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2.
Front Endocrinol (Lausanne) ; 15: 1411657, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39224125

RESUMO

Objective: The aim of this study is to assess the effectiveness of foot skin protection technology in elderly patients with diabetic peripheral neuropathy. Methods: The foot skin protection technology was developed based on a comprehensive literature review and preliminary research conducted by our research team. Subsequently, 88 elderly patients with diabetic peripheral neuropathy and experiencing foot skin problems were recruited from two community health service centers in Shanghai. Using a random number table, the participants were randomly assigned to either the control group or the experimental group. Patients in the experimental group received foot skin protection technology interventions, while those in the control group received standard community nursing guidance for a duration of 3 months. The incidence, severity, and discomfort associated with foot skin problems were evaluated before and after the intervention period in both groups. Results: The incidence, severity, and discomfort of foot skin problems notably reduced in the experimental group (all P< 0.05). Conclusion: The foot skin protection technology demonstrates significant potential in enhancing foot skin condition.


Assuntos
Pé Diabético , Neuropatias Diabéticas , Humanos , Masculino , Idoso , Feminino , Neuropatias Diabéticas/prevenção & controle , Pé Diabético/prevenção & controle , Pessoa de Meia-Idade , China/epidemiologia , , Idoso de 80 Anos ou mais
4.
BMC Musculoskelet Disord ; 25(1): 728, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39261824

RESUMO

BACKGROUND: Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven. AIM: Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment. DESIGN: Prospective cohort study, longitudinal. SETTING: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). POPULATION: Twenty (14f/6m) patients (12-16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20-50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany). METHODS: At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m). RESULTS: No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 - 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot. CONCLUSIONS: A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error. CLINICAL REHABILITATION IMPACT: The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis.


Assuntos
Braquetes , , Pressão , Escoliose , Humanos , Escoliose/terapia , Escoliose/fisiopatologia , Adolescente , Feminino , Masculino , Estudos Prospectivos , Criança , Pé/fisiopatologia , Estudos Longitudinais , Resultado do Tratamento , Terapia Combinada , Marcha
5.
J Biomech ; 175: 112300, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39217917

RESUMO

Running jumps that depart the ground from two feet require momenta redirection upward from initial momenta that are primarily horizontal. It is not known how each leg generates backward and upward impulses from ground reaction forces to satisfy this mechanical objective when jumping to maximize height. We examined whole-body linear momentum control strategies during these two-foot running jumps by uncovering the roles of each leg in impulse generation. 3D motion capture and force plates were used to record 14 male basketball players performing two-foot running jumps towards an adjustable basketball hoop. Total ground contact phase started from the first leg ground contact and ended at takeoff and was divided into center of mass descent and ascent subphases. During the total ground contact phase, all participants generated significantly more upward impulse with the first leg and ten participants generated significantly more backward impulse with the first leg compared to the second leg. During the descent subphase, all participants generated significantly more upward and backward impulses with the first leg. During the ascent subphase, all but one participant generated significantly more backward impulse with the second leg. In addition to group-level statistics, participant-specific strategies were described. Overall, this study revealed the fundamental whole-body momentum control strategies used in two-foot running jumps and supports future research into optimal jump techniques and training interventions that respect the need to satisfy the mechanical objectives of the movement.


Assuntos
Basquetebol , Corrida , Humanos , Masculino , Basquetebol/fisiologia , Corrida/fisiologia , Fenômenos Biomecânicos , Pé/fisiologia , Adulto , Adulto Jovem , Perna (Membro)/fisiologia
6.
BMC Musculoskelet Disord ; 25(1): 751, 2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39300395

RESUMO

BACKGROUND: Foot and ankle problems are frequently prevalent, especially among the elderly, ranging from 70 to 80%. In primary care, foot, and ankle complaints stand out as one of the most frequent reasons for orthopedic consultations. Patient-reported outcome measures are significant in the assessment burden of any condition on the effects of intervention as well as research. The Foot Function Index (FFI) is a region-specific tool that was identified as one of the most commonly used evaluation tools for foot complaints. This study aimed to translate, cross-cultural adapt, and test the psychometric properties of FFI in the Urdu language. METHODOLOGY: The FFI was translated into Urdu language (FFI-U) following Beaton et al. translation guidelines. The data were collected from 230 Urdu-speaking participants with different foot and ankle pathologies. Data collection started after the written informed consent from the participants. All participants completed the FFI-U, Visual Analogue Scale (VAS), SF-36, and the Foot and Ankle Outcome Score (FAOS) at baseline while only 30 participants completed ULFI-U after one week for test-retest reliability. The psychometric properties involved reliability and validity testing. Reliability was assessed where internal consistency was measured using Cronbach's alpha and test-retest reliability through the intra-class correlation coefficient (ICC). FFI-U was tested for face validity and construct validity (convergent and discriminant). Psychometric criteria were examined against priori hypotheses, and alpha level (p-value < 0.05) was considered statistically significant. RESULTS: FFI-U demonstrated good reliability with internal consistency (α = 0.86) and test-retest reliability with intra-class correlation coefficient = 0.845 (0.78-0.89). A moderate correlation was found using Pearson correlation between FFI-U total score and physical components of SF-36, VAS (pain, disability), and FAOS (γ= -0.65, 0.72, 0.71, -0.68) respectively, indicating convergent validity however, a weak correlation was found with mental components of SF-36 (γ=-0.25) demonstrating discriminant validity. Face validity was assessed at the pre-final testing stage by interviewing patients. There were no floor and ceiling effects found for FFI-U. CONCLUSION: The FFI-U has been found reliable, valid, and feasible tool to be used as a patient-reported outcome measure to assess functional levels with different foot and ankle disorders in Urdu speaking population.


Assuntos
Doenças do Pé , Psicometria , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto , Idoso , Doenças do Pé/diagnóstico , Doenças do Pé/psicologia , Doenças do Pé/fisiopatologia , Medidas de Resultados Relatados pelo Paciente , Comparação Transcultural , Traduções , Idioma , Inquéritos e Questionários/normas , Pé/fisiopatologia , Adulto Jovem , Articulação do Tornozelo/fisiopatologia
7.
J Sports Sci ; 42(15): 1477-1490, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39285616

RESUMO

Bike positional configuration changes strongly affect cycling performance. While consensus has emerged on saddle height optimisation, there is none for the relationship between other bike positional variables and cycling performance. Accordingly, this systematic review examines the effect of all major positional variables on performance in cycling, assessing differences between cycling disciplines and sex where possible. The systematic review, conducted per PRISMA guidelines, searched databases including Embase, Web of Science, Medline, and CINAHL, screening 16,578 studies. Of these, 47 were fully analysed. Study quality assessment using the NIH tool revealed none rated "good", 5 "fair" and 33 "poor". The analysis involved 724 participants (90 female, 454 male, 180 sex unstated). Studies focused on trunk angle/upper body position, handlebar height, Q factor, foot position, saddle fore-aft/height, seat tube angle and crank length. Participant cycling disciplines were often unspecified and few papers address women cyclists specifically. Key findings were associated with changing saddle height, trunk angle and saddle fore-aft. For trunk angle, accounting for the biomechanical and physiological effects as well as aerodynamic changes is important. Saddle fore-aft affects the hip angle and trunk angle. There are no clear recommendations for crank length, handlebar height, Q factor or cleat position.


Assuntos
Ciclismo , Postura , Equipamentos Esportivos , Tronco , Humanos , Ciclismo/fisiologia , Fenômenos Biomecânicos , Feminino , Postura/fisiologia , Tronco/fisiologia , Masculino , Desempenho Atlético/fisiologia , Fatores Sexuais , Desenho de Equipamento , Pé/fisiologia
8.
Sensors (Basel) ; 24(17)2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39275460

RESUMO

Pressure-relieving footwear helps prevent foot ulcers in people with diabetes. The footwear design contributes to this effect and includes the insole top cover. We aimed to assess the offloading effect of materials commonly used as insole top cover. We measured 20 participants with diabetes and peripheral neuropathy for in-shoe peak pressures while walking in their prescribed footwear with the insole covered with eight different materials, tested in randomized order. Top covers were a 3 mm or 6 mm thick open or closed-cell foam or a 6 mm thick combination of open- and closed-cell foams. We re-assessed pressures after one month of using the top cover. Peak pressures were assessed per anatomical foot region and a region of interest (i.e., previous ulceration or high barefoot pressure). Walking comfort was assessed using a 10-point Likert scale. Mean peak pressure at the region of interest varied between 167 (SD:56) and 186 (SD:65) kPa across top covers (p < 0.001) and was significantly higher for the 3 mm thick PPT than for four of the seven 6 mm thick top covers. Across 6 mm thick top covers, only two showed a significant peak pressure difference between them. Over time, peak pressures changed non-significantly from -2.7 to +47.8 kPa across top cover conditions. Comfort ratings were 8.0 to 8.4 across top covers (p = 0.863). The 6 mm thick foams provided more pressure relief than the 3 mm thick foam during walking in high-risk people with diabetes. Between the 6 mm thick foams and over time, only small differences exist. The choice of which 6 mm thick insole top cover to use may be determined more by availability, durability, ease of use, costs, or hygienic properties than by superiority in pressure-relief capacity.


Assuntos
Pé Diabético , Pressão , Sapatos , Caminhada , Humanos , Masculino , Feminino , Pé Diabético/fisiopatologia , Pessoa de Meia-Idade , Caminhada/fisiologia , Idoso , Órtoses do Pé , Desenho de Equipamento , Diabetes Mellitus/fisiopatologia , Úlcera do Pé/fisiopatologia , Úlcera do Pé/prevenção & controle , Pé/fisiologia , Pé/fisiopatologia
9.
Sensors (Basel) ; 24(17)2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39275490

RESUMO

An increase in plantar pressure and skin temperature is commonly associated with an increased risk of diabetic foot ulcers. However, the effect of insoles in reducing plantar temperature has not been commonly studied. The aim was to assess the effect of walking in insoles with different features on plantar temperature. Twenty-six (F/M:18/8) participants-13 with diabetes and 13 healthy, aged 55.67 ± 9.58 years-participated in this study. Skin temperature at seven plantar regions was measured using a thermal camera and reported as the difference between the temperature after walking with an insole for 20 m versus the baseline temperature. The mixed analyses of variance indicated substantial main effects for the Insole Condition, for both the right [Wilks' Lambda = 0.790, F(14, 492) = 4.393, p < 0.01, partial eta squared = 0.111] and left feet [Wilks' Lambda = 0.890, F(14, 492) = 2.103, p < 0.011, partial eta squared = 0.056]. The 2.5 mm-tall dimple insole was shown to be significantly more effective at reducing the temperature in the hallux and third met head regions compared to the 4 mm-tall dimple insole. The insoles showed to be significantly more effective in the diabetes group versus the healthy group, with large effect size for the right [Wilks' Lambda = 0.662, F(14, 492) = 8.037, p < 0.000, Partial eta-squared = 0.186] and left feet [Wilks' Lambda = 0.739, F(14, 492) = 5.727, p < 0.000, Partial eta-squared = 0.140]. This can have important practical implications for designing insoles with a view to decrease foot complications in people with diabetes.


Assuntos
Pé Diabético , Órtoses do Pé , , Pressão , Temperatura Cutânea , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Temperatura Cutânea/fisiologia , Pé/fisiopatologia , Pé/fisiologia , Pé Diabético/fisiopatologia , Sapatos , Caminhada/fisiologia , Idoso , Diabetes Mellitus/fisiopatologia , Adulto , Temperatura
10.
Sci Rep ; 14(1): 22000, 2024 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-39317709

RESUMO

This study investigated the local, remote, and contralateral effects of a four-week intrinsic foot muscle exercise intervention in recreationally active participants on foot parameters, flexibility, and performance of the posterior chain (PC). Twenty-eight healthy participants (12f, 16m) were randomly assigned to a control group or performed 2 × 6 min of foot exercises twice daily unilaterally at least five days/week for four weeks. At baseline (M1), after the intervention (M2), and after a four-week wash-out period (M3), we assessed bilateral Foot Posture Index-6, medial longitudinal arch mobility, single-leg stance balance, range of motion (ROM) (first metatarsophalangeal joint and ankle), and flexibility and performance of the PC. The FPI-6 score changes over time differed significantly between groups for both legs, improving by 26% in the trained- (p < .001) and 11% in the untrained leg (p = .02) in the intervention group from M1 to M2. Improvements were maintained at M3 for the trained leg (p = .02). Ankle range of motion and balance of the trained leg improved from M1 to M2, yet only became significant at M3 (ROM: p = .02; balance: p = .007). The other parameters did not change significantly. A four-week foot exercise intervention might have local but no remote effects in healthy young adults.German Clinical Trial Register (DRKS00027923) (24/08/2022).


Assuntos
, Amplitude de Movimento Articular , Humanos , Masculino , Feminino , Amplitude de Movimento Articular/fisiologia , Pé/fisiologia , Adulto , Adulto Jovem , Equilíbrio Postural/fisiologia , Músculo Esquelético/fisiologia , Exercício Físico/fisiologia , Articulação do Tornozelo/fisiologia , Terapia por Exercício/métodos
11.
Medicina (Kaunas) ; 60(9)2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39336461

RESUMO

Background and Objectives: Owing to the recent reports regarding the efficacy of rhythm step training (RST) in lower limb muscle development and motor skill enhancement, this study aimed to evaluate the effects of RST on foot and lower limb balance in children and adolescents diagnosed with flat feet using radiographic analysis. Materials and Methods: A total of 160 children and adolescents diagnosed with flat feet from a hospital in Seoul were randomly assigned to the general flat feet training (GFFT) (n = 80) or RST (n = 80) group. Patients in both groups exercised for 50 min once a week for 12 weeks. Key variables, such as quadriceps angle (Q-angle), calcaneal pitch angle (CPA), calcaneal-first metatarsal angle (CFMA), and navicular-cuboid overlap ratio (OR) were measured before and after the intervention. Results: Significant improvements in Q-angle (p < 0.001), CPA (p < 0.001), CFMA (p < 0.001), and navicular-cuboid OR (p < 0.001) were observed in the RST group compared to the GFFT group. RST was found to be more effective in normalizing the biomechanical function of the calcaneus and improving lower limb function. Conclusions: RST significantly enhances foot and lower limb balance in children and adolescents with flat feet, suggesting its potential use as an effective intervention for this population. The study did not specifically analyze the effects of various components of rhythm training, such as music, exercise intensity, and frequency, on the outcomes. Further research is needed to determine how each of these elements individually influences the results.


Assuntos
Terapia por Exercício , Pé Chato , Extremidade Inferior , Equilíbrio Postural , Humanos , Criança , Masculino , Feminino , Adolescente , Extremidade Inferior/fisiopatologia , Extremidade Inferior/diagnóstico por imagem , Terapia por Exercício/métodos , Pé Chato/fisiopatologia , Pé Chato/diagnóstico por imagem , Equilíbrio Postural/fisiologia , Pé/fisiopatologia , Pé/fisiologia , Pé/diagnóstico por imagem , Radiografia/métodos , Radiografia/estatística & dados numéricos , Resultado do Tratamento , República da Coreia
12.
Ann Plast Surg ; 93(4): 488-495, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39331747

RESUMO

BACKGROUND: Local flaps remain a valuable reconstructive tool as a means for limb salvage for patients with advanced arterial disease. Our single-center, retrospective cohort study aims to compare the outcomes of different patterns of blood flow affected by vascular disease to pedicles in local flap reconstruction of the foot and ankle. METHODS: A retrospective review of 92 patients and 103 flaps was performed. On angiograms, pattern of blood flow to the flap pedicle was determined to be direct inline flow (DF) or indirect flow (IF). Patterns of IF were either by arterial-arterial connections (AC) or unnamed randomized collaterals (RC). Primary outcomes were immediate flap success and limb salvage. Comparative analyses were performed using the χ2 and Fisher tests for categorical variables. RESULTS: Among all flaps, 73.8% (n = 76/103) had DF and 26.2% (n = 27/103) had IF. Both groups experienced similar rates of immediate flap success (DF = 97.3% vs IF = 92.6%, P = 0.281) and limb salvage (DF = 75.% vs IF = 66.7%, P = 0.403). However, the rate of contralateral amputation was significantly higher in the IF group (26.9% vs 5.3%, P = 0.006). When comparing the 3 distinct patterns of blood flow (DF vs AC vs RC), pedicled flaps were more commonly supplied by DF and AC, while random pattern flaps were more commonly supplied by RC (P = 0.042). CONCLUSIONS: Alternative routes of revascularization can maintain local flap viability and achieve similar rates of limb salvage but risks contralateral amputation. We found that pedicled and local muscle flaps require inline blood flow or blood supply by ACs. Meanwhile, random pattern flap can be supported by random collaterals.


Assuntos
Salvamento de Membro , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Humanos , Estudos Retrospectivos , Masculino , Feminino , Idoso , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/transplante , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Salvamento de Membro/métodos , Resultado do Tratamento , Extremidade Inferior/cirurgia , Extremidade Inferior/irrigação sanguínea , Doenças Vasculares Periféricas/cirurgia , Pé/cirurgia , Pé/irrigação sanguínea
13.
Ann Plast Surg ; 93(4): 510-515, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39331749

RESUMO

BACKGROUND: The surgical decision for limb-salvage with free tissue transfer (FTT), partial foot amputation (PFA), or below-knee amputation (BKA) for complex lower extremity (LE) wounds hinges on several factors, including patient choice and baseline function. However, patient-reported outcome measures (PROMs) on LE function, pain, and QoL for chronic LE wound interventions are limited. Thus, the study aim was to compare PROMs in patients who underwent FTT, PFA, or BKA for chronic LE wounds. METHODS: PROMs were collected via QR code for all adult chronic LE wound patients who presented to a tertiary wound center between June 2022 and June 2023. A cross-sectional analysis of patients who underwent FTT, PFA, or BKA was conducted. The 12-Item Short Survey (SF-12), PROM Information System Pain Intensity (PROMIS-3a), and Lower Extremity Functional Scale (LEFS) were completed at 1, 3, and 6 months and 1, 3, and 5 years postoperatively. Patient demographics, comorbidities, preoperative characteristics, and amputation details were collected. RESULTS: Of 200 survey sets, 71 (35.5%) underwent FTT, 51 (25.5%) underwent PFA, and 78 (39.0%) underwent BKA. Median postoperative time points of survey completion between FTT (6.2 months, IQR: 23.1), PFA (6.8 months, IQR: 15.5), and BKA (11.1 months, IQR: 21.3) patients were comparable (P = 0.8672). Most patients were male (n = 92, 76.0%) with an average age and body mass index (BMI) of 61.8 ± 12.6 years and 30.3 ± 7.0 kg/m2, respectively. Comorbidities for FTT, PFA, and BKA patients included diabetes mellitus (DM; 60.6% vs 84.2% vs 69.2%; P = 0.165), peripheral vascular disease (PVD; 48.5% vs 47.4% vs 42.3%; P = 0.790), and chronic kidney disease (CKD; 12.1% vs 42.1% vs 30.8%; P = 0.084). No significant differences were observed between FTT, PFA, and BKA patients in mean overall PROMIS-3a T-scores (49.6 ± 14.8 vs 54.2 ± 11.8 vs 49.6 ± 13.7; P = 0.098), LEFS scores (37.5 ± 18.0 vs 34.6 ± 18.3 vs 38.5 ± 19.4; P = 0.457), or SF-12 scores (29.6 ± 4.1 vs 29.5 ± 2.9 vs 29.0 ± 4.0; P = 0.298). CONCLUSION: Patients receiving FTT, PFA, or BKA for chronic LE wounds achieve comparable levels of LE function, pain, and QoL postoperatively. Patient-centered functionally based surgical management for chronic LE wounds using interdisciplinary care, preoperative medical optimization, and proper patient selection optimizes postoperative PROMs.


Assuntos
Amputação Cirúrgica , Retalhos de Tecido Biológico , Salvamento de Membro , Medidas de Resultados Relatados pelo Paciente , Humanos , Masculino , Feminino , Amputação Cirúrgica/métodos , Amputação Cirúrgica/estatística & dados numéricos , Salvamento de Membro/métodos , Pessoa de Meia-Idade , Estudos Transversais , Retalhos de Tecido Biológico/transplante , Idoso , Pé/cirurgia , Estudos Retrospectivos , Adulto , Qualidade de Vida
14.
Sensors (Basel) ; 24(18)2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39338788

RESUMO

BACKGROUND: Three-dimensional motion analysis using optoelectronic cameras and force platforms is typically used to quantify gait disorders. However, these systems have various limitations, particularly when assessing patients in an ecological environment. To address these limitations, several wearable devices have been developed. However, few studies have reported metrological information regarding their repeatability and sensitivity to change. METHODS: A healthy adult performed 6 min walking tests with FeetMe® system insoles under different walking conditions overground and on a treadmill. The standard error of measurement (SEM), the minimum detectable differences (MDDs), and the effect size (ES) were calculated for spatio-temporal parameters, and the ground reaction force was calculated from the 16,000 steps recorded. RESULTS: SEM values were below 3.9% for the ground reaction force and below 6.8% for spatio-temporal parameters. ES values were predominantly high, with 72.9% of cases between overground and treadmill conditions with induced asymmetry, and 64.5% of cases between treadmill conditions with and without induced asymmetry exhibiting an ES greater than 1.2. The minimum detectable differences ranged from 4.5% to 10.7% for ground reaction forces and 2.1% to 18.9% for spatio-temporal parameters. CONCLUSION: Our study demonstrated that the FeetMe® system is a reliable solution. The sensitivity to change showed that these instrumented insoles can effectively reflect patient asymmetry and progress.


Assuntos
Marcha , Caminhada , Humanos , Caminhada/fisiologia , Marcha/fisiologia , Adulto , Masculino , Dispositivos Eletrônicos Vestíveis , Sapatos , Órtoses do Pé , Feminino , Pé/fisiologia , Fenômenos Biomecânicos , Teste de Esforço/instrumentação , Teste de Esforço/métodos , Reprodutibilidade dos Testes
15.
Artigo em Inglês | MEDLINE | ID: mdl-39240769

RESUMO

Serous atrophy of bone marrow (SABM) is characterized by focal replacement of bone marrow elements with extracellular gelatinous substances. It has been associated with a wide range of chronic conditions, including anorexia nervosa, malignancy, chronic kidney disease, and certain chronic infections. Previous literature has reported the disorder as primarily diagnosed via bone marrow biopsy and occurring outside of the distal extremities. Herein we describe a case of SABM occurring in the feet diagnosed via magnetic resonance imaging (MRI), a phenomenon that is rarely reported. The patient is a 45-year-old woman with a history of end-stage renal disease, congestive heart failure, type 2 diabetes, and peripheral arterial disease who initially presented with nonhealing, bilateral foot ulcers. She subsequently underwent several podiatric medical surgeries due to persistent foot infections and poor wound healing. During her most recent hospitalization, MRIs of her feet were obtained, and findings of abnormal bone marrow signal were attributed to technical malfunction of the MRI coil or scanner. After troubleshooting sources of malfunction, a repeated MRI of the foot was obtained and again demonstrated the same bone marrow signal abnormalities; at this time, SABM was diagnosed. Knowledge of this condition can prevent the misinterpretation of SABM on MRI and prevent the waste of time and medical resources.


Assuntos
Atrofia , Medula Óssea , Imageamento por Ressonância Magnética , Humanos , Feminino , Pessoa de Meia-Idade , Medula Óssea/patologia , Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/patologia , Pé/patologia , Pé/diagnóstico por imagem
16.
J Foot Ankle Res ; 17(4): e70008, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39340794

RESUMO

INTRODUCTION: This study addresses the ossification process of the foot, a topic of great relevance within podiatry courses. Understanding the chronology of foot bone formation is essential for evaluating pathological processes and establishing appropriate therapeutic actions to improve patient quality of life. The main objectives of this work are to understand the ossification process of the foot bones and to propose an appropriate didactic methodology for effective learning of this process. MATERIALS AND METHODS: The individual ossification sequences of the foot bones were established and virtually recreated to make these processes more didactic and usable as teaching aids. The literature search was conducted using the PRISMA statement, focusing on terms, such as "bone ossification," "foot," and "bone development," and included relevant studies from medical databases. RESULTS: Updating the ossification ages and providing previously unavailable visual teaching material offers a useful tool for improving the teaching of this subject. It was found that, in general, the tarsal bones show significant differences in ossification ages between sexes, with later and slower ossification in males. These differences are statistically analyzed and presented in detailed comparative tables. CONCLUSIONS: The use of innovative teaching tools, such as virtual anatomical models, helps students to better understand the ossification process of foot bones. Implementing these tools in the podiatry curriculum not only facilitates knowledge acquisition but also enhances the quality of teaching and, consequently, the future clinical practice of students.


Assuntos
Osteogênese , Podiatria , Realidade Virtual , Humanos , Masculino , Podiatria/educação , Feminino , Osteogênese/fisiologia , Ossos do Pé/anatomia & histologia , Modelos Anatômicos , Pé/anatomia & histologia , Pé/fisiologia , Currículo , Anatomia/educação
17.
Ultrasound Med Biol ; 50(11): 1661-1668, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39218744

RESUMO

OBJECTIVE: Rheumatoid arthritis (RA) is a systemic connective tissue autoimmune disease that can infiltrate arterial walls. The delay in diagnosis and treatment of rheumatoid vasculitis (RV) in patients with RA may lead to irreversible damage to the arterial walls of small-to-medium vessels, which has serious and devastating consequences, most notably lung and cardiac damage. In this work an ultrasound image-based biomarker was developed to detect precursory changes in RV. METHODS: The ground truth was initiated from a medical diagnosis of RA, with arterial wall thickening of the proximal dorsalis pedis artery (DPA) indicating precursory changes of RV identified with ultrasound scanning. Ultrasound images of the DPA from 49 healthy subjects in the control group and 46 patients in the RA group were obtained. In total, 187 texture features were extracted from the images, followed by principal component analysis and linear discriminant analysis. RESULTS: The proposed biomarker detected a significant difference between the two groups (p = 5.74 × 10-18) with an area under the receiver operating characteristic curve of 0.85. Ten major textural features contributing most heavily to the biomarker were identified, with these textures being consistent with clinical observations of RV identified in previous studies. Interscan reproducibility was assessed by computing the biomarker twice based on repeated scans of each ankle. High interscan reproducibility was demonstrated by a strong and significant Pearson's coefficient (r = 0.85, p < 0.01) between the two repeated measurements of the proposed biomarker. CONCLUSION: The proposed biomarker can discriminate image textural differences seen in images acquired from RA patients, demonstrating precursory changes in RV compared with healthy controls. The major discriminative features identified in this study may facilitate the early identification and treatment of RV.


Assuntos
Vasculite Reumatoide , Ultrassonografia , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Ultrassonografia/métodos , Vasculite Reumatoide/diagnóstico por imagem , Adulto , Idoso , Artérias/diagnóstico por imagem , Pé/diagnóstico por imagem , Pé/irrigação sanguínea , Biomarcadores/sangue , Artrite Reumatoide/diagnóstico por imagem
18.
J Appl Biomech ; 40(5): 416-423, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39244190

RESUMO

Vertical loading rate (VLR) and pelvic floor muscle activity (PFA) increase with running velocity, which may indicate a relationship between VLR and PFA. Foot strike pattern has been shown to influence VLR while running, but little is known about its influence on PFA. Twenty healthy women ran on a treadmill for 2 conditions: with a rearfoot strike and with a forefoot strike. PFA was measured with electromyography. Running kinematics associated with VLR were collected using inertial measurement units and tibial accelerometers. Change scores between conditions were calculated for average PFA and running kinematics: peak vertical tibial acceleration, vertical excursion of the center of mass (VO), and cadence. Paired t tests assessed differences between running conditions for all variables. Pearson correlations assessed the relationships between changes in PFA and running kinematics. PFA was significantly higher during the forefoot compared with the rearfoot strike condition. Change in vertical tibial acceleration was positively correlated with change in PFA during the right stance. Change in cadence was negatively correlated, and change in vertical excursion of the center of mass was positively correlated with change in PFA during left stance. The average PFA increased during the forefoot strike pattern condition. Changes in PFA were correlated with changes in running kinematics associated with VLR.


Assuntos
Eletromiografia , , Músculo Esquelético , Diafragma da Pelve , Corrida , Humanos , Feminino , Corrida/fisiologia , Diafragma da Pelve/fisiologia , Pé/fisiologia , Músculo Esquelético/fisiologia , Fenômenos Biomecânicos , Adulto , Adulto Jovem , Marcha/fisiologia , Paridade/fisiologia
19.
Medicine (Baltimore) ; 103(37): e38763, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39287244

RESUMO

To improve the use of sensate anterolateral thigh (ALT) flaps for foot and ankle reconstruction, we employed a thinned nerve-selective harvesting technique. The data of 31 patients in whom sensate ALT perforator flaps were transferred for reconstruction of soft-tissue defects in the foot and ankle were reviewed. Flaps were elevated with 2 refinements. The first is the initial selection of the "true" sensory branch in the medial incision on the suprafascial plane. The second is flap thinning by keeping a cuff of thin deep fat surrounding the point where the perforator or nerve branch inserts into the superficial fat layer. The recipient site assessment consisted of complications, monofilament touch perception, sharp-blunt discrimination, axial circumference, and American Orthopedic Foot and Ankle Society score. After a mean follow-up of 31.7 months, all flaps survived uneventfully, except for marginal necrosis in 1 patient, infection in 1 patient, ulceration in 2 patients, and secondary thinning in 3 patients. The sensation of each flap was restored. A total of 87% and 90% of the patients exhibited 5 or more positive response points in the Semmes-Weinstein monofilament touch and sharp-blunt discrimination testings, respectively. The mean axial circumference of the reconstructed foot was 27.4 cm (the unaffected side was 25.8 cm). All patients achieved mobility in ordinary shoes with a mean functional score of 74.6. The thinned nerve-selective sensate ALT perforator flap can be a favorable option for foot and ankle reconstruction. This method also offers the possibility of preserving the nerve branch at the donor thigh.


Assuntos
Tornozelo , , Retalho Perfurante , Procedimentos de Cirurgia Plástica , Coxa da Perna , Humanos , Masculino , Estudos Retrospectivos , Feminino , Retalho Perfurante/transplante , Pessoa de Meia-Idade , Adulto , Procedimentos de Cirurgia Plástica/métodos , Coxa da Perna/cirurgia , Pé/cirurgia , Tornozelo/cirurgia , Lesões dos Tecidos Moles/cirurgia , Idoso , Traumatismos do Pé/cirurgia , Adulto Jovem , Resultado do Tratamento
20.
Physiol Rep ; 12(17): e70023, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39245807

RESUMO

This study investigated the coactivation of plantar flexor and dorsiflexor muscles and oxygen uptake during running with forefoot and rearfoot strikes at 15 and 19 km/h. We included 16 male runners in this study. The participants ran each foot strike pattern for 5 min at 15 and 19 km/h on a treadmill. During the running, respiratory gas exchange data and surface electromyographic (EMG) activity of the medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus, and tibialis anterior muscles of the right lower limb were continuously recorded. The indices of oxygen uptake, energy expenditure (EE), and muscle activation were calculated during the last 2 min in each condition. During the stance phase of running at 15 and 19 km/h, activation of the tibialis anterior and MG muscles was lower and higher, respectively, with forefoot strike than with rearfoot strike. The foot strike pattern did not influence the oxygen uptake. These results suggest that the foot strike pattern has no clear effect on the oxygen uptake when running at 15 and 19 km/h. However, forefoot strike leads to plantar flexion dominance during co-contraction of the tibialis anterior and MG muscles, which are an antagonist and agonist for plantar flexion, respectively, during the stance phase.


Assuntos
, Contração Muscular , Músculo Esquelético , Consumo de Oxigênio , Corrida , Humanos , Masculino , Corrida/fisiologia , Músculo Esquelético/fisiologia , Músculo Esquelético/metabolismo , Consumo de Oxigênio/fisiologia , Pé/fisiologia , Adulto , Contração Muscular/fisiologia , Tornozelo/fisiologia , Adulto Jovem , Eletromiografia
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