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1.
Biol Bull ; 238(1): 1-11, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32163724

RESUMO

While there is behavioral and anatomical evidence that coleoid cephalopods use their arms to "taste" substances in the environment, the neurophysiology of chemosensation has been largely unexamined. The range and sensitivity of detectable chemosensory stimuli, and the processing of chemosensory information, are unknown. To begin to address these issues, we developed a technique for recording neurophysiological responses from isolated arms, allowing us to test responses to biologically relevant stimuli. We tested arms from both a pelagic species (Doryteuthis pealeii) and a benthic species (Octopus bimaculoides) by attaching a suction electrode to the axial nerve cord to record neural activity in response to chemical stimuli. Doryteuthis pealeii arms showed anecdotal responses to some stimuli but generally did not tolerate the preparation; tissue was nonviable within minutes ex vivo. Octopus bimaculoides arms were used successfully, with tissue remaining healthy and responsive for several hours. Arms responded strongly to fish skin extract, glycine, methionine, and conspecific skin extract but not to cephalopod ink or seawater controls. Motor responses were also observed in response to detected stimuli. These results suggest that chemosensory receptor cells on O. bimaculoides arms were able to detect environmentally relevant chemicals and drive local motor responses within the arm. Further exploration of potential chemical stimuli for O. bimaculoides arms, as well as investigations into the neural processing within the arm, could enhance our understanding of how this species uses its arms to explore its environment. While not successful in D. pealeii, this technique could be attempted with other cephalopod species, as comparative questions remain of interest.


Assuntos
Braço , Octopodiformes , Animais , Decapodiformes , Sistema Nervoso
2.
Medicine (Baltimore) ; 99(11): e19016, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176030

RESUMO

This study investigated the stress induced by well-functioning hand constraint in forced-use therapy (FUT) for children with unilateral spastic cerebral palsy (CP).Seventeen children with unilateral spastic CP (mean age 5.8 years) received FUT: 4-week unaffected upper limb immobilization with a short-arm Scotchcast and were encouraged to incorporate it to their daily routines and plays. They were evaluated at pretreatment, immediate post-treatment, and 6 months post-treatment. The Korea-Child Behavior Checklist (K-CBCL) was used to assess the stress degree; box and block test (BBT), Erhardt Developmental Prehension Assessment (EDPA), Quality of Upper Extremity Skill Test (QUEST), and Pediatric Motor Activity Log (PMAL), upper limb function; and Pediatric Evaluation of Disability Inventory (PEDI), daily living activities.In the preschoolers, most scores of K-CBCL tended to increase after FUT; however, there was no significant change in all scale findings after FUT. In the school-aged children, most scores of K-CBCL tended to decrease after FUT; however, there was no significant change in all scale findings after FUT. The findings of the BBT, QUEST, PMAL how often and well subscales significantly improved post-treatment (P < .05).The 4-week FUT with well-functioning hand constraint significantly improved the UL function and did not induce emotional and behavioral problems in children with unilateral spastic CP.


Assuntos
Braço , Paralisia Cerebral/terapia , Imobilização/psicologia , Modalidades de Fisioterapia , Estresse Psicológico/etiologia , Paralisia Cerebral/psicologia , Lista de Checagem , Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Humanos , Imobilização/efeitos adversos , Masculino , Modalidades de Fisioterapia/efeitos adversos , Modalidades de Fisioterapia/psicologia
4.
Medicine (Baltimore) ; 99(6): e18932, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028402

RESUMO

BACKGROUND: Spasticity is one of the manifestations of motor dysfunction in upper motor neuron syndrome, which is characterized by increased muscle tone. Spasticity seriously affects the motor function and activity of daily life of patients. Some studies have shown that extracorporeal shock wave therapy (ESWT) can relieve spasticity in recent years. However, the effectiveness and safety of ESWT on spasticity after motor neuron injury have not been confirmed. The purpose of this systematic review (SR) is to evaluate the effectiveness and safety of ESWT on spasticity after upper motor neuron injury. METHODS: We will search China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), Wan Fang Data, China Biology Medicine (CBM), PubMed, Embase, The Cochrane Library, and Web of Science systematically from their inception dates through October 2019 to obtain randomized controlled trials (RCTs) using ESWT to relieve spasticity in patients after upper motor neuron injury. The primary outcome will be the Modified Ashworth Scale (MAS). Secondary outcomes will include Composite Spasticity Scale (CSS), Spasm Frequency Scale, Modified Tardieu Scale (MTS), electrophysiological study (ratio of maximum H reflex to maximum M response, root mean square value, integrated electromyogram, co-contraction ratio, etc.), or other spasticity-related outcomes. In addition, adverse events will also be assessed as safety measurement. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager software (RevMan, version 5.3.5) and R (version 3.6.1) software. RESULTS: We will synthesize current studies to evaluate the effectiveness and safety of ESWT on spasticity after upper motor neuron injury. CONCLUSION: Our study will provide evidence of ESWT on spasticity after upper motor neuron injury. ETHICS AND DISSEMINATION: The ethical approval is not required since SR is based on published studies. The results of this SR will be published in a peer-reviewed scientific journal according to the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. PROSPERO REGISTRATION NUMBER: CRD42019131059.


Assuntos
Braço/inervação , Tratamento por Ondas de Choque Extracorpóreas , Espasticidade Muscular/terapia , Humanos , Projetos de Pesquisa
5.
Medicine (Baltimore) ; 99(6): e18996, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028410

RESUMO

Upper extremity vein thrombosis (UE-VT) are more and more frequent pathologies and yet little studied. The aim is to describe the clinical and ultrasound features, UE-VT-related diseases, and the prevalence of pulmonary embolism (PE) and associated deaths.All UE-VT patients diagnosed by Doppler-ultrasound in Nantes University Hospital, from January 2015 to December 2017, were included retrospectively. UE-VT suspicion patterns, clinical features, UE-VT topography, and prevalence of PE and death were analyzed.Seven hundred and fifty-five UE-VT were analyzed, including 427 deep thrombosis (UE-DVT) and 328 superficial thrombosis (UE-SVT). In 86.2% (n = 651) UE-VT were related to endovascular devices. Among these thrombosis, one third is in connection with a PICC LINE and one quarter with a peripheral venous line. Forty nine percent (n = 370) of the patients had solid neoplasia or hematological malignancies. An inflammatory or systemic infectious context was found in 40.8% (n = 308) of the cases. The most frequently observed clinical sign at the UE-VT diagnosis was edema (28.6%). Among the UE-SVT it was the presence of an indurated cord (33.2%) and among the UE-DVT the indication of the Doppler-ultrasound was mainly a suspicion of infection on endovascular device (35.1%). In 10.6% (n = 80) of the cases the UE-VT were asymptomatic. The most frequently thrombosed veins were brachial basilic veins (16.7% of all thrombosed segments) followed by jugular (13%) and subclavian (12.3%) veins; 61.3% (n = 463) of UE-VT were in the right upper extremity; 63.3% (n = 478) UE-VT were occlusive. The occurrence of PE is 4% and the death rate is 10.2%, mainly related to the severe comorbidities of patients with UE-VT.UE-VT occurs in particular clinical contexts (hematological malignancies, solid cancers, systemic infections) and in the majority of endovascular devices (86.2%). The occurrence of PE is low.


Assuntos
Braço/irrigação sanguínea , Trombose/diagnóstico , Trombose Venosa/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/etiologia , Embolia Pulmonar/mortalidade , Estudos Retrospectivos , Trombose/complicações , Trombose/diagnóstico por imagem , Trombose/mortalidade , Ultrassonografia , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/mortalidade
6.
Medicine (Baltimore) ; 99(3): e18773, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011469

RESUMO

Cervical epidural anesthesia (CEA) is generally not used during upper-arm vascular surgery for hemodialysis in end-stage renal disease (ESRD) patients, despite its advantages. The Quality of Recovery-40 questionnaire (QOR-40) has been validated as a tool for assessing the degree of recovery after surgery. We hypothesized that CEA could provide a better outcome on the QOR-40 than general anesthesia after upper-arm vascular surgery for hemodialysis in ESRD patients.We divided anesthetic methods into general anesthesia and CEA. The QOR-40 was administered to 70 patients on the night before surgery and at 24 hours after surgery. Additional data, including consumption of opioid analgesics, occurrence of postoperative nausea and vomiting, and scores on a numeric rating scale (NRS) were collected.The total QOR-40 scores of the two groups differed significantly (P = .024) on postoperative day 1. Opioid consumption (P = .005) and occurrence of postoperative nausea (P = .019) in the post-anesthesia care unit (PACU) were significantly lower in the CEA group, whose NRS scores were significantly lower in the PACU (P < .001) and at postoperative day 1 (P = .016).Assessment of postoperative quality of recovery after upper-arm vascular surgery in ESRD patients showed that the CEA group had significantly better total QOR-40 and NRS scores. CEA could be used as an alternative anesthetic technique for upper-arm vascular surgery for hemodialysis in ESRD patients to improve the quality of recovery.


Assuntos
Período de Recuperação da Anestesia , Anestesia Epidural/métodos , Anestesia Geral/métodos , Braço/irrigação sanguínea , Braço/cirurgia , Derivação Arteriovenosa Cirúrgica , Falência Renal Crônica/terapia , Diálise Renal , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários
8.
Medicine (Baltimore) ; 99(1): e18576, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895804

RESUMO

A substantial limitation of dialysis fistulas is their high primary failure rate due to nonmaturation. Various studies have documented that patients with larger vein diameters exhibit reduced risks for nonmaturation. Nevertheless, some patients have small veins. Few studies have focused on patients with small veins. We hypothesize that sufficient venous dilation contributes to fistula maturation. Therefore, we studied the influence of cephalic vein dilation on fistula maturation in patients with small veins.Patients with small cephalic veins (diameter <2 mm) undergoing initial arteriovenous fistulae (AVF) operation were included. A total of 72 patients were enrolled in this study. A prospective study was performed, and the patients were followed for 6 weeks after surgery. Preoperative and postoperative duplex ultrasound mapping of veins was performed, and dilation of the cephalic vein was evaluated.The fistula maturation rate was 44.44%. Multivariate logistic regression analysis revealed a significant relationship between fistula maturation and preoperative cephalic vein dilation. Based on the results of ROC analysis, the fistula maturation rate in patients with vein dilation greater than or equal to the cut-off was 57.14% in the training data set and 54.55% in the testing data set. The independent influencing factors for fistula maturation were used to establish a combined index with logistic regression analysis. The fistula maturation rate in patients with combined indexes greater than or equal to the cut-off was 80.95% in the training data set and 77.78% in the testing data set.Our results demonstrated that preoperative venous dilation was associated with AVF maturation. For patients with small veins, venous distensibility needs to be carefully assessed before surgery, as it may be a better predictor of AVF maturation than venous diameter.


Assuntos
Braço/irrigação sanguínea , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Adulto , Idoso , Braço/diagnóstico por imagem , Feminino , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Diálise Renal , Ultrassonografia
11.
J Surg Oncol ; 121(1): 85-90, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31236970

RESUMO

Secondary Angiosarcoma (Stewart-Treves Syndrome) is a rare malignant cutaneous lesion, which arises in chronic lymphedema of the extremity, often observed after breast cancer treatment. We reviewed the history and the oncological outcome of two patients with this disease. Multimodal therapy including hyperthermic isolated limb perfusion with TNF-alpha and Melphalan, combined with radical resection of the affected skin and subcutaneous tissue including the fascia, with large safety margins may probably lead to better survival.


Assuntos
Hemangiossarcoma/patologia , Hemangiossarcoma/terapia , Linfangiossarcoma/patologia , Linfangiossarcoma/terapia , Braço , Quimioterapia do Câncer por Perfusão Regional , Feminino , Hemangiossarcoma/tratamento farmacológico , Hemangiossarcoma/cirurgia , Humanos , Hipertermia Induzida , Linfangiossarcoma/tratamento farmacológico , Linfangiossarcoma/cirurgia , Melfalan/administração & dosagem , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/administração & dosagem
12.
J Vasc Access ; 21(1): 105-109, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31328635

RESUMO

Non-maturation of arteriovenous fistulas is a frequent problem after dialysis access creation, especially in the forearm. The presence of accessory veins may play an important role in the non-maturing fistula. Several surgical and endovascular techniques are described to deal with this problem. We describe a new surgical technique in which we perform a rejoining of the arm veins to create a single large run-off vessel with greater diameter and flow for haemodialysis.


Assuntos
Braço/irrigação sanguínea , Derivação Arteriovenosa Cirúrgica/métodos , Diálise Renal , Veias/cirurgia , Adulto , Idoso de 80 Anos ou mais , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem
13.
J Vasc Access ; 21(1): 39-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31165669

RESUMO

BACKGROUND: Arm abduction influences cross-sectional area of the infraclavicular axillary vein, yet the effect of arm abduction on collapsibility of the vein has not been quantified. Decrease in collapsibility of the axillary vein can enable successful cannulation and can decrease injury to underlying vital structures. METHODS: The infraclavicular axillary vein was scanned in 70 patients close to the clavicle with a high-frequency linear transducer in arm adducted position (Point A), after arm abduction at the initial probe position (Point A') and after tracing the vein medially close to clavicle (Point B). Maximum and minimum cross-sectional area and circumference during tidal breathing and collapsibility indices during tidal and deep breathing were measured at three probe positions. RESULTS: The percentage change with respiration in cross-sectional area, circumference and the collapsibility indices computed from the above measurements were lesser in arm abducted position (p < 0.001). There was decrease in collapsibility index during tidal breathing from 25 at Point A to 7 at Point A' and 3 at Point B. Collapsibility index reduced from 91 at Point A to 30 at Point A' and 35 at Point B during deep breathing. CONCLUSION: We conclude that the collapsibility of the infraclavicular axillary vein could be reduced by arm abduction, and hence, abduction could be proposed as the ideal arm position for ultrasound-guided infraclavicular axillary vein cannulation.


Assuntos
Braço/irrigação sanguínea , Veia Axilar/diagnóstico por imagem , Posicionamento do Paciente , Respiração , Ultrassonografia , Adulto , Pontos de Referência Anatômicos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos
14.
Maturitas ; 132: 49-56, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31883663

RESUMO

OBJECTIVE: Most studies of the age-related changes in body composition are cross-sectional in design: there have been few longitudinal studies. The aim of this 5-year study was to document body composition changes in perimenopausal and older women. STUDY DESIGN: Prospective, longitudinal observational study. METHODS: 489 women were randomly selected from the electoral roll and stratified into 4 age groups by decade: 40-49, 50-59, 60-69 and 70-79 years. Dual-energy x-ray absorptiometry (DXA) was performed in the first and fifth years of the study. Total body mass (TBM), total fat mass (TFM), total lean mass (TLM), abdominopelvic fat mass, and appendicular fat and lean mass were determined. RESULTS: There were significant increases in TBM (p < 0.001), TFM (p < 0.01), TLM (p < 0.05), arm fat mass (p < 0.05), leg fat mass (p < 0.001) and leg lean mass (p < 0.05) within the 40-49 age decade. TBM, TFM and abdominopelvic fat started to decline from the 50-59 decade. Abdominopelvic fat reduction was significant from the 50-59 decade to the later decades (p = 0.05 to p < 0.001). Arm lean mass showed a significant reduction from the 50-59 decade (p < 0.01). Leg lean mass declined from the 60-69 decade, reaching significance in the 70-79 decade (p = 0.05). CONCLUSION: TFM and abdominopelvic fat declined from the 50-59 age decade, which is earlier than is suggested in the literature. Conversely, the decline in appendicular lean mass with age occurred later, from the 50-59 decade, with earlier and greater loss in the arms, which has implications for exercise strategies to maintain muscle mass from midlife on.


Assuntos
Composição Corporal , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Gordura Abdominal , Absorciometria de Fóton , Adiposidade , Adulto , Idoso , Braço , Peso Corporal , Feminino , Humanos , Perna (Membro) , Estudos Longitudinais , Pessoa de Meia-Idade , Músculo Esquelético , Estudos Prospectivos
15.
Support Care Cancer ; 28(1): 79-85, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30982096

RESUMO

BACKGROUND: The professional impact of upper limb lymphedema, which affects 15-20% of women after breast cancer treatment, has been poorly evaluated. OBJECTIVE: To analyze lymphedema characteristics and global lymphedema- and/or sleeve-attributed impact (mildly inconvenient to severely debilitating) on professional activities, workplace relationships, and workstation ergonomics. METHODS: Patients received a standardized, anonymous, self-administered questionnaire at consultation/hospitalization for treatment in a specialized lymphedema management center. RESULTS: All 134 consecutive women (March/2015-March/2017; median age 54), with 53-month median lymphedema duration and 34% median excess volume, were included; 35% considered global impact (arm-use impairment) high. For high vs. low global impact during occupational activities, univariate analyses identified global impairment as being associated with the low (23.8%), intermediate (60%), or high (63.2%) (p < 0.01) arm-use level, while multivariate analyses retained intermediate (OR 6.9 [95% CI 1.1-118.1], p < 0.01) and high (OR 4.5 [95% CI 1.5-37.3], p < 0.05) vs. low arm-use level. Lymphedema affected the careers of 70 (52.2%) patients, mostly those with severely impaired arm movement (53.8% vs. 10.2, p < 0.001), without modifying their relationships with colleagues and superiors for 84 (62.7%). Highly impaired women reported changed relationships with colleagues (45% vs. 20%, p < 0.01) and superiors (43.6% vs. 16.9%, p < 0.01). Only 10 women's (7.5%) job changes reflected lymphedema or its treatment. Workplace adaptations (53% ergonomic) were made for 36 (26.9%) patients, mostly those with greater arm-movement impairment (43.6% vs. 25.3%, p < 0.05), who were highly satisfied (86%). CONCLUSION: Upper limb lymphedema can significantly impact work, sometimes upending careers. The rare workstation adaptations were beneficial. Occupational physicians should assess lymphedema-attributed difficulties to improve working conditions.


Assuntos
Linfedema Relacionado a Câncer de Mama/epidemiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Mulheres Trabalhadoras/estatística & dados numéricos , Trabalho/fisiologia , Adaptação Fisiológica/fisiologia , Adulto , Idoso , Braço , Linfedema Relacionado a Câncer de Mama/psicologia , Linfedema Relacionado a Câncer de Mama/terapia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Ergonomia , Feminino , Humanos , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Inquéritos e Questionários , Extremidade Superior , Trabalho/psicologia , Trabalho/estatística & dados numéricos , Local de Trabalho/psicologia , Local de Trabalho/normas , Local de Trabalho/estatística & dados numéricos
16.
Ann Vasc Surg ; 62: 258-262, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31494264

RESUMO

BACKGROUND: To study the effect of prolonged complex decongestive therapy (CDT) on lymphedema in arms without a subcutaneous echo-free space (SEFS) on subcutaneous tissue ultrasonography. METHODS: Fifty-one patients with arm lymphedema treated for longer than 1 year using CDT in our clinic were retrospectively evaluated. Before starting CDT, subcutaneous tissue ultrasonography was performed to examine for the presence of an SEFS. Two-stage CDT was performed as recommended by the International Society of Lymphology. Limb circumference was measured, and limb volume was calculated at the initial and latest visits. RESULTS: In patients with lymphedema in which SEFS was observed anywhere in the arm on the initial visit (n = 25), the edema ratio was significantly reduced by a median of -15% (range, -106% to 17%; P < 0.001). On the other hand, in the arms with lymphedema in which SEFS was not observed (SEFS[-], n = 26), the edema ratio was not changed significantly by CDT (median, 1% [range, -30% to 23%]). In arms without an SEFS that were not treated using arm sleeves regularly (n = 15), no increase in edema ratio was observed (median, 1% [range, -29% to 16%]). CONCLUSIONS: In arms with lymphedema without SEFS, the effect of CDT on the reduction of arm volume is limited.


Assuntos
Braço/diagnóstico por imagem , Bandagens Compressivas , Linfedema/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Braço/fisiopatologia , Feminino , Humanos , Linfedema/diagnóstico por imagem , Linfedema/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Pressão , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia
17.
Med Probl Perform Art ; 34(4): 179-190, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31800669

RESUMO

AIMS: High string players (violin and viola) often suffer from musculoskeletal disorders. Although 3D motion analysis has proved helpful in diagnosing different musculoskeletal syndromes and identifying injurious movement patterns in violin and viola performance, more detailed analyses of upper body movement strategies and especially of the shoulder complex have not yet been recorded. The use of spherical surface markers on some anatomical landmarks is, however, inappropriate when an instrument is being played. The aim of this study was to develop and evaluate a novel marker-based method for analyzing upper body kinematics of high string players using conditions specific to violin and viola playing. METHODS: A custom upper body marker set was developed and a biomechanical model applied to 3D motion capture data of the pelvis, thorax, spine, head, and both upper limbs (scapula, upper arm, forearm, hand) of 12 professional violinists, to assess its clinical feasibility. FINDINGS: Lumbar and thoracic spine, thorax, neck, and left upper limb were quite static, while extensive motion occurred in the right upper limb. Most rotation angles showed a reasonable intersubject variability except for glenohumeral and wrist joints. Significant differences were observed between G- and D-string bowing, especially in the left wrist and right shoulder joints. INTERPRETATION: This study suggests that the proposed method is a valid tool for quantifying upper body movements in violin and viola performance. With the extended upper body model, it will improve understanding of the motor strategies adopted by high string players and may contribute to injury prevention, diagnosis, and treatment.


Assuntos
Fenômenos Biomecânicos , Movimento , Música , Braço , Estudos de Viabilidade , Humanos , Amplitude de Movimento Articular
18.
PLoS One ; 14(12): e0218644, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31860669

RESUMO

Changes to arm swing and gait symmetry are symptomatic of several pathological gaits associated with reduced stability. The purpose of this study was to examine the relative contributions of arm swing and gait symmetry towards gait stability. We theorized that actively increasing arm swing would increase gait stability, while asymmetric walking would decrease gait stability. Fifteen healthy, young adults (23.4 ± 2.8 yrs) walked on a split-belt treadmill under symmetric (1.2 m/s) and asymmetric walking (left/right, 5:4 speed ratio) with three different arm swings: held, normal, and active. Trunk local dynamic stability, inter-limb coordination, and spatiotemporal gait variability and symmetry were measured. Active arm swing resulted in improved local trunk stability, increased gait variability, and decreased inter-limb coordination (p < .013). The changes in local trunk stability and gait variability during active arm swing suggests that these metrics quantify fundamentally different aspects of stability and are not always comparable. Split-belt walking caused reduced local trunk stability, increased gait variability, and increased lower limb asymmetry (p < .003). However, the arm swing symmetry was unaffected by gait asymmetry, this suggests that the decreases in gait stability are linked to the increases in gait asymmetry rather than increases in arm swing asymmetry.


Assuntos
Marcha/fisiologia , Movimento/fisiologia , Caminhada/fisiologia , Braço/fisiologia , Fenômenos Biomecânicos , Feminino , Voluntários Saudáveis , Humanos , Perna (Membro)/fisiologia , Masculino , Tronco , Adulto Jovem
19.
Plast Reconstr Surg ; 144(5): 1197-1201, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31688768

RESUMO

Lymphedema arises from impaired lymphatic function. Quantification of lymphatic contractility has previously been shown using a custom-built near-infrared imaging system. However, to broaden the clinical use of functional lymphatic measurements, these measurements need to be performed using a standard-of-care, clinically available camera. The authors propose an objective, algorithmic, and clinically accessible approach to quantify lymphatic contractility using a 3-minute indocyanine green lymphangiograph recorded with a commercially available near-infrared camera. A retrospective review of the authors' indocyanine green lymphangiography video repository maintained in a Research Electronic Data Capture database was performed. All patients with a newly diagnosed unilateral breast cancer undergoing preoperative indocyanine green lymphangiography were included in the analysis. Patient medical records were then analyzed for patient demographics, and videos were analyzed for contractility. Seventeen consecutive patients with unilateral breast cancers underwent video processing to quantify lymphatic contractility of the ipsilateral extremity in contractions per minute. All patients were women, with an average age of 60.5 years (range, 38 to 84 years). The average lymphatic contractility rate was 1.13 contractions per minute (range, 0.67 to 2.5 contractions per minute). Using a clinically accessible standard-of-care device for indocyanine green lymphangiography, the authors were able to determine lymphatic contractility rates of a normal extremity. The authors' finding falls within the range of previously published data quantifying lymphatic contractility using a research device, suggesting that the authors' technique provides a clinically accessible, time-effective means of assessing lymphatic contractility. Potential future applications include both lymphedema surveillance and evaluation of nonsurgical and surgical interventions. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Diagnostic, IV.


Assuntos
Braço/fisiopatologia , Verde de Indocianina , Linfedema/diagnóstico por imagem , Linfografia/métodos , Mastectomia/efeitos adversos , Adulto , Idoso , Algoritmos , Neoplasias da Mama/cirurgia , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Vasos Linfáticos/diagnóstico por imagem , Linfedema/etiologia , Mastectomia/métodos , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Prognóstico , Estudos Retrospectivos , Gravação em Vídeo
20.
Hum Mov Sci ; 68: 102527, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31689575

RESUMO

Arm swing asymmetry is commonly observed in early Parkinson's disease (PD) and has been found to be useful for early diagnosis. However, there are uncertainties about the nature of its relationships with gait parameters, especially shoulder and elbow motions. Therefore, this study explored how these relationships are different between PD and controls. Forty one early PD and 23 controls were included. Participants walked at self-selected speed for 3D motion analysis. Arm swing at the wrist (AS), temporospatial parameters and kinematics in elbow, shoulder and trunk were obtained. Amplitudes and asymmetries of these variables were compared between PD and control groups. PD group showed increased AS asymmetry, compared to controls. Multiple hierarchical regression analysis on AS asymmetry was conducted in order to investigate how PD influences on the relationship between AS asymmetry and other variables. In pooled data (PD and control group), asymmetries in elbow and shoulder range of motion (RoM) were significant predictors for AS asymmetry but walking speed and asymmetries in temporospatial parameters were not significant. Group effect (PD effect) was significantly mediated by only elbow RoM asymmetry. Interaction between group and elbow RoM asymmetry was statistically significant, indicating that group was an effect modifier for elbow RoM asymmetry effect on AS asymmetry. Conclusively, arm swing asymmetry measured at the wrist represents the involvement of PD effect on the unilateral and distal upper limb in early stage. These findings are helpful for future researches related to clinical applications and mechanisms of arm swing asymmetry in PD.


Assuntos
Braço/fisiopatologia , Doença de Parkinson/fisiopatologia , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos , Estudos de Casos e Controles , Articulação do Cotovelo/fisiopatologia , Feminino , Marcha/fisiologia , Humanos , Masculino , Movimento/fisiologia , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Articulação do Ombro/fisiopatologia , Tronco/fisiopatologia , Velocidade de Caminhada/fisiologia
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