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1.
Vasc Endovascular Surg ; 57(1): 19-25, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35968758

RESUMO

PURPOSE: To establish a non-invasive test method for the rapid detection of severe ischemia (SI) in the limbs in patients with peripheral arterial disease (PAD). METHODS: Between November 2019 and May 2021, 22 patients admitted for PAD to 2 hospitals agreed to participate in the study. All patients underwent a local heating load (LHL) test. SI was defined as at least 1 ankle-brachial index value of <.4 and/or transcutaneous oximetry value of <30 mmHg. The other cases were classified as mild-to-moderate ischemia (MMI). The LHL test was performed simultaneously with 15 minutes of heating and measurement by attaching a blood flow meter measuring probe combined with a warmer to the patient's dorsal foot. Evaluation consisted of 200-s periods from the start of heating to 800 seconds. For each period, perfusion value (PV) was evaluated, and slope was calculated graphically based on linear regression as PV fluctuation per minute. Test accuracy was calculated using a receiver operating characteristic curve. RESULTS: Twenty-four limbs of 18 patients were finally evaluated; 4 patients (2 with missing data, 1 with collagen disease, and 1 with embolism) were excluded, with 13 and 11 limbs in the SI and MMI groups, respectively. The SI group showed a significantly lower slope value in the first 200 seconds and lower PV at 200 seconds and thereafter. From the slope value, it was possible to detect SI with 85% sensitivity and 73% specificity at 200 seconds. PV could be determined with higher accuracy in periods after 200 seconds, with 85% sensitivity and 82% specificity at 800 seconds. CONCLUSIONS: Our non-invasive LHL test could be used as a rapid screening test to detect SI in limbs within 200 seconds, as well as a more accurate test to detect ischemia within 800 seconds.


Assuntos
Calefação , Doença Arterial Periférica , Humanos , Resultado do Tratamento , Isquemia/diagnóstico , Doença Arterial Periférica/diagnóstico , Extremidade Inferior
2.
Clin Podiatr Med Surg ; 40(1): 193-207, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36368843

RESUMO

Dancers are highly vulnerable to injuries due to high dynamic overload, extreme positions and motions, and excessive use. Increased load at the forefoot with jumping and high-impact lands can cause sesamoiditis and stress fractures of the metatarsals. Significant plantarflexion can lead to posterior joint impingement and flexor hallucis longus tendonitis, whereas forced dorsiflexion can cause anterior joint impingement. Most pathologies can be diagnosed on physical examination and various imaging modalities. Treatment should be tailored to the dancers' needs and should begin with a course of conservative therapy with immobilization, physical therapy, and activity cessation.


Assuntos
Traumatismos do Tornozelo , Dança , Tendinopatia , Humanos , Traumatismos do Tornozelo/diagnóstico , Traumatismos do Tornozelo/etiologia , Traumatismos do Tornozelo/terapia , Dança/lesões , Tendinopatia/complicações , Extremidade Inferior , Músculo Esquelético , Articulação do Tornozelo
3.
Microvasc Res ; 145: 104445, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36209773

RESUMO

PURPOSE: Young non-Hispanic black (BL) males have displayed lower blood flow (BF) and vascular conductance (VC), but intact functional sympatholysis, during upper limb exercise when compared to non-Hispanic white (WH) males. This study sought to explore if similar differences were also present in the lower limbs. METHODS: Thirteen young BL males and thirteen WH males completed one visit comprised of rhythmic lower limb (plantar flexion) exercise as well as upper limb (handgrip) exercise for a limb-specific comparison. Limb BF, mean arterial pressure (MAP), and VC were evaluated at three submaximal workloads (8, 16, and 24 kg). To determine potential limb differences in functional sympatholysis, the impact of sympathetic nervous system activation (via cold-pressor test (CPT)) was evaluated at rest and during steady state exercise (30 % of maximal voluntary contraction) on a subsequent visit. RESULTS: MAP responses to lower and upper limb exercise were elevated in young BL males (vs WH males), resulting in significantly lower VC responses in the upper limb, but not the lower limb. Further, BL males, when compared to WH males, revealed no differences in functional sympatholysis, evident by similar responses in both the exercising leg and arm VC during CPT. CONCLUSION: The findings of the current study indicate that although elevated MAP responses were observed during both lower and upper limb exercise in young BL males, vascular conductance was only hindered in the upper limbs. This may potentially highlight enhanced compensatory mechanisms in the lower limb (vs upper limb) to maintain perfusion in young BL males.


Assuntos
Força da Mão , Simpatolíticos , Masculino , Humanos , Força da Mão/fisiologia , Fluxo Sanguíneo Regional , Exercício Físico/fisiologia , Extremidade Inferior , Pressão Sanguínea , Músculo Esquelético
4.
Sports Biomech ; 22(1): 102-122, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35866237

RESUMO

Shank rotation is associated with increased risk in lower limb injuries of weight-bearing sport activity. Straight-line running injury prevention research proposes a 'bottom-up' approach to minimising injury risk to the knee. This prophylactic recommendation is due to the observed distal-proximal coupling relationship between rearfoot and shank rotations. However, the coupling relationship between the calcaneus and shank is unknown in sports with high intensity decelerations, frequent changes of direction, associated with increased anterior cruciate ligament (ACL) injury risk. The aim of this study was to determine whether the movement of the calcaneus has a potential effect on the internal and external rotational movement of the shank, associated with ACL injury risk. We implemented a modified vector coding technique using segmental velocities in a local, anatomical reference frame to quantify the coupling relationship between the individual tri-planar calcaneus rotations and transverse plane shank rotations. During the loading phase, a distal-proximal coupling relationship between calcaneus eversion deceleration, abduction acceleration, and shank internal rotation deceleration was observed amongst most subjects. The distal-proximal coupling found between the calcaneus and shank justifies exploring interventions geared towards manipulating calcaneus motion to affect shank rotational movements during unanticipated change of direction tasks associated with ACL injury risk.


Assuntos
Lesões do Ligamento Cruzado Anterior , Calcâneo , Humanos , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Fenômenos Biomecânicos , Perna (Membro) , Articulação do Joelho , Extremidade Inferior
5.
Orthop Clin North Am ; 54(1): 23-35, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36402508

RESUMO

With improved chemotherapeutic treatment, patients with primary or metastatic bone tumor have improved prognoses and longer life expectancies; therefore, durable limb-salvage constructs are critical. For tumors of the proximal femur, endoprosthetic replacement is an option for treatment in primary and metastatic disease, with the goals being tumor and pain control, earlier mobilization, shorter recovery period, and, in primary tumors, cure. This study provides a summary of current concepts in the treatment of oncologic lesions in the proximal femur with endoprostheses. Discussion of the inherent complications of these constructs is presented as well as the risks and treatment of reconstruction failure.


Assuntos
Neoplasias Ósseas , Fêmur , Humanos , Fêmur/cirurgia , Salvamento de Membro , Extremidade Inferior/cirurgia , Reimplante , Neoplasias Ósseas/cirurgia
6.
Vasc Endovascular Surg ; 57(1): 5-10, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35968814

RESUMO

BACKGROUND: Treatment of chronic limb threatening ischemia (CLTI) poses a significant clinical challenge despite recent medical advancements. Chronic total occlusion (CTO) lesions make endovascular approaches to CLTI particularly challenging. Open proximal exposure with retrograde access and stenting (OPERAS) aims to solve this challenge through retrograde subintimal crossing of a CTO with direct visualization of proximal re-entry into the true lumen. We describe this novel technique and present its efficacy in eight patients. METHODS: We conducted a retrospective case series at a single tertiary academic center. Data for patients who received OPERAS intervention included demographics, peri-operative details, and follow-up information. Statistical analysis was performed on length of stay, major post-operative complications, further intervention, clinical progression at 1 year, and amputation-free survival at 1 year. Immediate technical failure (ITF) and limb-based patency (LBP) at 1 year were calculated. RESULTS: Nine limbs underwent OPERAS between January 2019 and March 2020. Inflow was achieved with common femoral artery endarterectomy. All limbs underwent balloon angioplasty and stenting of the SFA, and seven underwent the same procedure in the popliteal artery. ITF was 0% for all nine cases. There were no major post-operative complications, and ankle-brachial index significantly improved pre-and post-operatively (P < .001). Eight limbs (88.9%) sustained amputation-free survival at 1 year, and overall LBP was 67% at 1 year. CONCLUSION: Our study presents a hybrid revascularization option to address severe, anatomically complex limbs (GLASS III) that lack a single autogenous conduit for open surgical revascularization. OPERAS addresses a main point of technical failure of subintimal techniques by directly visualizing the wire in the true lumen. Our data suggest that OPERAS can be effective to: (1) improve technical success of luminal re-entry following a subintimal approach; (2) address inflow concurrently with severe femoropopliteal disease; and (3) can be utilized when distal tissue loss is involved.


Assuntos
Endarterectomia , Doenças Vasculares , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Endarterectomia/efeitos adversos , Extremidade Inferior , Artéria Poplítea , Complicações Pós-Operatórias , Isquemia Crônica Crítica de Membro
7.
J Musculoskelet Neuronal Interact ; 22(4): 486-497, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36458386

RESUMO

OBJECTIVES: This study investigated the effect of lower limb immobilization and retraining on postural control and muscle power in healthy old and young men. METHODS: Twenty men, nine old (OM:67.3±4.4 years) and eleven young (YM:24.4±1.6 years) underwent 2 weeks of unilateral whole-leg casting, followed by 4 weeks of retraining. Measures included center of pressure (CoP) sway length and area during single- and double-leg stance, maximal leg extensor muscle power, habitual and maximal 10-m gait speed, sit-to-stand performance, and 2-min step test. RESULTS: After immobilization, leg extension muscle power decreased by 15% in OM (from 2.68±0.60 to 2.29±0.63 W/kg, p<0.05) and 17% in YM (4.37±0.76 to 3.63±0.69 W/kg, p<0.05). Double-leg CoP sway area increased by 45% in OM (218±82 to 317±145 mm2; p<0.05), with no change in YM (p=0.43). Physical function did not change after immobilization but sit-to-stand performance (+20%, p<0.05) and 2-min step test (+28%, p<0.05) increased in OM following retraining. In both groups, all parameters returned to baseline levels after retraining. CONCLUSION: Two weeks of lower limb immobilization led to decreases in maximal muscle power in both young and old, whereas postural control was impaired selectively in old men. All parameters were restored in both groups after 4 weeks of resistance-based retraining.


Assuntos
Extremidade Inferior , Equilíbrio Postural , Masculino , Humanos , Perna (Membro) , Velocidade de Caminhada , Músculo Esquelético
8.
J Musculoskelet Neuronal Interact ; 22(4): 562-586, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36458393

RESUMO

We systematically reviewed existing literature regarding lower extremity neuromuscular rate of force development (RFD), maximal muscle strength (Fmax), and physical function in neurodegenerative populations, and to what extent these outcomes are affected and/or associated. Following PRISMA guidelines, 4 databases (Pubmed, Embase, SPORTDiscus, Web of Science) were searched. Across aging, Parkinson Disease (PD), Alzheimer's Disease (AD), Multiple Sclerosis (MS), or Stroke, included studies should report (Part 1) deficits in lower extremity RFD, Fmax, and physical function (~ individuals having inferior vs. superior physical function), and/or (Part 2) associations between RFD (or Fmax) and physical function. A total of N=32 studies (n=1087 participants) were included. Part 1: deficits in RFD (-31%, mean; N=22) were comparable to deficits in physical function (-26%; N=7), yet both deficits exceeded that of Fmax (-21%; N=20). Part 2: associations between RFD and physical function (r2=0.13, mean; N=16) were comparable to associations between Fmax and physical function ((r2=0.15; N=12). Lower extremity RFD is (1) particularly sensitive (i.e. adapts earlier and/or more extensively) towards neurodegeneration, and more so than Fmax, and (2) of importance for physical function but apparently not superior to Fmax. RFD could serve as a useful indicator/biomarker of changes in neuromuscular function elicited by neurodegeneration.


Assuntos
Doença de Alzheimer , Doenças Neurodegenerativas , Humanos , Envelhecimento , Força Muscular , Extremidade Inferior
9.
Medicine (Baltimore) ; 101(47): e31483, 2022 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-36451393

RESUMO

INTRODUCTION: Phlegmasia cerulea dolens (PCD) is an uncommon condition of acute deep vein thrombosis, characterized by marked swelling of the affected limb with pain and cyanosis. High mortality and morbidity rates have been reported. Early diagnosis, quick and effective treatment are crucial for preventing potential limb loss or even death. PATIENT CONCERNS: A 39-year-old woman presented to our emergency department with painful swelling and cyanotic discoloration of the left lower limb for 2 days. DIAGNOSES: Computed tomography revealed thrombosis in the left common iliac vein and inferior vena cava. Angiography demonstrated extensive venous occlusion from the lower inferior vena cava to the left popliteal vein. The diagnosis of PCD was made. INTERVENTIONS: Systemic anticoagulation with intravenous unfractionated heparin was initiated immediately. Mechanical thrombectomy with Angiojet and angioplasty were performed, and catheter-directed thrombolysis (CDT) was administered subsequently. OUTCOMES: Follow-up angiography revealed regression of the thrombosis and the opacification of the deep vein was restored. The patient was discharged from the hospital uneventfully. CONCLUSIONS: PCD is a rare but potentially limb and life-threatening condition that requires immediate recognition. Treatment should be in a timely manner. Anticoagulation alone may be inadequate and more aggressive management such as CDT and thrombectomy should be considered.


Assuntos
Heparina , Trombose Venosa , Feminino , Humanos , Adulto , Heparina/uso terapêutico , Trombectomia , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Cateteres , Extremidade Inferior , Cianose , Anticoagulantes , Terapia Trombolítica
10.
PLoS One ; 17(12): e0278444, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36454920

RESUMO

This prospective cohort study examined the impact of high anxiety levels on psychological state and gait performance during recovery in runners with lower body injuries. Recreational runners diagnosed with lower body injuries who had reduced running volume (N = 41) were stratified into groups using State Trait Anxiety Inventory (STAI) scores: high anxiety (H-Anx; STAI ≥40 points) and low anxiety (L-Anx; STAI <40 points). Runners were followed through rehabilitation to return-to-run using monthly surveys. Main outcome measures included kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11), Positive and Negative Affect Schedule (PANAS; Positive and negative scores), Lower Extremity Function Scale (LEFS), running recovery (University of Wisconsin Running Injury and Recovery Index [UWRI]) and CDC Healthy Days modules for general health, days of anxiety/tension, disrupted sleep and work/usual activities. Running biomechanics were assessed at baseline and the final visit using 3D motion capture and a force-plated treadmill. The time to return-to-running for was 5.0±3.1 and 7.9±4.1 months for L-Anx and H-Anx, respectively and participants who withdrew (n = 15) did so at 7.7±6.2 months. L-Anx maintained low anxiety and H-Anx reduced anxiety from baseline to final visit (STAI = 31.5 to 28.4 points, 50.4 to 37.8 points, respectively), whereas the withdrawn runners remained clinically anxious at their final survey (41.5 to 40.3 points; p < .05). Group by time interactions were found for PANAS positive, LEFS UWRI, general health scores, and days feeling worry, tension and anxiety (all p < .05). Final running performance in L-Anx compared to H-Anx was most improved with cadence (8.6% vs 3.5%; p = .044), impact loading rate [-1.9% vs +8.9%] and lower body stiffness [+14.1% vs +3.2%; all p < .05). High anxiety may identify runners who will experience a longer recovery process, health-related functional disruptions, and less optimization of gait biomechanics during rehabilitation after a lower extremity injury.


Assuntos
Transtornos de Ansiedade , Ansiedade , Humanos , Estudos Prospectivos , Placas Ósseas , Extremidade Inferior
11.
BMC Musculoskelet Disord ; 23(1): 1042, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36456951

RESUMO

BACKGROUND: Various clinical measures of static foot posture have been developed and used. However, consensus among clinical measures to classify foot posture remains to be established. Therefore, this study aimed to determine the level of agreement as a reliability component between two common clinical methods in asymptomatic adults: the normalised navicular height truncated (NNHt) and the Foot Posture Index-6 (FPI-6). METHODS: The NNHt and FPI-6 were conducted on 102 asymptomatic adults. The measurement sequence was randomly arranged for each participant. Weighted Kappa (Kw) was used to determine the agreement between the methods. RESULTS: Both the NNHt and FPI-6 achieved similar foot posture distributions: approximately 40-50% of the participants had a normal foot, approximately 40% had a pronated foot and approximately 10-20% had a supinated foot. The agreement between the methods to classify foot posture was excellent (Kw = 0.84). CONCLUSIONS: The present study found excellent agreement between two commonly used clinical measures. This finding highlights the NNHt and FPI-6 consensus for foot posture classification in asymptomatic adults.


Assuntos
, Extremidade Inferior , Adulto , Humanos , Reprodutibilidade dos Testes , Postura , Estatura
13.
Bone Joint J ; 104-B(12): 1284-1291, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36453038

RESUMO

Tumours of the sacrum are difficult to manage. The sacrum provides the structural connection between the torso and lower half of the body and is subject to both axial and rotational forces. Thus, tumours or their treatment can compromise the stability of the spinopelvic junction. Additionally, nerves responsible for lower limb motor groups as well as bowel, bladder, and sexual function traverse or abut the sacrum. Preservation or sacrifice of these nerves in the treatment of sacral tumours has profound implications on the function and quality of life of the patient. This annotation will discuss current treatment protocols for sacral tumours.Cite this article: Bone Joint J 2022;104-B(12):1284-1291.


Assuntos
Neoplasias , Sacro , Humanos , Qualidade de Vida , Pelve , Extremidade Inferior
14.
Ulus Travma Acil Cerrahi Derg ; 28(12): 1723-1730, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36453780

RESUMO

BACKGROUND: This study aimed to explore the relationship between the complications and clinical outcomes after intertrochanteric femoral fracture surgery, and the Singh index (SI), canal-calcar ratio (CCR), cortical thickness index (CTI), and canal flare index (CFI) - the radiological indices defining proximal femoral morphology in the literature - among patients over 60 years of age. METHODS: The data of 350 patients who were operated between 2015 and 2019 were evaluated retrospectively. The study included patients who underwent dual lag screw proximal femoral nailing and had good intraoperative reduction quality according to Fogagnolo's criteria. The relationships among radiological indices measured on radiographs acquired after trauma, and post-operative complications, Barthel activity index, and Harris hip score (HHS) were assessed statistically. RESULTS: Among 121 patients who met the study criteria, there were 63 (52.07%) female and 58 (47.93%) male patients. The mean length of follow-up was 37.09 (36-60) months. The patients had a mean age of 79.78 (60-97) years. At least one mechanical complication developed in 32 (26.4%) patients in the study group. No significant relationship could be established between radiological indices and post-operative complications (p>0.05). The relationship between SI and HHS was statistically significant (p<0.05). CCR, CTI, and CFI did not have a statistically significant relationship with and HHS (p>0.05). CONCLUSION: No statistically significant relationship could be established between radiological indices and post-operative complications. It should be considered that SI may be a parameter that affects clinical outcomes.


Assuntos
Fixação Intramedular de Fraturas , Fraturas do Quadril , Humanos , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Estudos Retrospectivos , Fêmur , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Extremidade Inferior , Fixação Intramedular de Fraturas/efeitos adversos , Complicações Pós-Operatórias/etiologia
15.
Ulus Travma Acil Cerrahi Derg ; 28(12): 1701-1707, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36453792

RESUMO

BACKGROUND: Cross leg free flaps are one of the salvage methods used for free tissue transfer in large tissue defects in the absence of recipient vessels. The fasciocutaneous flap above the posterior tibial artery can be harvested to protect the pedicle and to advance a distance to wound, which is equal to the length of fasciocutaneous flap. METHODS: Patients who were operated with cross leg free flap with the supporting fasciocutaneous flap on unwounded side were included in the study between years 2010 and 2020. Age, sex, location and size of the defects, arterial patencies, flap choices, fascio-cutaneous flap size, duration of operation, cross flap separation timing, complications, and time to return to work were evaluated. RESULTS: There were six patients with the etiology of high-energy electrical burns and trauma. There was only one arterial refilling for three patients and no refilling for others. Latissimus dorsi skin muscle flap was used in all but one patient. The mean defect size was 6.6×14.8 cm. The mean size of fasciocutaneous flaps was 4.08×5 cm. The mean operation time was 360 min. There was no complication except one dehiscence and one marginal necrosis and infection which were healed with wound care. Average time to return to work was 9 months. CONCLUSION: In similar cases, as wounded lower extremities with one or no artery refill, harvesting a fasciocutaneous flap with recipient vessels will be useful before considering the option of using a bridge free flap in medium to moderate sized defects.


Assuntos
Queimaduras por Corrente Elétrica , Retalhos de Tecido Biológico , Humanos , Artérias , Extremidade Inferior , Necrose
16.
Int Biomech ; 9(1): 33-41, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36414237

RESUMO

Gait asymmetry persists for most people after lower limb amputation and is associated with slower walking speeds. However, the relationship between gait asymmetry and patient-reported function remains unclear because they are not commonly assessed together. The purpose of this study was to determine relationships between gait asymmetries in people with lower limb loss and (1) patient-reported outcomes and (2) performance-based prosthetic functional measures. This cross-sectional analysis included nine people with unilateral limb loss aged 48.2 ± 13.1 years of mixed amputation etiology. Patient-reported outcomes included the Prosthetic Evaluation Questionnaire mobility subscale and Activities-specific Balance Confidence scale. Performance outcomes included the Berg Balance Scale and the 30-second sit-to-stand test. Walking performance measures included the 2-Minute Walk Test, during which APDM Opal sensors recorded spatiotemporal gait parameters, and daily step-counts from StepWatch4 activity monitors. The study found that the most asymmetric gait symmetry ratios (prosthetic-limb divided by intact-limb) could be attributed to prosthetic foot dorsiflexion-plantarflexion and rotation motion limitations: prosthetic-limb trailing double support (0.789 ± 0.052), toe-off (0.760 ± 0.068) and toe-out angle (0.653 ± 0.256). Single limb stance, and stance and swing phase durations were most strongly associated with balance and walking performance measures. Notably, no symmetry ratio was significantly associated with patient-reported prosthetic function (unadjusted Pearson correlation coefficients r < 0.50, P > 0.05). More gait symmetry was associated with better balance and walking performance but had no significant relationship with patient-reported function. Although achieving gait symmetry after lower limb loss is a common walking goal, symmetry was unrelated to the perception of functional mobility for people with lower limb loss.


Assuntos
Extremidade Inferior , Caminhada , Humanos , Estudos Transversais , Avaliação de Resultados em Cuidados de Saúde , Medidas de Resultados Relatados pelo Paciente
18.
Pediatr Rev ; 43(12): 704-713, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36450641
19.
J Appl Biomech ; 38(6): 424-433, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395764

RESUMO

Pain felt while performing rehabilitation exercises could be a reason for the low adherence of knee osteoarthritis patients to physical rehabilitation. Reducing compressive forces on the most affected knee regions may help to mitigate the pain. Knee frontal plane positioning with respect to pelvis and foot (functional knee alignment) has been shown to modify the mediolateral distribution of the tibiofemoral joint contact force in walking. Hence, different functional knee alignments could be potentially used to modify joint loading during rehabilitation exercises. The aim was to understand whether utilizing different alignments is an effective strategy to unload specific knee areas while performing rehabilitation exercises. Eight healthy volunteers performed 5 exercises with neutral, medial, and lateral knee alignment. A musculoskeletal model was modified for improved prediction of tibiofemoral contact forces and used to evaluate knee joint kinematics, moments, and contact forces. Functional knee alignment had only a small and inconsistent effect on the mediolateral distribution joint contact force. Moreover, the magnitude of tibiofemoral and patellofemoral contact forces, knee moments, and measured muscle activities was not significantly affected by the alignment. Our results suggest that altering the functional knee alignment is not an effective strategy to unload specific knee regions in physical rehabilitation.


Assuntos
Articulação do Joelho , Osteoartrite do Joelho , Humanos , Extremidade Inferior , Terapia por Exercício , Dor
20.
Sensors (Basel) ; 22(21)2022 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-36366025

RESUMO

There is a rapid increase in plantar pressure from the infant to toddler stage, yet little is known about the reasons for this change. More information about plantar pressure distribution can help clinicians identify early-stage foot-related diseases that may occur during transitions from childhood to adulthood. This information also helps designers create shoes that adapt to different needs. This research describes the development of a low-cost, built-in shoe plantar pressure measurement system that determines foot pressure distribution in toddlers. The study aimed to improve and provide data on pressure distribution during foot growth. This was accomplished by implementing a plantar pressure capacitive measurement system within shoes. The capacitive sensors were laminated using a copper tape sheet on plastic backing with adhesive, elastomer layers, and a combination of conductive and non-conductive fabrics. Constructed sensors were characterized using compression tests with repeated loads. Results demonstrated that the sensors exhibited rate-independent hysteresis in the estimation of pressure. This enabled a calibration model to be developed. The system can mimic more expensive plantar pressure measurement systems at lower fidelity. This emerging technology could be utilized to aid clinicians, researchers, and footwear designers interested in how pressure distribution changes from infants to toddlers.


Assuntos
Pé Diabético , Doenças do Pé , Humanos , Criança , Adolescente , Adulto Jovem , Sapatos , Pressão , , Extremidade Inferior
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