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1.
Appl Ergon ; 98: 103589, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34563748

RESUMO

Whole-body powered exoskeletons (WB-PEXOs) can be effective in reducing the physical demands of heavy occupational work, yet almost no empirical evidence exists on the effects of WB-PEXO use. This study assessed the effects of WB-PEXO use on back and leg muscle activities during lab-based simulations of load handling tasks. Six participants (4M, 2F) completed two such tasks (load carriage and stationary load transfer), both with and without a WB-PEXO, and with a range of load masses in each task. WB-PEXO use reduced median levels of muscle activity in the back (∼42-53% in thoracic and ∼24-43% in lumbar regions) and legs (∼41-63% in knee flexors and extensors), and mainly when handling loads beyond low-moderate levels (10-15 kg). Overall, using the WB-PEXO also reduced inter-individual variance (smaller SD) in muscle activities. Future work should examine diverse users, focus on finding effective matches between WB-PEXO use and specific tasks, and identify applications in varied work environments.


Assuntos
Exoesqueleto Energizado , Humanos , Perna (Membro) , Região Lombossacral , Músculo Esquelético , Projetos Piloto
2.
J Int Med Res ; 49(11): 3000605211056783, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34816739

RESUMO

The ongoing global administration of vaccines for coronavirus disease 2019 (COVID-19) means that increasing numbers of patients are likely to present with post-vaccination complications. We describe the first reported case of neuralgic amyotrophy (NA) involving the lumbosacral plexus occurring after AstraZeneca COVID-19 vaccination. The patient presented with acute-onset leg paralysis following administration of the vaccine. Based on the clinical, electrodiagnostic, and radiologic findings, the patient was diagnosed with post-vaccination NA. We speculate that the COVID-19 vaccine elicited an immune-mediated inflammatory response to the injected antigen due to inflammatory immunity in a patient with predisposed susceptibility to NA.


Assuntos
Neurite do Plexo Braquial , COVID-19 , Neurite do Plexo Braquial/induzido quimicamente , Neurite do Plexo Braquial/diagnóstico , Vacinas contra COVID-19 , Humanos , Perna (Membro) , Plexo Lombossacral , Paraplegia , SARS-CoV-2 , Vacinação/efeitos adversos
3.
Sensors (Basel) ; 21(21)2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34770384

RESUMO

A major cause of bone mass loss worldwide is osteoporosis. X-ray is considered to be the gold-standard technique to diagnose this disease. However, there is currently a need for an alternative modality due to the ionizing radiations used in X-rays. In this vein, we conducted a numerical study herein to investigate the feasibility of using microwave tomography (MWT) to detect bone density variations that are correlated to variations in the complex relative permittivity within the reconstructed images. This study was performed using an in-house finite-element method contrast source inversion algorithm (FEM-CSI). Three anatomically-realistic human leg models based on magnetic resonance imaging reconstructions were created. Each model represents a leg with a distinct fat layer thickness; thus, the three models are for legs with thin, medium, and thick fat layers. In addition to using conventional matching media in the numerical study, the use of commercially available and cheap ultrasound gel was evaluated prior to bone image analysis. The inversion algorithm successfully localized bones in the thin and medium fat scenarios. In addition, bone volume variations were found to be inversely proportional to their relative permittivity in the reconstructed images with the root mean square error as low as 2.54. The observations found in this study suggest MWT as a promising bone imaging modality owing to its safe and non-ionizing radiations used in imaging objects with high quality.


Assuntos
Perna (Membro) , Imageamento de Micro-Ondas , Densidade Óssea , Estudos de Viabilidade , Humanos , Processamento de Imagem Assistida por Computador
4.
Sensors (Basel) ; 21(21)2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34770692

RESUMO

Movement dynamics during running was previously characterized using a trunk-mounted accelerometer, and were associated with a history of overuse injuries. However, it remains unknown if these measures are also linked to the development of overuse injuries. The aim of this study was therefore to determine how movement dynamics alter in response to fatigue, and the possible link with developing lower-leg overuse injuries during a six-month follow-up period. Two hundred and eight movement science university students completed a 12-min all-out run while wearing a trunk-mounted accelerometer. Dynamic stability, dynamic loading and spatiotemporal measures were extracted from the accelerometer. Participants sustaining an injury within the 6-month period demonstrated significantly higher RMS ratio values in the vertical direction and lower RMS ratio values in the anteroposterior direction, and lower impact acceleration values in the anteroposterior direction in an unfatigued state compared to the uninjured group. They also demonstrated an increase in dynamic loading in the horizontal plane during the run. In addition, with running fatigue both groups exhibited changes in dynamic stability and loading measures. These results show the potential of using a single trunk-mounted accelerometer to detect changes in movement dynamics that are linked to lower-leg overuse injuries.


Assuntos
Transtornos Traumáticos Cumulativos , Perna (Membro) , Acelerometria , Fenômenos Biomecânicos , Transtornos Traumáticos Cumulativos/diagnóstico , Humanos , Estudos Prospectivos
7.
BMJ Case Rep ; 14(11)2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34782374

RESUMO

Proximal muscle weakness of the legs is a symptom with a broad differential diagnosis. It is mainly caused by neuromuscular disorders and is often a diagnostic challenge. Here, we present a 73-year-old man with isolated proximal weakness of the legs due to lumbar root involvement on the basis of neuroborreliosis. After treatment with intravenous antibiotics he recovered completely. This is the first described case with isolated proximal muscle weakness of the legs due to neuroborreliosis. Despite the fact neuroborreliosis is a rare cause of proximal muscle weakness of the legs, clinicians should include it in their differential diagnosis, especially since it is a treatable condition.


Assuntos
Perna (Membro) , Neuroborreliose de Lyme , Administração Intravenosa , Idoso , Diagnóstico Diferencial , Humanos , Neuroborreliose de Lyme/complicações , Neuroborreliose de Lyme/diagnóstico , Neuroborreliose de Lyme/tratamento farmacológico , Masculino , Debilidade Muscular/etiologia
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(5): 822-826, 2021 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-34728046

RESUMO

With the wide application of vascular Doppler ultrasound as well as the improvement of instrument precision and personnel operation practice,calf muscular venous thrombosis(CMVT)has been more and more frequently diagnosed among patients,becoming a common clinical disease.However,it is controversial about the anticoagulant therapy for CMVT patients.In this article,we summarize the current research progress of anticoagulation therapy,aiming to provide reference for the treatment of CMVT.


Assuntos
Embolia Pulmonar , Trombose Venosa , Anticoagulantes/uso terapêutico , Humanos , Perna (Membro) , Músculo Esquelético , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico
9.
J Wound Care ; 30(Sup11): S1-S25, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34756097

RESUMO

This consensus document is endorsed by The Queen's Nursing Institute (QNI) and The Queen's Nursing Institute Scotland (QNIS).


Assuntos
Enfermagem em Saúde Comunitária , Perna (Membro) , Humanos , Escócia
10.
BMC Musculoskelet Disord ; 22(1): 952, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781944

RESUMO

BACKGROUND: High rates of musculoskeletal injuries such as plantar fasciitis and stress fractures have been observed among physically active military personnel. During service time, infantry soldiers use issued boots daily that should fit well and provide comfort to prevent injuries and decrease lower extremity pain effectively. The association of military boot comfort with overuse injuries remains unclear. This study investigates the relationship between the chosen military boot size, perceived boot comfort and lower leg overuse injury. METHODS: During the cross-sectional study, 227 (males, n = 213; females, n = 14) active-duty infantry soldiers at a mean age of 29.5 years old, and with an average service time of 7.2 years were assessed for a history of overuse injury, footprint length, appropriate shoe size, and footwear comfort. Males with a history of overuse injury (n = 32) and non-injured age-matched controls (n = 34) were selected for detailed testing and establishing the possible relationship between footwear comfort and lower leg overuse injury. RESULTS: No relationship was found between footwear comfort and a history of lower leg overuse injury. N = 38 (57.6%) of study subjects were wearing an inappropriate shoe size daily. Inappropriate shoe size usage affected footwear comfort ratings significantly. CONCLUSIONS: Study results showed that improper boot size was significantly related to comfort ratings but was not associated with a history of lower leg overuse injury.


Assuntos
Transtornos Traumáticos Cumulativos , Traumatismos da Perna , Militares , Adulto , Estudos Transversais , Transtornos Traumáticos Cumulativos/diagnóstico , Transtornos Traumáticos Cumulativos/epidemiologia , Feminino , Humanos , Perna (Membro) , Masculino , Sapatos
12.
J Wound Care ; 30(10): 854-865, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34644140

RESUMO

OBJECTIVE: This study evaluated the impact of four weeks of treatment with Prontosan Wound Irrigation Solution and Prontosan Wound Gel (B. Braun Medical Inc., US) on adults with hard-to-heal leg wounds. Overall change (weeks 1-5) in the Global Quality of Life scale (GQOL), changes in body, psyche and everyday life (EDL) quality of life (QoL) subscores, and changes in wound appearance and size after treatment were assessed. METHOD: In this prospective, open-label, single-arm, five-centre study, non-hospitalised patients with no more than two wounds below the knee were recruited into the study; wounds were ≥5cm2 and ≤50cm2 and present for ≥4 weeks. The investigator or a designee applied the wound solution and gel to the wounds at clinic visits, and patients/caregivers applied the wound solution and gel at home. Wound-QoL questionnaires were completed at the initial screening and at each week of treatment. Wound size and photographs were obtained at pre- and post-treatment during clinic visits. RESULTS: A total of 43 patients were enrolled in the study. Mean GQOL scores decreased by 1.11 (46.1%). Body, psyche and EDL decreased by 1.17 (60.0%), 1.26 (41.8%) and 1.00 (42.2%), respectively. Wounds also showed improvement in odour, appearance and size. Adverse events were mild in intensity and transient in nature. CONCLUSION: This study demonstrated marked improvement in the QoL of patients with hard-to-heal leg wounds below the knee during four weeks of treatment with the wound solution and gel. Wounds also showed improvement in odour, appearance and size, and the treatment solution and gel were well tolerated. DECLARATION OF INTEREST: B. Braun Medical Inc. funded the research and preparation of this article. AK, DV, CRC and WC are employees of B. Braun Medical Inc. AO and RS declare no conflict of interest.


Assuntos
Perna (Membro) , Qualidade de Vida , Adulto , Humanos , Estudos Prospectivos , Irrigação Terapêutica , Cicatrização
13.
Artigo em Inglês | MEDLINE | ID: mdl-34682543

RESUMO

Previous studies of support legs in rearward-facing infant CRS models have focused on frontal impacts and have found that the presence of a support leg is associated with a reduction in head injury metrics. However, real-world crashes often involve an oblique principal direction of force. The current study used sled tests to evaluate the effectiveness of support legs in rearward-facing infant CRS models for frontal and frontal-oblique impacts with and without a simulated front row seatback. Frontal and frontal-oblique impact sled tests were conducted using the simulated Consumer Reports test method with and without the blocker plate, which was developed to represent a front row seatback. The Q1.5 anthropomorphic test device (ATD) was seated in rearward-facing infant CRS models, which were tested with and without support legs. The presence of a support leg was associated with significant reductions of head injury metrics below injury tolerance limits for all tests, which supports the findings of previous studies. The presence of a support leg was also associated with significant reductions of peak neck tensile force. The presence of the blocker plate resulted in greater head injury metrics compared to tests without the blocker plate, but the result was non-significant. However, the fidelity of the interaction between the CRS and blocker plate as an adequate representation of the interaction that would occur in a real vehicle is not well understood. The findings from the current study continue to support the benefit of support legs in managing the energy of impact for a child in a rearward-facing CRS.


Assuntos
Sistemas de Proteção para Crianças , Perna (Membro) , Acidentes de Trânsito , Fenômenos Biomecânicos , Criança , Desenho de Equipamento , Humanos , Lactente
14.
Orphanet J Rare Dis ; 16(1): 418, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627330

RESUMO

BACKGROUND: Hemihyperplasia and hemihypoplasia result in leg length discrepancy (LLD) by causing skeletal asymmetry. Beckwith-Wiedemann syndrome (BWS) and Silver-Russell syndrome (SRS) are opposite growth-affecting disorders caused by opposite epigenetic alterations at the same chromosomal locus, 11p15, to induce hemihyperplasia and hemihypoplasia, respectively. Because of their somatic mosaicism, BWS and SRS show a wide spectrum of clinical phenotypes. We evaluated the underlying epigenetic alterations and potential epigenotype-phenotype correlations, focusing on LLD, in a group of individuals with isolated hemihyperplasia/hemihypoplasia. RESULTS: We prospectively collected paired blood-tissue samples from 30 patients with isolated hemihyperplasia/hemihypoplasia who underwent surgery for LLD. Methylation-specific multiplex-ligation-dependent probe amplification assay (MS-MLPA) and bisulfite pyrosequencing for differentially methylated regions 1 and 2 (DMR1 and DMR2) on chromosome 11p15 were performed using the patient samples. Samples from patients showing no abnormalities in MS-MLPA or bisulfite pyrosequencing were analyzed by single nucleotide polymorphism (SNP) microarray and CDKN1C Sanger sequencing. We introduced a metric named as the methylation difference, defined as the difference in DNA methylation levels between DMR1 and DMR2. The correlation between the methylation difference and the predicted LLD at skeletal maturity, calculated using a multiplier method, was evaluated. Predicted LLD was standardized for stature. Ten patients (33%) showed epigenetic alterations in MS-MLPA and bisulfite pyrosequencing. Of these, six and four patients had epigenetic alterations related to BWS and SRS, respectively. The clinical diagnosis of hemihyperplasia/hemihypoplasia was not compatible with the epigenetic alterations in four of these ten patients. No patients showed abnormalities in SNP array or their CDKN1C sequences. The standardized predicted LLD was moderately correlated with the methylation difference using fat tissue (r = 0.53; p = 0.002) and skin tissue (r = 0.50; p = 0.005) in all patients. CONCLUSIONS: Isolated hemihyperplasia and hemihypoplasia can occur as a spectrum of BWS and SRS. Although the accurate differentiation between isolated hemihyperplasia and isolated hemihypoplasia is important in tumor surveillance planning, it is often difficult to clinically differentiate these two diseases without epigenetic tests. Epigenetic tests may play a role in the prediction of LLD, which would aid in treatment planning.


Assuntos
Perna (Membro) , Síndrome de Silver-Russell , Metilação de DNA/genética , Epigênese Genética/genética , Humanos , Hiperplasia , Estudos Prospectivos , Síndrome de Silver-Russell/genética
16.
Sensors (Basel) ; 21(20)2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34696005

RESUMO

The purpose of this work was to describe the leg-muscle-generated push force characteristics in sprint kayak paddlers for females and males on water. Additionally, the relationship between leg pushing force characteristics and velocity was investigated. Twenty-eight paddlers participated in the study. The participants had five minutes of self-chosen warm-up and were asked to paddle at three different velocities, including maximal effort. Left- and right-side leg extension force were collected together with velocity. Linear regression analyses were performed with leg extension force characteristics as independent variables and velocity as the dependent variable. A second linear regression analysis investigated the effect of paddling velocity on different leg extension force characteristics with an explanatory model. The results showed that the leg pushing force elicits a sinus-like pattern, increasing and decreasing throughout the stroke cycle. Impulse over 10 s showed the highest correlation to maximum velocity (r = 0.827, p < 0.01), while a strong co-correlation was observed between the impulse per stroke cycle and mean force (r = 0.910, p < 0.01). The explanatory model results revealed that an increase in paddling velocity is, among other factors, driven by increased leg force. Maximal velocity could predict 68% of the paddlers' velocity within 1 km/h with peak leg force, impulse over 10 s, and stroke rate (p-value < 0.001, adjusted R-squared = 0.8). Sprint kayak paddlers elicit a strong positive relationship between leg pushing forces and velocity. The results confirm that sprint kayakers' cyclic leg movement is a key part of the kayaking technique.


Assuntos
Músculo Esquelético/fisiologia , Esportes Aquáticos , Fenômenos Biomecânicos , Feminino , Humanos , Perna (Membro) , Masculino
17.
PLoS One ; 16(10): e0257443, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34653208

RESUMO

BACKGROUND: Although the inter-arm blood pressure (BP) difference has been advocated to be associated with cardiovascular events, the implication of inter-leg BP difference has not been well established. This study was conducted to investigate whether inter-arm and -leg BP differences have prognostic value in patients undergoing percutaneous coronary intervention (PCI). METHODS: In this prospective study, we consecutively enrolled 667 patients who underwent PCI. Both arm and leg BPs were measured at the day after PCI. The primary outcome was a major adverse cardiovascular event (MACE) including cardiac death, acute coronary syndrome, coronary revascularization, stroke, and hospitalization for heart failure during the follow-up period. RESULTS: Mean age was 64.0±11.1 years old, and males were predominant (70.5%). During a mean follow-up period of 3.0 years, MACE occurred in 209 (31.3%) patients. The inter-leg systolic BP difference (ILSBPD) was significantly higher in patients with MACE than those without (9.9±12.3 vs. 7.2±7.5 mmHg, P = 0.004). The inter-arm systolic BP difference was not significantly different between patients with and without MACE (P = 0.403). In multivariable Cox regression analysis, increased ILSBPD was independently associated with the development of MACE (per 5 mmHg; hazard ratio, 1.07; 95% confidence interval, 1.01-1.14). The inter-arm systolic BP difference was not associated with MACE in the multivariable analysis. CONCLUSION: Increased ILSBPD was independently associated with worse cardiovascular outcomes after PCI. As ILSBPD is easy to measure, it may be helpful in the risk stratification of patients undergoing PCI.


Assuntos
Pressão Sanguínea , Doenças Cardiovasculares/diagnóstico , Perna (Membro) , Intervenção Coronária Percutânea , Idoso , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Feminino , Seguimentos , Humanos , Perna (Membro)/fisiologia , Perna (Membro)/fisiopatologia , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Prognóstico , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento
18.
J Neuroeng Rehabil ; 18(1): 155, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702299

RESUMO

BACKGROUND: The lower-extremity motor coordination test (LEMOCOT) is a performance-based measure used to assess motor coordination deficits after stroke. We aimed to automatically quantify performance on the LEMOCOT and to extract additional performance parameters based on error analysis in persons with stroke (PwS) and healthy controls. We also aimed to explore whether these parameters provide additional information regarding motor control deficit that is not captured by the traditional LEMOCOT score. In addition, the associations between the LEMOCOT score, parameters of error and performance-based measures of lower-extremity impairment and gait were tested. METHODS: Twenty PwS (age: 62 ± 11.8 years, time after stroke onset: 84 ± 83 days; lower extremity Fugl-Meyer: 30.2 ± 3.7) and 20 healthy controls (age: 42 ± 15.8 years) participated in this cross-sectional exploratory study. Participants were instructed to move their big toe as fast and accurately as possible between targets marked on an electronic mat equipped with force sensors (Zebris FDM-T, 60 Hz). We extracted the contact surface area of each touch, from which the endpoint location, the center of pressure (COP), and the distance between them were computed. In addition, the absolute and variable error were calculated. RESULTS: PwS touched the targets with greater foot surface and demonstrated a greater distance between the endpoint location and the location of the COP. After controlling for the number of in-target touches, greater absolute and variable errors of the endpoint were observed in the paretic leg than in the non-paretic leg and the legs of controls. Also, the COP variable error differentiated between the paretic, non-paretic, and control legs and this parameter was independent of in-target counts. Negative correlations with moderate effect size were found between the Fugl Meyer assessment and the error parameters. CONCLUSIONS: PwS demonstrated lower performance in all outcome measures than did controls. Several parameters of error indicated differences between legs (paretic leg, non-paretic leg and controls) and were independent of in-target touch counts, suggesting they may reflect motor deficits that are not identified by the traditional LEMOCOT score.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Adulto , Idoso , Estudos Transversais , Humanos , Perna (Membro) , Extremidade Inferior , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações
19.
J Clin Neurosci ; 93: 112-115, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34656233

RESUMO

Decompression surgery is the most common surgical treatment for lumbar spinal stenosis (LSS). Relatively low satisfaction rate was reported. Patients often complaint of residual numbness despite significant pain relief. We hypothesized that numbness had a significant impact on patient satisfaction, but had not been evaluated, which is associated with low satisfaction rate. This study aimed to examine how much numbness is associated with patient satisfaction. We retrospectively reviewed prospectively collected data from consecutive patients who underwent decompression without fusion for LSS. We evaluated the Numeric Rating Scale (NRS) scores of low back pain (LBP), leg pain, and leg numbness preoperatively and at the final follow-up visit. Improvement was evaluated using minimum clinically important differences (MCIDs). Patient satisfaction was evaluated using the question, "How satisfied are you with the overall result of your back operation?". There are four possible answers consisting of "very satisfied (4-point)", "somewhat satisfied (3-point)", "somewhat dissatisfied (2-point)", or "very dissatisfied (1-point)". Spearman correlation was used to evaluate the association between patient satisfaction and reaching MCIDs. A total of 116 patients were included. All three components had correlation with patient satisfaction with the correlation efficient of 0.30 in LBP, 0.22 in leg pain, and 0.33 in numbness. Numbness had greatest correlation efficient value. We showed that numbness has a greater impact than leg/back pain on patient satisfaction in patients undergoing decompression for LSS. We suggest not only LBP and leg pain but also numbness should be evaluated pre- and postoperatively.


Assuntos
Dor Lombar , Estenose Espinal , Descompressão Cirúrgica , Humanos , Hipestesia/etiologia , Perna (Membro) , Dor Lombar/cirurgia , Vértebras Lombares/cirurgia , Satisfação do Paciente , Estudos Retrospectivos , Estenose Espinal/complicações , Estenose Espinal/cirurgia , Resultado do Tratamento
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