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1.
Medicine (Baltimore) ; 99(12): e19496, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195949

RESUMO

BACKGROUND: Dysmenorrhea seriously affects the ability of women to perform normal social activities and decreases their quality of life. Primary dysmenorrhea can be effectively treated with acupuncture. Based on the wrist-ankle acupuncture (WAA) theory, we designed a portable WAA point compression treatment strap that treats diseases by automatically applying pressure to acupuncture points. The proposed study aims to evaluate the immediate analgesic effect of the acupressure wrist-ankle strap in patients with primary dysmenorrhea. METHODS: The study will be a randomized controlled trial conducted from May 1, 2019 to May 30, 2020 that includes 78 students from Shanghai University of Traditional Chinese Medicine who have primary dysmenorrhea and meet the eligibility criteria. Participants will be randomly divided into 2 groups in a 1:1 allocation ratio. The intervention group will use the acupressure wrist-ankle strap equipped with tip compression component parts on the internal side; the control group will use the nonacupressure wrist-ankle strap with the tip compression parts removed. All participants will be treated for 30 minutes on the 1st day of menstruation. The primary outcome is the pain intensity score measured by the visual analog scale. The secondary outcomes are the onset time of analgesia, the pain threshold at Yinlingquan (SP 9), skin temperature at Guanyuan (CV 4), and expectations and satisfaction of patients as investigated via the expectation and treatment credibility scale. DISCUSSION: This trial will be the 1st study to evaluate the analgesic effect of the acupressure wrist-ankle strap in patients with primary dysmenorrhea. The quality of this study is ensured by the randomization, nonacupressure control, and blinded design. The results may provide evidence for a potential alternative treatment for primary dysmenorrhea and evidence-based proof of the analgesic effect of WAA.


Assuntos
Acupressão/efeitos adversos , Pontos de Acupuntura , Terapia por Acupuntura/métodos , Dismenorreia/terapia , Analgesia por Acupuntura/instrumentação , Analgesia por Acupuntura/estatística & dados numéricos , Adolescente , Adulto , Tornozelo , China/epidemiologia , Dismenorreia/epidemiologia , Dismenorreia/psicologia , Feminino , Humanos , Limiar da Dor , Satisfação do Paciente , Qualidade de Vida , Escala Visual Analógica , Punho , Adulto Jovem
2.
Instr Course Lect ; 69: 509-522, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017749

RESUMO

Numerous nerve disorders affect the foot and ankle, and specificity is essential for diagnosis. We review a systematic process to conduct a history and physical examination for nerve disorders and how to categorize these pathologies. Several common nerve-related pathologies of the foot and ankle are then described. Finally, we discuss systemic neurologic conditions which can cause symptoms in the foot and ankle. A vast array of treatment options exist for painful nerve lesions of the foot: both nonsurgical and surgical. Treatment options depend on the affected nerve's function and location within the foot. Essential nerves will be managed much differently than nonessential nerves. Also important to consider is whether this is the initial treatment, treatment following one recurrence, or treatment following multiple recurrences. After the proper diagnosis is made, consideration of these principles should allow for early and effective interventions to be made. Recalcitrant nerve conditions of the foot and ankle can represent a management challenge. As with primary nerve disorders, surgical management is warranted in cases where conservative management fails. Furthermore, patients may continue to experience neurologic complications or recurrence of symptoms even after surgical intervention, at which point further surgical procedures may be undertaken. Neurolysis, transection with or without containment, barrier procedures, and peripheral nerve stimulation are viable potential surgical options for patients with chronic or recurrent nerve pain, depending upon patient-specific underlying pathology.


Assuntos
Tornozelo , , Neuralgia/terapia , Articulação do Tornozelo , Humanos , Exame Físico
3.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(2): 173-178, 2020 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-32030947

RESUMO

Objective: To investigate the effectiveness of the Evans lateral lengthening calcaneal osteotomy (E-LLCOT) in treatment of talocalcaneal coalition (TCC) with hindfoot valgus deformity. Methods: Between January 2014 and October 2017, 10 patients (13 feet) of TCC with hindfoot valgus deformities underwent E-LLCOTs. There were 6 males (8 feet) and 4 females (5 feet) with an age of 13-18 years (mean, 15.8 years). The disease duration was 10-14 months (mean, 11.5 months). The foot deformity was characterized by hindfoot valgus, forefoot abduction, and collapse of the medial arch. Pain site was the tarsal sinus in 4 feet, TCC in 5 feet, and ankle joint in 4 feet. There were tightness of the gastrocnemius in 3 cases (4 feet) and Achilles tendon in 7 cases (9 feet) on Silverskiold test. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 46.54±9.08 and visual analogue scale (VAS) score was 6.54±0.88 after walking 1 kilometer. The AOFAS ankle-hindfoot score and VAS score were adopted to evaluate the postoperative function of the foot. The talar-first metatarsal angle (T1MT), talonavicular coverage angle (TCA), talar-horizontal angle (TH), calcaneal pitch angle (CP), and heel valgus angle (HV) were measured after operation. Results: All incisions healed by first intention. All patients were followed up 12-30 months (mean, 18 months). At last follow-up, the AOFAS ankle-hindfoot score and VAS score were 90.70±6.75 and 1.85±0.90, respectively, showing significant differences when compared with preoperative scores ( t=-23.380, P=0.000; t=35.218, P=0.000). X-ray films showed that the osteotomy healed at 2-4 months (mean, 3 months) after operation. At last follow-up, the T1MT, TCA, TH, and HV were significantly lower than preoperative ones ( P<0.05), and the CP was significantly higher than preoperative one ( P<0.05). During the follow-up, the pain did not relieve obviously in 1 patient (1 foot), and the cutaneous branch of the sural nerve injured in 1 patient (1 foot). Conclusion: For TCC with severe hindfoot valgus deformity, E-LLCOT can effectively correct deformity and relieve pain.


Assuntos
Calcâneo , Deformidades do Pé , Ossos do Metatarso , Adolescente , Tornozelo , Calcâneo/cirurgia , Feminino , Humanos , Masculino , Osteotomia , Resultado do Tratamento
4.
Bone Joint J ; 102-B(2): 205-211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009424

RESUMO

AIMS: To evaluate the donor site morbidity and tendon morphology after harvesting whole length, full-thickness peroneus longus tendon (PLT) proximal to the lateral malleolus for ligament reconstructions or tendon transfer. METHODS: A total of 21 eligible patients (mean age 34.0 years (standard deviation (SD) 11.2); mean follow-up period 31.8 months (SD 7.7), and 12 healthy controls (mean age, 26.8 years (SD 5.9) were included. For patients, clinical evaluation of the donor ankle was performed preoperatively and postoperatively. Square hop test, ankle strength assessment, and MRI of distal calf were assessed bilaterally in the final follow-up. The morphological symmetry of peroneal tendons bilaterally was evaluated by MRI in healthy controls. RESULTS: Among the patients, the mean pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Karlsson-Peterson score were 98.7 (SD 2.5; p = 0.480) and 98.5 (SD 2.4; p = 0.480), and 98.3 (SD 2.4; p = 0.162) and 97.9 (SD 2.5; p = 0.162), respectively. There was no significant difference between square hop test bilaterally (p = 0.109) and plantar flexion peak force bilaterally (p = 0.371). The harvested limb had significantly less eversion peak force compared to the contralateral limb (p < 0.001). Evidence of probable tendon regeneration was observed in all the patients by MRI and the total bilateral peroneal tendon index (mean ratio of harvested side cross-sectional area of peroneal tendon compared with the contralateral side) was 82.9% (SD 17.4). In 12 healthy controls, peroneal tendons (mean 99.4% (SD 4.3) were found to be morphologically symmetrical between the two sides. CONCLUSION: The current study showed satisfactory clinical foot and ankle outcomes after full-thickness PLT harvesting and indicated the regenerative potential of PLT after its removal. Level of Evidence: Level IV, therapeutic retrospective case series. Cite this article: Bone Joint J 2020;102-B(2):205-211.


Assuntos
Articulação do Tornozelo/fisiopatologia , Tornozelo/fisiopatologia , Pé/fisiopatologia , Ligamentos Articulares/fisiopatologia , Tendões/transplante , Sítio Doador de Transplante/fisiopatologia , Adulto , Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/diagnóstico por imagem , Feminino , Pé/diagnóstico por imagem , Humanos , Ligamentos Articulares/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos , Recuperação de Função Fisiológica , Regeneração , Estudos Retrospectivos , Transferência Tendinosa , Tendões/diagnóstico por imagem , Tendões/fisiologia , Coleta de Tecidos e Órgãos/métodos , Coleta de Tecidos e Órgãos/reabilitação , Sítio Doador de Transplante/diagnóstico por imagem , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
5.
Zhongguo Zhen Jiu ; 40(2): 147-51, 2020 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-32100499

RESUMO

OBJECTIVE: To observe the auxiliary analgesic effect of wrist-ankle acupuncture on patients undergoing transforaminal endoscope surgery. METHODS: A total of 64 patients with lumbar disc herniation who underwent percutaneous lateral transforaminal endoscope surgery were randomly divided into an observation group and a control group, 32 cases in each group. The patients in the control group were treated with injection of 1% lidocaine for routine local infiltration anesthesia. The patients in the observation group were treated with wrist-ankle acupuncture at lower 5 area and lower 6 area for 30 min, 5 min before routine local infiltration anesthesia; immediately, 15 min, 30 min after insertion the left-right technique, up-down technique, and rotation technique were applied for six times, respectively. The mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2) and pain visual analogue scale (VAS) were compared between the two groups at the time points of intraoperative puncture (T1), circular saw grinding (T2), and placement of working channel (T3). The intention of reoperation was recorded immediately after operation and 24 h after operation. The expectation and treatment credibility scale (ETCS) was used to evaluate the relationship between patients' expectation and efficacy 5 min before operation and immediately after operation. RESULTS: At T2 and T3 during the operation, the MAP and HR in the obserrvation group were lower than those in the control group, while SpO2 was higher than that in the control group (P<0.05). At T1, there was no significant difference of MAP, HR and SpO2 between the two groups (P>0.05). At T2, the peak VAS and average VAS in the observation group were lower than those in the control group (P<0.05), but there was no significant difference at T1 and T3 (P>0.05). The intention of reoperation in the observation group was higher than that in the control group both immediately after operation and 24 h after operation (P<0.05). In the observation group, the scores of each item in ETCS immediately after operation were higher than those 5 min before operation (P<0.05), while in the control group there was no significant difference between immediately after operation and 5 min before operation (P>0.05). The scores of ETCS1, ETCS2 and ETCS3 immediately after operation in the observation group were higher than those in the control group (P<0.05). CONCLUSION: The wrist-ankle acupuncture has positive auxiliary analgesic effect on lumbago during transforaminal endoscope surgery, and strengthens the patients' confidence on the operation effect.


Assuntos
Analgesia por Acupuntura , Tornozelo , Endoscopia , Punho , Analgésicos , Humanos , Coluna Vertebral/cirurgia
7.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(1): 46-52, 2020 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-31939234

RESUMO

Objective: To investigate the effectiveness of arthroscopic talocalcaneal coalition resection in painful adults via a modified posterior approach. Methods: Between January 2015 and December 2017, 9 patients with painful talocalcaneal coalition accepted arthroscopic resection via the posterior malleolus high lateral observation approach combined with the lower medial operation approach. Of them, 6 were male and 3 were female, aged from 19 to 30 years (mean, 24 years). Among them, 2 cases had no definite local trauma and 7 cases had a history of sprain of foot and ankle. The disease duration ranged from 6 to 30 months, with a median of 12 months. Rozansky classification of talocalcaneal coalition for the 9 patients: 5 cases (5 feet) were type Ⅰ, 2 cases (2 feet) type Ⅱ, and 2 cases (2 feet) type Ⅲ. The patients had no sequelae of limb dysfunction and no limb joint surgery in the past. All the patients received anteroposterior and lateral X-ray films and CT scans of the ankle joint during follow-up. The visual analogue scale (VAS) score and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot score were used to evaluate the effectiveness. Results: The operation time was 60-90 minutes (mean, 76 minutes). All patients were followed up 12-24 months (mean, 18 months). All the incisions healed by first intention, without infection, skin necrosis, lower extremity deep vein thrombosis, vascular nerve and tendon injury, bone bridge recurrence, and other complications. The ankle function recovered well and the pain was relieved obviously after operation, and the patients returned to work at 3-5 months after operation, with an average of 3.9 months. At last follow-up, the VAS score was 0.7±0.5, which was significantly improved ( t=20.239, P=0.000) when compared with preoperative score (4.2±0.5); the AOFAS ankle-hind foot score was 94±4, which was significantly improved ( t=-27.424, P=0.000) when compared with preoperative score (62±2). According to AOFAS ankle-hindfoot scoring system, the results were excellent in 7 cases and good in 2 cases at last follow-up. Conclusion: It is more intuitive, more space, and more flexibility for operation via the modified posterior malleolus high lateral observation approach combined with the lower medial operation approach in talocalcaneal coalition. It is feasible to remove talocalcaneal coalition programmatically according to the specific anatomic signs during the operation.


Assuntos
Dor , Ossos do Tarso , Adulto , Tornozelo , Articulação do Tornozelo , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto Jovem
8.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(1): 87-91, 2020 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-31939241

RESUMO

Objective: To investigate the clinical application of the anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap in repair of foot and ankle defects. Methods: Between October 2014 and October 2018, 18 cases with foot and ankle defects were treated. There were 12 males and 6 females with an average age of 32.8 years (range, 8-56 years). There were 11 cases of traffic accident injuries, 3 cases of falling from height injuries, and 4 cases of heavy objects injuries. The wound was at the dorsum of the foot in 9 cases, the heel in 4 cases, the lateral malleolus in 5 cases. The time from injury to flap repair was 7-34 days (mean, 19 days). The size of wound ranged from 6.0 cm×2.5 cm to 11.0 cm×6.0 cm. The foot and ankle defects were repaired with the peroneal artery terminal perforator propeller flap in size of 6 cm×3 cm-18 cm×7 cm, which donor site was repaired with the anterior tibial artery perforator propeller flap in size of 8 cm×3 cm-16 cm×6 cm. Results: One patient had a hemorrhagic swelling in the peroneal artery terminal perforator propeller flap, and survived after symptomatic treatment. All recipient and donor sites healed by first intention. Eighteen patients were followed up 6-15 months (mean, 12.5 months). At last follow-up, the shape, color, texture, and thickness of the flaps in the donor sites were similar with those in the recipient sites. There were only linear scars on the donor sites. The two-point discrimination of the peroneal artery terminal perforator propeller flap ranged from 10 to 12 mm (mean, 11 mm). According to American Orthopaedic Foot and Ankle Society (AOFAS) score criteria, the results were excellent in 15 cases and good in 3 cases, with an excellent and good rate of 100%. Conclusion: The foot and ankle defects can be repaired with the anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap. The procedure is not sacrificing the main vessel and can avoid the skin grafting and obtain the good ankle function.


Assuntos
Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles , Adolescente , Adulto , Tornozelo , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Pele , Artérias da Tíbia , Resultado do Tratamento , Adulto Jovem
9.
Oper Orthop Traumatol ; 32(1): 29-34, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31940050

RESUMO

OBJECTIVE: The so-called ankle block represents a local anesthesia form which enables easy performance of all surgical procedures of the foot and ankle. INDICATIONS: Interventions distal to the medial and lateral malleoli. CONTRAINDICATIONS: Acute and chronic infections in the area of injection; allergy to the local anesthesia. SURGICAL TECHNIQUE: All five sensory foot nerves are blocked. The two deep lying nerves, the tibial nerve and the deep fibular nerve, can be directly anesthetized perineurally using anatomical landmarks. The other three nerves are subcutaneously infiltrated near their branches. RESULTS: The success rate ranges from 88 to 94%; smaller areas may also be further blocked intraoperatively. The ankle block is a cost-effective procedure which can also be performed without problems in multimorbid patients due to its minor side effects.


Assuntos
Tornozelo , Bloqueio Nervoso , Tornozelo/inervação , Tornozelo/cirurgia , , Humanos , Nervo Tibial , Resultado do Tratamento
10.
Insect Biochem Mol Biol ; 116: 103260, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31682920

RESUMO

Most moths utilize sex pheromones released by the female to attract a mate. Females produce the sex pheromone in the pheromone gland in a biosynthetic pathway which consists of several key enzymes. Fatty acyl-CoA reductase is one of the key enzymes, which catalyzes the conversion of fatty acyl-CoA to the corresponding alcohol, playing an important role in producing the final proportion of each pheromone component. In Helicoverpa zea, (Z)-11-hexadecenal is the major sex pheromone component in female pheromone glands and previously a large amount of hexadecanal was also found in female and male tarsi. In our previous study, we compared the transcriptome between pheromone glands and tarsi and found 20 fatty acyl-CoA reductases in both tissues. In this study, we functionally characterized four FARs which were expressed at high levels according to the transcriptome of pheromone glands and tarsi. Fatty acyl-CoA reductase 1 was homologous to other moth pheromone gland specific fatty acyl-CoA reductases, and it was also present in male tarsi. Functional expression in yeast cells indicates that only fatty acyl-CoA reductase 1 was able to produce fatty alcohols. In addition, a decreased mRNA level of fatty acyl-CoA reductase 1 in female pheromone glands and male tarsi by RNAi knockdown caused a significant decrease in the production of (Z)-11-hexadecenal in pheromone glands and hexadecanal in male tarsi. This study is the first to demonstrate the direct function of a fatty acyl-CoA reductase in male tarsi and also confirms its role in sex pheromone biosynthesis in H. zea.


Assuntos
Aldeído Oxirredutases/genética , Proteínas de Insetos/genética , Mariposas/metabolismo , Aldeído Oxirredutases/química , Aldeído Oxirredutases/metabolismo , Aldeídos/metabolismo , Sequência de Aminoácidos , Animais , Tornozelo , Glândulas Exócrinas/química , Feminino , Proteínas de Insetos/química , Proteínas de Insetos/metabolismo , Larva/crescimento & desenvolvimento , Larva/metabolismo , Masculino , Mariposas/crescimento & desenvolvimento , Filogenia , Alinhamento de Sequência , Atrativos Sexuais/biossíntese , Transcriptoma
11.
J Sports Sci ; 38(1): 100-105, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31638481

RESUMO

A common practice in resistance training is to perform sets of exercises at, or close to failure, which can alter movement dynamics. This study examined ankle, knee, hip, and lumbo-pelvis dynamics during the barbell back squat under a moderate-heavy load (80% of 1 repetition maximum (1RM)) when performed to failure. Eleven resistance trained males performed three sets to volitional failure. Sagittal plane movement dynamics at the ankle, knee, hip, and lumbo-pelvis were examined; specifically, joint moments, joint angles, joint angular velocity, and joint power. The second repetition of the first set and the final repetition of the third set were compared. Results showed that while the joint movements slowed (p < 0.05), the joint ranges of motion were not altered There were significant changes in most mean joint moments (p < 0.05), indicating altered joint loading. The knee moment decreased while the hip and lumbo-pelvis moments underwent compensatory increases. At the knee and hip, there were significant decreases (p < 0.05) in concentric power output (p < 0.05). Whilst performing multiple sets to failure altered some joint kinetics, the comparable findings in joint range ofmotion suggest that technique was not altered. Therefore, skilled individuals appear to maintain technique when performing to failure.


Assuntos
Extremidade Inferior/fisiologia , Região Lombossacral/fisiologia , Pelve/fisiologia , Treinamento de Resistência/métodos , Levantamento de Peso/fisiologia , Adulto , Tornozelo/fisiologia , Fenômenos Biomecânicos , Quadril/fisiologia , Humanos , Joelho/fisiologia , Masculino , Análise e Desempenho de Tarefas , Adulto Jovem
12.
J Sports Sci ; 38(3): 336-342, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31795818

RESUMO

A decrease in speed when sprinting on the bend compared with the straight has been attributed to kinetic, kinematic and spatiotemporal modifications. Although maximal speed is dependent on an athlete's ability to accelerate, there is limited research investigating the acceleration phase of bend sprinting. This study used a lower limb and trunk marker set with 15 optoelectronic cameras to examine kinematic and spatiotemporal variables of the lower limb during sprinting on the bend and straight. Nine sprinters completed up to six 30 m maximal effort trials in bend (radius 36.5 m, lane one) and straight conditions. An increase in body lateral lean at touchdown resulted in a number of asymmetric kinematic modifications. Whilst the left limb demonstrated a greater peak hip adduction, peak hip internal rotation and peak ankle eversion on the bend compared with the straight, the right limb was characterised by an increase in peak hip abduction. These results demonstrate that kinematic modifications start early in the race and likely accumulate, resulting in greater modifications at maximal speed. It is recommended that strength and conditioning programmes target the hip, ankle and foot in the non-sagittal planes. In addition, sprint training should prioritise specificity by occurring on the bend.


Assuntos
Extremidade Inferior/fisiologia , Corrida/fisiologia , Atletismo/fisiologia , Aceleração , Tornozelo/fisiologia , Fenômenos Biomecânicos , Pé/fisiologia , Quadril/fisiologia , Humanos , Joelho/fisiologia , Postura/fisiologia , Rotação , Estudos de Tempo e Movimento , Adulto Jovem
13.
Comput Methods Biomech Biomed Engin ; 23(2): 43-53, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31809575

RESUMO

Biomechanical behavior of ankle ligaments varies among individuals, with the underlying mechanism at multiple scales remaining unquantified. The present probabilistic study investigated how population variability in ligament material properties would influence the joint mechanics. A previously developed finite element ankle model with parametric ligament properties was used. Taking the typical external rotation as example loading scenario, joint stability of the investigated population was consistently shared by specific ligaments within a narrow tolerance range, i.e. 62.8 ± 8.2 Nm under 36.1 ± 5.7° foot rotation. In parallel, the inherent material variability significantly alters the consequent injury patterns. Three most vulnerable ligaments and the consequent rupture sequences were identified, with the structural weak spot and the following progressive stability loss dominated by the relative stiffness among ligaments. This study demonstrated the feasibility of biofidelic models in investigating individual difference at the material level, and emphasized the importance of probabilistic description of individual difference when identifying the injury mechanism of a broad spectrum.


Assuntos
Tornozelo/fisiologia , Simulação por Computador , Ligamentos Articulares/fisiologia , Fenômenos Biomecânicos , Humanos , Modelos Biológicos , Probabilidade , Rotação , Torque
14.
Sports Biomech ; 19(2): 157-167, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29781789

RESUMO

External supports that reduce ankle joint mobility such as ski-boots can impair postural control of healthy participants. Although this disruptive effect has been attributed to the rigidity of the external supports, the results remained controversial and no study has been conducted in order to evaluate the influence of ski-boots rigidity. Hence, the question about the influence of ankle support rigidity on postural control remains open. This study was therefore undertaken in order to investigate the effect of ski-boots rigidity on postural control. Ten healthy active participants were recruited. The wearing of soft and rigid ski-boots was compared to barefoot while standing on a seesaw generating mediolateral and anteroposterior instability. Centre of pressure displacements were sampled with a force platform. The surface electromyographic activity of the main muscles from the leg, thigh and trunk was recorded. A motion analysis system was also used to calculate the ankle, knee and hip angles. The results did not reveal any negative influence of ski-boot rigidity on postural control but rather suggest a less active postural control with the rigid ski-boots which offered a higher mechanical contribution.


Assuntos
Equilíbrio Postural/fisiologia , Sapatos , Esqui/fisiologia , Equipamentos Esportivos , Adolescente , Tornozelo/fisiologia , Fenômenos Biomecânicos , Eletromiografia , Desenho de Equipamento , Feminino , Quadril/fisiologia , Humanos , Joelho/fisiologia , Masculino , Movimento/fisiologia , Músculo Esquelético/fisiologia , Estudos de Tempo e Movimento , Adulto Jovem
15.
Muscle Nerve ; 61(1): 52-57, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31588574

RESUMO

INTRODUCTION: Loss of ambulation in Duchenne muscular dystrophy presages scoliosis, respiratory failure, and death. Strategies to maintain ankle range of motion are employed, but little evidence exists to support these approaches and limited information is available concerning current practice. METHODS: In this study we assessed baseline bracing data from 187 boys participating in a multicenter, international clinical trial. RESULTS: Ankle-foot orthoses (AFOs) were recommended for 54% of the boys, with nighttime static AFOs and nighttime dynamic AFOs utilized in 94% and 6% of these boys, respectively. Daytime static AFOs were recommended for 3 boys. Compliance with bracing recommendations was 54% for nighttime static braces and 67% for nighttime dynamic braces. DISCUSSION: The basis for the variation in recommended AFO use is unknown and requires further study. Long-term follow-up of boys may permit assessment of the effects of AFO use.


Assuntos
Tornozelo , Braquetes , Distrofia Muscular de Duchenne/reabilitação , Distrofia Muscular de Duchenne/terapia , Articulação do Tornozelo , Criança , Pré-Escolar , Método Duplo-Cego , , Humanos , Masculino , Aparelhos Ortopédicos , Cooperação do Paciente , Modalidades de Fisioterapia , Amplitude de Movimento Articular , Resultado do Tratamento , Caminhada
16.
Orthop Clin North Am ; 51(1): 121-130, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739875

RESUMO

Peroneal tendon pathology is becoming an increasingly recognized source of lateral-sided ankle pain. High clinical suspicion, along with judicious physical examination coupled with confirmatory advanced imaging modalities, are necessary to make an accurate diagnosis and aid in guiding treatment. Peroneal pathology encompasses several distinct conditions. Peroneal tendon tears and injuries to the peroneal retinaculum must be identified to guide treatment. Patients with peroneal pathology report high levels of satisfaction after surgical management with most returning to their preinjury level of function. An early and accurate diagnosis, along with treatment tailored to the individual, is necessary to obtain optimal outcomes.


Assuntos
Traumatismos do Tornozelo/cirurgia , Traumatismos dos Tendões/cirurgia , Transferência Tendinosa/métodos , Tendões/cirurgia , Tornozelo/anatomia & histologia , Tornozelo/diagnóstico por imagem , Tornozelo/patologia , Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos do Tornozelo/patologia , Fenômenos Biomecânicos , Cadáver , Humanos , Incidência , Instabilidade Articular/epidemiologia , Instabilidade Articular/etiologia , Instabilidade Articular/cirurgia , Imagem por Ressonância Magnética , Medidas de Resultados Relatados pelo Paciente , Radiografia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Ruptura , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/patologia , Tendões/anatomia & histologia , Tendões/patologia
17.
J Sports Sci ; 38(5): 503-510, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31865845

RESUMO

Accelerometer cut points are an important consideration for distinguishing the intensity of activity into categories such as moderate and vigorous. It is well-established in the literature that these cut points depend on a variety of factors, including age group, device, and wear location. The Actigraph GT9X is a newer model accelerometer that is used for physical activity research, but existing cut points for this device are limited since it is a newer device. Furthermore, there is not existing data on cut points for the GT9X at the ankle or foot locations, which offers some potential benefit for activities that do not involve arm and/or core motion. A total of N = 44 adults completed a four-stage treadmill protocol while wearing Actigraph GT9X sensors at four different locations: foot, ankle, wrist, and hip. Metabolic Equivalent of Task (MET) levels assessed by indirect calorimetry along with Receiver Operating Characteristic (ROC) curves were used to establish cut points for moderate and vigorous intensity for each wear location of the GT9X. Area under the ROC curves indicated high discrimination accuracy for each case.


Assuntos
Actigrafia/instrumentação , Actigrafia/estatística & dados numéricos , Exercício/fisiologia , Monitores de Aptidão Física/estatística & dados numéricos , Acelerometria/instrumentação , Acelerometria/estatística & dados numéricos , Adulto , Tornozelo , Calorimetria Indireta , Teste de Esforço , Feminino , , Quadril , Humanos , Masculino , Curva ROC , Valores de Referência , Punho
18.
Rev Med Suisse ; 15(675): 2274-2277, 2019 Dec 11.
Artigo em Francês | MEDLINE | ID: mdl-31840954

RESUMO

Total ankle prosthesis is increasingly recognized in the management of severe osteoarthritis and has established itself as a valid alternative to arthrodesis. However, this procedure remains delicate, indications must be targeted, and the complex surgical technique requires specific expertise from the surgeon. In recent years, ankle arthroplasty has undergone a major expansion, with improvements in design and surgical techniques. New technologies have also emerged, offering tailor-made planning and instrumentation possibilities. The influence of these techniques on long-term results has yet to be demonstrated, but benefits such as reduced operating time and improved surgical accuracy are interesting. The purpose of this article is to provide an update on ankle prosthesis in the treatment of ankle osteoarthritis.


Assuntos
Artroplastia de Substituição do Tornozelo , Prótese Articular , Tornozelo , Articulação do Tornozelo , Resultado do Tratamento
19.
Anticancer Res ; 39(11): 6175-6181, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704845

RESUMO

BACKGROUND/AIM: Acral lentiginous melanoma (ALM) is a rare entity on the foot. This study aimed to reveal its clinical presentations, histopathology and treatment options. MATERIALS AND METHODS: Seven cases of ALM involving foot were treated in our Institute in a 3-year period. RESULTS: The patients' age ranged from 38 to 84 years, with a mean of 65. The ratios of males to females and white to non-white were 4:3 and 5:2, respectively. Clinically, ALM presented as asymmetric, irregular shaped, black-brown, variegatedly discolored, papular, verrucoid, ulcerated or nodular lesions with or without pain. All ALMs were treated with either wide local excision (WLE) or toe amputation. Histologically, ALM was characterized by multiple single and nested atypical melanocytes growing along the dermal-epidermal junction, and extending into dermal layer in nodular growth pattern. CONCLUSION: ALM is a rare, asymmetric, irregularly bordered, variegatedly pigmented lesion. WLE or toe amputation is the standard treatment option.


Assuntos
Tornozelo/patologia , Doenças do Pé/patologia , Melanoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Tornozelo/cirurgia , Feminino , Seguimentos , Doenças do Pé/cirurgia , Humanos , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Nevo/cirurgia , Prognóstico , Neoplasias Cutâneas/cirurgia
20.
J Am Podiatr Med Assoc ; 109(4): 312-316, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31762307

RESUMO

Compartment syndromes associated with arthroscopy have been rarely reported. Compartment syndrome after knee arthroscopy has been reported in some case reports, whereas we could find only one case report of acute compartment syndrome following ankle arthroscopy after Maisonneuve fracture. However, there has been no previous report of a case of acute compartment syndrome after ankle arthroscopy in an atraumatic patient. In this article, we present a case of acute compartment syndrome during ankle arthroscopic procedures in an atraumatic patient.


Assuntos
Articulação do Tornozelo/diagnóstico por imagem , Artroscopia/efeitos adversos , Síndromes Compartimentais/etiologia , Cistos Glanglionares/cirurgia , Instabilidade Articular/cirurgia , Complicações Pós-Operatórias/etiologia , Adulto , Tornozelo/diagnóstico por imagem , Cistos Glanglionares/diagnóstico por imagem , Humanos , Instabilidade Articular/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino
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