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1.
Sci Rep ; 14(1): 12916, 2024 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839895

RESUMO

This study was designed to assess the optimal access route for the endovascular treatment of acute lower extremity deep vein thrombosis. This was a retrospective analysis of patients with acute lower extremity deep venous thrombosis who underwent endovascular treatment from February 2009 to December 2020. Patients underwent non-direct calf deep vein puncture (NDCDVP) from February 2009 to December 2011 and direct calf deep vein puncture (DCDVP) from January 2012 to December 2020. Catheter directed thrombolysis (CDT) was used to treat all patients in the NDCDVP group, whereas patients in the DCDVP group were treated with CDT or the AngioJet rhyolitic thrombectomy system. In patients exhibiting iliac vein compression syndrome, the iliac vein was dilated and implanted with a stent. Technical success rates and perioperative complication rates were compared between these two treatment groups. The NDCDVP group included 83 patients (40 males, 43 females) with a mean age of 55 ± 16 years, while the DCDVP group included 487 patients (231 males. 256 females) with a mean age of 56 ± 15 years. No significant differences were observed between these groups with respect to any analyzed clinical characteristics. The technical success rates in the NDCDVP and DCDVP groups were 96.4 and 98.2%, respectively (P > 0.05). In the NDCDVP group, the small saphenous vein (SSV)or great saphenous vein (GSV)were the most common access routes (77.1%, 64/83), whereas the anterior tibial vein (ATV) was the most common access route in the DCDVP group (78.0%, 380/487), followed by the posterior tibial vein (PTV) and peroneal vein (PV)(15.6% and 6.4%, respectively). Relative to the NDCDVP group, more patients in the DCDVP group underwent the removal of deep vein clots below the knee (7.2% [6/83] vs. 24.2% [118/487], P < 0.001). Moreover, relative to the NDCDVP group, significantly lower complication rates were evident in the DCDVP group (local infection: 10.8% vs. 0.4%, P < 0.001; local hematoma: 15.7% vs. 1.0%, P < 0.001). The position change rate was also significantly lower in the DCDVP group relative to the NDCDVP group (0% [0/487] vs. 60.2% [50/83], P < 0.001). The calf deep veins (CDVs) represent a feasible and safe access route for the endovascular treatment of lower extremity deep vein thrombosis.


Assuntos
Procedimentos Endovasculares , Extremidade Inferior , Trombose Venosa , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Trombose Venosa/terapia , Estudos Retrospectivos , Procedimentos Endovasculares/métodos , Procedimentos Endovasculares/efeitos adversos , Idoso , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/cirurgia , Adulto , Trombectomia/métodos , Trombectomia/efeitos adversos , Resultado do Tratamento , Terapia Trombolítica/métodos , Perna (Membro)/irrigação sanguínea
2.
Sci Rep ; 14(1): 12860, 2024 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834832

RESUMO

A common theory of motor control posits that movement is controlled by muscle synergies. However, the behavior of these synergies during highly complex movements remains largely unexplored. Skateboarding is a hardly researched sport that requires rapid motor control to perform tricks. The objectives of this study were to investigate three key areas: (i) whether motor complexity differs between skateboard tricks, (ii) the inter-participant variability in synergies, and (iii) whether synergies are shared between different tricks. Electromyography data from eight muscles per leg were collected from seven experienced skateboarders performing three different tricks (Ollie, Kickflip, 360°-flip). Synergies were extracted using non-negative matrix factorization. The number of synergies (NoS) was determined using two criteria based on the total variance accounted for (tVAF > 90% and adding an additional synergy does not increase tVAF > 1%). In summary: (i) NoS and tVAF did not significantly differ between tricks, indicating similar motor complexity. (ii) High inter-participant variability exists across participants, potentially caused by the low number of constraints given to perform the tricks. (iii) Shared synergies were observed in every comparison of two tricks. Furthermore, each participant exhibited at least one synergy vector, which corresponds to the fundamental 'jumping' task, that was shared through all three tricks.


Assuntos
Eletromiografia , Movimento , Músculo Esquelético , Humanos , Músculo Esquelético/fisiologia , Masculino , Adulto , Movimento/fisiologia , Feminino , Adulto Jovem , Fenômenos Biomecânicos , Patinação/fisiologia , Perna (Membro)/fisiologia
3.
J Bodyw Mov Ther ; 39: 176-182, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876623

RESUMO

INTRODUCTION: Pain sensitivity is the main finding of central sensitization (CS) and can occur in patients with chronic shoulder pain. However, there is limited evidence concerning the distribution of pain sensitivity in shoulders, forearms, and legs in patients with CS associated with chronic shoulder pain. The present study aimed to determine the distribution of pain sensitivity in patients with CS associated with chronic subacromial pain syndrome (SPS). METHOD: This cross-sectional study included 58 patients with chronic SPS and CS (patient group) and 58 healthy participants (control group). The presence of CS was determined using the Central Sensitization Inventory (CSI). To determine the distribution of pain sensitivity, pressure pain threshold (PPT) measurements were performed from the shoulders, forearms, and legs. RESULTS: There was no significant difference between the two groups in terms of sociodemographic data (p > 0.05). The patient group had a significantly higher CSI score (p < 0.001) and lower PPTs in all regions (p < 0.05) than the control group. Unlike the control group, the patient group had lower PPTs on the affected side for the shoulder [mean difference (MD) 95% confidence interval (CI): 1.2 (-1.7 to -0.6)], forearm [MD 95% CI: 1.1 (-1.7 to -0.6)], and leg [MD 95% CI: 0.9 (-1.4 to -0.3)] compared with the contralateral side (p < 0.001). CONCLUSION: Pain sensitivity is more pronounced in the affected shoulder and the forearm and leg located on this side than in those on the contralateral side in patients with CS associated with chronic SPS.


Assuntos
Sensibilização do Sistema Nervoso Central , Dor Crônica , Limiar da Dor , Humanos , Estudos Transversais , Feminino , Masculino , Sensibilização do Sistema Nervoso Central/fisiologia , Pessoa de Meia-Idade , Adulto , Limiar da Dor/fisiologia , Dor Crônica/fisiopatologia , Dor de Ombro/fisiopatologia , Síndrome de Colisão do Ombro/fisiopatologia , Medição da Dor , Antebraço/fisiopatologia , Perna (Membro)/fisiopatologia
4.
J Bodyw Mov Ther ; 39: 279-284, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876639

RESUMO

Lateral ankle sprains (LAS) often lead to chronic ankle instability (CAI). The Ebbets foot drills were created to strengthen the lower leg muscles and reduce the risk of LAS. The current study aimed to explore the activation of the lower leg muscles during the Ebbets foot drills. Twenty-two (22) college students without LAS participated in the study. Surface electromyography (sEMG) of the tibialis anterior (TA), tibialis posterior (TP), and peroneus longus (PL) was collected during each of the Ebbets foot drills and a normal walking trial. The sEMG mean root mean square (RMS) was calculated for each walking and Ebbets foot drill trial duration. The mean RMS was higher during the Ebbets foot drills compared to normal walking for all muscles. The TA sEMG mean RMS was greater (4.0-68.3%, P = 0.001-0.023) during all the Ebbets foot drills than during the walking trial. The TP had greater mean RMS during the toe-in (50.4%, P < 0.001), toe-out (55.0%, P < 0.001), and backward walking (47.3%, P < 0.001) drills, than during the walking trial. The PL had greater mean RMS during all Ebbets foot drills (19.4-53.7%, P < 0.001) except for the heel walking and inversion drills. Ebbets foot drills higher muscle activity than regular walking, suggesting that the Ebbets foot drills could aid in the strengthening of the TA, TP, and PL muscles. These results build evidence on Ebbets' theory and indicate that these drills may be used to rehabilitate LAS and CAI.


Assuntos
Eletromiografia , Músculo Esquelético , Caminhada , Humanos , Masculino , Músculo Esquelético/fisiologia , Feminino , Adulto Jovem , Caminhada/fisiologia , Traumatismos do Tornozelo , Adulto , Perna (Membro)/fisiologia , Terapia por Exercício/métodos , Instabilidade Articular/fisiopatologia , Instabilidade Articular/reabilitação
7.
PLoS One ; 19(6): e0304136, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38848389

RESUMO

INTRODUCTION: Single-leg cycling is a commonly used intervention in exercise physiology that has applications in exercise training and rehabilitation. The addition of a counterweight to the contralateral pedal helps single-leg cycling mimic cycling patterns of double-leg cycling. To date, no research has tested (a) the influence of a wide range of counterweight masses on a person's cycling biomechanics and (b) the optimal counterweight mass to emulate double-leg cycling. OBJECTIVES: The purpose of this study was to determine the effects of varying counterweights on the kinematics (joint angles) and kinetics (joint moments, work) of cycling using a 3D analysis. METHODS: Twelve participants cycled at 50W or 100W with different counterweight masses (0 to 30 lbs, 2.5 lbs increments), while we analyzed the pedal force data, joint angles, joint moments, and joint power of the lower limb using 3D motion capture and 3D instrumented pedals to create participant-specific musculoskeletal models. RESULTS: The results showed that no single-leg cycling condition truly emulated double-leg cycling with respect to all measured variables, namely pedal forces (p ≤ 0.05), joint angles (p ≤ 0.05), joint moments(p ≤ 0.05), and joint powers (p ≤ 0.05), but higher counterweights resulted in single-leg cycling that was statistically similar (p > 0.05), but descriptively, asymptotically approached the biomechanics of double-leg cycling. CONCLUSION: We suggest that a 20-lb counterweight is a conservative estimate of the counterweight required for using single-leg cycling in exercise physiology studies, but further modifications are needed to the cycle ergometer for the biomechanics of single-leg cycling to match those of double-leg cycling.


Assuntos
Ciclismo , Humanos , Fenômenos Biomecânicos , Ciclismo/fisiologia , Masculino , Adulto , Adulto Jovem , Feminino , Perna (Membro)/fisiologia
9.
Nutrients ; 16(10)2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38794667

RESUMO

BACKGROUND: Various nutritional strategies are increasingly used in sports to reduce oxidative stress and promote recovery. Chokeberry is rich in polyphenols and can reduce oxidative stress. Consequently, chokeberry juices and mixed juices with chokeberry content are increasingly used in sports. However, the data are very limited. Therefore, this study investigates the effects of the short-term supplementation of a red fruit juice drink with chokeberry content or a placebo on muscle damage, oxidative status, and leg strength during a six-day intense endurance protocol. METHODS: Eighteen recreational endurance athletes participated in a cross-over high intensity interval training (HIIT) design, receiving either juice or a placebo. Baseline and post-exercise assessments included blood samples, anthropometric data, and leg strength measurements. RESULTS: A significant increase was measured in muscle damage following the endurance protocol in all participants (∆ CK juice: 117.12 ± 191.75 U/L, ∆ CK placebo: 164.35 ± 267.00 U/L; p = 0.001, η2 = 0.17). No group effects were detected in exercise-induced muscle damage (p = 0.371, η2 = 0.010) and oxidative status (p = 0.632, η2 = 0.000). The reduction in strength was stronger in the placebo group, but group effects are missing statistical significance (∆ e1RM juice: 1.34 ± 9.26 kg, ∆ e1RM placebo: -3.33 ± 11.49 kg; p = 0.988, η2 = 0.000). CONCLUSION: Although a reduction in strength can be interpreted for the placebo treatment, no statistically significant influence of chokeberry could be determined. It appears that potential effects may only occur with prolonged application and a higher content of polyphenols, but further research is needed to confirm this.


Assuntos
Atletas , Estudos Cross-Over , Sucos de Frutas e Vegetais , Força Muscular , Resistência Física , Polifenóis , Humanos , Polifenóis/farmacologia , Masculino , Adulto , Força Muscular/efeitos dos fármacos , Resistência Física/efeitos dos fármacos , Resistência Física/fisiologia , Adulto Jovem , Feminino , Estresse Oxidativo/efeitos dos fármacos , Perna (Membro)/fisiologia , Método Duplo-Cego , Frutas/química , Photinia/química , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiologia , Músculo Esquelético/metabolismo , Exercício Físico/fisiologia , Treino Aeróbico/métodos
10.
Tomography ; 10(5): 773-788, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38787019

RESUMO

Background: The purpose of this study was to investigate the dependence of Intravoxel Incoherent Motion (IVIM) parameters measured in the human calf on B0. Methods: Diffusion-weighted image data of eight healthy volunteers were acquired using five b-values (0-600 s/mm2) at rest and after muscle activation at 0.55 and 7 T. The musculus gastrocnemius mediale (GM, activated) was assessed. The perfusion fraction f and diffusion coefficient D were determined using segmented fits. The dependence on field strength was assessed using Student's t-test for paired samples and the Wilcoxon signed-rank test. A biophysical model built on the three non-exchanging compartments of muscle, venous blood, and arterial blood was used to interpret the data using literature relaxation times. Results: The measured perfusion fraction of the GM was significantly lower at 7 T, both for the baseline measurement and after muscle activation. For 0.55 and 7 T, the mean f values were 7.59% and 3.63% at rest, and 14.03% and 6.92% after activation, respectively. The biophysical model estimations for the mean proton-density-weighted perfusion fraction were 3.37% and 6.50% for the non-activated and activated states, respectively. Conclusions: B0 may have a significant effect on the measured IVIM parameters. The blood relaxation times suggest that 7 T IVIM may be arterial-weighted whereas 0.55 T IVIM may exhibit an approximately equal weighting of arterial and venous blood.


Assuntos
Imagem de Difusão por Ressonância Magnética , Músculo Esquelético , Humanos , Imagem de Difusão por Ressonância Magnética/métodos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Masculino , Adulto , Feminino , Perna (Membro)/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Campos Magnéticos , Movimento (Física) , Voluntários Saudáveis , Adulto Jovem
11.
BMC Musculoskelet Disord ; 25(1): 391, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762469

RESUMO

BACKGROUND: Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP. METHOD: This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg. RESULTS: In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age. Overall, 1,077 (21%) reported pain in the foot/lower leg. The odds ratios (ORs) of pain were higher in females (OR 1.31, 95% confidence interval (CI) 1.13-1.53), individuals who could ambulate (Gross Motor Function Classification System Level I (OR 1.84, CI 1.32-2.57) and II (OR 2.01, CI 1.46-2.79) compared to level V), and in individuals with decreased range of motion of the ankle (dorsiflexion 1-10 degrees (OR 1.43, CI 1.13-1.83) and ≤ 0 degrees (OR 1.46, CI 1.10-1.93) compared to ≥ 20 degrees). With increasing age the OR of pain increased (OR 1.02, CI 1.01-1.03) as well as the reported pain intensity (p < 0.001). CONCLUSIONS: Pain in the foot and lower leg appears to be a significant problem in individuals with CP, particularly in those who walk. As with pain in general in this population, both pain intensity and frequency increase with age. The odds of pain in the foot and lower leg were increased in individuals with limited dorsiflexion of the ankle. Given the cross-sectional design causality cannot be inferred and it is unknown if pain causes decreased range of motion of the ankle or if decreased range of motion causes pain. Further research is needed on causal pathways and importantly on prevention.


Assuntos
Paralisia Cerebral , Perna (Membro) , Sistema de Registros , Humanos , Paralisia Cerebral/epidemiologia , Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Masculino , Feminino , Estudos Transversais , Adulto , Adolescente , Criança , Adulto Jovem , Suécia/epidemiologia , Pré-Escolar , Prevalência , Pé/fisiopatologia , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/diagnóstico , Dor/etiologia , Medição da Dor
12.
Games Health J ; 13(3): 207-214, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38709784

RESUMO

Background: Virtual reality (VR)-enhanced indoor hybrid cycling in people with spinal cord injury (SCI) can be comparable to outdoor hybrid cycling. Method: Eight individuals with chronic thoracic-lesion SCI performed voluntary arm and electrically assisted leg cycling on a hybrid recumbent tricycle. Exercises were conducted outdoors and indoors incorporating VR technology in which the outdoor environment was simulated on a large flat screen monitor. Electrical stimulation was applied bilaterally to the leg muscle groups. Oxygen uptake (VO2), heart rate, energy expenditures, and Ratings of Perceived Exertion were measured over a 30-minute outdoor test course that was also VR-simulated indoors. Immediately after each exercise, participants completed questionnaires to document their perceptual-psychological responses. Results: Mean 30-minute VO2 was higher for indoor VR exercise (average VO2-indoor VR-exercise: 1316 ± mL/min vs. outdoor cycling: 1255 ± 53 mL/min; highest VO2-indoor VR-exercise: 1615 ± 67 mL/min vs. outdoor cycling: 1725 ± 67 mL/min). Arm and leg activity counts were significantly higher during indoor VR-assisted hybrid functional electrical stimulation (FES) cycling than outdoors; 42% greater for the arms and 23% higher for the legs (P < 0.05). Similar responses were reported for exercise effort and perceptual-psychological outcomes during both modes. Conclusion: This study proposes that combining FES and VR technology provides new opportunities for physical activity promotion or exercise rehabilitation in the SCI population, since these modes have similar "dose-potency" and self-perceived effort. Human Research Ethics Committee of the University of Sydney Ref. No. 01-2010/12385.


Assuntos
Braço , Traumatismos da Medula Espinal , Realidade Virtual , Humanos , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/fisiopatologia , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Braço/fisiologia , Perna (Membro)/fisiologia , Perna (Membro)/fisiopatologia , Consumo de Oxigênio/fisiologia , Frequência Cardíaca/fisiologia , Terapia por Exercício/métodos , Terapia por Exercício/instrumentação , Terapia por Exercício/psicologia , Terapia por Exercício/normas , Exercício Físico/psicologia , Exercício Físico/fisiologia , Ciclismo/fisiologia , Ciclismo/psicologia , Terapia por Estimulação Elétrica/métodos , Terapia por Estimulação Elétrica/instrumentação
13.
BMJ Open ; 14(5): e085044, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38719285

RESUMO

BACKGROUND: Venous access in patients with obesity presents significant challenges. The success of central venous catheterisation largely depends on the cross-sectional area (CSA) of the internal jugular vein (IJV). While techniques like the Trendelenburg position have been traditionally used to increase IJV CSA, recent studies suggest its ineffectiveness in patients with obesity. Conversely, the potential of the effect of passive leg raising (PLR) has not been thoroughly investigated in this group of patients. METHODS: This protocol outlines a planned randomised controlled trial to evaluate the effect of PLR on the CSA of the IJV in patients with obesity slated for central venous catheterisation. The protocol involves dividing 40 participants into two groups: one undergoing PLR and another serving as a control group without positional change. The protocol specifies measuring the CSA of the IJV via ultrasound as the primary outcome. Secondary outcomes will include the success rates of right IJV cannulation. The proposed statistical approach includes the use of t-tests to compare the changes in CSA between the two groups, with a significance threshold set at p<0.05. ETHICS APPROVAL: This study has been approved by the Institutional Review Board of Shanghai Tongren Hospital. All the participants will provide informed consent prior to enrolment in the study. Regarding the dissemination of research findings, we plan to share the results through academic conferences and peer-reviewed publications. Additionally, we will communicate our findings to the public and professional communities, including patient advocacy groups. TRIAL REGISTRATION NUMBER: ChiCTR: ChiCTR2400080513.


Assuntos
Cateterismo Venoso Central , Veias Jugulares , Perna (Membro) , Obesidade , Adulto , Feminino , Humanos , Masculino , Cateterismo Venoso Central/métodos , Veias Jugulares/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Obesidade/terapia , Posicionamento do Paciente/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Ultrassonografia
14.
PLoS One ; 19(5): e0302249, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38809851

RESUMO

BACKGROUND: Running economy, commonly defined as the metabolic energy demand for a given submaximal running speed, is strongly associated with distance running performance. It is commonly believed among running coaches and runners that running with increased forward postural lean either from the ankle or waist improves running economy. However, recent biomechanical research suggests using a large forward postural lean during running may impair running economy due to increased demand on the leg muscles. PURPOSE: This study tests the effect of altering forward postural lean and lean strategy on running economy, kinematics, and muscle activity. METHODS: 16 healthy young adult runners (23±5 years, 8M/8F) ran on a motorized treadmill at 3.58m/s using three postural lean angles [upright, moderate lean (50% of maximal lean angle), and maximal lean] and two strategies (lean from ankle and lean from waist [trunk lean]). Metabolic energy consumption, leg kinematics, and muscle activation data were recorded for all trials. RESULTS: Regardless of lean strategy, running with an increased forward postural lean (up to 8±2 degrees) increased metabolic cost (worsened economy) by 8% (p < .001), increased hip flexion (p < .001), and increased gluteus maximus (p = .016) and biceps femoris (p = .02) muscle activation during the stance phase. This relation between running economy and postural lean angle was similar between the ankle and trunk lean strategies (p = .743). CONCLUSION: Running with a large forward postural lean reduced running economy and increased reliance on less efficient extensor leg muscles. In contrast, running with a more upright or moderate forward postural lean may be more energetically optimal, and lead to improved running performance.


Assuntos
Músculo Esquelético , Corrida , Humanos , Corrida/fisiologia , Fenômenos Biomecânicos , Masculino , Músculo Esquelético/fisiologia , Feminino , Adulto , Adulto Jovem , Metabolismo Energético/fisiologia , Postura/fisiologia , Equilíbrio Postural/fisiologia , Perna (Membro)/fisiologia
15.
Neurol Res ; 46(7): 644-652, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38695372

RESUMO

BACKGROUND: The Leg Activity Measure is the only self-report measure that has been published to date that takes into account both the influence on quality of life and passive and active function in the literature. AIMS: The purpose is to examine the translation, cross-cultural adaptation validity and reliability of the Turkish version of the Leg Activity Measure (Tr-LegA). METHODS: Neurological patients (n = 52) with lower limb spasticity (aged 47.09 ± 14.74 years) were enrolled. The study consisted of two stages. At the first stage, the scale was translated into Turkish and culturally adapted. Validity and reliability analyses were conducted at the second stage. Construct validity was evaluated by exploratory factor analysis (EFA). The Rivermead Mobility Index (RMI), Nottingham Health Profile (NHP), and Functional Independence Measure (FIM) were used for convergent validity. The reproducibility (test-retest reliability) was assessed by the intraclass correlation coefficient (ICC). Furthermore, the standard error of measurement (SEM) was calculated. RESULTS: EFA suggested one factor for the Passive Function and two factors for the Active Function and Impact on Quality of Life Scales (QoL). Tr-LegA Passive and Active Function Scales were correlated with the total RMI, NHP, and FIM (p < 0.05). Tr-LegA Impact on Quality of Life Scale was correlated with the RMI and NHP (p < 0.05). Tr-LegA Passive Function Scale (ICC = 0.997), Tr-LegA Active Function Scale (ICC = 0.996), and Tr-LegA Impact on Quality of Life Scale (ICC = 0.976) had good reliability. Only Passive Function Scale had a significant floor effect (25%). CONCLUSIONS: Tr-LegA is a valid and reliable multidimensional scale for passive and active function and quality of life in patients with lower limb spasticity. THE CLINICAL TRIAL NUMBER: NCT05182411.


Assuntos
Espasticidade Muscular , Qualidade de Vida , Humanos , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/fisiopatologia , Pessoa de Meia-Idade , Masculino , Feminino , Reprodutibilidade dos Testes , Adulto , Turquia , Avaliação da Deficiência , Perna (Membro)/fisiopatologia , Idoso , Comparação Transcultural , Traduções , Psicometria/normas
16.
PLoS One ; 19(5): e0298257, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38771839

RESUMO

OBJECTIVES: The main purpose of this research study was to compare mean modified straight-leg raise test (mSLR) and hamstring muscle length (HL) between chronic non-specific low back pain (LBP) and healthy subjects to understand the possibility of neuropathic causes in LBP population as it may impact the diagnosis and treatment of LBP. Another purpose was to compare mean mSLR between those with lumbar nerve root impingement and those without as determine by magnetic resonance imaging (MRI). METHODS: The design of the study is cross sectional and included 32 subjects with ages ranging from 18-50 years old. Clinical exam objective measures were collected such as patient questionnaires, somatosensory tests, HL range of motion, and a mSLR test, and were compared to the findings from a structural lumbar spine MRI. RESULTS: There were no significant differences in mean HL angulation and mSLR angulation between LBP and healthy subjects (p>0.05). There was no significant difference in mean HL by impingement by versus no impingement (38.3±15.6 versus 44.8±9.4, p = 0.08, Cohen's d = 0.50). On the other hand, there was a significant difference in mean mSLR angulation by impingement (57.6.3±8.7 versus 63.8±11.6, p = 0.05, Cohen's d = 0.60). CONCLUSIONS: The mSLR test was found to be associated with lumbar nerve root compression, regardless of the existence of radiating leg symptoms, and showed no association solely with the report of LBP. The findings highlight the diagnostic dilemma facing clinicians in patients with chronic nonspecific LBP with uncorrelated neuroanatomical image findings. Clinically, it may be necessary to reevaluate the common practice of exclusively using the mSLR test for patients with leg symptoms. This study may impact the way chronic LBP and neuropathic symptoms are diagnosed, potentially improving treatment methods, reducing persistent symptoms, and ultimately improving disabling effects.


Assuntos
Músculos Isquiossurais , Dor Lombar , Imageamento por Ressonância Magnética , Humanos , Dor Lombar/fisiopatologia , Dor Lombar/diagnóstico , Dor Lombar/diagnóstico por imagem , Adulto , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Músculos Isquiossurais/fisiopatologia , Músculos Isquiossurais/diagnóstico por imagem , Adolescente , Adulto Jovem , Imageamento por Ressonância Magnética/métodos , Amplitude de Movimento Articular/fisiologia , Perna (Membro)/fisiopatologia , Perna (Membro)/diagnóstico por imagem
17.
J Biomech ; 169: 112138, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38728788

RESUMO

The shoe sole is identified as a fall risk factor since it may impede the afferent information about the outside world collected by the plantar sensory units. However, no study has directly quantified how the shoe sole compromises body balance and increases fall risk. This study aimed to inspect how the sole affects human balance after an unexpected standing-slip. It was hypothesized that individuals wearing the sole, relative to their barefoot counterparts, would exhibit 1) more impaired stability and 2) disrupted lower limb muscle activation following a standing-slip. Twenty young adults were evenly randomized into two groups: soled and barefoot. The soled group wore a pair of customized 10-mm thick soles, while the other group was bare-footed. Full-body kinematics and leg muscle electromyography (EMG) were collected during a standardized and unexpected standing-slip. The EMG electrodes were placed on the tibialis anterior, gastrocnemius, rectus femoris, and biceps femoris bilaterally. Dynamic stability, spatiotemporal gait parameters, and the EMG latency of the leg muscles were compared between groups. The sole impeded the initiation of the recovery step possibly because it interfered with the accurate detection of the external perturbation and subsequently activated the leg muscles later in the soled group than in the barefoot group. As a result, individuals in the soled group experienced a longer slip distance and were more unstable than the barefoot group at the recovery foot liftoff. The findings of this study could augment our understanding of how the shoe sole impairs body balance and increases the fall risk.


Assuntos
Acidentes por Quedas , Eletromiografia , Músculo Esquelético , Equilíbrio Postural , Sapatos , Humanos , Equilíbrio Postural/fisiologia , Masculino , Músculo Esquelético/fisiologia , Feminino , Adulto Jovem , Acidentes por Quedas/prevenção & controle , Adulto , Perna (Membro)/fisiologia , Marcha/fisiologia , Fenômenos Biomecânicos
18.
J Electromyogr Kinesiol ; 77: 102887, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38761513

RESUMO

OBJECTIVES: This study examined the effects of acute normoxic and hypoxic exposure on neuromuscular and hemodynamic physiological responses performed during dynamic step muscle actions. METHODS: Thirteen recreationally active men (mean ± SD age: 21.2 ± 2.9 yrs) performed dynamic leg extensions unilaterally under Normoxic (FiO2 = 21 %) and Hypoxic (FiO2 = 13 %) conditions in a randomized order at 20 %, 40 %, 60 %, 80 %, and 100 % of their maximal strength. Electromyographic (EMG) amplitude, EMG frequency, (Oxygenated and Deoxygenated hemoglobin; OxyHb, DeoxyHb), Total hemoglobin (TotalHb), and skeletal muscle tissue oxygenation status (StO2) were measured from the vastus lateralis during all contractions. RESULTS: There were no detectable differences in the neuromuscular responses between normoxia and hypoxia for EMG amplitude (p = 0.37-0.74) and frequency (p = 0.17-0.83). For EMG amplitude there were general increases with intensity (p < 0.01-0.03). EMG frequency remained similar from 20% to 80% and then increased at 100 % effort (p = 0.02). There was no significant difference in patterns of responses for OxyHb (p = 0.870) and TotalHb (p = 0.200) between normoxia and hypoxia. StO2 (p = 0.028) decreased and DeoxyHb (p = 0.006) increased under hypoxia compared to normoxia during dynamic step muscle actions performed in a randomized order. CONCLUSION: Unlike fatigue, acute hypoxemia in an unfatigued state does not impact the localized neuromuscular responses, but minimally impacts the hemodynamic responses.


Assuntos
Eletromiografia , Hemodinâmica , Hipóxia , Músculo Esquelético , Humanos , Masculino , Hipóxia/fisiopatologia , Adulto Jovem , Músculo Esquelético/fisiopatologia , Músculo Esquelético/fisiologia , Hemodinâmica/fisiologia , Treinamento Resistido/métodos , Perna (Membro)/fisiologia , Contração Muscular/fisiologia , Consumo de Oxigênio/fisiologia , Adulto
19.
BMJ Open ; 14(5): e078114, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38729754

RESUMO

INTRODUCTION: Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life. The first choice of treatment is a conservative treatment, consisting of exercises, skin care, lymph drainage and compression. Reconstructive lymphatic surgery is also often performed, that is, lymphovenous anastomoses, lymph node transfer or a combination. However, robust evidence on the effectiveness of reconstructive lymphatic surgery is missing. Therefore, the objective of this trial is to investigate the added value of reconstructive lymphatic surgery to the conservative treatment in patients with lymphoedema. METHODS AND ANALYSIS: A multicentre randomised controlled and pragmatic trial was started in March 2022 in three Belgian university hospitals. 90 patients with arm lymphoedema and 90 patients with leg lymphoedema will be included. All patients are randomised between conservative treatment alone (control group) or conservative treatment with reconstructive lymphatic surgery (intervention group). Assessments are performed at baseline and at 1, 3, 6, 12, 18, 24 and 36 months. The primary outcome is lymphoedema-specific quality of life at 18 months. Key secondary outcomes are limb volume and duration of wearing the compression garment at 18 months. The approach of reconstructive lymphatic surgery is based on presurgical investigations including clinical examination, lymphofluoroscopy, lymphoscintigraphy, lymph MRI or CT angiography (if needed). All patients receive conservative treatment during 36 months, which is applied by the patient's own physical therapist and by the patient self. From months 7 to 12, the hours a day of wearing the compression garment are gradually decreased. ETHICS AND DISSEMINATION: The study has been approved by the ethical committees of University Hospitals Leuven, Ghent University Hospital and CHU UCL Namur. Results will be disseminated via peer-reviewed journals and presentations. TRIAL REGISTRATION NUMBER: NCT05064176.


Assuntos
Linfedema , Qualidade de Vida , Humanos , Linfedema/terapia , Linfedema/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Ensaios Clínicos Pragmáticos como Assunto , Bélgica , Estudos Multicêntricos como Assunto , Perna (Membro)
20.
J Drugs Dermatol ; 23(5): 380, 2024 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-38709685

RESUMO

Wound repair of the pretibial and forearm regions presents a challenge during dermatologic surgery as these areas are under significant tension and exhibit increased skin fragility. Various methodologies have been proposed for the closure and repair of such wounds, however, the use of the bilayered suture technique may be simpler and more effective than other techniques such as the pinch stitch, pully stitch, slip-knot stitch, pulley set-back dermal suture, horizontal mattress suture, pully stitch, and tandem pulley stitch. Our objective was to describe a novel method for the repair of pretibial and forearm wounds following Mohs micrographic surgery utilizing bilayered closure followed by tissue adhesive application.  J Drugs Dermatol. 2024;23(5):380.     doi:10.36849/JDD.7139  .


Assuntos
Antebraço , Cirurgia de Mohs , Neoplasias Cutâneas , Técnicas de Sutura , Cicatrização , Humanos , Cirurgia de Mohs/efeitos adversos , Cirurgia de Mohs/métodos , Antebraço/cirurgia , Neoplasias Cutâneas/cirurgia , Adesivos Teciduais , Perna (Membro)/cirurgia , Masculino , Feminino
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