patients).Restoration of the outflow from the popliteal artery in one of the tibial arteries by HR was possible in 28 of 41 (68.29%) patients, within 12 months rethrombosis of the arterial reconstruction zone occurred in 8 patients (28.57%) - with secondary patency after 12 months of 71.43% (20 of 28 patients). The restoration of the outflow from the popliteal artery into two tibial arteries by HR was possible in 13 of 41 (31.71%) patients, from them rethrombosis of the FPS within 12 months occurred in 1 patient (7.69%) - the secondary patency within 12 months was 92.31% (12 of 13 patients). In the case of combined SOL of FAS and arteries of PTAS, reconstruction of FAS without intervention on the arteries of PTAS requires performing of ID with determining of SD. Performing of ID with determining of SD is an effective diagnostic technique that allows to formulate a differentiated approach to the tactics of surgical treatment of patients with diabetes mellitus with CCLLI, caused by the SOL of FAS and PTAS. The indicator which allows to restore the patency of FAS without intervention on the arteries of the PTAS is SD>60 ml/min; with SD 30-60 ml/min, the reconstruction of the arteries of the PTAS after the restoration of the patency of FAS can be delayed and performed as elective surgery at the second stage; with SD<30 ml/min, simultaneous reconstruction of FAS and PTAS arteries is required by performing HR or two-stage open arterial reconstruction. The HR is an effective method of blood circulation restoration in patients with diabetes mellitus with CCLLI, caused by a combined SOL of FAS and PTAS, and according to the results: the patency of the FPS within 12 months is 78.05% and does not significantly differ from the results of FAS reconstruction in 1st group of patients with SD>60 ml/min - where patency of the FPS within 12 months is 78.13% (p>0.05). In case of thrombosis of the FPS, thrombectomy from the shunt, supplemented by the restoration of the magistral blood flow from the popliteal artery into two tibial arteriesby the method of balloon angioplasty, demonstrates reliably better secondary patency of the femoropopliteal shunt after 12 months - 92.31% in comparison with the secondary patency of the FPS within 12 months after restoration of the magistral blood flow from the popliteal artery into one tibial artery - 71.43% (p<0.05).


Asunto(s)
Diabetes Mellitus , Arteria Poplítea , Humanos , Isquemia/cirugía , Extremidad Inferior/cirugía , Arteria Poplítea/cirugía , Estudios Retrospectivos , Stents , Resultado del Tratamiento , Grado de Desobstrucción Vascular
6.
BMC Musculoskelet Disord ; 22(1): 769, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34503484

RESUMEN

BACKGROUND: Obesity is common in persons with a lower limb amputation, an amputation can also lead to further weight gain. Data regarding the prevalence of obesity in the Dutch population with a lower limb amputation are lacking. Furthermore, the impact of obesity on skin problems of the residual limb and the need of prosthetic repairs is unknown. The aim of this study was to determine the prevalence of obesity in Dutch persons with a lower limb amputation and to investigate the relationship between body weight, body mass index and skin problems of the residual limb and the frequency of prosthetic repairs. METHODS: A survey was performed among adults with a unilateral lower limb amputation due to any cause, and who are user of a prosthesis. The survey consisted of measurement of the subjects' body height and weight, a questionnaire which assessed self-reported skin problems in the previous month and factors potentially associated with these skin problems, and assessment of the frequency of visits to the orthopedic workshop. RESULTS: In total, 413 persons were enrolled. Of them, 39% (95 % confidence interval 35;44) were overweight and 28% (95% confidence interval 24;33) were obese. A total of 77% (95% confidence interval 73;81) reported one or more skin problems in the past month. Body weight and body mass index were neither associated with the presence of skin problems in general nor with the number of prosthetic repairs. Persons with severe skin problems had a slightly lower body mass index (26.6 kg/m2 vs. 28.0 kg/m2, p = 0.012). Persons with skin problems were younger than those without (difference in means 6.0 years (95% confidence interval 3.0;8.9)). CONCLUSIONS: Our findings show that obesity is common in the Dutch ambulant population with a lower limb amputation, with a prevalence being higher than in the general Dutch adult population. However, its negative impact on the presence of skin problems and the frequency of prosthetic repairs may be limited.


Asunto(s)
Amputación , Miembros Artificiales , Índice de Masa Corporal , Piel/patología , Adulto , Humanos , Extremidad Inferior/cirugía , Países Bajos , Implantación de Prótesis
8.
BMC Infect Dis ; 21(1): 957, 2021 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-34530753

RESUMEN

BACKGROUND: Gas gangrene is usually manifested as myonecrosis and subcutaneous gas accumulation, but rarely manifested as arterial occlusion or pneumatosis in the right ventricle and the pulmonary artery. CASE PRESENTATION: We report a case of gas gangrene caused by Clostridium septicum. The patient developed gas gangrene after being pecked by a chicken but turned for the better following antibiotic treatment and debriment. Imaging test revealed a rare occlusion of the right femoral artery and pneumatosis in the right ventricle and the main pulmonary artery. CONCLUSIONS: In the presence of gas gangrene, special care must be taken to prevent against the formation of circulatory air embolism. The gas gangrene-induced gangrene in the limb of this patient might be attributed to the combined action of infection and arterial occlusion. MDT (Multidisciplinary team)-Green Channel mode is conductive to treatment success of gas gangrene.


Asunto(s)
Clostridium septicum , Gangrena Gaseosa , Arteria Femoral/diagnóstico por imagen , Arteria Femoral/cirugía , Gangrena/etiología , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Extremidad Inferior , Arteria Pulmonar/diagnóstico por imagen
9.
J Int Med Res ; 49(9): 3000605211045230, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34530632

RESUMEN

The number of patients with heart failure with reduced ejection fraction (HFrEF) is increasing. These patients have a reduced cardiorespiratory reserve. Therefore, preoperative evaluation is essential to determine the best type of anaesthesia to use in patients with HFrEF. A 70-year-old man with HFrEF was scheduled to undergo debridement of skin necrosis due to thrombotic occlusion of the right common iliac artery. He had undergone wound dressing changes under local anaesthesia every other day for several months, and treatment for heart failure was on-going. A sciatic nerve and fascia iliaca compartment block was performed under ultrasound guidance because of the patient's cardiopulmonary function. After confirming adequate sensory blockage, surgery was performed without any haemodynamic instability or complications. Thereafter, debridement was performed twice more using the same block technique, and a skin autograft was also successfully performed. We successfully performed an ultrasound-guided sciatic nerve and fascia iliaca compartment block in a patient with HFrEF who was scheduled to undergo lower limb surgery. Peripheral nerve block is an alternative option for patients with HFrEF.


Asunto(s)
Insuficiencia Cardíaca , Bloqueo Nervioso , Anciano , Anestésicos Locales , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/cirugía , Humanos , Extremidad Inferior/diagnóstico por imagen , Extremidad Inferior/cirugía , Masculino , Nervio Ciático , Volumen Sistólico , Ultrasonografía Intervencional
10.
JBJS Rev ; 9(9)2021 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-34534190

RESUMEN

¼: Telemedicine has become an emerging necessity in the practice of orthopaedic surgery following the paradigm shift that was brought on by the COVID-19 pandemic. ¼: Physical examination is an integral component of orthopaedic care and plays a crucial role in diagnosis. ¼: Based on our experience and expert opinion in the literature, we recommend the following infrastructure for a virtual orthopaedic physical examination: a computing device with a functioning camera and high-definition input/output audio, a 720p (high-definition) display, a processing speed of 3.4 GHz, an internet connection speed range from 1 to 25 Mbps, adequate lighting, a steady camera that is positioned 3 to 6 ft (0.9 to 1.8 m) from the patient, a quiet environment for the examination, and clothing that exposes the area to be examined. ¼: When performing a virtual examination of the lower extremity, inspection, range of motion, and gait analysis can be easily translated by verbally instructing the patient to position his or her body or perform the relevant motion. Self-palpation accompanied by visual observation can be used to assess points of tenderness. Strength testing can be performed against gravity or by using household objects with known weights. Many special tests (e.g., the Thessaly test with knee flexion at 20° for meniscal tears) can also be translated to a virtual setting by verbally guiding patients through relevant positioning and motions. ¼: Postoperative wound assessment can be performed in the virtual setting by instructing the patient to place a ruler next to the wound for measuring the dimensions and using white gauze for color control. The wound can be visually assessed when the patient's camera or smartphone is positioned 6 to 18 in (15 to 46 cm) away and is held at a 45° angle to the incision.


Asunto(s)
COVID-19 , Ortopedia/métodos , Examen Físico/métodos , Telemedicina/métodos , Humanos , Extremidad Inferior , SARS-CoV-2
11.
Br J Community Nurs ; 26(Sup10): S22-S28, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34542317

RESUMEN

The use of compression therapy to treat chronic oedema of the lower limbs can be a challenge, especially when this is undertaken by clinicians who have limited experience and knowledge of the theoretical principles which underpin its use in clinical practice. This articles aims to discuss the reasoning which underpins the use of compression hosiery in the management of lymphoedema and how this understanding can improve treatment outcomes and reduce the burden of disease on patients and clinical resources.


Asunto(s)
Linfedema , Medias de Compresión , Enfermedad Crónica , Humanos , Extremidad Inferior , Linfedema/enfermería , Resultado del Tratamiento
12.
J Wound Care ; 30(Sup9): S17-S23, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-34554853

RESUMEN

As of 2014, diabetes is estimated to affect 422 million people globally. It is well recognised that lower extremity amputations secondary to diabetes have a high mortality rate perioperatively. The purpose of this article is to provide a simple, step-by-step guide to surgeons who need to perform a transtibial amputation. The case report of a 62-year-old female patient with poorly controlled diabetes who developed necrotising fasciitis of the lower extremity and systemic sepsis is used to illustrate the procedure. Knowing how to complete this operation is essential due to its effectiveness in quickly eliminating a source of pedal sepsis.


Asunto(s)
Tobillo , Pie Diabético , Amputación , Articulación del Tobillo , Pie Diabético/cirugía , Femenino , Pie/cirugía , Humanos , Extremidad Inferior , Persona de Mediana Edad
13.
Res Sports Med ; 29(6): 586-592, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34477036

RESUMEN

This study examined the biomechanics of the lower limbs during four typical Tai Chi (TC) movements: wave hand in cloud, leaning fly side, repulse monkey, and brush knee and twist step, in order to provide biomechanical evidence-based recommendations for patients with knee osteoarthritis (OA) practicing TC. Joint angles and joint moments of the hip, knee, and ankle in frontal and sagittal plane as well as ground reaction forces were examined while performing TC and regular walking in an experienced 38 years old TC master. The results showed that relative to walking, the four TC movements are characterized by a wide motion range of lower limbs, slow increase in joint loading, and strong muscle activity during performance. Therefore, these TC movements could be suitable for patients with knee OA to practice for improving the muscle strength of their lower limbs and functional ability.


Asunto(s)
Extremidad Inferior/fisiología , Osteoartritis de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/rehabilitación , Rango del Movimiento Articular/fisiología , Tai Ji/métodos , Caminata/fisiología , Soporte de Peso/fisiología , Adulto , Fenómenos Biomecánicos , Humanos , Cinética , Masculino
14.
Ann Ital Chir ; 92: 452-459, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34524114

RESUMEN

PURPOSE: The aim of this study is to compare two dynamic imaging modalities employed to study peripheral lymphatic system, Magnetic Resonance Lymphangiography (MRL) and Indocyanine Green Lymphangiography (ICGL), evaluating their role for planning lymphaticovenular anastomosis (LVA) or other surgical-nonsurgical treatments in patients with lymphedema of the extremities. MATERIALS AND METHODS: We conducted a retrospective study of 32 patients (26 women) with a mean age of 38 years (range 18-73) enrolled from January 2014 to December 2018; 20 out of 32 were affected by lower limb lymphedema with 6 cases of primary lymphedema; all of them had stage II disease. All the patient underwent ICGL and MRL within a month of one another, by injecting different contrast medium into interdigital web spaces. In each patient we rated the number of lymphatic vessels visualized, considering the wrist for the upper limb and the ankle for the lower limb. Student's t-test was applied. RESULTS: All patients completed both the diagnostic examinations without any significant complications. A statistically significant difference (p < 0.05) was found between the number of lymphatic vessels identified on the wrist/ankle (34 on ICGL vs 70 on MRL and 82 on ICGL vs 26 on MRL, considering affected and healthy limbs respectively). In particular, dermal backflow in advanced lymphedema seems to hinder lymphatic vessels detection on ICGL. Conversely, on healthy limbs, MRL hardly identifies lymphatics, because of their fast lymphatic flow and almost virtual lumen. CONCLUSIONS: Both MRL and ICGL are dynamic diagnostic modalities that permit an effective evaluation of lymphatic vessels anatomical and functional status in extremities lymphedema these diagnostic procedures may be considered complementary because they show different aspects of lymphatic system. KEY WORDS: Indocyanine green, MR lymphangiography.


Asunto(s)
Verde de Indocianina , Linfedema , Adolescente , Adulto , Anciano , Femenino , Humanos , Extremidad Inferior/diagnóstico por imagen , Linfedema/diagnóstico por imagen , Linfografía , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
15.
Angiol Sosud Khir ; 27(3): 173-179, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34528603

RESUMEN

The article is a review of literature dedicated to simultaneous open and endovascular (hybrid) operations in treatment of patients with chronic ischaemia of lower limbs. Despite good results of endovascular interventions, in many situations involvement of arteries below the inguinal fold and multilevel lesions are arguments in favour of performing an open operation. On the other hand, open multilevel interventions are accompanied by an increased risk of complications and mortality. Hybrid interventions appear to be a safe and efficient alternative combining advantages of two methods of treatment and making it possible to achieve an optimal outcome with a minimal surgical wound. Also discussed herein are the problems of terminology, indications for, techniques and results of treatment, providing a historical background, followed by analysing problem spots of using this technique and trends of development.


Asunto(s)
Isquemia , Extremidad Inferior , Arterias , Humanos , Isquemia/diagnóstico , Isquemia/etiología , Isquemia/cirugía , Recuperación del Miembro , Extremidad Inferior/cirugía , Resultado del Tratamiento
16.
Med Biol Eng Comput ; 59(10): 2115-2126, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34467446

RESUMEN

The kinematics of the body center of mass (bCoM) may provide crucial information supporting the rehabilitation process of people with transfemoral amputation. The use of magneto-inertial measurement units (MIMUs) is promising as it may allow in-the-field bCoM motion monitoring. Indeed, bCoM acceleration might be obtained by fusing the estimated accelerations of body segments' centers of mass (sCoM), the formers being computed from the measured accelerations by segment-mounted MIMUs and the known relative position between each pair of MIMU and underlying sCoM. This paper investigates how erroneous identifications of MIMUs positions impact the accuracy of estimated 3D sCoM and bCoM accelerations in transfemoral amputee gait. Using an experimental design approach, 215 simulations of erroneous identifications of MIMUs positions (up to 0.02 m in each direction) were simulated over seven recorded gait cycles of one participant. MIMUs located on the trunk and sound lower limbs were shown to explain up to 77% of the variance in the accuracy of the estimated bCoM acceleration, presumably due to the higher mass and/or angular velocity of these segments during gait of lower-limb amputees. Therefore, a special attention should be paid when identifying the positions of MIMUs located on segments contributing the most to the investigated motion. Sensitivity of the estimated vertical body center of mass acceleration to erroneous identifications of MIMU positions in the anteroposterior (AP), mediolateral (ML), and vertical (V) directions, expressed in percentage of the total variance of the estimation accuracy.


Asunto(s)
Amputados , Fenómenos Biomecánicos , Marcha , Aceleración , Humanos , Extremidad Inferior
17.
Medicine (Baltimore) ; 100(38): e27297, 2021 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-34559141

RESUMEN

ABSTRACT: Despite the impact of leg muscle strength on lower extremity motor performance-including walking and sit-to-stand transfer-it remains difficult to predict the relationship between bilateral leg muscle strength and lower extremity performance. Therefore, this study was designed to predict lower extremity function through the differential modeling of logarithmic and linear regression, based on knee extension strength.The study included 121 individuals living in the same community. The bilateral strengths of the knee extensors were measured using a handheld dynamometer, and the Timed Up & Go test (TUG) performance time and 5-m minimum walking times were assessed to predict lower extremity motor functions. Bilateral normalized knee extension muscle strengths and lower extremity motor function scores, including walking or TUG performance times, were assessed on the logarithmic and linear models. The Akaike information criterion (AIC) was used to evaluate the coefficient compatibility between the logarithmic regression model and the linear regression model.The AIC value for the linear model was lower than that for the logarithmic model regarding the walking time. For walking time estimation in the linear model, the coefficient value of knee extension strength was larger on the strong than on the weak side; however, the AIC value for the logarithmic model was lower than that for the linear model regarding TUG performance time. In the logarithmic model's TUG performance time estimation, the coefficient value of knee extension strength was larger on the weak than on the strong side.In conclusion, our study demonstrated different models reflecting the relationship between both legs' strengths and lower extremity performance, including the walking and TUG performance times.


Asunto(s)
Articulación de la Rodilla/fisiología , Extremidad Inferior/fisiología , Fuerza Muscular , Prueba de Paso , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Modelos Lineales , Modelos Logísticos , Masculino , Persona de Mediana Edad
18.
J Pak Med Assoc ; 71(9): 2163-2166, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34580507

RESUMEN

OBJECTIVE: To assess the risk factors for lower limb amputations in diabetic patients presenting with foot ulcers. Methods: The analytical cross-sectional study was conducted at the Mayo Hospital, Lahore, Pakistan, from December 1, 2019, to May 31, 2020, and comprised patients of either gender having type 1 or type 2 diabetes and foot ulcers. The wounds were assessed according to Wagner wound staging and wound sepsis was evaluated in terms of local infection of the wound, leucocytosis and osteomyelitis of the bone. The glycaemic control of these patients was assessed on presentation by measuring glycated haemoglobin levels. Data was analysed using SPSS 26. RESULTS: Of the 135 patients, 82(60.7%) were males and 53(39.2%) were females. Majority patients 59(43.7%) were aged 50-60 years. All 135(100%) patients underwent some type of amputation. Of all the amputations, 91(67.4%) were done in patients with poor glycaemic control on presentation, and 56(41.5%) in those with stage 4 wound. Local wound infection, increased total leukocyte count and bone showing features of osteomyelitis were significantly associated with increased risk of lower extremity amputations (p<0.05). Conclusion: With proper glycaemic control and early presentation and treatment, majority of amputations could be avoided in diabetic patients with foot ulcers.


Asunto(s)
Diabetes Mellitus Tipo 2 , Pie Diabético , Amputación , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Pie Diabético/epidemiología , Pie Diabético/cirugía , Femenino , Humanos , Extremidad Inferior/cirugía , Masculino , Pakistán/epidemiología , Centros de Atención Terciaria
19.
Sensors (Basel) ; 21(18)2021 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-34577352

RESUMEN

To improve the recognition rate of lower limb actions based on surface electromyography (sEMG), an effective weighted feature method is proposed, and an improved genetic algorithm support vector machine (IGA-SVM) is designed in this paper. First, for the problem of high feature redundancy and low discrimination in the surface electromyography feature extraction process, the weighted feature method is proposed based on the correlation between muscles and actions. Second, to solve the problem of the genetic algorithm selection operator easily falling into a local optimum solution, the improved genetic algorithm-support vector machine is designed by championship with sorting method. Finally, the proposed method is used to recognize six types of lower limb actions designed, and the average recognition rate reaches 94.75%. Experimental results indicate that the proposed method has definite potentiality in lower limb action recognition.


Asunto(s)
Algoritmos , Máquina de Vectores de Soporte , Electromiografía , Extremidad Inferior
20.
Sensors (Basel) ; 21(18)2021 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-34577394

RESUMEN

The extent to which muscle synergies represent the neural control of human behavior remains unknown. Here, we tested whether certain sets of muscle synergies that are fundamentally necessary across behaviors exist. We measured the electromyographic activities of 26 muscles, including bilateral trunk and lower limb muscles, during 24 locomotion, dynamic and static stability tasks, and we extracted the muscle synergies using non-negative matrix factorization. Our results show that 13 muscle synergies that may have unique functional roles accounted for almost all 24 tasks by combinations of single and/or merging of synergies. Therefore, our results may support the notion of the low dimensionality in motor outputs, in which the central nervous system flexibly recruits fundamental muscle synergies to execute diverse human behaviors. Further studies are required to validate the neural representation of the fundamental components of muscle synergies.


Asunto(s)
Movimiento , Músculo Esquelético , Electromiografía , Humanos , Extremidad Inferior , Postura
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