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1.
Sensors (Basel) ; 23(2)2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36679418

RESUMO

Wearable devices have been shown to play an important role in disease prevention and health management, through the multimodal acquisition of peripheral biosignals. However, many of these wearables are exposed, limiting their long-term acceptability by some user groups. To overcome this, a wearable smart sock integrating a PPG sensor and an EDA sensor with textile electrodes was developed. Using the smart sock, EDA and PPG measurements at the foot/ankle were performed in test populations of 19 and 15 subjects, respectively. Both measurements were validated by simultaneously recording the same signals with a standard device at the hand. For the EDA measurements, Pearson correlations of up to 0.95 were obtained for the SCL component, and a mean consensus of 69% for peaks detected in the two locations was obtained. As for the PPG measurements, after fine-tuning the automatic detection of systolic peaks, the index finger and ankle, accuracies of 99.46% and 87.85% were obtained, respectively. Moreover, an HR estimation error of 17.40±14.80 Beats-Per-Minute (BPM) was obtained. Overall, the results support the feasibility of this wearable form factor for unobtrusive EDA and PPG monitoring.


Assuntos
Resposta Galvânica da Pele , Dispositivos Eletrônicos Vestíveis , Humanos , Fotopletismografia/métodos , Estudos de Viabilidade , , Frequência Cardíaca
2.
Sensors (Basel) ; 23(2)2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36679552

RESUMO

Diabetes mellitus presents a high prevalence around the world. A common and long-term derived complication is diabetic foot ulcers (DFUs), which have a global prevalence of roughly 6.3%, and a lifetime incidence of up to 34%. Infrared thermograms, covering the entire plantar aspect of both feet, can be employed to monitor the risk of developing a foot ulcer, because diabetic patients exhibit an abnormal pattern that may indicate a foot disorder. In this study, the publicly available INAOE dataset composed of thermogram images of healthy and diabetic subjects was employed to extract relevant features aiming to establish a set of state-of-the-art features that efficiently classify DFU. This database was extended and balanced by fusing it with private local thermograms from healthy volunteers and generating synthetic data via synthetic minority oversampling technique (SMOTE). State-of-the-art features were extracted using two classical approaches, LASSO and random forest, as well as two variational deep learning (DL)-based ones: concrete and variational dropout. Then, the most relevant features were detected and ranked. Subsequently, the extracted features were employed to classify subjects at risk of developing an ulcer using as reference a support vector machine (SVM) classifier with a fixed hyperparameter configuration to evaluate the robustness of the selected features. The new set of features extracted considerably differed from those currently considered state-of-the-art but provided a fair performance. Among the implemented extraction approaches, the variational DL ones, particularly the concrete dropout, performed the best, reporting an F1 score of 90% using the aforementioned SVM classifier. In comparison with features previously considered as the state-of-the-art, approximately 15% better performance was achieved for classification.


Assuntos
Diabetes Mellitus , Pé Diabético , Humanos , Pé Diabético/diagnóstico ,
3.
PLoS One ; 18(1): e0277971, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36649238

RESUMO

BACKGROUND: In-shoe pressure measurement systems are used in research and clinical practice to quantify areas and levels of pressure underfoot whilst shod. Their validity and reliability across different pressures, durations of load and contact areas determine their appropriateness to address different research questions or clinical assessments. XSENSOR is a relatively new pressure measurement device and warrants assessment. RESEARCH QUESTION: Does the XSENSOR in-shoe pressure measurement device have sufficient validity and reliability for clinical assessments in diabetes? METHODS: Two XSENSOR insoles were examined across two days with two lab-based protocols to assess regional and whole insole loading. The whole insole protocol applied 50-600 kPa of pressure across the insole surface for 30 seconds and measured at 0, 2, 10 and 30 seconds. The regional protocol used two (3.14 and 15.9 cm2 surface area) cylinders to apply pressures of 50, 110 and 200 kPa to each insole. Three trials of all conditions were averaged. The validity (% difference and Root Mean Square Error: RMSE) and repeatability (Bland Altman, Intra-Class Correlation Coefficient: ICC) of the target pressures (whole insole) and contact area (regional) were outcome variables. RESULTS: Regional results demonstrated mean contact area errors of less than 1 cm2 for both insoles and high repeatability (≥0.939). Whole insole measurement error was higher at higher pressures but resulted in average peak and mean pressures error < 10%. Reliability error was 3-10% for peak pressure, within the 15% defined as an analytical goal. SIGNIFICANCE: Errors associated with the quantification of pressure are low enough that they are unlikely to influence the assessments of interventions or screening of the at-risk-foot considering clinically relevant thresholds. Contact area is accurate due to a high spatial resolution and the repeatability of the XSENSOR system likely makes it appropriate for clinical applications that require multiple assessments.


Assuntos
Diabetes Mellitus , Sapatos , Humanos , Reprodutibilidade dos Testes , Pressão , , Desenho de Equipamento
4.
PeerJ ; 11: e14341, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36643633

RESUMO

Background: Studies on motor unit behaviour with varying rates of force development have focussed predominantly on comparisons between slow and ballistic (i.e., very fast) contractions. It remains unclear how motor units respond to less extreme changes in rates of force development. Here, we studied a small intrinsic foot muscle, flexor hallucis brevis (FHB) where the aim was to compare motor unit discharge rates and recruitment thresholds at two rates of force development. We specifically chose to investigate relatively slow to moderate rates of force development, not ballistic, as the chosen rates are more akin to those that presumably occur during daily activity. Methods: We decomposed electromyographic signals to identify motor unit action potentials obtained from indwelling fine-wire electrodes in FHB, from ten male participants. Participants performed isometric ramp-and-hold contractions from relaxed to 50% of a maximal voluntary contraction. This was done for two rates of force development; one with the ramp performed over 5 s (slow condition) and one over 2.5 s (fast condition). Recruitment thresholds and discharge rates were calculated over the ascending limb of the ramp and compared between the two ramp conditions for matched motor units. A repeated measures nested linear mixed model was used to compare these parameters statistically. A linear repeated measures correlation was used to assess any relationship between changes in recruitment threshold and mean discharge rate between the two conditions. Results: A significant increase in the initial discharge rate (i.e., at recruitment) in the fast (mean: 8.6 ±  2.4 Hz) compared to the slow (mean: 7.8 ± 2.3 Hz) condition (P = 0.027), with no changes in recruitment threshold (P = 0.588), mean discharge rate (P = 0.549) or final discharge rate (P = 0.763) was observed. However, we found substantial variability in motor unit responses within and between conditions. A small but significant negative correlation (R2 = 0.33, P = 0.003) was found between the difference in recruitment threshold and the difference in mean discharge rate between the two conditions. Conclusion: These findings suggest that as force increases for contractions with slower force development, increasing the initial discharge rate of recruited motor units produces the increase in rate of force development, without a change in their recruitment thresholds, mean or final discharge rate. However, an important finding was that for only moderate changes in rate of force development, as studied here, not all units respond similarly. This is different from what has been described in the literature for ballistic contractions in other muscle groups, where all motor units respond similarly to the increase in neural drive. Changing the discharge behaviour of a small group of motor units may be sufficient in developing force at the required rate rather than having the discharge behaviour of the entire motor unit pool change equally.


Assuntos
Neurônios Motores , Contração Muscular , Humanos , Masculino , Contração Muscular/fisiologia , Neurônios Motores/fisiologia , Músculo Esquelético/fisiologia ,
5.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(1): 62-67, Ene-Feb. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-214357

RESUMO

Antecedentes y objetivos: En el desarrollo del pie plano valgo adquirido del adulto ha cobrado gran importancia el fallo de la columna medial, y no tanto la rotura del tibial posterior, siendo principalmente la lesión del ligamento en hamaca calcaneonavicular (spring ligament) el determinante del desarrollo de esta deformidad. Nuestro objetivo es analizar los resultados clínico-radiológicos de la reparación del ligamento en hamaca y valorar la utilidad e integración de las cuñas de titanio poroso en las osteotomías a las que se asocia la reparación ligamentosa. Material y métodos: Realizamos un estudio retrospectivo de 23 casos con una edad media de 63 años, diagnosticados de pie plano valgo adquirido del adulto estadio IIB de la clasificación RAM tras fallo de tratamiento ortoprotésico, valorando los resultados clínicos mediante la escala de la American Orthopaedic Foot and Ankle Society y los resultados radiológicos pre- y postoperatorios basándose en la variación de los ángulos estudiados (cobertura talonavicular y ángulo talar - 1.° metatarsiano en la proyección dorsoplantar y línea de Meary en la proyección lateral). Resultados: Los puntuación media en escala de la American Orthopaedic Foot and Ankle Society pasó de 52±10 preoperatorio a 88±6 (p<0,05). En cuanto a los resultados radiológicos, se demostró una mejoría estadísticamente significativa (p<0,05) en la variación de los ángulos en el postoperatorio. Conclusiones: La reparación de los estabilizadores mediales, asociada a técnicas óseas ofrece excelentes resultados clínico-radiológicos en el tratamiento del pie plano valgo adquirido del adulto estadio IIB.Además, las cuñas de titanio poroso presentan una adecuada integración, evitando los problemas de pinzamiento de los peroneos asociada al uso de placas y la necesidad posterior de retirada.(AU)


Background and aims: The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies. Material and methods: We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis). Results: The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement. Conclusion: Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pé Chato , Deformidades do Pé , Pé/cirurgia , Estudos Retrospectivos
6.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(1): T62-T67, Ene-Feb. 2023. ilus
Artigo em Inglês | IBECS | ID: ibc-214358

RESUMO

Background and aims: The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies. Material and methods: We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis). Results: The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement. Conclusion: Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.(AU)


Antecedentes y objetivos: En el desarrollo del pie plano valgo adquirido del adulto ha cobrado gran importancia el fallo de la columna medial, y no tanto la rotura del tibial posterior, siendo principalmente la lesión del ligamento en hamaca calcaneonavicular (spring ligament) el determinante del desarrollo de esta deformidad. Nuestro objetivo es analizar los resultados clínico-radiológicos de la reparación del ligamento en hamaca y valorar la utilidad e integración de las cuñas de titanio poroso en las osteotomías a las que se asocia la reparación ligamentosa. Material y métodos: Realizamos un estudio retrospectivo de 23 casos con una edad media de 63 años, diagnosticados de pie plano valgo adquirido del adulto estadio IIB de la clasificación RAM tras fallo de tratamiento ortoprotésico, valorando los resultados clínicos mediante la escala de la American Orthopaedic Foot and Ankle Society y los resultados radiológicos pre- y postoperatorios basándose en la variación de los ángulos estudiados (cobertura talonavicular y ángulo talar - 1.° metatarsiano en la proyección dorsoplantar y línea de Meary en la proyección lateral). Resultados: Los puntuación media en escala de la American Orthopaedic Foot and Ankle Society pasó de 52±10 preoperatorio a 88±6 (p<0,05). En cuanto a los resultados radiológicos, se demostró una mejoría estadísticamente significativa (p<0,05) en la variación de los ángulos en el postoperatorio. Conclusiones: La reparación de los estabilizadores mediales, asociada a técnicas óseas ofrece excelentes resultados clínico-radiológicos en el tratamiento del pie plano valgo adquirido del adulto estadio IIB.Además, las cuñas de titanio poroso presentan una adecuada integración, evitando los problemas de pinzamiento de los peroneos asociada al uso de placas y la necesidad posterior de retirada.(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pé Chato , Deformidades do Pé , Pé/cirurgia , Estudos Retrospectivos
7.
Sensors (Basel) ; 23(1)2023 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-36617087

RESUMO

Fall detection and physical activity (PA) classification are important health maintenance issues for the elderly and people with mobility dysfunctions. The literature review showed that most studies concerning fall detection and PA classification addressed these issues individually, and many were based on inertial sensing from the trunk and upper extremities. While shoes are common footwear in daily off-bed activities, most of the aforementioned studies did not focus much on shoe-based measurements. In this paper, we propose a novel footwear approach to detect falls and classify various types of PAs based on a convolutional neural network and recurrent neural network hybrid. The footwear-based detections using deep-learning technology were demonstrated to be efficient based on the data collected from 32 participants, each performing simulated falls and various types of PAs: fall detection with inertial measures had a higher F1-score than detection using foot pressures; the detections of dynamic PAs (jump, jog, walks) had higher F1-scores while using inertial measures, whereas the detections of static PAs (sit, stand) had higher F1-scores while using foot pressures; the combination of foot pressures and inertial measures was most efficient in detecting fall, static, and dynamic PAs.


Assuntos
, Redes Neurais de Computação , Humanos , Idoso , Pressão , Exercício Físico , Sapatos
8.
J R Soc Interface ; 20(198): 20220758, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36651181

RESUMO

Modern human feet are considered unique among primates in their capacity to transmit propulsive forces and re-use elastic energy. Considered central to both these capabilities are their arched configuration and the plantar aponeurosis (PA). However, recent evidence has shown that their interactions are not as simple as proposed by the theoretical and mechanical models that established their significance. Using three-dimensional foot scans and statistical shape and deformation modelling, we show that the shape of the longitudinal and transverse arches varies widely among the healthy adult population, and that the former is subject to load-induced arch flattening, whereas the latter is not. However, longitudinal arch shape and flattening are only one of the various foot shape-deformation relationships. PA stiffness was also found to vary widely. Yet only a small amount of this variability (approx. 10-18%) was explained by variations in foot shape, deformation and their combination. These findings add to the mounting evidence showing that foot mechanics are complex and cannot be accurately represented by simple models. Especially the interactions between longitudinal arch and PA appear to be far less constrained than originally proposed, most likely due to the many degrees of freedom provided by the structural complexity of our feet.


Assuntos
, Adulto , Humanos , Fenômenos Biomecânicos
9.
Sci Rep ; 13(1): 1130, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36670191

RESUMO

Lower Permian deposits of the Boskovice Basin in the Czech Republic have long been renowned for extraordinarily abundant specimens of discosauriscid seymouriamorphs, some of which showing exceptional preservation, including widespread soft tissues. The only other tetrapods from the strata are represented by rare temnospondyls. However, recent fieldwork in the Asselian (lowermost Permian) of the Boskovice Basin has yielded a diverse assemblage of tetrapod tracks, illuminating a hidden terrestrial tetrapod diversity. Here, we describe well-preserved isolated tracks, manus-pes couples, and a slab with trackways composed of approximately 20 tracks in at least four different directions belonging to early-diverging, or 'pelycosaur-grade', synapsids. The material originates from three localities situated within the Letovice and Padochov formations and is assignable to the ichnotaxon Dimetropus. The best-preserved specimen further shows rare skin impressions, which have not been observed from the hands or feet of early-diverging mammal-line amniotes before. The new material adds to the scarce record of synapsids from the Carboniferous/Permian transitional interval of equatorial Pangea. At the same time, it highlights the significance of the ichnological record of the Boskovice Basin which has long been neglected despite offering evidence for the presence of diverse faunal components that have not been reported from these basinal deposits before.


Assuntos
, Fósseis , Animais , Mãos , Pele , República Tcheca , Mamíferos
10.
Artigo em Inglês | MEDLINE | ID: mdl-36673657

RESUMO

BACKGROUND: In the 21st century, with the rapid development of many human life areas, physical activity should be prevalent in health maintenance and promotion. Body posture is a motor habit characteristic of every individual. Its correctness depends on numerous aspects, e.g., physical activity, age, mental state, or eating habits. There are numerous reports in the literature on the impact of physical activity on body posture, correct foot arch development, and the level of aerobic capacity in children and adolescents, but there is a noticeable lack of assessments of these characteristics and their correlations in adults. AIM: To evaluate aerobic capacity in males and females in relation to selected body posture elements. METHODS: The study involved 45 females and 46 males aged 20-21 years. The inclusion criteria involved declared good health and no contraindications. Selected somatic traits, body posture, and physical capacity indicators were determined. RESULTS: Physical capacity shows a significant relationship with body mass in both sexes (female: r = -0.346; p = 0.020; male: r = -0.321; p = 0.030). A significant correlation was observed between aerobic capacity and lean body mass in females (r = -0.428; p = 0.003) and body mass (r = -0.461; p = 0.001) and body fat percentage in males (r = -0.443; p = 0.002). A significant correlation was demonstrated between maximal oxygen uptake and Clarke's angle (r = -0.300; p = 0.045) in females, between maximal oxygen uptake and the loaded area of the right foot (r = -0.247; p = 0.098) in the male group, and between maximal oxygen uptake and spine lateral deviation (r = 0.352; p = 0.018) in females. There was no dimorphism between body posture elements and physical capacity except for the level of foot longitudinal arches, feet loading surface, spine lateral deviation, and the range of spine mobility in the sagittal and frontal planes. Aerobic capacity significantly influenced lean body mass (ß = -0.379; p = 0.007) and spine deviation from the anatomical axis in the frontal plane in females (ß = 0.287; p = 0.039) and body fat percentage in males (ß = -0.443; p = 0.002). CONCLUSIONS: Selected body posture elements demonstrate relationships with physical capacity in both sexes. The results should find wide practical applications, e.g., in promoting a comprehensive assessment of body posture and physical capacity as determinants of health maintenance.


Assuntos
Composição Corporal , Coluna Vertebral , Adulto , Criança , Adolescente , Masculino , Humanos , Feminino , , Postura , Oxigênio
11.
Artigo em Inglês | MEDLINE | ID: mdl-36673731

RESUMO

This study evaluated the effects of a single exercise session of Self-Myofascial Release (SMR) on the posterior muscular chain flexibility after one hour from the intervention. Thirty-six participants performed SMR using a rigid ball under the surface of both feet. Participants were tested with the Sit and Reach (S&R) test at four different times: before (T0), immediately after (T1), 30 (T2), and 60 (T3) minutes after the SMR intervention. The sample (n = 36) was categorized into three groups: (1) flexible, (2) average, and (3) stiff, based on the flexibility level at T0 (S&R values of >10 cm, >0 but <10 cm and <0 cm, respectively). For the whole sample, we detected significant improvements in the S&R test between the T1, T2, and T3 compared to T0. The stiff group showed a significant (p < 0.05) improvement between T1-T2 and T1-T3. Results were similar between the average group and the whole sample. The flexible group did not show any significant difference (p > 0.05) over time. In conclusion, this investigation demonstrated that an SMR session of both feet was able to increase posterior muscular chain flexibility up to one hour after intervention. Considering that a standard training session generally lasts one hour, our study can help professionals take advantage of SMR effects for the entire training period. Furthermore, our results also demonstrate that physical exercise practitioners should also assess individuals' flexibility before training, as the SMR procedure used in this work does not seem necessary in flexible individuals.


Assuntos
Exercício Físico , Terapia de Liberação Miofascial , Humanos , Amplitude de Movimento Articular , , Massagem
12.
Artigo em Inglês | MEDLINE | ID: mdl-36673958

RESUMO

The Star Excursion Balance Test (SEBT) is a common assessment used across clinical and research settings to test dynamic standing balance. The primary measure of this test is maximal reaching distance performed by the non-stance limb. Response time (RT) is a critical cognitive component of dynamic balance control and the faster the RT, the better the postural control and recovery from a postural perturbation. However, the measure of RT has not been done in conjunction with SEBT, especially with musculoskeletal fatigue. The purpose of this study is to examine RT during a SEBT, creating a modified SEBT (mSEBT), with a secondary goal to examine the effects of muscular fatigue on RT during SEBT. Sixteen healthy young male and female adults [age: 20 ± 1 years; height: 169.48 ± 8.2 cm; weight: 67.93 ± 12.7 kg] performed the mSEBT in five directions for three trials, after which the same was repeated with a response time task using Blazepod™ with a random stimulus. Participants then performed a low-intensity musculoskeletal fatigue task and completed the above measures again. A 2 × 2 × 3 repeated measures ANOVA was performed to test for differences in mean response time across trials, fatigue states, and leg reach as within-subjects factors. All statistical analyses were conducted in JASP at an alpha level of 0.05. RT was significantly faster over the course of testing regardless of reach leg or fatigue state (p = 0.023). Trial 3 demonstrated significantly lower RT compared to Trial 1 (p = 0.021). No significant differences were found between fatigue states or leg reach. These results indicate that response times during the mSEBT with RT is a learned skill that can improve over time. Future research should include an extended familiarization period to remove learning effects and a greater fatigue state to test for differences in RT during the mSEBT.


Assuntos
, Equilíbrio Postural , Adulto , Humanos , Masculino , Feminino , Adulto Jovem , Tempo de Reação , Equilíbrio Postural/fisiologia , Fadiga , Cognição
13.
Nat Ecol Evol ; 7(1): 32-41, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36604550

RESUMO

The longitudinal arch of the human foot is viewed as a pivotal adaptation for bipedal walking and running. Fossil footprints from Laetoli, Tanzania, and Ileret, Kenya, are believed to provide direct evidence of longitudinally arched feet in hominins from the Pliocene and Pleistocene, respectively. We studied the dynamics of track formation using biplanar X-ray, three-dimensional animation and discrete element particle simulation. Here, we demonstrate that longitudinally arched footprints are false indicators of foot anatomy; instead they are generated through a specific pattern of foot kinematics that is characteristic of human walking. Analyses of fossil hominin tracks from Laetoli show only partial evidence of this walking style, with a similar heel strike but a different pattern of propulsion. The earliest known evidence for fully modern human-like bipedal kinematics comes from the early Pleistocene Ileret tracks, which were presumably made by members of the genus Homo. This result signals important differences in the foot kinematics recorded at Laetoli and Ileret and underscores an emerging picture of locomotor diversity within the hominin clade.


Assuntos
Hominidae , Animais , Humanos , Hominidae/anatomia & histologia , Fósseis , Marcha , Pé/anatomia & histologia , Caminhada
15.
Medicine (Baltimore) ; 102(3): e32722, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36701727

RESUMO

The purpose of this study was to investigate the diagnostic performance of a novel semi-quantitative dual-energy computed tomography (DECT) scoring system in monitoring urate deposition. This study included 287 patients with gout. All patients underwent ankle/foot DECT scans. DECT scores at different stages were compared and their diagnostic efficacies evaluated. Associations between DECT scores and clinical variables were evaluated. Gouts with positive DECT results in early, middle, and late stages were 78.5 %, 81.4 %, and 95.8 %, respectively (all P > .05). The total and ankle/midfoot DECT scores at different stages significantly increased with disease duration (all P < .05). DECT scores of 4 regions excluding the first metatarsophalangeal joint in early and middle stages were lower than those in late stage (all P < .05). DECT scores achieved excellent diagnostic performance for differentiating gout in early stage from middle and late stages (area under the curve, 0.923 and 0.949), with high sensitivity, specificity, positive predictive value, and negative predictive value (all > 85 %). Total DECT score was highly positively correlated with the volume of urate crystals (R = 0.873, P < .001). Disease duration, serum uric acid level, bone erosion, and Achilles tendon involvement significantly affected total DECT scores (all P < .01). In conclusion, longer disease duration, higher serum uric acid levels, bone erosion, and Achilles tendon involvement were closely associated with total DECT scores. DECT scoring system may be an invaluable tool for gout diagnosis owing to its high detection efficacy and a surrogate method to evaluate the amount of urate crystals and erosion of surrounding tissues.


Assuntos
Artrite Gotosa , Gota , Humanos , Ácido Úrico , Tornozelo , Gota/diagnóstico por imagem , Artrite Gotosa/diagnóstico ,
16.
Med Sci Monit ; 29: e938485, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36632023

RESUMO

BACKGROUND Plantar pressure analysis is widely used in the study of knee osteoarthritis (KOA). The present study aimed to investigate the static and dynamic plantar pressure distribution in patients with different stages of unilateral KOA using the Footscan® platform system. MATERIAL AND METHODS We recruited 94 patients aged 61.75±7.23 years old with different stages of unilateral KOA for static and dynamic analysis using the Footscan® platform system. The static pressure (%) of the left, right, anterior, posterior, and the pelvic rotation (°) was assessed. The peak pressure (PP, kPa) was investigated in 10 areas of the foot: medial heel (MH), lateral heel (LH), midfoot (MF), first to fifth metatarsals (M1-M5), hallux (T1), and toes 2-5 (T2-5). The correlation between KOA stages and plantar pressure distributions was investigated. RESULTS The results revealed that static pressure on the unaffected side and pelvic rotation were positively correlated with KOA stages. In addition, there was a positive correlation between KOA stages and PP of M5, MF, and LH zones on the affected side and PP of M2, M3, and M4 zones on the unaffected side, and a negative correlation between KOA stages and PP of T1 and T2-5 zones on the affected side. CONCLUSIONS With the progression of KOA, static plantar pressure tends to distributed on the unaffected side, and the dynamic plantar pressure tends to be distributed laterally on both feet. The plantar pressure distributions in unilateral KOA patients are abnormal and are closely related to the severity of KOA.


Assuntos
Osteoartrite do Joelho , Humanos , Pessoa de Meia-Idade , Idoso , Marcha , Pressão , , Calcanhar
17.
Medicina (Kaunas) ; 59(1)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36676771

RESUMO

The main objective of the present study was to determine the relationship between kinesiophobia and pain (general and foot pain), foot function, and disease activity in patients with rheumatoid arthritis (RA). A total of 124 interviews were carried out with participants with RA. Participants were recruited from the Hospital Universitario Virgen de las Nieves de Granada in Spain. Interviews took place in January 2021. Participants completed the following questionnaires during an appointment with their rheumatologist: Foot Function Index (FFI), Tampa Scale for Kinesiophobia (TSK-11), and the Visual Analogue Scale Pain foot (VAS Pain). Furthermore, the Simplified Disease Activity Index (SDAI) was used to measure disease activity. Of the 124 participants, 73% were women, and their mean age was 59.44 years (SD 11.26 years). In the statistical analysis, positive linear correlations (p < 0.001) were obtained between the variables TSK-11 and VAS (related to general pain or foot pain) and FFI (in its three subscales). Additionally, a negative correlation between the TSK-11 and the educational background was shown. This study provided information about the relationship between foot function and pain with different levels of kinesiophobia in patients with RA. Additionally, the educational background of the patient was considered a predictor of whether or not a patient suffered from kinesiophobia.


Assuntos
Artrite Reumatoide , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Transversais , Dor/etiologia , , Inquéritos e Questionários , Artrite Reumatoide/complicações
18.
J Exp Biol ; 226(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36484122

RESUMO

In order to investigate the foot manipulation of a clam without a Keber's valve, Calyptogena okutanii was examined by light microscopy, magnetic resonance imaging and computed tomography. The foot chamber was divided into two compartments by a dense muscle fastener zone (FZ) comprising a pedal artery and sinuses in the mid-sagittal plane in between muscles running in the anterior-posterior oblique direction. The distal part of the foot chamber (inflatable fastener bag, IFB) had a loose superficial muscle layer. The proximal part of the foot chamber (visceral reservoir, VR) was covered by a dense superficial muscle layer. The outlet of the VR was connected with the hinge ligament duct, consisting of the hinge ligament, a pair of shells and the pericardium. Based on these anatomical structures, foot extension starts from contraction of muscles in the FZ, so that flow in the FZ is stopped. Then, the superficial muscles of the foot contract, and the pressure of the IFB increases so that the foot can extend. Foot retraction starts from the relaxation of muscles in the FZ so that the hemolymph returns to the VR. The hinge ligament duct allows a constant return flow from the foot chamber to the gills and the heart. The heart rate and the flow in the FZ, which decreased and increased during the foot extension and retraction, respectively, supported this model. In conclusion, the FZ of Calyptogena okutanii could be an alternative to Keber's valve in Anodonta, playing a similar role.


Assuntos
Bivalves , Animais , , Músculos , Brânquias
19.
Surg Radiol Anat ; 45(1): 25-28, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36522467

RESUMO

In the routine treatment at the hospital, it was observed that a 31-year-old Asian woman developed foot pain after work, with clinical manifestations including local tenderness, abrasion, and a rare case of polydactyly with bilateral foot asymmetry. In addition, we also found that the patient had two-handed symmetric polydactyly. According to our observations, there seem to be few similar cases reported in the past of a two-handed symmetric polydactyly combined with a feet asymmetry polydactyly in the same person, so this is a relatively rare reported case of polydactyly. This paper aims to present detailed case report and discuss related diseases in a morphological and clinical study.


Assuntos
Deformidades Congênitas do Pé , Deformidades Congênitas da Mão , Polidactilia , Feminino , Humanos , Adulto , Polidactilia/diagnóstico , , Mãos
20.
Comput Biol Med ; 152: 106381, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36563541

RESUMO

Hammer toes are one of the common deformities of the forefoot that can lead to compensatory changes during walking in individuals with this condition. Predicting the adverse effects of tissue damage on the performance of other limbs is very important in the prevention of progressive damage. Finite element (FE) and musculoskeletal modeling can be helpful by allowing such effects to be studied in a way where the internal stresses in the tissue could be investigated. Hence, this study aims to investigate the effects of the hammer toe deformity on the lower extremity, especially on the plantar fascia functions. To compare the joint reactions of the hammer toe foot (HTF) and healthy foot (HF), two musculoskeletal models (MSM) of the feet of a healthy individual and that of a participant with hammer toe foot were developed based on gait analysis. A previously validated 3D finite element model which was constructed using Magnetic Resonance Imaging (MRI) of the diabetic participant with the hammer toe deformity was processed at five different events during the stance phase of gait. It was found that the hammer toe deformity makes dorsiflexion of the toes and the windlass mechanism less effective during walking. Specifically, the FE analysis results showed that plantar fascia (PF) in HTF compared to HF played a less dominant role in load bearing with both medial and lateral parts of PF loaded. Also, the results indicated that the stored elastic energy in PF was less in HTF than the HF, which can indicate a higher metabolic cost during walking. Internal stress distribution shows that the majority of ground reaction forces are transmitted through the lateral metatarsals in hammer toe foot, and the probability of fifth metatarsal fracture and also progressive deformity was subsequently increased. The MSM results showed that the joint reaction forces and moments in the hammer toe foot have deviated from normal, where the metatarsophalangeal joint reactions in the hammer toe were less than the values in the healthy foot. This can indicate a vicious cycle of foot deformity, leading to changes in body weight force transmission line, and deviation of joint reactions and plantar fascia function from normal. These in turn lead to increased internal stress concentration, which in turn lead to further foot deformities. This vicious cycle cause progressive damage and can lead to an increase in the risk of ulceration in the diabetic foot.


Assuntos
Pé Diabético , Síndrome do Dedo do Pé em Martelo , Ossos do Metatarso , Humanos , Síndrome do Dedo do Pé em Martelo/complicações , , Fáscia/diagnóstico por imagem , Fenômenos Biomecânicos
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